The memories are individual and indelible. CEO David Seagraves remembers slogging on foot through rain and debris to get to Sumter Regional Hospital in Americus the night it was struck by a tornado.
The shock hit Seagraves when he realized that he could see the whole building.
"Before [the tornado], you couldn't get a clear view of the entrance, because of the oak trees," he said. "The trees were all down, and the white strobe lights from the alarm system were blinking in unison from the windows against a blacked-out city. That was a creepy sight."
The March 1 tornadoes killed nine people in Sumter, Taylor and Baker counties and caused more than $210 million in damage, demolishing dozens of homes and businesses.
Crystal Wiggins, an obstetrics staff nurse on duty that night, remembers the howling of the wind and the voice of a terrified patient clinging to her, crying and praying at the top of her lungs in Spanish. Wiggins, who was to be married on March 24, didn't know if she would survive.
"The tornado seemed to go on forever, and I remember thinking: 'Is this my last moment? Will I not get to say goodbye to anyone?' " said Wiggins, RN, BSN.
Susan Fussell rode out the tornado in her home five miles away. Fussell, the vice president of nursing at Sumter Regional, already had given instructions to move patients into the halls and to put babies with their mothers, because of the bad-weather warning.
Soon after 9:15, Fussell's cellphone rang. Her executive secretary, who had been visiting a friend in the hospital, said: "Susie, do you know we've been hit? I'm in the hospital. You've got to come. It's bad."
"My husband, son and I took off, and, when we got to a policeman blocking the road, I told him he had to let me by," said Fussell, BSN, RN-BC. The police officer said that they could try to make their way to the hospital. When Fussell and her family topped the crest of a hill, she discovered the scope of the damage.
"It looked like an atomic bomb had dropped," she said. "Light posts and trees were down, buildings destroyed, and we were zigzagging through debris everywhere."
Stefani Meyer, RN, BSN, the charge nurse in the emergency department, remembers shattered glass from the ambulance entrance and water from broken pipes and from driving rain everywhere.
A hospital administrator leads a tour in the aftermath of a tornado that hit Sumter Regional Hospital in Americus. A patient was only a few feet away when this piece of lumber was impaled in the wall.
"The most amazing thing was how fast everyone came to help us," Meyer said. "We had ambulances from every county, EMS staff, our own off-duty staff, even administrators from other hospitals. Everyone showed up quick."
Hospital at ground zero
"We always expected that we would be responding to a disaster [somewhere else]," Seagraves said. "We never expected to be the epicenter of disaster. Yet everyone rose to the occasion, and we didn't lose anyone."
It was fortunate that the hospital's main phone line held up long enough to get an emergency 911 call out to nurses, doctors and emergency workers, who knew what to do.
"We had a local emergency-event planning committee in place. We'd pro-actively thought events through, had developed communication between all entities and had practiced drills," Fussell said. "That night we saw the value of community collaboration."
Fussell said that her nurses acted both on instinct and on their training in emergency fundamentals.
"They had to use critical thinking and make important decisions, and they did. That's what carried us through. I've never been so proud in my whole life," she said.
When Fussell arrived at the hospital, she found nurses and nonambulatory patients "lined up like soldiers." Each nurse had a patient and his or her records to ensure continuance of care. The atmosphere was tense but calm.
Wiggins said that managers decided immediately to get patients out of the third-floor obstetrics unit — the hardest-hit area of the hospital. There were live electrical wires and ankle-deep water. Walls were caved in and roofs were gone.
Wiggins helped another nurse get a bed-ridden patient with seriously high blood pressure ready to move.
"You'd be surprised what you remember to do in the middle of a disaster," she said. Wiggins carefully clamped a hose before opening the patient's medication pump, knowing that it could be fatal if the woman received too large a dose. Wiggins later found a blood pressure machine so the staff could continue to monitor the patient's condition and prevent a possible seizure.
Nurses grabbed bottles and nipples from the nursery; water and soda for nursing mothers; and patients' records. Medical records workers showed up to save paper files that would have been lost to mold or water damage.
In less than four hours, 55 patients were evacuated to other hospitals.
The tornado tore off this wall, leaving a gaping hole in the side of the hospital.
"It took awhile to get roads cleared, but our staff didn't skip a beat in providing them care. Everyone worked as a team," Seagraves said.
