A fascinating article by Dr. Sushrut Jangi in the New England Journal of Medicine. He was working at the medical tent at the Boston Marathon when the bombs struck. His account is fascinating.
The doctors were woefully unprepared for the kind of carnage and human misery that was about to come their way. And it’s not their fault. Who thinks of preparing the medical tent for a terrorist attack? Maybe all that will change next year at far too many events in America.
Here’s a short snippet of Dr. Jangi’s article – go read the entire thing over at the NEJM:
At the tent, I stood in a crowd of doctors, awaiting victims, feeling choked by the smoke drifting along Boylston. Through the haze, the stretchers arrived; when I saw the first of the wounded, I was overwhelmed with nausea. An injured woman — I couldn’t tell whether she was conscious — lay on the stretcher, her legs entirely blown off. Blood poured out of the arteries of her torso; I saw shredded arteries, veins, ragged tissue and muscle. Nothing had prepared me for the raw physicality of such unnatural violence. During residency I had seen misery, but until that moment I hadn’t understood how deeply a human being could suffer; I’d always been shielded from the severe anguish that is all too common in many parts of the world.
“Clear the aisles!” Andersen called. More victims followed: someone whose legs had been charred black, another man with a foot full of metal shrapnel, a third with white bone shining through the thigh. I watched in shock as the victims were rushed down the center aisle to ambulances at the far end of the tent. Many of us barely laid our hands on anyone. We had no trauma surgeons or supplies of blood products; tourniquets had already been applied; CPR had already been performed. Though some patients required bandages, sutures, and dressings, many of us watched these passing victims in a kind of idle horror, with no idea how to help. When I asked Andersen what I could do, he glanced at me sadly, shook his head, and threw up his hands.
We returned to the cots and worked on patients with minor injuries from the blast, following instructions that came over the microphone. Hearing “Perform a secondary survey,” we examined chests and backs for superficial wounds. Beside me, James Broadhurst, a family physician, rebandaged a woman with a calf injury. One older woman screamed at me, “Please, find my daughter! Did she survive?” Two sisters sat on a cot in tears; when I asked if I could help, they shook their heads. I drifted among the beds, ashamed that there was no other skill I could contribute. Nearly every physician I saw looked back at me with the same numb, futile expression….
Broadhurst told me later, “I’m a family medicine doctor. I don’t know how to care for horrific trauma.”