Fast and Furious
Every May, Mayo Clinic hospitalist Jason Persoff, MD, SFHM, sheds his doctor’s gear, grabs his camera and camcorder, and heads to the Midwest in search of ferocious weather for two weeks. “My wife jokingly calls it my ‘midlife crisis prevention program,’ ” says Dr. Persoff, who works in Jacksonville, Fla.
This year, he put his doctor’s gear back on sooner than he expected.
After 20 years of chasing storms, Dr. Persoff found himself in what might have been considered an inevitable situation: helping people injured in a tornado. When a monstrous twister with winds of more than 200 mph barreled through Joplin, Mo., on May 22, Dr. Persoff was less than a mile from its path. He and a “chase partner,” Robert Balogh, MD, an Oklahoma-based internist and former hospitalist, were able to rush to the scene and assist in the aftermath.
In the moments after the fast-forming storm, Dr. Persoff hoped that the damage wouldn’t be so devastating, despite the first ominous signs he saw along the highway.
“We were dealing with a raining sky of debris,” he says. “There was Styrofoam insulation falling from the sky, papers, there was a Barbie doll in the middle of the road, but I have no idea where that came from. There were trees and twigs and leaves, so I knew that the destruction to Joplin had been significant. But I hoped that it would be very limited.”
As he traveled along another road, he saw two dozen flipped-over semi-trucks.
“There was no decision,” Dr. Balogh says. “We knew right then that the chase was over for us.”
One hospital serving the area, St. John’s Regional Medical Center, was destroyed, its roof ripped off, he learned. At press time, the tornado had killed more than 150 and caused an estimated $3 billion in damage.
Dr. Persoff checked in at the ED of another hospital, Freeman Health System, and offered his help. He spent 10 hours there, first treating trauma patients.
“We were immediately put to work because there were just so many people coming in,” he says. “The initial trauma that came in was pretty fast and furious. If somebody could be saved, and it wasn’t going to require an effort that would jeopardize resources, they did everything they could to save people. They put in chest tubes, ventilated them, [performed] other procedures.
“If somebody was dying and that was pretty obvious, it required us to rethink how we were going to approach things. And I made a diligent effort to help the dying with low doses of pain medication to help them through.”
There were amputations, impalements, eviscerations.
“We had patients who were covered in glass, and by covered I don’t mean they just had glass in their skin—they were covered with it,” he says. “When you’d examine them, there was a risk of your glove getting torn doing an exam.”
Dr. Balogh describes the patient influx as an “absolutely overwhelming” onslaught, with ambulances, cars, and pickup trucks that had rescued strangers on the roadside arriving seemingly nonstop.
It was so frantic, he says, that he was worried “if I even take time to talk to one patient .. I’ve missed the next 15.”
When the patients from St. John’s began to arrive at Freeman, Dr. Persoff treated them, too. He wrote admission orders on 24 patients.
“The patients weren’t able to provide history,” he says. “Some of the medical records fell as far as, I think, Kansas City (160 miles to the north), from the air,” he explains. “So we had no medical records. We had patients who were demented or delirious. We had patients who’d undergone routine procedures, several patients who were postoperative.”