In the days after the tornado, Meyer and other staff members gathered supplies and set up a first-aid station with the American Red Cross at the nearby First Baptist Church. The tornado had destroyed the Americus medical community — doctors' offices; the new Sumter Healthplex, a $3.1 million facility that housed the hospital's imaging and laboratory services; and the 143-bed hospital that served 10 counties.
The buildings were in shambles, but the hospital's spirit proved indestructible.
"A hospital is not a building; it's the people," said Marcus Johnson, marketing and public relations director at Sumter Regional. "Our people are caregivers, and the spirit of the hospital is inside them."
Care in makeshift quarters
That spirit carried the staff through difficult times. They gave urgent care in tents provided by the Georgia Emergency Management Agency, from a few days after the tornado hit until April 30. Then they moved to a 24-hour urgent care center in modular units.
The tents were drafty and leaked, but they served 2,000 patients. From a tent city to a trailer park, the staff joked.
Wiggins gives management high marks for keeping staff informed. "They furnished counselors to anyone who needed them and gave out their personal cellphone numbers in our first meeting," she said.
Business-interruption insurance has paid the salaries of the hospital's 700-plus employees, but most are working light shifts and adapting to different duties.
"They may be counting IV poles in the warehouse instead of delivering babies," Fussell said. "Staff members have done a fabulous job of devising ways to document equipment."
Some nurses are on loan to other hospitals, where local physicians are delivering babies or performing surgeries.
"Working in new areas and cross-training are creating stronger nurses, and we're forming new bonds," Meyer said.
Support and fund-raising have come from many sources.
"Some nurses from Gulfport Memorial Hospital [in Mississippi] who had been through [Hurricane] Katrina came to encourage us," Fussell said. "They advised me that everything and everybody would be crazy for a long time; the trick is to take turns.
"Our latest challenge is trying to fast-track an interim facility, while planning a permanent hospital at the same time. It is crazy but necessary."
Sumter Regional is the only hospital in the United States to have been rendered inoperable while the community around it remained stable, Fussell said. "There is no other health care system within 40 miles, so this was an unprecedented situation."
It differed from the hospitals in New Orleans after Hurricane Katrina, "because we didn't lose our population or our employees; we simply lost something for them to do," Seagraves said.
The challenge ahead
Getting a hospital back into business is not easy, he said. Agency, government and hospital leaders have been working through a mountain of red tape as they try to create the best outcome for this rural area. Fussell is hopeful that their work will bring about changes that will help others — a positive outcome from a negative situation.
"There are so many things that we've had to learn from this experience," Seagraves said.
The tornado tore off the wall of this room at Sumter Regional Hospital. Officials are unsure whether the hospital will be repaired or a new facility will be built.
It has made him appreciate having a willing and adaptable executive team. "There is no way we would have gotten this far this quickly, if not for very capable folks," he said.
Funded in part by the Federal Emergency Management Agency's public assistance program, a 70,000-square-foot interim health care facility made of prefabricated units will be operational soon. It will house 70 beds; a labor/delivery, recovery and postpartum unit; four operating suites; a critical-care unit; and an emergency room — the same services the hospital offered before the tornado but on a smaller scale.
Administrators hope that the business-interruption insurance will hold out until the interim facility begins generating income and that the community will embrace the temporary solution. Patient support is crucial to keeping physicians and staff, and to the future of the hospital.
Community support
"The patients came to visit us in a tent and in trailers," Fussell said. "We are already back to the previous year's [number of] visits in urgent care and have had only one documented patient complaint since March 1."
She believes that patients will come because the community has done nothing but say "thank you, thank you, thank you" for the staff's efforts since the tornado.
There is still the question of whether to repair the original building or build a new one. Seagraves is in favor of a new building.
"If we could build something from scratch, we could eliminate a lot of inefficiencies of the old hospital — which was built in 1953, 1977 and 1999 — and provide this community with a modern, state-of-the-art facility," he said. "I don't know where we'll find the money, but we need to find a way to make it happen."
The prevailing belief in Americus these days is that Sumter Regional Hospital is indestructible and that it will come back better than ever.
Wiggins did get married on her original wedding date, but not in the demolished Reese Park, as she had originally planned. She just celebrated her first year as a nurse and said that the tornado taught her not to take anything for granted.
She said she also learned that nothing is more important than people.
"It confirmed my decision to be a nurse," she said. "I love what I do, and I'm so proud of everyone who left their homes and showed up to help us. It shows you their dedication."