Doctors and nurses at the main hospital in the US town of Joplin, Missouri, had just minutes to rush patients away from windows and outside walls before it was ravaged by a massive tornado that ripped a wide path through, leaving at least 116 people dead and countless more injured. Officials said the death toll was expected to rise.
"I've heard people talk about being in tornadoes and saying it felt like the building was breathing," Rod Pace, a manager at the ruined nine-storey hospital said. "It was just like that."
He held on to double doors fitted with magnets to keep them closed at up to 100lbs of pressure. They flew open anyway, tossing him into a hallway. With its windows blown in and its car park resembling a scrapyard the hospital was a ruin yesterday. X-rays were found 70 miles away. The devastation elsewhere in Joplin was even more alarming. Shopping complexes, churches, schools had been crushed or badly damaged.
It's never easy to comprehend what destruction a strong tornado can wreak. They strip bark from trees. "You see pictures of the Second World War, the devastation with the bombing. That's really what it looked like," said Kerry Sanchetta, the headmaster of the town's demolished high school. "I couldn't even make out the side of the building."
One resident, Tom Rogers, said his house had been destroyed. "We heard the tornado sirens. All of a sudden, everything came crashing down on us. We pulled our heads up and there was nothing. It was gone," he told The Joplin Globe.
Melodee Colbert-Kean, a Joplin councilwoman who serves as vice mayor, said: "It is just utter devastation anywhere you look to the south and the east – businesses, apartment complexes, houses, cars, trees, schools: you name it, it is levelled."
As more rain fell on the town, tales of heartbreaking loss and of survival were exchanged. Rescue workers reported finding bodies in cars around the town that had been picked up and dumped by the twister. Others perished in homes shattered by the wind.
Survivors told of split-second decisions that saved their lives, like Jeff Lehr, a reporter for The Joplin Globe, who had to abandon a cat that wouldn't come out from under his bed and sprint to the basement of his apartment building, or Isaac Duncan who fled into the cold storage room of a petrol station shop.
"There was an awful, pulsing, hectoring noise outdoors before the windows began imploding, and flying glass forced me to the stairs without him [the cat]," Mr Lehr said. "I literally slid down them as something wooden shot past me, and a large chunk of insulation from who knows where slapped my face."
Mr Duncan and a friend found themselves crammed into the shop's cooler with about 20 strangers. The sound of their terror and of the tornado passing overhead was captured by Mr Duncan's mobile phone and yesterday was playing on cable news stations around the world. "Jesus, Jesus, Jesus," one woman is heard groaning.
"We all just jumped in the cooler," Mr Duncan told CNN. "There was glass everywhere, most of the people got cut pretty bad."
When the roar was gone they came out. "The only thing that was left standing was the cooler that we were in – everything that was around it was gone."
Another man told a reporter that downstairs in his house he thought the end had come when the floor started to buckle under his feet.
"We thought we were going to be sucked up the chimney," he said.
It is a tornado season that has already entered the history books. The terrible storm that struck Tuscaloosa, Alabama, last month killed 236 people. So far this year, 453 people have died in tornadoes across the US.
With winds in excess of 200mph, the Joplin twister gouged a path that was a mile wide and six miles long. It was survivable only for those inside the sturdiest of structures. And then there is the peril of debris flying through the air – planks, bricks, cars, whole lorries. As well as the dead, there were hundreds with injuries yesterday.
Officials said that a quarter of the town was heavily damaged and 2,000 buildings strafed by its winds. The hospital, St John's Regional Medical Centre, was wrecked in under a minute. As the door-to-door search for survivors continued, the Missouri Governor Jay Nixon warned that the final death toll was likely to rise. "I don't think we're done counting," he told the Associated Press.