Mayor Thomas M. Menino grimaced in pain. He bit his lower lip and pushed with both hands on the arms of his wheelchair Thursday, trying but failing to stand on a right leg confined in a cast.
Menino was undeterred. He tucked his elbows further under his arms and pushed harder, grabbing the lectern for balance and rising to his feet. In that moment, Menino seemed to embody the fortitude of his city, knocked down but fighting to stand.

“We are one Boston,” Menino said, his voice hoarse and cracking as he scanned the crowd of 2,000 at an interfaith prayer service commemorating those killed and wounded in the Boston Marathon bombings. “No adversity, no challenge, nothing can tear down the resilience in the heart of this city and its people.”
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Menino demonstrated that resilience this week as he repeatedly signed himself out of Brigham and Women’s Hospital to attend official briefings and press conferences. He had undergone surgery Saturday to repair a broken leg, but waved off painkillers this week to keep his head clear in the aftermath of the bombings, his staff said.
At press conferences, Menino has appeared in a wheelchair while other officials stood at a podium. A hospital admittance bracelet was wrapped around his wrist, and a white sheet sat folded in his lap to conceal medical equipment still attached to his body.
Menino announced last month that he would not seek a sixth term, a decision prompted by a bruising succession of health woes. The 70-year-old mayor recently spent five months in hospitals and in the Parkman House, a city-owned mansion with an elevator, where he convalesced after a serious illness. Menino had endured a respiratory illness, blood clots, and a broken vertebra, but seemed to be rebounding until Friday, when he twisted his ankle and broke a bone that needed to be set with a plate and screws.
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On Tuesday evening, he joked after a press briefing that the hospital had given him a two-hour furlough. In a private conference room in the Westin Copley Place, Menino winced in pain as he shifted his ankle.
“It’s not about me; it’s about the families, and it’s about the city,” Menino said. “I’m the mayor. Mayors work all the time. When people expect us to be there, I want to be there.”
Thursday, Menino was there, on the altar of the Cathedral of the Holy Cross when the prayer service began, sitting in a wheelchair and facing President Obama, Governor Deval Patrick, and a church packed from one end to the other. When it was the mayor’s time to speak, he was wheeled to the lectern by his son, Thomas M. Menino Jr., a Boston police detective who was working at the Marathon finish line when the bombs exploded.
“This is Boston,” Menino said as he concluded his remarks, “a city with the courage, compassion, and strength that knows no bounds.”
Menino, who was discharged from the Brigham right before the prayer service, gingerly lowered himself into his wheelchair and his son pushed him from the altar. The mayor took his place next to his wife, Angela. Menino took off his glasses, wiped his eyes, and bowed his head, pressing his lips to his folded hands as he prayed.
In his remarks, Patrick made a point of recognizing Menino. Those assembled in the cathedral responded with a roar.
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“I’m thankful for Mayor Menino,” Patrick said. “Mayor Menino started Monday morning frustrated he couldn’t be at the finish line this time, as he always is, and then late that afternoon checked himself out of the hospital to help this city, our city, face down this tragedy.”
Andrew Ryan can be reached at acryan@globe.com.