Tens of thousands cheered when Heather Abbott, a 38-year-old Marathon bombing survivor and new amputee, balanced on one leg to throw the first pitch at a Red Sox game in mid-May.
What may have looked effortless to the adoring crowd was the result of hours of painstaking labor, of learning to work with a body that was dramatically altered, of learning to overcome the fear of falling as so many looked on.
Hour by hour, day by day, Abbott worked with a team of therapists at Spaulding Rehabilitation Hospital to learn to balance herself, to stand, to walk. When she considered using a wheelchair to get to the mound, they coaxed her — goaded her even — to show the people of Boston just how far she had come.
Far from the limelight, these therapists carved new paths for those most grievously injured by the April 15 attacks, showing those with use of only one arm how to open a water bottle with the use of a vegetable drawer, and those with one leg how to navigate a shower, how to live a life that is suddenly filled with countless obstacles.
Through April, May, and into June, the path for those most seriously injured in the bombings wound from acute care hospitals across Boston to Spaulding in Charlestown. Here, therapists devoted three hours a day to each patient, many with severed limbs and torn psyches, painstakingly teaching them how to begin stitching their lives back together.
They were their coaches, often urging survivors through one more round of exercises as fatigue hovered. And they became their confidants, witnessing, along with nurses, an abyss of emotions.
In the weeks following the April 15 bombings, 32 Marathon attack survivors arrived at Spaulding with a stunning array of injuries, from amputated legs and fingers to shattered bones, scorched limbs and severed nerves.
Just 12 days after the blasts, Spaulding, a worn, 42-year-old facility on Boston's Charles River, relocated to a state-of-the-art building on the tip of the old Charlestown Navy Yard. The move, planned long before the blasts, meant staffers were still learning their way around the sprawling 132-bed facility, deciphering the alarm system, figuring out where supplies were stored, and mastering phone connections, even as survivors were wheeled in.
With media from around the world clamoring to get inside for interviews — and some wandering in unannounced looking for the survivors — hospital administrators locked down the fifth floor where most of the patients were staying, and listed them in their admission papers under aliases, starting with famous presidents and ending up with the names of popular cars.
Spaulding's team of therapists, used to working in obscurity, grew accustomed to omnipresent camera crews in the lobby. Monitored by hospital administrators, media angled for interviews in the hospital's airy third-floor gym as they documented Marathon blast patients' first tentative steps toward recovery.
Among those to take their first steps at Spaulding was Martha Galvis, a petite 60-year-old who had been advised that such a milestone would not come easily in the tense hours after shrapnel severed the nerves in her left leg, seared the skin on her left hand, shattered three fingers and forced the amputation of her ring finger.
But the elation from that first journey across her room gave way to tears a day later with news about her husband, also injured in the blasts. An imaging test had revealed a cruel new twist — a brain tumor.
"Our faith will get us through," Martha Galvis said, as she broke the news of her husband's tumor to Laura Driscoll, a 28-year-old evening-shift nurse at Spaulding who often lingered to chat with the gentle couple from Nashua.
Tears started to slide down the nurse's face as she listened silently, she and her patient sharing a box of tissues.
A day earlier, hours before she learned of her husband's tumor, Galvis joined therapist Samantha Geary in Spaulding's therapy kitchen, just off the gym. How will you grab water from the fridge, Geary asked Galvis, testing her patient's abilities. With her left hand heavily bandaged and her right hand clutching her cane for support, Galvis's ethereal smile emerged and she said softly, "I will call my husband."
Geary, 28, about the age of the Galvis's three children, giggled. Growing up in Norwood, she played many sports. As an occupational therapist, she channels her passion for physical challenges into teaching patients with severely injured or missing limbs how to master daily activities, such as cooking, cleaning, bathing, and dressing.
She coaxed a hesitant Galvis through a foreign routine, teaching her how to lean on the fridge for balance, while hanging her cane on the counter. That allowed Galvis to grab the bottle with her good right hand. Then Geary demonstrated how to open the bottle one-handed, by wedging it into the fridge's vegetable drawer, which can double as a vise, as she turned the cap with one hand.
The lesson was more successful than one a few days earlier, when Galvis struggled to stir thick brownie mix one-handed. "I never bake at home," said Galvis, a Columbian native who was more anxious about how she would open a can of beans to cook her favorite vegetable dishes.
Their final stop was the gym, where several Marathon attack survivors, with their tell-tale scorched skin often worked side-by-side, yet were so focused on their intensive sessions they often didn't seem to notice each other.
On this day, 31-year-old Paul Norden, one of two Stoneham brothers to lose a right leg in the bombings, concentrated on balancing on his left leg on a spongy block while lifting a yellow ball. He barely needed to grab his walker for support.
"The Nordens love a challenge," Marissa Osborne, an occupational therapist who worked with Norden's brother, J.P., confided later. "If you say, 'You can't do that,' they want to prove you wrong."
Across the room, Geary coaxed a weary Galvis through a series of arm lifts to build strength in her "good" arm.
