When two pressure-cooker bombs filled with nails, ball bearings, and black powder exploded at the finish line of the 2013 Boston Marathon, killing three people and wounding hundreds more, Jorge Alvarez, MD, did what he believes anybody would do: Run toward the danger.
“I was proud to do it at the time, and I would do it again if the same situation came up in whatever capacity,” the Texas cardiologist told Texas Medicine.
Dr. Alvarez and his wife, Becky, both took part in the marathon that year: Becky as a runner – checking off a bucket-list item – while Dr. Alvarez, who practices at the Cardiology Clinic of San Antonio, volunteered on the medical staff. On race day, he was in charge of the ice-down tent, ready to help runners who might suffer from heat stroke.
The weather was cool, giving Dr. Alvarez and his team a relatively slow day. The medical tent was about 50 yards from the finish line, so when his wife crossed, Dr. Alvarez stepped out to meet her.
The couple took a photograph, made plans to meet up later that evening, and Dr. Alvarez went back into the medical tent.
“The next thing I know I heard something really loud. It was such a loud bang. It wasn’t like gun-fire, but it was so massive that after you heard it you actually felt the concussion from it,” he said. “I knew it was an explosion.”
Outside, the celebratory mood at the finish line had been replaced by confusion, fear, blood, and dust. Dr. Alvarez walked out of the tent and saw people running toward him.
“There was dust everywhere. Their hair was singed and you could smell it,” he said. “And then the second bomb went off. That’s when I knew, ‘OK something really bad is happening right now.’ ”
Texas Medicine spoke to Dr. Alvarez recently about his experience at the bombing, which happened five years ago this month. Dr. Alvarez, who grew up in San Antonio and completed all of his medical training there, said his parents played a large role in his reactions that day.
“My dad, who is my role model, always said, ‘You always do what’s better for everyone else, and you work hard at it.’ And that’s my upbringing: You always put yourself second and help those who are in more need than you are.”
What do you remember about the scene?
It was 50 yards so I got there really quickly. There were people laying on the ground bleeding, so I started helping. One of the ladies who actually died, I was trying to help her. She didn’t have a pulse and so I started doing chest compressions. There was another gentleman there, and they loaded her up … and I told him to keep on doing the chest compressions. I didn’t even know who he was.
There was another lady I saw. She had a huge gash in her right leg, and her ankle looked like it was almost disarticulated. I didn’t have anything so I pulled off my belt and made a tourniquet. I was having somebody hold pressure, and I said, “Let go of the pressure.” He was like, “Are you sure?” And I said, “Let go of the pressure.” And he said, “Are you sure?” And I was, like, “Yes, I need to see if she’s still bleeding!” She wasn’t so we got her on a gurney and transported her back.
Right about that time there was a policeman who started yelling at us to get away, that there was [yet] another bomb. But there were three or four other people on the ground, and I was, like, “We can’t leave. These people are going to die.”
I remember thinking at that time, “I’m going to die, but you got to push through, get this thing done.” Luckily there wasn’t another bomb.
How many people did you treat?
I have no idea. I went back to the massive tent, which by that time had been set up as this huge triage area, and I was helping people. I remember there was this one girl who was right at the finish line when the bomb went off. She got hurt, she was in a lot of pain. She was crying, saying “I was so close.” I remember we had stacks of the medals that you get when you finish. And I was, like, “Hold on, you did finish, we crossed you on the finish line.” So I went and grabbed one of the medals and gave it to her. Her mom was crying. It was very emotional.
What happened that evening?
I had asked if there was anything I could do, but because it’s such a big medical center everybody was there, people were going to the OR, everything was set up. They thanked us for the help and then I just remember walking out of the tent. I had blood on my clothes, and I thought, “I need to go wash.”
I was finally able to get ahold of my wife and get back to the hotel. She met me there, we went to the room, washed, and it was like, what do we do now? It was about 9 o’clock and I was starving. We went down to get some food and the whole time I was shaking. I was just in awe.
What advice do you have for physicians who might find themselves in a similar, chaotic situation?
I will tell you from my experience I relied on what I knew. I’m a cardiologist; what do I know about mass-casualty trauma? But it’s the simple things, right? Stop the bleeding, make sure they’re breathing. Really, once that initial fixing is done, you go into compassionate doctor mode, which is to support the people that are injured and console them in the best way you know how. When you’re faced with something like that, the goal is to try to help as many people as possible, and that’s what you do. As a physician, we have a special duty to maintain and keep people calm in the worst situations.
Tex Med. 2018;114(4):28-29
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