BETHESDA, Md. — He had the hip strength, the bone density, and the comfort with his prosthetic. He could balance on one leg, hop up and down, and tackle some of the hardest workouts in the gym. So everyone at Walter Reed wanted to know: When would Patrick Downes start running again?
He wasn’t ready to consider the question, not with his wife, Jessica Kensky, back in a wheelchair nearly two years after the Boston Marathon bombings, unable to limp two blocks without stopping from the pain.
Their injuries at first had seemed so similar, capturing the region’s attention, the newlyweds who loved to run together and who lost their left legs below the knee. But as more time passed, their recoveries diverged. Patrick was thriving, and Jess was not, with a damaged right leg that refused to heal. He didn’t want to run again without her. She couldn’t bear to hold him back.
And so, with her encouragement, barely two weeks after Jess underwent surgery to remove her lower right leg as well, Patrick pulled on a running blade and took his first strides down the corridor between the prosthetics lab and the rehab gym at Walter Reed National Military Medical Center.
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Some activities in a prosthetic felt like a clunky approximation of what he had done before, but this was different. By the time Patrick made his first cut at the end of the hall, he felt a surge of adrenaline. He felt athletic. He felt fast. He felt like himself again.
That was February 2015, and within a few weeks, he was up to a mile. Last June, he completed a five-mile road race; this past January, he finished a half-marathon. On Monday, three years after the attack, Patrick Downes will set out from Hopkinton to run the Boston Marathon.
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‘It feels spiritual’
Physically, he feels better than at any time since the bombing — alive with the rush of air that swells his lungs on training runs, with the way his natural right leg and his carbon-fiber running blade pump like alternating pistons.
“I feel like I’m celebrating the body that I have left, and it feels spiritual,” said Patrick, who with Adrianne Haslet-Davis will become the first people who lost limbs in the 2013 bombing to attempt to run the full race. “It feels triumphant.”
Circling the track at Walter Reed or following wooded trails nearby, he pictures himself bobbing along the Boston Marathon course, a rebuke in running togs to the terror attack that nearly killed him.
Sometimes imagining it gives him chills. Sometimes it makes him surge so fast he has to check himself and concentrate on the short, quick steps he has practiced with his physical therapist, trying to strike each time on the sweet spot of the running blade.
He is running for several causes, but especially to raise money for a BC Strong scholarship friends have launched in honor of Patrick and Jess, for students with disabilities and financial need. As the miles pass, he thinks of everything he loved about the sense of community and the spirit of service at Boston College, and imagines the first scholarship recipient arriving at The Heights to a warm welcome.
Still, as he prepares for the race, he cannot shake feelings of self-indulgence, of guilt over running when his wife still can’t walk.
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Just last summer, Jess seemed to be making cautious progress after her second amputation, walking the 5-mile course during Patrick’s first road race and gingerly trying on running blades of her own in late August.
Last September and October, they made their first long visit home after more than a year at Walter Reed in Bethesda, where they have received special Defense Department permission for care from the military’s top specialists. Back in Cambridge, they savored long walks around Fresh Pond, where they had so often run together before the bombing.
“Every day is not a good day,” Jess said then. “But they’re all better than I was doing on that busted leg.”
But just as she was starting to envision hosting holidays and resuming something like a regular life, one setback sprang up after another. Inflamed pockets of fluid known as bursae have plagued the ends of both amputated legs. The nubs of her shin bones have changed shape through a process known as resorption, one contorted into a sharp hook. And a staph infection in her left leg wiped her out and left her weaker than she had been since the first days after the bombings.
So she has returned to the operating room for four surgeries since the end of October, each one requiring its own long recovery, and each one meant to be the last. Then the cycle repeats, leaving her less optimistic that this is merely a phase, more resigned to the possibility that this is her life.
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“I felt like I was putting pieces back together, and it just feels like it all really fell apart,” she said.
In 2005, when they both ran Boston — Patrick as a BC senior with an official bib, Jess as a “bandit” accompanying a friend — she hammered out a nine-minute-mile pace, while he trudged across the finish line in 5 hours and 14 minutes.
Today, she lags behind him in physical capacity in a way she never did before.
“The gap just feels enormous,” Jess said. “I told Patrick, I just think everything he is right now and feels, as he deserves to feel, I just feel the opposite.”
That gap is something they discuss often in counseling, inescapable as Patrick wheels her to and from the operating room, handles the driving, runs the errands, and takes care of so much in their temporary apartment at Walter Reed.
She recently turned 35, he is almost 33, and for most of their marriage they have been amputees and full-time patients.
“As the years go by, sometimes we’ll say out loud to each other, ‘We were blown up by a bomb. Two people intentionally did this, and we can’t help where we were standing or what we were doing or how we were hurt,’ ” said Jess, who suffered even more grievously than Patrick because she was hugging him as they cheered runners at the finish line, her body sheltering him from some of the blast. “Neither of us had any fault in that. These are the cards we were dealt.”
