Wednesday April 23rd 2014

Boston: Standing Strong and Proud

By Annie Lewis-O’Connor, PhD, NP-BC, MPH

Annie Lewis-O’Connor

I am a born and raised Bostonian and couldn’t be prouder of my beloved city. Yes—we Bostonians are known for saying “watah” (water) and “pahk” (park) and “cah” (car). We have lots of iconic events—among them the Boston Marathon, which began in 1897! For us, April 15, 2013, the 116th Boston Marathon, will forever be a day of permanent memories—mostly shock and disbelief, but also full of pride. I have probably attended 20 Boston Marathons in my life, loving each and every one. This year I planned to go into work and then meet some of my nurse practitioner friends who were volunteering in the medical tent at 4pm near the finish line.

I was particularly excited this year. I sit on the board of Casa Myrna Vasquez—our local domestic violence shelter and state hotline—and we had five people running to raise money for our organization. Many marathoners dedicate their run to various charities. I plugged their bib numbers into my computer and watched all five on their journey to the finish line. Around 2:40 pm, all five were approaching and I was getting ready to send out a congratulatory email, when I heard “Code Amber Alert- External.” This signifies an event outside the hospital that might result in the influx of patients. My immediate reaction was fear. I work at Brigham and Women’s Hospital, less than one mile from the finish line. My cell phone signified “an explosion.” I thought “a gas line—not at the marathon—so many people—how bad?” The next message on my cell phone was “2 bombs, many hurt…”

While I don’t currently work in the emergency department, I have 20 years of experience in ED and thought I might be able to help. I immediately went to our ED, and as I arrived I heard, “Three traumas-1 minute out.” Everyone was gowned, gloved and had eye protectors on. Within seconds the victims started to arrive. They were critical: bloodied, burnt, open wounds, severed limbs, faces with pellet wounds, and wounds with shrapnel. This was a true disaster and felt like a war zone. When I went to Haiti following the earthquake—that was bad. Yet that was a natural disaster. This was intentional. This was personal. This was my city!

In the ED, I was looking for runners—I never saw one. I felt relief and panic. Maybe they were spared. My heart was pounding–I know so many people who go to the marathon—I have friends all over the city—friends in the medical tent, friends who are Boston police officers and firefighters. Were my neighbors there? More stable patients arrived. I went to one who was quiet—he looked at me dazed and said, “What just happened?” I responded, “I don’t know, but we will take really good care of you.” He asked me to repeat myself—I think his ear drum was ruptured. Many were in shock—some speechless, others sobbing.

Some 30 patients were seen and treated. Nurses and physicians gathered around the most critical in teams, stabilizing them so they could be moved to the operating room. I was amazed at how fast the first person was moved to the OR. Many patients lost a limb that day—some lost more than one. And, as we know, that day three people lost their lives. Some are still in critical and serious condition. Every person I encountered that day in the hospital was focused on helping and working together. As I reflect on that, it simply warms my heart.

We paid close attention to making sure everyone was identified, knowing their loved ones would be looking for them. Our unit coordinators worked diligently on this task. Social workers, patient and family relations, and our interfaith clergy were in a huddle. I knew they would care for the emotional and spiritual needs of our families and loved ones.

The ED was full before the trauma patients arrived. As I rounded in the ED to see how our other patients and their families were doing, the patients were amazing: “Don’t worry about me—please take care of them.” Out of the corner of my eye, I saw the janitor mopping up the streams of blood. I asked, “Are you okay?” He responded, “What else can I do?” It was chaotic—but organized. Everyone was arriving to help. Security was asked to control the crowds.

As I went to the first hospital briefing, news on the TV and on our cell phones was beginning to reveal the evil acts—there were two bombings and one was at the finish line. Then we heard a rumor that the JFK Library had a bomb. Panic was starting to set in, but very soon we were embraced by the state and local police, FBI and ATF. While it seemed unnatural, it gave us a sense of protection. My children were calling and were worried because they were seeing things on TV that I had not seen. I told them I was safe and secure, and somewhat believed that. I asked them to pray.

The hospital leadership team began to plan. Very quickly the decision was made to lock down the hospital. In 30 years of working in Boston hospitals, this was a first for me. We were decisive, strategic and forward thinking. We knew we had to work together and that communication was key. Our priorities were quite simple—care for the patients and their families and ensure our staff had the resources to do so. While we worried about the unknown, we stayed focused.

The pride I feel for Boston is helping to mitigate the sadness I feel over the senseless evil acts that occurred that day. In my previous positions in Boston, I had participated in city-wide disaster drills, so I knew the City of Boston could handle this. In total, six hospitals cared for some 180 people. And if I calculated correctly, some 20 operating rooms were in use in the first hours of the bombings. This no doubt saved many lives.

The actions of the many first responders fill me with great pride— police, firefighters, EMS, NPs in the medical tent, nurses and physicians who were at the marathon as spectators and the people of the City of Boston who helped one another that day. Instead of running away from the bombs that were exploding, they stayed and helped those injured.

I never did meet my nurse practitioner friends at the finish line that day—they are all physically safe, and we are all emotionally healing. We know we will be forever changed. When the sadness begins to take hold of me, I think of all those who made a difference that day and that week, and being a Bostonian and being a nurse has never felt better.

— Annie Lewis-O’Connor is a member of the Massachusetts Association of Registered Nurses. She is an instructor at Harvard Medical School and founder and director of the Women’s CARE Clinic at Brigham and Women’s Hospital in Boston. She is also chair of the National Collaborative on Violence and Abuse.

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