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doi: 10.1097/01.NT.0000398688.32770.be
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Neurologists in the Eye of A Monster Tornado: Coping with the Wreckage in Alabama

Talan, Jamie

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ARTICLE IN BRIEF

Neurologists in Alabama describe the aftermath of a catastrophic tornado in April.

DR. DANIEL C. POTTS ...
DR. DANIEL C. POTTS ...
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Daniel C. Potts, MD, thought he was prepared for the tornado that touched down on Tuscaloosa and across other regions of Alabama on April 27. His hospital had tornado preparation measures in place for days. But when he watched the sky darken with its gray centrifuge canvassing the afternoon sky — the tornado was more than a mile wide at its peak and tracked 132 miles through five counties — he knew that it would take a monumental medical effort to help the people of his community and beyond.

Dr. Potts, a neurologist and associate clinical professor of neurology at the College of Community Health Sciences and the University of Alabama School of Medicine, had been in the eye of this un-perfect storm for more than a week and he knows that the worst, at least for neurologists, is yet to come.

“We've been doing a lot of triage but soon we will see people coming to us with neurological symptoms,” he said.

After spending the first few days at the hospital doctoring broken bones, lacerations, chest pain, and mild-to-moderate trauma outside of the action in the emergency department where the most serious patients were taken, he and his colleagues have gone on the road into hard-hit neighborhoods pushing a red wagon with medical supplies, including medicines.

One afternoon, he got word about an elderly woman with dementia wandering around her obliterated house. He found her in the basement. It took 45 minutes to coax her onto the street, where the Red Cross mobile unit was handing out food and supplies.

One week after the tornado, 80 people in Tuscaloosa were still missing.

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EYEWITNESS TO A DISASTER

Dr. Potts has been a neurologist in the western Alabama city since 1997. “I have never been this close to disaster before,” he said. “The closest thing I can think of is taking care of my dad with Alzheimer's disease and experiencing his death from pneumonia. We have to rise to the occasion and find a way to help in crisis situations. That is just what we do.”

April 27 was no ordinary day. By mid-morning, a small tornado had already smacked down on Tuscaloosa and sent power lines down all over the city. This was actually good because schools had been closed for the day and most people were inside watching or listening to news reports from veteran meteorologist James Spann. He was manning the SkyCam overlooking downtown Tuscaloosa for ABC 33/40 as those who still had coverage watched the tornado bear down on the streets, destroying restaurants, bulldozing stores and cars like tinker toys thrown into the air. “Oh, crap this is bad,” the meteorologist said.

The regional medical center and the University of Alabama were south of the heart of the damage. Dr. Potts and others in the neurology clinic saw their patients earlier in the day and by 3 PM they were heading home. Dr. Potts lives two miles from the center of the city and made sure his wife and daughters were safe before venturing back out. There was no question that his skills would be needed back at the hospital.

Trees were no longer where they had been earlier in the day. In some neighborhoods he passed, entire houses were pounded to the ground. A local hamburger shop had served its last lunch. The smell of donuts hung faintly in the air but there was no sign of the popular Kripsy Kreme storefront.

People were running. Children were walking alone, dazed and lost.

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STORIES: ON AND OFF THE WARDS

Shawna Medders, a registered nurse who works with Dr. Potters at the Alabama Neurology and Sleep Medicine center, had also gone home to check on her mother, who had lost power that morning in her own home. Her husband works for the Alabama Power Company and he'd been working all day already. By lunch, 100,000 people lost power. By the end of the day, it would be half a million and Brent Medders, a lead line man, would work 150 hours straight before he shut his eyes from the disaster cleanup.

Nurse Medders had worked in the surgical trauma unit for years and had a good idea what was ahead of her once she could get through the roadblocks on the way to the hospital. She had to abandon her car about a mile from the hospital and didn't stop running until she saw a charge nurse working the crowded halls. “Where do you need me?” she asked.

Neurologists Ben Lucy, MD, and Thomas Patton, MD, were already on the floor in makeshift trauma units. The more serious cases were being taken directly downstairs to the emergency room. By the next day, the staff manning the hospital had taken care of over 2,000 tornado-related injuries. Even the auditorium was turned into a MASH unit.

“I just knew I had to be there to help take care of our community,” said Dr. Patton, a neurologist at the Alabama Neurology and Sleep Medicine center. “This has been and will continue to be a community effort.”

Dr. Lucy, a neurology hospitalist, was on call when the tornado hit the city. He was rounding on the usual fare of neurology patients, strokes, seizures and unexplained headaches. He went down to the emergency room to offer a hand. A neonatologist looked up. “Neurologist,” he yelled. He was taking care of a 5-month old with severe head trauma. Dr. Lucy is an adult neurologist but helped stabilize the child so that he could be shipped out.

His next case was a 20-year-old college student who broke her back and was paralyzed. They stabilized her with high-dose steroids and an ambulance took her to the University of Birmingham for surgery. A week after the tornado, two of his patients remained in critical condition; a 20-year old girl who was thrown by the force of the wind and suffered a severe blow to the head and is in a coma and another young woman who is showing the faintest signs of neurological recovery. She is squeezing the doctor's hand on command.

Dr. Potts was treating a 22-year-old man from a nearby housing project. He was shaken up, for sure, said the neurologist. “He said he had nearly died 50 times but skirting death this time was big.” The young man went out to score some drugs and the drug dealer screamed at him to get out of his house. He left, stared up at the ominous sky. He heard something about a tornado but there was a wet blanket of air and black cloud falling from the sky. He ran back into the guy's house and within a minute the house was gone and the drug dealer was dead under a torrent of metal and wood. His arm was bleeding but he limped out and made his way to the hospital. “I was saved for a reason,” he told the doctor. “Everything is different now.”

THE DEVASTATION afte...
THE DEVASTATION afte...
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The drug addict's compound fracture was set later that evening.

Dr. Potts and Nurse Medders found a man outside covered in blood. “My back hurts,” he told them. He was asking for a gown. When they helped take off his shirt they saw that his back was covered with shards of glass. He said that he had thrown his wife and children into the tub and put his body over them to protect them. The bathroom came down on him. “These were the minor trauma cases,” said Dr. Potts.

Later in the week, Dr. Potts saw one of his patients wandering around a neighborhood devastated by the tornado. She survived by taking a pocket door off and stealing herself under it with piles of clothes on top of her. When she got up an hour later, she walked out of her closet and into the street. Her house was gone.

The team continues to help with general medical treatments but they know it is only a matter of time until those who sustained head injuries will need assessment and care. Patients with dementia are also of major concern.

Dr. Patton said he's been seeing a lot of depression and anxiety among his patients. A lot of his dementia patients are more disorientated, which is not surprising given many are displaced. “I find myself just listening more to patient's stories. Sometimes that is the best thing you can do,” he said.

Dr. Potts and Dr. Patton are making a lot of house calls to their patients who can't make it in. Several pharmacies were destroyed in the tornado and medicines are being shipped in from all over the country. Dr. Potts said that they are anticipating patients coming in with traumatic brain injury, seizures and cognitive problems.

Many doctors from out of the state are now being told that they should stay put. “The biggest help right now is that our communities need money for medical supplies,” said Dr. Potts. United Way of West Alabama (http://www.uwwa.org) is giving 100 percent of funds received back into the relief effort. The Red Cross is helping support local make-shift medical units throughout the city offering help to hard-hit communities.

©2011 American Academy of Neurology

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