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So when she realized he was avoiding running for her sake, she insisted he try to run, and then run farther, as lonely as it felt to be unable to join him. Have faith in me, she urged him, have faith in us.
Five miles in flip-flops
After Patrick ran that 5-miler last June in less than an hour, he began floating the far-off possibility of the Boston Marathon to Jess and their physical therapist, Kelly McGaughey. By the end of the summer, he had enlisted his brother as a training partner.
Eleven years ago, Brendan Downes was a BC sophomore when Patrick — the older brother he had admired since “I was old enough to admire somebody” — came staggering over Heartbreak Hill and into view on campus, near the Marathon’s 21-mile mark. Sensing that Patrick could use a boost, Brendan jumped in alongside him, planning to run a few blocks in flip-flops. Fueled by adrenaline and “liquid courage,” he somehow shadowed his brother all the way to the finish.
He didn’t run again for nearly a decade, until he bought some running shoes and completed the 2014 Marathon in tribute to Patrick and Jess, finishing in an emotionally draining 5:10. One and done, he thought — until Patrick approached him about 2016. Yes, Brendan, a 30-year-old Washington civil rights lawyer, told his brother. Yes, of course.
After the holidays, Jess’s sister, Sarah, joined them, the only member of the Kensky family yet to run a marathon. Back in 2013, she had just signed the paperwork to start public health graduate school in Colorado when the bombings occurred. Sarah flew to Boston that night — and returned home just once over the following summer to gather clothing, moving in with Jess and Patrick as their caretaker at age 25.
Motivated by the experience, Sarah shifted focus to trauma survivors, finishing her master’s last year. Today she works at Walter Reed’s Brain Fitness Center, helping soldiers with brain injuries and collecting research data.
With Brendan and Sarah in the same city, they have met Patrick for weekend training runs. At first, they kept close watch. “I felt like I could hear my sister in my head: Don’t let Patrick overdo it. Make sure he takes care of himself,” Sarah said.
Before they peaked at 20 miles, though, they shifted from caretakers to teammates. “He has incredible grit. You go on these long runs, and you almost forget to check on him,” Brendan said. “I’m just thinking to myself, ‘Man, this is hard,’ and then you realize the guy next to you has one leg.”
They have all savored the way the runs make them feel like peers again, Brendan entertaining the group with steady commentary, Sarah cheerfully pacing them up hills. As the oldest, Patrick has become a kind of captain, codifying in group e-mails a set of commandments hashed out in the field: “No. 2, You do not have to be missing a limb to request a break.” “No. 3, fist bumps/high fives are required with each team member after each mile.” “No. 7, motivational swearing is a must.”
Short strides now second nature
On a recent morning, Patrick kissed Jess goodbye and drove off the base for one of the nearby trails he favors for shorter weekday runs.
He parked near a Chevy Chase ball field and got out wearing neon-green running shoes. Then he sat down and removed his prosthetic, running shoe and all, and stashed it in the trunk. In its place, he donned the running blade.
Leaning against a fence for balance, he stretched for a full five minutes, more than in his college days, before setting out down a paved trail with the short strides that have become second nature this year.
He passed a riding stable, the chestnut horses nosing the dirt, and bursts of spring color — golden forsythia, lavender redbud — before following the trail through a field and into the woods. Coming the other way, a jogger in an orange cap took note of Patrick’s prosthetic and gave him a thumbs up.
At a bend, Patrick pointed out the remains of a fallen tree that had blocked the path the previous weekend. That day, Brendan cleared it in a flying leap. The old Patrick would have done the same, but he gently stepped over it. “If this thing caught,” he said, gesturing to his blade, “I’d be in real trouble.”
Soon, a voice on the iPhone strapped to his arm chirped up: One mile down, 10 minutes and 16 seconds elapsed. He offered a fist bump and slowed to a walk — a lesson from McGaughey, his physical therapist, who encourages all amputee runners, and new marathoners, to walk a minute at each mile marker, so they can hydrate and make sure everything feels right. In addition to special socket moisturizer, McGaughey also reminds amputee runners to bring along an Allen wrench.
Patrick followed the trail to the end and back, 3½ miles. He said he was looking forward to Boston, where his running trio will expand to include Tom Treacy, the college buddy who introduced him to Jess a decade ago, and B.J. Ganem, a Marine and below-knee amputee who first visited Patrick and other survivors in April 2013 through the Semper Fi Fund, a support network for wounded veterans, and has become a good friend.
Patrick said he was thinking about names to write upside down inside his shirt, to flip up for inspiration, one per mile: Martin Richard, Krystle Campbell, Lingzi Lu, Sean Collier. Friends from Walter Reed. Family. And Jess, who is always on his mind, whose picture in a tiny medallion adorns the laces of his running shoe.
On Monday, Patrick will imagine her right alongside him, hoping for the day when the two of them can run together again. It need not be the Boston Marathon, he said, or laps around Fresh Pond. Any stretch of pavement will do.
Eric Moskowitz can be reached at eric.moskowitz@globe.com. Follow him on Twitter @GlobeMoskowitz.