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Fast and Furious

From: The Hospitalist, July 2011

Storm-chasing hospitalist does emergency duty in Missouri

by Thomas R. Collins

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.

Fast and Furious

“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 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.
—Jason Persoff, MD, SFHM, hospitalist, Mayo Clinic, Jacksonville, Fla.

“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.”

Leaving the hospital, he said, was gut-wrenching.

“I felt like a loser. I felt like I was handing patient-care responsibilities to a completely overtaxed system because I was tired,” he says. “When I started not making good decisions, I knew that I wasn’t helping anybody and it was time for me to step aside. But that was a very hard decision to make.”

Dr. Persoff says he’ll never forget the triage nurse on duty. She was there when he arrived, about 6:30 p.m., and was perfectly orchestrating the trauma care, even though there was no way for any of the hospital staff to know what had become of their own families and homes. And she was still there when he left at 4 a.m., so efficient and fresh it was as if she’d “just come in from having showered.”

Debris from destroyed homes is seen after a massive tornado passed through the town on May 24, 2011 in Joplin, Missouri.
Debris from destroyed homes is seen after a massive tornado passed through the town on May 24, 2011 in Joplin, Missouri.

“I don’t know what she knew or where her house was or where her family was,” he says. “I just knew that she was there working like there was no tomorrow and doing it in a way that I couldn’t. That was one of the times where I was like, ‘Wow, this is really humbling.’ ”

Dr. Persoff, who writes about his hobby at Stormdoctor.blogspot.com, continued his storm chasing; he even helped provide assistance two days later, after storms near Oklahoma City exacted a human toll that was not nearly as severe. But first, he says, he had to do some soul-searching. After all, he had hoped for a tornado to form in the Joplin area.

“My chase partners and I were talking about how can the rational person want to continue storm-chasing after having seen what we’d seen. And it took me a while to sort of figure out where my own conscience was on this,” he says. “I felt very guilty for having even wanted [a tornado] earlier in the day. Then I also felt like, had the storm not formed where it did, I wouldn’t have been there, my partner Dr. Balogh wouldn’t have been there, and we would not have been able to assist in that disaster.

“So in many ways it was karma. It happened. We were there at a time when Joplin needed some help.”

After the storm, Dr. Persoff received words of thanks from the town.

Jane Culver, a floor nurse with whom he worked, told him via email: “People often say to me, ‘Doctors are just in it for the money, they really don’t really care about me.’ Well, I say they don’t know the Dr. Jason Persoffs of the world. You are a true humanitarian, and the people of Joplin are lucky you were in our midst at our hour of need.”

Fast and Furious

Stephanie Conrad, whose grandmother Clara had her broken hip cared for by Dr. Persoff, called him “the angel doctor.”

“Thank you so much for using your knowledge, skills, and expertise during this crisis,” Conrad wrote in an email. “It is physicians like you that make a difference in the lives of others. You were truly a blessing that night.” TH

Tom Collins is a freelance medical writer based in Florida.


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