In the world of crisis response, all disasters are local

Robert Mitchell, M.D.

Robert Mitchell, M.D.

Last May I found myself, like many of you, sitting with my doctor following up on some very bad back pain I was experiencing. Going over the MRI with me he remarked something to the effect, ‘this is so interesting’, pointing to a “tumor-like mass” on his computer screen; ‘I’ve never seen anything quite like this before,’ he went on to say almost matter-of-factly.

As a physician, I understood exactly. Bluntly, this translated to, “it sucks to be you.” Or from my standpoint as the patient or victim, this is my personal medical “disaster”. The doctor was not actually experiencing my pain. Or the urgency I felt to get it fixed! Nor will he experience the stress, possible complications or recovery from any surgery that I may need; or any loss of physical abilities; weakness, numbness, paralysis, unresolved pain.

After all it’s not his crisis. So from a distance, for him it is interesting. I get it. He will go about his life as usual; work, family, chores, golf, meetings, vacation.

The impact of my medical “disaster”? Very LOCAL! Mine alone; to deal with and bear. This is not meant to point a finger at the doctor or imply he is not caring or sympathetic; not at all. He is both caring AND sympathetic. Just, not his problem; not his pain. There is a process and he will shepherd me through that process. This is how the system works!

Watching Snohomish CO. Department of Emergency Management director John Pennington in his news conference this morning from Arlington, I’m sure you are aware of Saturday’s Oso mudslide disaster, loss of lives and ongoing large-scale multi-agency response effort, he was asked by a reporter about the newly-arriving, “State-owned”, National Guard forces; not a “local” asset.

“Why wasn’t the National Guard here sooner?” the reporter inquired.

The answer is a simple one. Not until local resources are fully used or nearly exhausted; only then can State, and eventually, Federal help be requested; roughly translated, in the beginning all crisis response rests with the “locals.” Once requested, it will take 4-6 days or more to actually get State/Fed assets to the scene and integrated into the already complex ongoing response operation. This is not meant to be accusatory or cruel; just reality.

This underlines the ongoing need for crisis-response education and a disaster-readiness collaboration involving local hospitals, public officials, fire service and law enforcement; and most importantly, the local community, schools, businesses, private citizens, neighborhoods.

Together Snohomish CO. Fire District 1, Swedish Edmonds and Operation Military Family have undertaken just such a volunteer, unfunded collaborative initiative: ‘The Disaster Medicine Project’. Its community-centered and caring purpose: to strengthen the capability of our Edmonds populace to effectively react to and bounce back more rapidly from any disaster or large-scale emergency, whether train, freeway, Puget Sound sea transport, over-head air traffic, ferry or earthquake-related. Or a fire and power outage at nearby Swedish Edmonds.

Disaster strikes, as in Oso, without warning! By surprise, at night, on weekends, holidays, or rush hour, raining or freezing cold; anytime! Arriving at the crisis operations center in Arlington on Sunday, I witnessed over a hundred local folks; fire, law enforcement, city and county officials, citizens, even Costco and Home Depot! Organized under the ‘Incident Command’ system, diligently and tirelessly going about the response work to be done.

This orchestration of response does not just happen. It results from planning together, training together, exercising together. I know! I was involved in much of that process. Perfect? No, it can never be perfect due to the unpredictability of disasters. Doing the job well? Absolutely!

As is the standard, disaster “declarations” by the governor and the president occurred a few days into the crisis allowing State and Federal resources to be activated and funding to ramp up. All lives saved up to that point in time? Due to the efforts of “local” responders and systems; on their own.

It’s always the same. At the start, response is “local.” Called resilience, this ability to respond and recover locally directly reflects the time and energy a community puts into its preparedness programs. In Arlington their response readiness efforts are on full display. Emergency response agencies, public and private sectors, working together; no easy feat!

When it’s your back or your back yard, your home, your family, your community; it’s local and it becomes very personal!

- Article submitted by Robert Mitchell, M.D. This article is 7th in the author’s Crisis Response 101 educational series devoted to hospital emergency preparedness.

Robert Mitchell, M.D., is an Edmonds resident for 30 years, board certified in OB/GYN, practicing at Stevens/Swedish-Edmonds for 18 years, retired from active OB/GYN practice in 2002. “I was struck by the events on 9/11 and became interested in the areas of disasters and response attaining board certification in Disaster Medicine in 2007. Now embedded in many local disaster response projects, I have enthusiastically volunteered all my time over the past eleven years working with Joint Base Lewis-McChord, hospitals, law enforcement, emergency management and the fire service in crisis response training, planning and exercises. As acting medical director and Lead Instructor for the SnoCO Fire District 1 Basic Disaster Life Support course and an adviser to the Disaster Medicine Project, a SnoCO Fire District 1 initiative, I am committed to strengthening our healthcare and community resilience potential.”

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4 Comments

  1. Robert,
    You might like to tell people where they can volunteer at the local level so they may be prepared and trained for a disaster in the future. Or I can do that too.

    I have already been asked to help many times this week because of my local training before the disaster struck.
    -Nathan

  2. Thanks Nathan! for reading the article and for your concern as a citizen to prepare for emergencies. I appreciate your acknowledgement of the need for readiness and applaud any training you have undertaken to be able to do your part.

    Doc Mitchell

  3. Please see http://www.esca1.com to become involved in local disaster relief in the future.

  4. I wish to thank all who have contacted me regarding my health. I am doing well. It has taken almost a full year to recover – just beginning to consider light exercise to combat the relentless march of weight gain and abdominal girth.

    Fortunately I did not require surgery. The “tumor-like” mass seen on MRI resolved on its own over 4 months. In retrospect what was thought to be a possible tumor was the result of severe inflammation around the offending herniated lumbar disk. Anxiously awaiting the 4 month follow-up MRI – the feeling of being ALONE in my potential long-term battle for life was very frustrating and real to me.

    These same feelings of extreme anxiety and impatience due to the uncertainty and the absence of concrete knowledge about their loved ones are what the “mudslide” community is experiencing. Response can’t be fast enough for them.

    What I saw and heard everywhere at the site yesterday was a concerted and VERY CONCERNED effort by all in charge to include the community in all the digging and searching. This is part of healing. Realize though – this challenges the response leadership. The search area is saturated with hazardous sewage and other waste, submerged sharp objects, and deep-sucking mud – unseen dangers everywhere. What is not needed? – more casualties. The job at hand is massive enough.

    Doc Mitchell

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