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04/23/2013

A doctor's powerful first-hand account of the Boston bombings

Boston
Runners continue to run towards the finish line of the Boston Marathon as an explosion erupts near the finish line of the race. (REUTERS/Dan Lampariello)

The New England Journal of Medicine has published a compelling first-person piece by Dr. Sushrut Jangi, who was working at the Boston Marathon's medical tent in Copley Square last Monday -- just a few hundred metres from where the first bomb exploded.

It provides a powerful point-of-view we haven't really heard yet -- the experience of the on-site medical volunteers, many of whom feared for their own safety but stuck around to do what they could in the face of overwhelming trauma and injuries.

Jangi's account is starkly honest and made all the more powerful as a result. The hospitalist at Boston's Beth Israel Deaconess Medical Center writes about his physical reaction when the reality of what had happened began to sink in:

"There are bombs," a woman whispered. My hands began to shake."

He goes on to write about his own, very human instincts to run away -- an urge quickly overpowered by his sense of duty to the wounded:

"I almost fled, thinking there might be more bombs nearby ... But from within the tent, I heard (medical coordinator John) Andersen's voice, an echo of my own conscience: "All medical personnel stay with your patients."

What came next he describes as a fog of fear and bravery, professionalism and panic: EMTs bolted towards the explosion and experienced doctors like Pierre Rouzier couldn't even figure out how to triage themselves.

Jangi also interviewed Rouzier about the mindset he clicked into:

"Rouzier said he couldn't remember the wounded as real people; he believed his actions had been mechanical rather than compassionate. "I didn't look anyone in the eye," he said. Instead, he saw limbs, legs, and gaping wounds. "The last person I saw at the scene -- I never got her name, and she never got mine."

For me, the most powerful part of the piece was when Jangi described the helplessness, horror and confusion that washed over him as patients began flooding into the tent, many with devastating injuries he had never encountered before:

"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."

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar


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