The Podium

Lessons from the Marathon bombing

Items from the memorial in Copley Square in honor of the Marathon bombing victims are on display in an exhibit at Northeastern University.  (Essdras M Suarez/ Globe Staff)/

Working at Boston’s largest Level One Trauma Center, the staff at Boston Medical Center care for patients with complicated medical issues every day. But as we all have come to understand, April 15, 2013, was not like any other day, and the events that our nation observed have forever changed the way many of us approach medicine.

All of us at BMC who were involved with Marathon Monday and its aftermath think about that day while moving forward with our daily lives and work. We all had different reactions and adjustments to the violence that transpired six months ago. While many of us are still working through our personal challenges associated with the tragedy, many more have likely placed the incident in a mental storage compartment in order to facilitate forward progress. However, not a day goes by when we do not think about the Marathon and how we can take the lessons learned and apply them to our future trauma victims and patients.

Like most hospitals, BMC spends a significant amount of time preparing for large-scale disasters. Detailed plans are in place for every department, and staff are trained for a wide range of events in order to facilitate a sense of clarity during the most chaotic of circumstances. As expected, and to the credit of all involved, the staff at BMC executed the tactics of those plans brilliantly on Marathon Monday. Because of this level of preparation and collaboration, we were in the right position to work together to save lives. Multi-disciplinary teams were created to provide the ideal care to every patient, and input was valued from all members of the extended care team. The renewed sense of partnership among colleagues, and a deeper sense of appreciation for the contribution of all of those involved in the delivery system, allowed us to provide the optimal experience and outcomes for our Marathon patients.


On Marathon Monday and the weeks afterward, this collaboration extended across the entire hospital spectrum, with staff joining together to do anything and everything to care for those who came through our doors. The examples are far beyond the limited specifics that can be detailed here: neurosurgeons pushed gurneys, nurses painted patients’ fingernails, nurse practitioners and physician assistants facilitated visits outside of BMC when patients and loved ones were at different hospitals, surgical residents and medical students brought in treats patients wanted just to help them push through one more arduous day, and dietary staff baked birthday cakes so special days did not go unrecognized.

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The Marathon showed us what we do well, but also taught us things we can improve upon. In the Division of Vascular Surgery, where I work, one meaningful outcome was the creation of a multi-disciplinary collaborative team across various specialties and departments to coordinate the optimal care for future lower extremity amputation patients and their families. The team includes surgeons (Vascular, Plastic, and Orthopedic), nurses, physical therapists, rehabilitation specialists, pharmacists, psychiatrists and psychologists, social workers and patient advocates. Our goal is to enhance the outcomes and experiences for these patients as they make short- and long-term adjustments to their “new normal”.

On a personal level, the Marathon tragedy has linked patients and caregivers in a unique way because of the sheer magnitude of the event, the national attention, and the hopes and prayers from people all over the world asking us to help these patients heal and move on to what inevitably will be a very different way of living for them and their families. Without a doubt, the intensity of this experience created long-lasting relationships among the patients themselves, but unique bonds also formed between the caregivers and their patients.

All of us try extremely hard to provide exceptional care to our patients in a manner that we would expect for our loved ones, in an environment where patients feel supported both physically and emotionally, and where patients can be heard and become part of the care team. Unfortunately this model has not always been the norm as our health-care system has undergone dramatic change, and doctors and hospitals are under unprecedented economic pressures and time constraints. In an ideal world, it would not have taken something like this tragedy to wake us all up to our own collective shortcomings. But for many of us, Marathon Monday is now a powerful reminder of why we became doctors or caregivers in the first place, and has created a reinvigorated model of compassionate health care that will benefit all of our patients as we move forward into the future.

Dr. Jeffrey Kalish is director of endovascular surgery at Boston Medical Center and assistant professor of surgery and radiology at Boston University School of Medicine.