From celebration to tragedy

DOs at Boston Marathon become first responders to gruesome scene

Two DOs—a race medical director and a runner—quickly responded to the bomb blasts.

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The medical director of the Boston Marathon’s elite athlete medical tent, Martin S. Levine, DO, MPH, had finished helping some of the world’s fastest long-distance runners recover from the race when he heard the first of the two explosions.

As he has told more than a dozen media outlets, Dr. Levine saw blood everywhere and rushed to help the wounded. Live bodies, limbs and chunks of human tissue lay scattered helter-skelter. Many of those injured had severed or mangled legs.

Metal shards, nails, and other shrapnel and blast-generated debris had ripped open flesh and gouged through calf muscles, said Dr. Levine, who was the AOA’s 2011-12 president. He removed his belt and his identification badge’s lanyard and applied them as tourniquets, as did some other physicians at the scene.

Dr. Levine helped triage the blast victims and convey the most seriously injured to awaiting ambulances using cots and boards as makeshift gurneys. Even those with less severe wounds were bleeding profusely and needed prompt medical attention.

“I remember saying to one patient who was not as seriously injured as the others, ‘Come on. Let’s go. Let’s get you out of here,’ ” Dr. Levine told The DO. A family physician and sports medicine specialist in Bayonne, N.J., Dr. Levine had to shift gears dramatically in assuming the role of a trauma physician.

At the finish-line medical tent, another osteopathic physician, who competed in the marathon, was recovering from severe leg cramps when she heard the bombs explode, the first barely 50 yards away. Almost immediately, Danielle A. Deines, DO, morphed from patient into first responder.

“I had finished the race more than an hour and a half before the first explosion and was trying to get back on my feet,” remembers Dr. Deines, who is a first-year resident in pediatrics at the University of New Mexico School of Medicine in Albuquerque. “Every time I would stand up, my legs would cramp up again. But after I heard the second explosion, I forced myself up and asked a nurse what I could do to help.”

As an intern who is not a licensed physician in Massachusetts, Dr. Deines wanted to do whatever she could do legally, as injured blast victims were brought into the tent for treatment. The nurse suggested that she initially focus on discharging the recuperating runners, who had been moved to one corner of the tent. Most of them wanted to leave but needed a physician’s signature first.

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“They were a little freaked out and saying ‘I just want to get out of here,’ ” Dr. Deines says.

After discharging several athletes, she concentrated on getting needed supplies ready for use and assisted with triage of the incoming wounded.

“One man, who was there with his wife and daughter, had a pretty severe leg injury, but it looked like the leg was salvageable, so we were trying to get him on an ambulance,” Dr. Deines says. “He was definitely aware of how much pain he was in. Other blast victims seemed kind of dazed and didn’t know what had happened, but they were conscious.”

Despite the horrors she witnessed Monday, Dr. Deines intends to compete in the Boston Marathon again. She expects heightened security measures will be instituted in the future but cannot envision what they will be.

“There were bomb-sniffing dogs out on the street during this year’s marathon,” she says. “I’m not sure what else they can do. Securing 26 miles of a race course would be extremely difficult.”

Planning to leave Boston on Saturday, Dr. Deines says the city is still filled with runners. “There are blue and yellow jackets all over the streets here,” she says. “People don’t care whether they finished the race or not. They are just proud to have been a part of it.”

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