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By most accounts, Boston and the state handled last year's Boston Marathon bombing as well as could be expected. Decades of disaster drills appear to have paid off, with thousands of people from various agencies joining forces to try to save as many lives and limbs as possible.
So in the shadow of last year's horror, how are officials preparing for this year's race? Planning is taking place on several fronts, amid uncertainty and some strong emotions.
Emergency And Emotional Preparedness
For several months now, emergency responders, law enforcement officials and others have been gearing up for the possibility of another marathon attack. Master Sgt. Kenneth Huddleston, with the federal Department of Homeland Security's mobile training unit, recently held a class for Hopkinton police officers.
"The start of the marathon here in Hopkinton is a very attractive place if you are the bad guys," he said. "So what better place to start to increase the awareness and increase the security than right here?"
This was one of dozens of preparedness sessions being held to focus on topics such as supporting a bomb squad and responding to terrorism or suicide bombings. During the session, instructor Curt Tilley showed officers a video of how to handle a motorist who is behaving suspiciously. He then took the class out to a parking lot to search a car, where he identified clues that revealed a fake bomb under the hood.
"You're wired in, you have your power, your initiator, your switch, your explosive," Tilley explained.
Authorities are taking dozens of extra precautions this year, including conducting car searches at security checkpoints along the marathon route. There are also new restrictions on what runners and spectators can do and bring to the race. There will be additional surveillance cameras to help the 3,500 police officers and 400 National Guard soldiers on patrol. And several emergency response centers will be set up throughout the route, all connected to the main state Emergency Management Agency headquarters in Framingham.
Centralized medical emergency centers are also part of preparedness efforts.
Maureen McMahon, the director of emergency management at Boston Medical Center, says that on Marathon Monday four people will staff their command center — a large room in a nondescript building near the hospital filled with desks, computers, televisions and phones.
"We'll have people coming in and out. We might be getting reports from the field. We'll be requesting information," McMahon said. "So this is going to be a monitoring condition, it's not going to be a full activation."
Full activation was last year, when hospitals had just minutes to prepare for scores of severely injured people. Not one patient taken to a Boston hospital from the finish line died. Even so, most medical facilities are making some changes. Almost all will have extra staff on race day. And because so many medical workers volunteered to help last year, several hospitals have new notification and chain of command procedures.
The biggest issue following the bombings was communication — coordinating staff and media and handling patients and their loved ones. Hospitals want to prevent another case of mistaken identity. That's what happened with Karen Rand. She was carrying her friend Krystle Campbell's identification when she was transported from the finish line to Mass General for amputation surgery. Campbell died at the finish line, but her family was told that she was the one in surgery.
"While I understand how it happened, I had Krystle's identification and her phone on me, I still think that even as crazy as it was, there has to be a way to identify people," Rand said. "Whether it's what they look like, what size they are, the age, anything that when family are calling and saying this is what the person I'm looking for looks like, you have some other way to identify a little bit easier."
Paul Biddinger, medical director for emergency preparedness at MGH, says the hospital has improved its systems.
"We worked very hard with our staff to make sure that everyone is trained on our state-of-the-art procedures for how to identify what is proper and what is not proper identification for the victims," he said.
But Biddinger and other hospital workers say the core issue they're working on is emotional preparedness. Not just for the anniversary of the bombings, but also for next week's race.
Every hospital is offering counseling to its workers. The Schwartz Center for Compassionate Healthcare has been holding drop-in meetings for medical caregivers to discuss with their peers their feelings about responding to the bombing. At one recent session, many admitted that they are still processing the trauma, including Vicki Noble, an emergency medicine physician at MGH.
"I think my feeling that day — and continues to be my feeling which I think gives me some strength — was one of immense pride," Noble said holding back tears. "I'm sorry, I thought I was doing better too. I just felt, I was watching the pre-hospital teams, watching the police, watching the firefighters, watching the volunteers, and I was just so proud."
Organizers of these sessions issued a report describing an array of caregiver emotions: fear, guilt, anxiety about the upcoming marathon and anniversary, and resentment that a signature Boston event has been marred by violence. The facilitators advice, perhaps for everyone: talk about your feelings, stay connected, and take care of yourself. And if it feels too overwhelming to be reminded of the marathon this year, get away from it.
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