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The Podium

Medical response to Marathon bombings was a community-wide effort

Medical workers aid an injured man at the Marathon after two bombs exploded near the finish line. David L. Ryan Photo/Boston Globe.David L. Ryan

Growing up in Boston, you know that Patriot’s Day and the Boston Marathon come together to create a day like no other. We pause to celebrate our heritage, the city shines and our streets fill with millions of residents and visitors from around the block and around the world. For most of my life, I worked those same streets for Boston EMS, ending a 36-year career as chief of the department in 2009.

There were many nights I went home proud of the men and women of Boston EMS, but I was never more proud of them and the residents of my town, than I was last week.


While in one moment we saw terror and brutality, in the next we saw our community’s love and compassion. We saw our EMTs, paramedics, police officers, and firefighters spring into action and perform their jobs heroically.

They weren’t the only first responders, though. Bystanders and marathon volunteers, regular people given the chance to run, decided instead to stay and help the professional responders do their jobs. Some comforted victims, urging them to hold on and that help was on the way. Some helped carry victims to the medical tent for triage. Some did more by helping to control bleeding, in some cases using their own clothes as tourniquets to stop life-threatening blood loss.

It was an amazing example of humanity, service and teamwork.

For years, responders in Boston, as in other cities, have utilized large public events as “planned disasters,” anticipating and preparing for mass casualties if something goes wrong. In Boston, First Night, Fourth of July on the Esplanade, and the 2004 Democratic National Convention, all offered the city’s medical community a chance to hone their plans and skills in managing high-profile, public events. In my current role at the Federal Emergency Management Agency, we work with communities big and small across the country to prepare for these worst-case scenarios.


On Marathon Day, those response preparations were clear. It was no accident that not a single hospital in the city was overwhelmed with patients in the aftermath of the bombings. It was no accident that patients were appropriately triaged and transported in an orderly manner to the appropriate hospital based on their needs. And it was no accident that a Medical Intelligence Center was fully staffed and operating on race day to keep track of patients, coordinate resources and share information with the medical community throughout the region. All of these are tangible results of disaster planning that has gone on in Boston for more than 20 years.

What was not planned for was the kindness of strangers. It almost never is.

In fact, what usually happens in the wake of a criminal act is that the public is pushed back. That’s often necessary to protect people. In the immediate aftermath, the Boston Police worked quickly to secure the scenes and restore order, but the priority for everyone in the first moments centered on helping the survivors. They had crucial support in those moments from ordinary people — ordinary people who decided to do extraordinary things.

We’ve seen this type of selfless service before following disasters, and in emergency management, we often remind people to prepare to be self-sufficient for several days in the aftermath of a disaster. The response in Boston shows that many are willing to help and their actions can save lives, and this is a resource we should continue to harness.


Such training can occur through existing programs, such as the Medical Reserve Corps, which Boston has had in place for several years. Using existing structures to recruit, train and include willing bystanders in response planning will help future efforts. It also offers a way for people to contribute and to be identified in the crowd as someone willing to help.

While nothing can replace those we lost, as a community we can take some solace that our long marathon of preparedness saved lives on that terrible day. At FEMA we often stress that there is no one agency or entity responsible for emergency response. It takes a “whole community” of emergency responders to prepare for disasters and save lives. We owe it to those who were lost and those who were injured to keep improving.

In a disaster, everyone has something to give and never was that more evident than on Marathon Monday. For the EMTs and paramedics of Boston EMS, a special “Thank you for a job well done!” To the citizens of our town, I’ve never been more proud.

Rich Serino is deputy administrator of the Federal Emergency Management Agency.