boston marathon

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Heat Takes Marathoners By Surprise

It was hotter than expected on Marathon Monday, and there may have been more charity or first-time runners than usual. Both these things could help explain why almost 4,000 runners and a few spectators walked or were wheeled into a medical tent along the course.

The Mecca Of Marathon Medicine

As temperatures rose above 70 degrees and the sun blazed, Clyde Dickey, from Rockwall, Texas, said he downed too much Gatorade.

“I just threw up a little bit, and I felt faint” as I crossed the finish line, Dickey said. “I thought I had heat exhaustion. I gave [the race] all I had, but the heat just got to me.”

Clyde Dickey from Texas tried for a personal record, pushed too hard and was treated for heat exhaustion. (Martha Bebinger/WBUR)

Clyde Dickey from Texas tried for a personal record, pushed too hard and was treated for heat exhaustion. (Martha Bebinger/WBUR)

Dickey was underground, waiting for the T when the bombs went off last year and regrets that he wasn’t able to help those wounded. He added Boston TV stations to his cable package so he could watch all the specials in the year since.

“I love coming here,” Dickey said. “This is the mecca of marathons.”

And perhaps the mecca of marathon medicine. So when a guy from Michigan, who trained all winter in 20-degree weather, collapsed at the finish line, a volunteer scooped him into a wheelchair and had him on a cot with an IV in his arms within minutes. Another volunteer caught a woman from Washington, D.C., who started spinning as she slowed down.

“I wasn’t quite expecting it but today we saw quite a bit of hyperthermia, people overheating,”
said Dr. Pierre d’Hemecourt, one of the marathon’s medical directors. He said the tents, which were larger with more staff and equipment than last year, were busy most of the day.

“Most of [the activity] being relatively minor, dehydration, things like musculoskeletal complaints,” d’Hemecourt said. “So overall it’s been a pretty good day.”

Which, in contrast to last year, was a relief for many of the doctors, nurses and other volunteers who staffed the medical tents. Continue reading

Can You Run Hard While Weeping? Some Boston Marathoners Will Find Out

On the eve of the Boston Marathon, some runners said this year’s race may be as taxing emotionally as it is physically.

Tom Pfleeger, of Gulfport, Miss., finished the marathon about 40 minutes before two bombs went off last year, having completed what he thought was a perfect race. Then, the euphoria was snatched away.

“You went from the top of the mountain to lowest, low,” Pfleeger said, to being “so sad for all the people who were killed and injured.”

Carrie Lundell (left) and her niece Becky Anderson have been crying a lot as today's race approaches, but hope to keep tears at bay while they run. (Courtesy Carrie Lundell)

Carrie Lundell (left) and her niece Becky Anderson have been crying a lot as Monday’s race approaches but hope to keep tears at bay while they run. (Courtesy Carrie Lundell)

Pfleeger is one of many runners who say they are back to take care of unfinished emotional business. Beverly Dwight, from Belchertown, Mass., is running her first Boston Marathon. Last year, she was a volunteer at the finish line.

“I was able to walk away from what happened,” Dwight said slowly. “Not a day goes by where I don’t think about those who are much less fortunate.”

Dwight is prepared to cry while she runs.

They “could be tears of joy,” Dwight said, “just joy to be part of it and a sense of kind of one with the city of Boston.”

Some runners worry about becoming overwhelmed.

“It’s going to be insane. I’m hoping it doesn’t tip me over to the emotional part because it’s super hard to run when you’re like feeling verklempt,” said Carrie Lundell, from Orange County, Calif. She clutched at her throat, using the Yiddish word that means “choked with emotion.”

“I just need to take it right up to that level, but not over until we cross the finish line, and then there’s going to be a lot of tears,” Lundell said.

Lundell will be running with her niece Becky Anderson from Eagle Mountain, Utah. Anderson ran the marathon last year, finishing 15 minutes before the first explosion. Continue reading

Marathon Reflection: How To Raise Secure Children In An Insecure World?

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help injured following the explosions. (Charles Krupa/AP)

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help the injured following the explosions. (Charles Krupa/AP)

One year ago, on the day of the Boston Marathon bombing, Dr. Gene Beresin shared advice on how to talk to children about the frightening event. Here, a year later, he and Dr. Paula Rauch, a fellow professor of psychiatry at Harvard Medical School, help parents draw broader lessons about how best to help children face such stresses and even grow through them.

By Drs. Paula K. Rauch and Gene Beresin
Guest contributors

For the most affected families, April 15th, 2013 was a life-changing event. For many in our community it produced a lesser, but still significant, set of challenges, and for some facing other family adversity or chronic stresses, it may have seemed like a minor event with little personal impact.

Regardless of how personal or significant the marathon bombing and its aftermath were for you, every one of us will face life challenges within our families and in the larger community. How can we face stressful experiences in ways that support our children’s resilience, and help them grow through those challenges? How do we raise secure, confident children in an uncertain world?

Start small

Children develop confidence and competence by facing new experiences, difficult transitions and unavoidable frustrations throughout childhood. Life continually presents a child with developmental challenges, such as falling asleep alone in a crib, saying goodbye at a new preschool, facing the first day of school with a sea of unfamiliar faces, dealing with a relentlessly annoying peer, being cut from the travel team, and, for some teens, making this month’s tough decisions about college.

