The tragic bombings at the 2013 Boston Marathon raise many thoughts and feelings. My heart goes out to all of the victims and their friends and families. Fear and aggression have become a depressing part of our landscape, yet our world is not without hope and not without gratitude. Heading to Boston the following evening, I was anxious to spend some time with my son who lives and goes to school in there, not far from where the explosions took place. As we walked around the city in the early evening, I shared with him that I was a little scared, but not paralyzed. He told me that he and his friends were talking about next years marathon, wondering if it would be poorly attended or perhaps there would be a huge and powerful gathering to show support and solidarity.
We were both grateful for the strong presence of police in cars, on motorcycles, and on foot and the more than occasional sounds of sirens as ambulances raced through the city. We both felt a deep sense of appreciation for the paramedics, police, firefighters, nurses, doctors, security personnel, and bystanders who provided first aid and other support to injured people. All of these people and many others that must be ready for highly skilled and prompt life-saving interventions, (hopefully life-saving). THANK YOU ALL!
As I reflect more on this, I realize that both structure and collaborative relationships are important.
By structure I mean the individuals must be trained to respond to a variety of highly charged and sometimes dangerous situations. The ambulance must be gassed up and equipment in perfect working order, first aid boxes must be full and complete, emergency rooms must be staffed and hospitals ready to accommodate sudden influxes of people with a wide range of traumatic injuries, and psychotherapists available to help victims, families, and bystanders cope with horrific tragedies.
By relationship I mean that people are interacting with patience and respect despite the huge stresses at hand. Professionals must be able to offer input and ask for help as they consider the best action to take, which first aid supplies are best, which hospital for transport, and perhaps make extraordinarily challenging decision about who to save or who to try to save first. This doesn’t happen in a vacuum. Multiple layers of communication and collaboration are going on and often very effective. Amazing to me how quickly informal systems are created with a clear purpose, (help in any way you can) and a few simple rules like offer your expertise, don’t get in the way, and be willing to take direction from others with expertise! In a follow up MedPage Today article called, Boston Bombing a Lesson in Prep for Hospitals, Journalist Kathleen Struck reported that Dr. Osgood, MD, Tufts Medical Center’s emergency management chief stated, “One nice thing I saw — and it was really touching — was that most of the Boston police that responded knew our emergency department staff,” Osgood said. “Those weren’t people who were shaking hands and introducing themselves in the emergency department. Folks knew each other.” As the investigation unfolds, the organized planning and spontaneous collaboration of law enforcement and the Boston community will be vital.
My friend and colleague Tony Salerno, an ED doc offers this great example of both the structure and relationship in his practice. I wish for my son and his young colleagues getting ready to graduate a solid sense of hope along with the collaborative, compassionate energy needed to balance structure and relationship in a healthier world to come. This photograph from the Boston Bombing site reveals the devastation of the incident and many flags together.