This post was authored by Michael S. Emery, MD, FACC, co-chair-elect of the ACC’s Sports and Exercise Cardiology Section Leadership Council.

On Monday, April 15, tragedy struck one of the oldest and most revered marathons in the world – the Boston Marathon. I was there as a medical volunteer in the ICU section at the finish line. It started off as a beautiful day, which was evident by the rather light use of our medical services (whereas the previous year, heat was a major factor). This was my first time volunteering, and I was there not just to help but to learn and experience marathon medicine at its finest.

At 2:50 p.m., while caring for a dehydrated athlete in the medical tent, I heard and felt the two explosions. The nurse helping me asked if the sound was thunder, but the sky was clear. I quickly began to realize that something bad had just happened and even before we were informed of anything, I immediately sent a text message to my wife letting her know that I was alright. The medical tent was about 100 yards from the finish line blast. Word came quickly that a bomb had exploded at the finish line and we were instructed to move all athletes to one end of the tent, to start hanging IV bags, and for all physicians to head to the finish line area.

Several of us then sprinted out of the tent towards the finish line. One of the first things I saw was the now famous spectator missing both legs with bones protruding being wheeled off the sidewalk towards the medical tent. The carnage, blood, smoke and injuries were a visual image that I will never forget.  One of the first sites I went to was a local running store located at the finish line, as I heard there were injured people inside. At that time, I had no idea whether the bomb had exploded inside a building or outside, nor did I know of the potential for secondary devices. It was smoky inside the building but there did not appear to be any more injured persons inside, so I made my way back to the sidewalk outside.

Once outside, the sidewalk was now covered in blood and there was so much, it was actually pooling in spots. There were injured bodies everywhere with multiple Boston Athletic Association physicians, bystanders, and EMS personnel doing what they could. Victims that could be put into wheelchairs were done so with volunteers wheeling them to the medical tent. Others were performing CPR, holding pressure on wounds, stabilizing compound fractures, applying tourniquets and as quickly as possible loading victims into waiting ambulances or wheelchairs.

While it was chaotic, there was a definite sense of purpose to rapidly stabilize and clear that sidewalk. As we loaded people into ambulances, the police were trying to get us out of the area as quickly as possible since there was a concern of secondary devices. At the time, I was not overly concerned about my own safety as adrenaline and my medical training took over. Even though I’m a cardiologist and not trained to handle trauma, it really was about the basics of care – stabilize and evacuate!

As I made my way back to the medical tent after helping to clear that initial blast site, the tent had turned into a triage center with areas setup for level 1s and level 2s. It didn’t take long to clear the medical tent of victims before they started dismissing volunteers from the tent so the police could sweep it.

Our next concern was for the several thousands of runners who did not make it to the finish line. We had worried about their medical needs with regards to the more typical marathon-related injuries. A small group of us, led by the marathon medical directors, made our way to the Boston Common where the runners on the course were instructed to meet. However, by that time I think most had found family and did not want to be in the area.

Obviously, marathon medicine took a back seat to mass causality that dreadful day. As a sports cardiologist, I spend a lot of my time assessing athletes and in particular answering questions about potential cardiac complications related to sports and the risks of sudden cardiac death. That all became irrelevant that afternoon. I am so very thankful to all of the physician and support staff that were on hand that day to respond to this tragedy. There were several other cardiologists, sports medicine physicians, emergency medicine physicians, residents, and fellows-in-training in the tent who put fear aside to run towards “ground zero.” While there were three fatalities and 260+ causalities with many limbs lost, undoubtedly, our combined and rapid response saved lives that day. I am proud to call all of them colleagues and friends.

Beyond the care for the athletes and victims, the emotional support that day and beyond has been a testament to the human spirit. I am not from Boston, do not have any family connections there, never trained or went to school there, and have never run the Boston Marathon; but the city, the Boston Marathon and Patriot’s Days will forever be a part of me. Next year, you can find me volunteering again at that finish line caring for the athletes! #bostonstrong

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