It is often tempting as a parent to want to smooth over these challenges, alleviate uncertainty and facilitate a child’s comfort and success. But it is important to recognize that these age-appropriate frustrations and disappointments are essential for building lifelong coping skills. Children need to learn how to manage new and difficult situations, and while parents cannot solve the challenges for a child, they can provide appreciation and emotional support for that child’s efforts. Living through a multitude of such experiences makes the normal feelings of distress more familiar and less frightening.

Face serious challenges together Continue reading

Boston Marathon Medical Director: Getting Back To What The Race Is About

 

Medical personnel work outside the medical tent after the Boston Marathon bombing on April 15, 2013. (Elise Amendola/AP)

Medical personnel work outside the medical tent after the Boston Marathon bombing on April 15, 2013. (Elise Amendola/AP)

Last April 15 at about 2:45, Dr. Aaron Baggish was enjoying the sunny spring day and, in his role as medical director of the Boston Marathon, marveling at the low volume of runners who needed his care. Then the first bomb exploded, about 15 feet away from him. It blew out his right eardrum but the crowd blocked much of the force of the blast, and within seconds he was over the barrier and starting to work on the injured.

After the bombing, Dr. Baggish, who heads the Cardiovascular Performance Program at Massachusetts General Hospital, declined requests for interviews, feeling unable to speak publicly about what happened. But as Boston gears up for its next marathon on April 21 and he prepares to help oversee the race’s medical staff once again, he agreed to share some of his thoughts.

As you reflect back on what happened at last year’s marathon, what are you thinking, what lessons do you see?

Basically, I gave up very early on trying to make sense of any of this. There’s no way to make sense of a senseless, horrible act. We’ll never be able to put it into a neat compartment and say, ‘Oh, yes, that’s why this happened.’ No sense can be made of it. So the next step is, what was the impact on me personally? How do I go about some form of healing process? And how do you reconcile the personal trauma with ‘I have a job I have to do’? And we have a job now that we have to do this year, which is as important if not more important than ever: To run the safest, most medically comprehensive race we possibly can.

Are you medical director again?

Of course. You’d better believe it. Nowhere I’d rather be.

Dr. Aaron Baggish (Courtesy MGH)

Dr. Aaron Baggish at work (MGH)

To ask you your own questions, what was the impact on you personally? How do you go about some form of healing process?

It’s been a series of phases, if you will. There was an immediate, necessary phase of blocking everything out and dealing with the professional aftermath: the meetings and debriefings and making sure the volunteers were okay. That lasted for about a month and was more of a business-as-usual sort of feel than anyone could imagine.

But once the media coverage slowed down and Boylston Street was cleared, that’s when the real, hard personal work started. That’s when the concept of PTSD became a reality.

For example?

For example, I was participating in a Triathlon on Lake Winnepesaukee in August. It’s a race I do every year, a half Iron Man, it’s a special day for me, and I was standing on the beach and watching the professional athletes get going, and they fired a cannon for the men’s start. I knew it was coming. What I didn’t realize was that they would fire a second cannon for the women. So three minutes later, they fired a second cannon and I just disintegrated. I had an unbelievable physiological response. I became nauseous, shaking, and it was then I realized that this was a real, deep scar that would be left for a long time. That was a turning point for me; it made me aware I needed to talk about things more, not publicly but with family and friends and colleagues. That was a good step, and over the fall I very actively engaged with people I trust and feel emotionally safe with, to make certain I could start processing some of this. That took some time, and there were some dark moments there. Continue reading

New ‘Active Shooter’ Protocol: Despite Danger, Stop The Bleeding Faster

Emergency responders comfort a woman on a stretcher who was injured in one of the blasts near the Boston Marathon finish line. (Jeremy Pavia/AP)

Emergency responders comfort a woman on a stretcher who was injured in one of the blasts near the Boston Marathon finish line. (Jeremy Pavia/AP)

In any mass attack on the public — whether gun or bomb, mall or marathon — the first priority is to stop the killing. Typically, medical care tends to be delayed until danger is past. But that is now changing, to more of an emphasis on also stopping the victims’ bleeding — faster.

In the wake of the Sandy Hook Elementary School shooting nearly a year ago, a group of medical, military and law enforcement experts, commissioned by the American College of Surgeons, convened to answer a burning question: How do you increase survival in such mass attacks?

That “Hartford Consensus” group issued its initial concept document just 10 days before the Boston Marathon bombings in April, said Dr. Lenworth Jacobs, a trauma surgeon at Hartford Hospital. The much-admired emergency response to the marathon attack only bolstered the group’s findings. Support grew, and federal authorities — Homeland Security and FEMA — adopted the Hartford-based protocols in September, he said.

‘You get that timer in your head: If there are people alive…you’ve just really got to speed things up.’

Dr. Jacobs appears on Radio Boston today, and explains what the new guidelines say. The background:

In an attack, he said, “There are three zones. There’s the hot zone, which is actually dangerous, there’s an active shooter there, and the whole concept is to suppress that threat. However, in the warm zone, which is usually pretty close to the hot zone but it’s out of the sight of the shooter, there, you want to be controlling the hemorrhage. And classically, those have been different things. Law enforcement people have gone to suppress the shooter but have not necessarily been involved in controlling the hemorrhage. Now you want to have them, and the medical and rescue service people, involved very quickly in controlling hemorrhage. And then in the cold zone, which is safe, you need to do a full assessment of that person and then transport them to hospital.

What has happened is that these have been three very separate zones with three different kinds of people in there. What we’re proposing is that those zones should be compressed. So yes, you will have a hot zone but almost overlapping is the warm zone and overlapping that is the cold zone. So that the care is done much more quickly.” Continue reading