Ten Years Have Passed - November 6, 2005

This will be the second blog entry I have written in regards to the November 5, 2005 tornado that struck Vanderburgh and Warrick counties. In a way, this one really is not about the tornado and the disaster left in its path, but more about a patient of mine and how two tornado stories crossed paths.

Sometimes we only meet people for a few tense minutes in EMS and then we never know what happens after the patient is delivered and the paths diverge once again.

Before anyone goes all HIPAA on me regarding confidentiality, I have permission from the person whose story I am about to tell to relay it as written.

But first, I have to tell how I got there.

This was not the first time I had responded to a tornado strike. It was my third.

On the night of November 5, 2005, the wife and I had went to bed fairly early. I had to be up the next morning to drive to Tell City, Indiana to work a part-time paramedic shift at Perry County EMS, so staying up late was not really an option. My wife’s parents were in town and were staying here at the house with us. Early in the morning on the 6th, I remember the phone ringing and getting a call from my ex-wife who stated very factually that there was a tornado and it was heading pretty close to our house. I remember acknowledging the call and starting to get up, but then falling back to sleep almost immediately, as if it did not quite register in my mind.

It was probably less than two minutes later when I was awakened again. This time it was the wind. I now know what they mean by it sounds like a freight train. It sounded closer than what it turned out it was. In actuality, the path went somewhat southwest to the northeast, about three quarters of a mile south of my house across the corn fields in the river bottoms area. This is south of the levee that protects Evansville from floods.

The sound soon subsided and I had not really heard anything other than the wind. Even though I had thought, “That sounds like a tornado,” I still feel rapidly back to sleep.

The phone rang again.

This time it was AMR dispatch. The tornado had hit the Eastbrook Mobile Home Park on Lynn Road in the south east corner of the county.

In less than two minutes, I had grabbed a uniform and was out the door. The normal fifteen minute drive to work took about six minutes in the dark of a very early Sunday morning. It was a very surreal feeling out that morning. It was windy at my house with leaves blowing around. It looked wet, but it was not really raining (at least at my house). My father-in-law later told me that I sprayed the house and garage with rocks from the driveway when I departed.  I remember meeting an Evansville Police Car at the intersection of Highway 41 and Riverside. The officer saw my uniform and waved me through the red with an extreme sense of urgency.

I got to our station and began readying units for response. We emptied the place of every ambulance we had in less than thirty minutes. There were other ambulances coming from other counties as well.

I ended up on the last unit we had, sitting at our most central post location, covering the city for 911 calls while every other asset we had was at the scene. The city behaved. We sat… and we sat. We listened to the radio traffic. Two separate triage areas were set up. One to the north and the other to the south. The scene was big and was hard to assess in the middle of the night. The south triage area could only be reached by going south into the river bottoms near my home and then heading east to where it was established at the parking lot to the Angel Mounds Boat Ramp on the Ohio River.

We watched the District 10 disaster response trailer pass our posting location on highway 41 on its way to the scene.

Then we received our call. We were sent to scene staging at the corner of Pollack and Green River Road. We responded… but as we pulled into that parking lot we were sent to south triage at the boat ramp.

At this point, the radio traffic had indicated that quite a few patients were being transported but they were only coming out of the debris a few at a time. We did not have a clue what we would be receiving.

As a paramedic, you always prepare before arrival on a call. What you are supposed to do as well as initial care planning run through your head. It was less than a five minute response.

As we pulled up to triage, the ambulance in front of us was already loading a patient. We were being directed to a pickup truck with several firefighters and a supine patient in the rear. When we were about seventy-five feet away, something I saw triggered training… the patient was lying on a door… like maybe it had once been an exterior door to a home. It was being used as a spine board.

Something about the patient had caught my eye. The lateral sides of her knees were touching the door on both sides of her body, one knee pointing left, the other pointing right. Normally, the pelvis does not allow the legs to fall into this position. When they do it is indicative of what is called an “open book” pelvic fracture.

The first responders were preparing to move her to a long spine board. I exited the ambulance and yelled ahead of me for them to hold off on that move for a moment. At that time, I had been in EMS twenty-three years, but I had just recently learned that you cannot apply a spine board in the usual way using a “log roll” technique when the patient has this type of pelvic fracture. If they are moved in the normal fashion, the jagged fractures of the pelvis can lacerate the femoral arteries and they can exsanguinate in mere minutes.

I climbed up in the back of the pickup, and we all worked to apply a tight pelvic wrap using a blanket to bind the pelvis back into a more normal, splinted position and then slid her feet first onto the long spine board without using a “log roll” technique.

We initiated transport and our patient received ALS care in route. Her pain was tremendous. I remember that extra caution was taken to make the ride in to the ER fast but smooth. We were diverted to the trauma center downtown as the closest one had already been deluged with patients. It was amazing that we only received one patient… but that was how they were being found… one at a time.

