Boston Teaching Hospitals: A Model of Preparation in Marathon Bombings

By Joanne Conroy, MD

After the investigation, pursuit, and capture of those responsible for the Boston Marathon bombings, there was incredible elation across Boston and across the United States. I saw people glued to TVs in airports and workplaces. It is great when good triumphs over evil and the good guys win!

The bombing affected so many permanently. Some lost loved ones. For others, their lives were irreparably changed simply because they stood in the wrong place at the wrong time. The wounds are almost unthinkable.

But there are things to be thankful for. The most important is that the injured were in Boston.

Boston is a city often criticized for high health care costs. But Boston area teaching hospitals have created a well-functioning trauma network that had prepared for just such a disaster. These institutions could call on not just one trauma team but create multiple teams so they did not have to choose who should be treated first. Hospitals were staffed to flex up and to meet and exceed our expectations for trauma care.

As Tamara Audi wrote in her Wall Street Journal article, “Paul Biddinger, chief of emergency preparedness at Massachusetts General Hospital … raced to the hospital and found the response well under way. Thirty patients who had been in the emergency department were transferred upstairs to make room for those wounded in the bombing. Trauma surgeons, orthopedic surgeons, nurses, respiratory therapists were standing by. Two of the patients taken to Massachusetts General Hospital were near death. Their mangled legs were destroyed, with bones hanging by shreds of muscle and skin. Blood flowed profusely. Many had suffered massive wounds and burns.”

Mass General and other area teaching hospitals were prepared. There are other examples as well. On April 19, 1995, when Timothy McVeigh and his accomplices bombed the federal courthouse in Oklahoma City, the University and Children’s Hospital, a teaching hospital, played a critical role treating the most severely burned and triaging on the scene, amputating limbs when necessary to extract victims from the building wreckage.

Washington policymakers begrudge dollars that are spent in support of graduate medical education. But in tragedies like those in Boston and Oklahoma City, that investment pays off in delivering crucial medical care, mitigating injuries and saving lives. Teaching hospitals have the capacity and expertise to respond when they’re needed. Their bench strength of physicians and nurses in training who know how to function as a team is augmented by dedication to service: Hundreds of Boston employees, when they heard of the tragedy last Monday, voluntarily reported to work at the city’s teaching hospitals.

The facilities in Boston also have a strong supportive infrastructure, which is not cheap, to provide crisis staff, psychiatrists, rehabilitation specialists, and therapists who will help create a new normal for the bombing survivors.

As we look to reduce the federal deficit, is graduate medical education really where we want to cut?

Dr  Joanne Conroy MD—Joanne Conroy, MD, is Chief Health Care Officer at the Association of American Medical Colleges. She can be reached at jconroy@aamc.org. Follow her on Twitter @joanneconroymd.

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