6 months after the Boston Marathon bombings: Thanking and supporting first responders

Six months ago the city of Boston and the country were rocked by the bombings at the marathon. Some who were at the finish line in Boston that day refer to it simply as "April 15."

It's a less charged way of referring to an experience more horrifying than most of our worst nightmares.

For me, this tragedy has been much more than a news story. I've been a runner for more than 20 years, all the while keeping my eye toward the moment I cross that particular finish line as the ultimate prize. I didn't make the cut to compete in the 2013 race. Dejected, I didn't even attend to watch. But nonetheless, at 2:50 p.m. on April 15, 2013, even my world was changed forever.

What I personally lost that day was a not just a vision of a perfect dream, but also a sense of security. I lost the ability to tell myself "everything's okay" the ensuing night the county adjacent to mine was in lockdown during a (successful) manhunt for suspect Dzhokhar Tsarnaev. As I watched a lone news reporter broadcast from the deserted darkness through the wee hours of that morning, I kept waiting to hear a message of reassurance. Instead, while my children slept in the next room, I listened to the trembling in the reporter's voice, and the instruction to stay indoors with doors and windows locked.

This past weekend, the city of Boston reflected on the aftermath of the tragedy, as numerous first responders returned to the bomb site to pay tribute and share support with others who were present during the attack. For many of these individuals, their emotional injuries have been no less severe than those of the victims who were hospitalized. Even though the rest of us genuinely see these clinicians, firefighters, soldiers and quick-thinking bystanders as heroes, many of them are haunted by a feeling that they didn't help enough. In the meantime, their invisible wounds too often go unrecognized and unhealed.

Immediately after the bombings, FiercePracticeManagement featured a special interview with physician wellness expert Dike Drummond, M.D. At the time we published Drummond's advice for managing trauma, most of the victims of this particular tragedy were likely still in shock. Six months later, responders like physical therapist Nicole F. McGerald and emergency physician Christina Hernon, M.D., revealed to the Boston Globe that they still grapple with the idea that they were victimized every bit as much as their patients.

This same notion was also articulated very poignantly in April by James Broadhurst, M.D., in a YouTube video for UMass Medical School. Broadhurst, a family physician at UMass Memorial Medical Center, was volunteering in the medical tent at the Boston Marathon for the ninth time the day the bombs went off.

"It was a picture perfect day," he told me during a June interview for a Medical Economics article I wrote about physicians coping with the aftermath of the gruesome, sorrowful scene that unfolded.

Though the events of that day were highly personal to Broadhurst and colleagues Chad Beattie, M.D., and Pierre Rouzier, M.D., when I spoke with them roughly two months after the attack, they were remarkably candid with me about their challenges. Broadhurst, in particular, had made a conscious decision to discuss the matter only to media outlets within the medical profession. Despite the rawness of emotion I heard in these doctors' stories, they were all functioning well at work and reported they were healing. If a silver lining exists, it's that all three of the doctors I interviewed said that the experience would positively affect the way they practiced medicine going forward.

Patients' lives will be improved because of the agony these people endured, but that doesn't mean the healers' recovery is complete. Although I can't speculate about any particular person's experience, mental health experts know that the path to healing is often more jagged than straight. First responders are especially vulnerable to post-traumatic stress disorder, the Globe noted, because of the high value placed on stoicism in their professions.

Symptoms of PTSD, including heightened anxiety, inability to relax, increased irritability and feeling detached, are often ignored by sufferers until they compound into deep psychological problems, according to the article.

The takeaway here is that even if the bombing and the city's world-class response don't seem like news anymore, I'd like to use this platform to remind you that a trauma of this magnitude brings victims a fresh set of challenges every day, with no predefined end point. As many of you are reading from offices all over the country, very few of you likely know physicians who were affected by this particular event. But you are all part of the same community. You have an ability to take time out of your day to think about your colleagues' journeys and send them healing energy.

And as Dr. Drummond told me when we spoke the day after the bombing, "all physicians are in some way traumatized by their training." As a group, you endure and fix things many of the rest of us will never see. At some point in your career, you have or may encounter the unthinkable, and you will rise to the occassion because that is who you are and what you have been trained to do. This column is my way, as a bystander, of recognizing and thanking you for doing it, and reminding you that it's never a bad time to extend that same support to one another. - Deb (@PracticeMgt)

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