It was a quick turnaround at the ER. I remember someone from the hospital making our cot and putting two bottles of water on it for us to drink. I was very much worried about the patient and this specific injury, knowing that if she survived it was going to take a lot to return to normal lower extremity function. But true to EMS fashion, I shoved the thoughts from my head and went back to work, not knowing what else the early morning would bring. I remember asking our medical director a few weeks later if the patient I had brought in that night truly did have an open book pelvic fracture and he had indicated that my assumption and treatment was correct.

Over the eight years that followed, I would use this scenario (patient info redacted of course) in paramedic class to drive home how to treat these types of injuries and what to look for when approaching the patient.

One rule I have always tried to enforce with myself was this: Never follow up on your own patient outcomes. I guess I never wanted to know if it turned out badly. So even though I thought about this call a lot, I never really knew the outcome.

Then it happened. Eight years later.

I received a message from someone on Facebook stating that I had saved their life in 2005. I did not know how to respond… I took a chance and typed back, asking if this was at the tornado and if she had incurred a pelvic injury. I waited for the response… it came, and I quote: “Yes and yes. I was the girl on the door!”

We talked for about a week on Facebook, and she wanted to meet. So we set a time to meet at my office at AMR. She said she had something for me and I had already thought of something appropriate to give to her as well.

On September 12, 2013, Christie Nolan walked into AMR.

Christie Nolan

We chatted for a long time. She told me how she had looked out the window just in time to see her own SUV lifted off the ground by the wind. It then crashed through the wall and pinned her through the floor to the ground under the debris. She was there for a long time. She told how she was afraid to open her eyes so she kept them shut. She talked about the sounds and the smells and how they were still remembered.

She talked about how she finally decided that she probably would not be found unless she tried to get herself out. She knew something was very wrong with her legs. She started moving things with just her hands and started making a way out from under the debris, until after a long period of work and quite some distance, she made it out to where rescuers could find her. She talked about keeping her eyes tightly closed the entire time.

They placed her on the door. They took her to the boat ramp. She heard our voices and was treated and appropriately and cared for by all.

I explained why we had placed the pelvic wrap and not log rolled her. We talked about the long course of her recovery and how now she could not only walk but could dance as well. She had recovered well. Best of all, she was in an EMT class.

She gave me a gift… one I use now for teaching that same open book pelvic fracture scenario. A copy of the x-ray of her injury. Now students can see the actual damage this type of injury causes on the inside. I gave her a gift as well… the challenge coin from the response. She deserved it. She was a rescuer… she rescued herself enough to be found by digging with her hands out of the rubble, enough so that she could be found.



A photo Christie made and placed on Facebook

Some did not make it that night. She did. She is now an EMT and living in Tennessee. She wants to keep her Indiana EMT certification. I am going to help her put her recertification papers in order soon. She thinks I am a hero. I see myself as a grumpy, old paramedic.

I am fond of telling people that we do not save lives… we are simply like a life preserver, thrown to the immediate aid of those in peril and that we keep them safe and get them to where they need to be.

This is one of the few cases where the “how” of how we cared for a patient made a difference. We stay in touch. It seems like this week of November always accentuates that contact…

As I sit here in bed tonight writing this, it is raining outside. There is thunder occasionally at a distance. It is pretty warm out, a lot like that night in 2005. The memories come back pretty easily. Like a movie.

I have read several stories from other medics and EMTs tonight. Many saw a lot more than me. I will always remember how Terri Clark described doing her first chest decompression that night. I will remember how Sammy Sookey stayed at the scene till the last patient was out. I will remember the dedication of Nate Stoermer and how he handled medical command… and I will remember the discussions about this night with a now departed friend. I will remember the actions of Knight Township (now gone, but not forgotten) and all of the other departments and agencies. I will always remember my response to Petersburg and the tornado damage and patients there as well. I am glad I only had one patient on this particular night.

As I finish this, it is only a couple of hours before the exact time marking the passing of ten years. Even though I am not at all happy about how I met Christie Nolan, I am glad I was there in that moment as I am sure are all of those who helped that night.

Christie… be safe. Thank you for showing those of us in EMS what the other side of the story looks like. We rarely have anyone thank us after the call. Sometimes it even makes us feel uneasy or out of place. I would like to thank you for letting us be there for you. Recognizing each individual as you did by seeking them out is a wonderful, unforgettable gesture.

I have purposefully left out pictures from the tornado and some other aspects as this writing is about the patient and the caregiver. If you would like to read a bit more and see a couple of pictures from that night, please see my entry at:

http://leeturpenffff.blogspot.com/2014/12/bring-me-to-life-song-revisited.html

An article posted today in the Courier and Press:

http://www.courierpress.com/news/local/for-first-responders-vivid-memories-of-november-tornado-remain-22a37e65-6cdb-07d9-e053-0100007f0809-341030831.html