Marathon bombing survivors Jessica Kensky and Patrick Downes find healing through their work helping others

Jessica Kensky and Patrick Downes were newlyweds in 2013. They were looking forward to building their new life together.

But their lives changed dramatically when they went to watch the Boston Marathon that April 15th. They were at the finish line when two bombs went off in the crowd of spectators. Three people died. Seventeen people lost limbs. Both Downes and Kensky lost a leg.

"After we were hurt, we were dependent on other people for everything," Downes said. "It was like we were children again."

They relied on their parents to help them get dressed and cook for them. Downes had a relatively steady recovery. Kensky had one complication after another.

"I just had infections and falls and poor wound healing, and you name it, I had it," she said in a recent interview at WBUR's studios.

Kensky's remaining leg had been badly damaged in the bombing. She felt relentless pain. So she had doctors amputate that one, too — in early 2015.

Now, 10 years after the marathon bombings and after rigorous physical therapy, their bodies have rebounded. They've even completed the Boston Marathon multiple times — sometimes running, sometimes walking, sometimes hand cycling.

"Physically, I think what we've achieved is beyond my wildest dreams. I never thought we'd be able to do the things we've been able to do again," Kensky said. "Emotionally, I think it's complicated."

"Being a part of this tragedy doesn't mean you're excused from other life tragedies," she continued. "There's been other hard times that we've faced as a couple that had absolutely nothing to do with the Boston Marathon bombing. And those honestly loom larger to me today."

For Kensky, in particular, there was the loss of her father, who was diagnosed with an aggressive form of thyroid cancer just before the coronavirus pandemic started and died about a year later.

“I'm still reeling from that loss. It's been a little over two years, and I guess to me that takes up a lot more of my time and emotional energy and emotional space than being a part of the bombing,” she said.

Kensky was able to be by her father's side when he was receiving treatment at the outpatient cancer center at Massachusetts General Hospital where she works as an oncology nurse. That means he was able to see her back at work before he died, which was meaningful to both of them. He played a huge role in her walking again, she said.

Returning to work has played a significant role in Kensky's recovery. It's brought about a sense of normalcy.

"I just know that when I put on scrubs again and my badge and went in to work, it was like getting a part of myself back," Kensky said. "Until we got to start putting pieces of our life back together, I felt like I was just a 'Boston Marathon survivor.' You know, it was being responsible again, taking care of other people, having coworkers and colleagues and friends who knew me. It was priceless."

Kensky also earned a master's degree and is now working on a doctorate in nursing. Downes finished his doctorate in psychology and now works as a clinical psychologist for Home Base, a mental health program for veterans run by Mass. General.

The pair say they don't know if they would be in the same place now if not for the care they received at Walter Reed National Military Medical Center in Bethesda, Maryland, starting in 2014. At Kensky's father's suggestion, they asked for and were granted the opportunity, as civilians, to be cared for alongside sick and wounded veterans. They spent three years there.

"I think we both recognize it as a very sacred place. And we didn't want anyone to think that we were taking that for granted or felt entitled to that. But we were really in survival mode, so we were trying to fight for any resources we could get," Downes said. "And it ended up being a really special place for us."

They made lifelong friendships with military veterans who were their fellow patients.

"What I was really struck by was when we met these people, I didn't think we had much in common — our life paths had been very different," Downes said. "But many of the men and women who were injured in combat had signed up post-9/11, with this just ferocious determination to ensure that terrorism never happens on U.S. soil again. And when [the Boston Marathon bombings] happened, they told us that they took it so personally. And some of them would apologize to us that something like this could happen again in our country."

Working with doctors and therapists who have the most expertise in dealing with amputations helped Jessica make the complex decision to have her second leg removed — and to make progress afterward, the couple said.

"I would say it was almost like it was the expectation at Walter Reed that you would get back to all you were doing before  — and then some," Kensky said. "And I think when that becomes the expectation, things start to come together in order for that to happen.”

For example, skiing. Kensky didn't even like skiing before. And not long after her second amputation, Walter Reed sent her, Downes and a group of veterans to hit the slopes of Breckenridge in Colorado.

Doctors and therapists also helped her figure out techniques to keep her steadiness and stamina when she returned to caring for cancer patients all day on two prosthetic legs.

After the couple was discharged from Walter Reed, Kensky was raring to go back to work. But Downes, who had been her longtime caregiver, hit a low point. It was that struggle that helped him come to a realization about his own work and recovery.

“We got home, and I said, ‘What was that all for?' " Downes said. "I was really in this philosophical place of... You survive something. You almost die. For what reason? What am I supposed to do with all of this? And the only thing that I could really come up with ... is to be in service of other people.

"But I didn't know that I could really be of service to other people, because I felt so depleted," he added. "I was just exhausted. And I didn't want to be a psychologist who didn't have empathy. That wouldn't work so well."

Downes had good friends working at Home Base, and they gave him the opportunity to do a postdoctoral fellowship there. It was in those moments that Downes said he started to find his purpose again — and draw upon all his past experience to try to make a positive contribution for other people.

He now works for the program 20 hours per week. He doesn't tell his patients he's a survivor of the marathon attack unless they ask about it.

"Sometimes they find it out on their own,” Downes said. "It has been emotional at times when we talk about it. But I've also found that it can be a really powerful therapeutic tool.”

Whether he talks about his history or not, his experience with post-traumatic stress disorder, depression and anxiety in the years following the marathon bombings factors into the therapy he provides, Downes said.

“I'd like to think that it helps me better be aware of when someone's in a stuck pattern of thinking about the world in a negative way, better be able to recognize anger as it comes up, better be able to recognize fears that they have about getting back to life the way it was before or in a new way," Downes said. "I had no appreciation for the many ripple effects that trauma has. It impacts your self-identity, your relationships, your work, your leisure time, the way you see the world... I mean, it just permeates everything.”

Kensky and Downes said they don't really think that often about how their roles have reversed — from patient to helper, or healer.

"I mean, I recognize that I'm in a healing role and that people are coming to me with, perhaps, that expectation," Downes said. "But for me, it really does feel like a collaborative process."

Downes is grateful for the opportunity to be with his clients in the raw, solemn moments when they're working to figure out their own sense of purpose — and, he said, it's important to him and his wife to be able to validate what others are going through, after all the support they've received from total strangers.

"People we've never met before have been in our corner, have cheered us on, have told our story, have listened to our story," he said. "And that's not true for most people who experience trauma. They often do it very much alone."

Meanwhile, Kensky said her experience has changed the way she approaches patients and the vulnerability brought about by cancer. It's struck her that clinicians can sometimes think they'll never end up in that seat, as the patient.

"I think sometimes clinicians ...  think that there's something about us that we're never going to be in that seat [as a cancer patient]," Kensky said. "But I think that my life experience thus far has shown me that it's totally random who ends up in that seat."

She tries to reinforce that randomness for her patients.

"Because I think we as humans can ... get into guilt and shame and, 'What did I do wrong?' and, 'I should have gone to the doctor sooner.' And I think for a lot of my patients, it's important to hold up a different mirror sometimes."