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In the dark, early days of the pandemic, Dr. Paul Ginart worked in the COVID-19 ward at Brigham and Women’s Hospital, where as many as 20 patients were on ventilators at one time.

As patients would die, their beds “would immediately get refilled by other equally sick patients,” Ginart said.

The hectic, frantic months of spring of 2020 gave way to subsequent COVID surges, an ordeal that exacted a heavy toll on doctors and nurses who confronted firsthand the ravages of COVID. On Monday, Ginart will join 1,500 other health care workers stationed at medical tents along the storied Boston Marathon course, a much-needed chance to savor a celebration of strength and resilience.

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The Marathon, which was canceled in 2020 then moved from the spring to the fall this year, will bring a welcome sense of normalcy that “celebrates the spirit of human endurance, which I think is so much of what these past two years have been about,” said Ginart, 32, a fourth-year resident at Brigham and Women’s and a first-time race volunteer.

“The Boston Marathon carries a lot of importance and weight for a lot of people a lot of years, but this year, in particular, being able to come together and celebrate that endurance and that resilience is something that feels really poignant,” he added.

For Ginart, navigating families through end-of-life discussions has always been part of the job. So not being able to do so face-to-face because of restrictions, and watching patients die alone, were among the most distressing aspects of COVID care.

“Having them face-to-face at the bedside, being able to see what you see, I think is something that I took for granted, how much that helps in terms of getting on the same page and trying to figure out what the overall best thing is to do for a patient,” he said.

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COVID-19 has been a life changer and a game changer, Ginart said, shifting priorities, clarifying purpose.

“In a lot of ways, COVID helped me drown out the noise,” he said. “It has made me more intentional and more reflective about how I spend my time.”

When Heather Garvie, a 28-year-old surgical nurse at Tufts Medical Center, first volunteered in the Marathon’s medical tents in 2019, she left with such a feeling of positivity that she couldn’t wait to return.

“I leave race day feeling really good about myself and my career,” Garvie said, “and how I was able to contribute to making this event happen and making it memorable for the runners.”

The 26.2-mile race stands as some people’s biggest accomplishment in life, she said. “Words can’t express how amazing that is to be a part of that for someone. We’re there to support them, and it’s amazing to see.”

Dr. Paul Ginart worked in the COVID-19 ward at Brigham and Women’s Hospital.
Dr. Paul Ginart worked in the COVID-19 ward at Brigham and Women’s Hospital. Lane Turner/Globe Staff

It’s much-needed positivity for Garvie, now more than ever.

During the early stages of the pandemic, work became “like a bad dream” that Garvie dreaded.

“I was terrified to come to work,” she said. “There was so much uncertainty. It was definitely very challenging and very emotional at times.”

“The whole flow of the hospital completely changed; there were no visitors, we had no surgeries. It was almost like a ghost town,” Garvie said.

The return of the Marathon is an opportunity to tuck away the doom and gloom, she said. For her, it represents hope and progress and a meaningful return to tradition after trying times.

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“It symbolizes a positive turn of events in this pandemic, like we’re maybe rounding a corner here,” Garvie said. “I feel like we need this little pep rally. I think it’ll really boost everyone’s spirits, because it’s such a positive event to be a part of and to celebrate.”

Chris Troyanos, the medical coordinator of the Boston Marathon since 1996, said it was easy rounding up medical volunteers this year.

“This is an iconic event and people love to be a part of it,” Troyanos said.

The medical tents — two at the starting line, two near the finish line with more than 100 cots each, and 26 tents in between —are mini-emergency rooms with high-tech lab equipment to check blood counts and sodium levels, and saline IVs for the dehydrated, Troyanos said.

The camaraderie, joyous spirit, and opportunity to practice medicine in a fluid, outdoor event environment keeps many volunteers returning year after year to be a part of the Marathon’s tight-knit medical team, Troyanos said.

“It’s such a unique medical opportunity that they don’t normally see in a clinical setting,” he said, calling it a combination of sports-, disaster-, and event-medicine.

“We have so many people that are not from the area; they’re from all over the country; they come from far distances at their own expense to take part in my medical program and they’ve been here for years.”

Katie Powers, a maternity nurse at Manatee Memorial Hospital in Bradenton, Fla., is back this year for her 10th Boston Marathon. Had it not been canceled in 2020, she’d be celebrating her 11th. It’s one of many races she normally volunteers for each year, from New York, to Texas, to Washington, D.C.

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“It is an honor and a privilege to work with such an incredible medical team,” Powers said. “It is just amazing how we work together in sync. Many of us only see each other once a year, but we come together and we work so closely as a team.”

At 7 a.m. Monday, Powers and the rest will report to Tent B and other spots near the finish line to receive their Marathon jackets and learn their assignments for the day. If sunshine and warm temperatures hold out for Monday’s race, heat stroke and dehydration will be the primary conditions to treat, Powers said.

But it can range, widely, she said, from fatigue and cramps, to panic attacks and incontinence.

“You name it,” Powers said. “You experience it in the medical tent.”

For Dr. Jeffrey Schneider, the Marathon has been near and dear since he was a little boy in Framingham handing out orange slices to passing runners. The 48-year-old has run the race twice and been a spectator dozens of times, bringing his wife and their two children to cheer the elite runners all the way through to the wheelchair racers, said Schneider, an attending physician in Boston Medical Center’s emergency department.

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When two bombs exploded near the finish line on April 15, 2013, Schneider and his family were watching the race in Brookline. He gathered his family and drove toward BMC to help treat patients but got stuck in traffic. Schneider ran the final couple of miles.

This year, after years of urging by his wife, Schneider will try his hand as a medical volunteer. It felt like the right time “to give back,” he said.

“The Marathon, for me, is a very emotional experience; it’s an inspirational event. I’m excited, and I’m nervous, and I’m looking forward to it,” Schneider said, his voice wavering with emotion. “I think it really symbolizes a little bit about perseverance, about endurance, about hope, about optimism, about strength.”

As a volunteer, Schneider says he will be awash in all that energy, a welcome relief after so much grief.

“I’m looking forward to high-fiving any runner that I can who comes by … congratulating them, cheering for them, cheering with them, and just being thankful that we have this opportunity to run.”




Tonya Alanez can be reached at tonya.alanez@globe.com or 617-929-1579. Follow her on Twitter @talanez.