The doctors at the Boston Marathon bombing were woefully unprepared for the carnage

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.”


Follow me on Twitter: @aravosis | @americablog | @americabloggay | Facebook | Google+. John Aravosis is the editor of AMERICAblog, which he founded in 2004. He has a joint law degree (JD) and masters in Foreign Service from Georgetown (1989); and worked in the US Senate, World Bank, Children's Defense Fund, and as a stringer for the Economist. Frequent TV pundit: O'Reilly Factor, Hardball, World News Tonight, Nightline & Reliable Sources. Bio, .

Share This Post

  • http://www.rebeccamorn.com/mind BeccaM

    I know what you mean. They bitch about things that aren’t in the bill at all, but are completely silent about the things that are — and which deserve complaint, such as the uncontrolled premium insurance purchase mandate.

  • d3clark

    Highly doubtful. Trauma specialists, without their trauma team (nurses, tech, anesthesiologists, equipment, ORs, critical care units, etc. are virtually useless. A trauma specialist at the marathon medical tent wouldn’t have been able to do much more than the EMTs, RNs, MDs- compress bleeders, get IVs going while loading them into ambulances to get to ERs for definitive treatment: surgery, blood, etc.

  • emjayay

    You oughta read all the ignorant uninformed comments on any ACA related news item on Yahoo! News. Almost all are totally outraged by things that have no basis in reality. There’s a health insurance article or two there right now, with all the usual reactionary hysteria from commenters.

  • James McConnell

    I use something called Soluto. RIght now it is blocking 3 social networks, 3 ad network trackers and 12 company trackers. It’s freeware. Side question: Why are there so many fucking trackers at Ablog? THey ain’t on Craig’s.

  • James McConnell

    THe lasting effects. From now on there will be trauma specialists and many, many ambulances at every public event, to the detriment of the economics of the event and the patients at hospitals needing thier trauma skills for other reasons.

  • nicho

    There are other world-class hospitals close by — the Brigham and Boston Medical Center (which sees more than its fair share of trauma on a regular basis). The real advantage was that they were able to spread patients out to lessen the load or to leave some hospitals free to handle routine cases that would come in independent of the bombing victims.

  • hauksdottir

    Like Swami below, I use Firefox with NoScript. What I see is MY CHOICE.

    It prevents redirects, obnoxious tracking markers, pop-ups and pop-unders, and material from other sites. Sometimes there will be a white space in lieu of a video… right click, scroll to NoScript, temporarily allow the script. MY CHOICE. If I choose to support a site by allowing their ads to be visible? Again, my choice to make page permissions permanent.

    Given the hazards that piggyback via scripts, I’d rather take the extra moment to decide if I want the script (especially java) to run. Not being annoyed by pop-ups is a plus.

  • Swami_Binkinanda

    Firefox with NoScript lets you pick which javascript goes through so you can whitelist ads that aren’t invasive and pay the piper, or allow all temporarily, etc. Also the no tracking, httpseverywhere from eff, and antivirus toolbar from AVG or your choice of provider.

  • http://www.rebeccamorn.com/mind BeccaM

    Yep. It keeps the Proles desperate and willing to scapegoat each other rather than the plutocratic bastard class.

  • http://www.facebook.com/profile.php?id=1526664170 Sara Orel

    I changed over to Firefox to see if it made a difference, and the ads are not blocking the text. But most of my stuff is in Explorer and I prefer that program (don’t scold me). This is frustrating, but I think I will check americablog with firefox for a few days and hope it gets straightened out.

  • ComradeRutherford

    “Why should the victims have to depend on charity and bake sales for prostheses and rehab?”

    Because that’s the way the Conservatives want it.

  • http://www.rebeccamorn.com/mind BeccaM

    The amazing thing is with all the carnage, only (!) three people died. The presence of those medical tents and the fact there were two hospitals close by undoubtedly prevented an even greater tragedy from happening. Without immediate treatment, the number of dead could easily have gone into the dozens.

    In truth though, I would rather not have us be treating every significant sporting or social event like it’s a potential terrorist attack waiting to happen. Us being afraid is how the terrorists win, and we’ve already seen how authoritarians will gladly take advantage of that fear to abridge fundamental liberties we were all once taught were inalienable.

  • Alison

    The carnage was within a couple of miles of two of the best hospitals in the world: Beth Israel Deaconess and Mass General. The grievously injured could not have asked for better care.

    Now all they have to do is figure out how to pay for it. This is a great argument for free health care in the USA. Why should the victims have to depend on charity and bake sales for prostheses and rehab?

  • pappyvet

    Woefully….full of woe. We are all Wednesday’s child

  • emjayay

    Even with a pop-up blocker I’m getting pop-ups on this site that have no way to cancel them and cover parts of the text.

  • Hue-Man

    “But across the country, more and more trauma centers and emergency departments are closing. And they’re closing in communities that need them the most.” http://www.theatlantic.com/health/archive/2013/04/the-decline-of-emergency-care/275306/

    Spoiler alert: “First, they have tried to figure out what makes a trauma center more likely to close. It turns out a major reason isn’t poor performance. It’s cost. Trauma centers are expensive to run; they depend on public funding (such as Medicare reimbursements) and face financial pressures from HMOs to specialize in more profitable services.”

  • nicho

    Most doctors are “woefully unprepared” for dealing with major trauma in the field, especially multiple-casualty trauma. It’s just not part of their training or experience. The doctors at the finish line in Boston were fortunate in that they had plenty of help available. They had a medical facility set up with cots, supplies, IVs, good light, ambulances standing by, etc. Had this bombing occurred anywhere else along the parade route, it would have been 10 times worse — if not greater.

  • Drew2u

    conversely, as soon as victims got to hospitals, there were no more fatalities. That says more about preparedness and activeness than it does any unpreparedness.

  • avahome

    Please keep writing articles and giving us the bare facts. I haven’t really read much to date that is this descriptive…….we need it. We need to know we are not immune from horror on our soil.

© 2014 AMERICAblog News. All rights reserved. · Entries RSS