"It's a cool thing in this setting because we get to see their progress from the beginning," Geary would say later. "Some may need therapy for years, but we get to see the immediate effect."
Like when Abbott, the survivor from Rhode Island, threw the first pitch at a Red Sox game at the end of her 12-day Spaulding stay. One of 16 survivors who lost limbs in the blast, Abbott had her left leg amputated below the knee.
Petrified at the thought of getting distracted and losing her balance in front of the Fenway crowd, Abbott contemplated throwing the pitch from her wheelchair, instead. "I said to her 'Don't you dare,' " Geary recalled, tearing up at the memory of the emotional exchange.
"You take your crutches and you hop out there," Geary told Abbott. "Everybody needs to know you're OK."
Despite a rain delay and soggy grass, Abbott hopped out to the mound with her crutches and a wide smile to throw that pitch just after leaving Spaulding. "I was so proud of her," Geary said.
Dara Casparian, a 25-year-old physical therapist who partnered with Geary to work with Abbott and Galvis — and who walked with Abbott out to the mound — said she felt honored, but also nervous to be a part of the survivors' recovery.
"These people have jobs to get back to and the world to get back to," Casparian said. "It's like the whole world is watching."
Physical, emotional trauma
At the height of the influx, 23 of the 30 beds on Spaulding's fifth floor were occupied by Marathon bombing survivors. Their stay ranged anywhere from 10 to 30 days, with some — like Martha Galvis — likely to stay far longer.
Caring for patients horribly injured in house fires and car crashes is nothing new to staffers, but the sheer number of survivors, their level of trauma, and their youth — many in their 20s and 30s — touched even veteran staffers. Especially late at night, when it was quiet and anxieties would rear up, sometimes in unexpected ways.
One patient cried out during thunder storms, the loud crack conjuring up memories of the explosions. Another cringed in fear when nurses silently peeked in her door to check on her, unnerved by sudden movements in the darkness.
"But during the day, she was full of life, busy with the media," said Suzzette Chiong-Oglesby, the fifth floor's nursing manager. The floor is typically reserved for patients who have lost limbs or been seriously burned.
Oglesby advised her staff to not worry about waking the woman, whom she did not identify, and instead instructed them to call out to her during late-night room checks to reassure her.
Another woman, independent and active before the blasts, initially balked at Spaulding's protocol for new amputees. On admission, they are taught to call nurses for help any time they need to get in or out of their wheelchair, until a therapist certifies they are strong enough to do it on their own — rules that were repeated often as Spaulding nursed 15 of the 16 attack survivors who lost limbs.
Waking up in the middle of the night, new amputees can forget that they are missing a leg, and easily fall when they try to get out of bed. On her first night at Spaulding, the woman adamantly insisted that she didn't need help. By the next day, however, she had calmed down, Oglesby said.
Nurses on the fifth floor who cared for them said these patients were fortunate in one way that many of their other patients are not: They were bathed in much more attention from family, friends and strangers, with so many cards and flowers spilling out of their rooms that they lined the floor's reception desk for weeks.
At night when other patients' family members would head home, many of the survivors' supporters would linger — especially a clan from Stoneham, that would gather in the floor's lounge for a game of poker. Paul and J.P. Norden, two brothers who each lost a right leg in the bombings, were among five friends from Stoneham badly injured.
On the night after Paul Norden was released from Spaulding, the poker game abruptly paused when a TV news segment featured another of the Stoneham injured, Marc Fucarile.
J.P. Norden rolled his chair away from the table, turning his back to his friends. He silently watched images of his childhood friend, who also lost a leg and fractured the other, interviewed from his bed at Massachusetts General Hospital, still too weak to enter Spaulding.
As the news anchor spoke of the shrapnel lodged in Fucarile's heart, J.P. exhaled and bowed his head.
An ‘angel’ in purple scrubs
Laura Driscoll wore purple scrubs, Martha Galvis's favorite color, and jumped into the back of the ambulance to greet her patient when she returned in late May from Brigham and Women's Hospital after a sixth hand surgery.
Galvis traveled between Spaulding and Brigham for more than a month — hospitalized longer than most of the amputees — as doctors readied her severely damaged hand for skin graft surgery.
"I was selfishly happy when she came back," said Driscoll. Earlier, she had erased another nurse's name on the assignment board and wrote hers in to ensure she would still be caring for Galvis. "My angel," Galvis calls Driscoll, who cradled her patient's hand when medications weren't fast enough to dampen the pain.
Six weeks after the bombings, Galvis had mastered many of the requirements that signal enough independence to go home — deftly folding a basket of laundry, chopping vegetables and cooking a Spanish quiche for her therapists one-handed, in addition to walking without a cane.
Yet at May's end, as J.P. Norden greeted reporters in Spaulding's lobby for a news conference at his discharge, Galvis headed again to the third floor for therapy, one of a handful of survivors still at Spaulding.
If she heals well from her skin grafts and next hand surgery, doctors hope to send her home about two weeks after Father's Day, a day with resonance this year for the Galvis family and their caregivers. Further brain scans suggest Alvaro Galvis's tumor is likely benign, though doctors have ordered more tests.