Boston Strong, BIDMC Strong
The first bomb on Boylston Street went off at 2:49 p.m. It was change of shift at Beth Israel Deaconess Medical Center, which, despite the Patriot’s Day holiday, was well staffed to manage a surge of patients from the Boston Marathon. However, the patients who came through the door of the Berenson Emergency Department (ED) on that Monday afternoon were not the dehydrated runners they expected. Instead, it was one of the worst mass casualty events BIDMC has ever seen. In large part due to rigorous disaster training, when the first victims of the Boston Marathon bombing came through the doors only 11 minutes later, the staff at BIDMC was poised and ready. “Patients were coming in two and three at a time,” recalls Alok Gupta, M.D., acute care surgeon and surgical incident commander. “We got seven patients over the course of four minutes.”
Twenty-four victims were admitted to BIDMC, 14 of whom were critically injured, including six who were sent within the first hour to the operating room (OR) as a result of their injuries. In the ED, emergency physicians and nurses immediately assessed and coordinated the incoming patients at the door and systematically distributed them to the available resources based on individual needs. “We train a lot,” says Meg Femino, director of emergency management. “I think Beth Israel Deaconess probably drills more than any other hospital in the state to improve our disaster operation plans and also to build up pattern recognition in staff. What made it go so smoothly was that we had practiced this before. They knew what they were supposed to do, and they fell into their roles.” Despite the severities of the injuries, every single victim who was treated at a hospital survived.
Within three hours of the bombings, the 24 patients were organized into a Mass Casualty Service. The unique decision not to incorporate the victims into the regular trauma service helped caregivers recognize that patients had similar needs for physical therapists, psychologists, social workers, and chaplain services. A team of 40 clinician and non-clinician staff volunteered to form the multidisciplinary team which streamlined the patients’ care and evolved with their needs, focusing not only on their physical ailments but also on their mental well-being. “It is a very delicate balance with any patient, but with families that are dealing with that kind of crisis, you need to be very gentle with the way you are helping them to contain and express what they need,” says Julia Dunbar, former director of the Department of Pastoral Care and Education.
While caregivers were concentrated on their patients, the world turned its eyes to Boston. “It was unusual compared to any other incident or disaster I have had to manage,” says Marsha Maurer, R.N., chief nursing officer and event incident commander. “The emergency aspect, which was so intense, was over within three hours. But there was a series of unfolding events over the next week that added a whole other layer of complexity.” As the city came to grips with the tragedy, the medical center managed overwhelming media requests, dignitary visits, and law enforcement presence. The spotlight intensified later in the week as both suspects were treated at BIDMC. “Whether someone is a victim or a suspect, everyone gets the same standard of care, and I think we carried that out,” Gupta says.
As the healing process continues, the medical center remains committed to caring for the mental and physical well-being of these victims. The events of that day and the days that followed forever changed the lives of those involved—not only the victims, but also the caregivers and staff, many of whom had never been exposed to such disaster. “We were at our best,” Dunbar says. “Despite the chaos, despite everything, we were really all at our very best. And that says a lot about who we are as a hospital and as a community.”
Support both the immediate and longer-term needs of patients, families, and caretakers impacted by such devastating, life-altering events through the BIDMC Emergency Relief Fund.