eDocTalk article

“…everyone (in Mass General anesthesiology) got pages that we were on a crisis alert…”

May 2013

David Frazer, M.D., a former Legacy intern, was on the scene in Boston during the aftermath of the bombings there. Dr. Frazer completed his intern year 2011-2012 at Legacy Good Samaritan and Legacy Emanuel medical centers in the departments of surgery and internal medicine/ICU, after graduating from medical school at OHSU. Darcy E. Deering, M.D., was his residency program director at Legacy. Dr. Frazer is now a resident doctor in anesthesiology and critical care at Massachusetts General Hospital.

He was present throughout the entire Boston bombing experience. He was in the hospital treating patients, and he also lives close to where the MIT officer was killed and a few miles from where one of the alleged bombers was killed.

Here’s the account that he sent to Legacy’s Megan Turnell.

 

On Monday at 3 p.m., about 30 minutes after the marathon bombings, everyone in the Massachusetts General Hospital (MGH) anesthesia department got pages that we were on a crisis alert, and that we were postponing all elective surgeries to clear ORs for multiple incoming traumas.

About 180 people were injured in the bomb attack. The EMS coordinators at the bomb scene did a great job distributing the numbers and acuity of patients among the Boston hospitals based on hospital capacity, Level 1 trauma and ICU beds numbers. At MGH we took in about 15-20 for surgery. About 13 of those went to ICU beds. I think the ER treated about 20-30 for non-surgical wounds.

Distributing the wounded

The Brigham and Woman's Hospital took in approximately the same numbers of surgical and ICU patients as we did at Massachusetts General. All of the children under 12 went to Boston Children's Hospital, and the rest of the patients got distributed among the smaller Tuft's, Beth Israel and Boston Medical Center hospitals. Dividing all of the patients based on trauma, surgical, ICU, and sub-acute ED capabilities among all of Boston's hospitals worked amazingly well. Whoever coordinated that in such an efficient way so quickly should get a medal.

Because the two bombs at the marathon exploded horizontally to the ground, there were several devastating lower extremity injuries, blast amputations, and several below-knee amputations and above-knee amputations. These had to be done in surgery immediately or within the following days because the limbs weren't salvageable. There were also numerous foreign fragments of pellets, ball bearings and nails that were part of the bombs. These were extracted and given to the police as evidence.

On Tuesday through Thursday, there was a constant SWAT team and military presence at the entrance of MGH. It was honestly very comforting. I, and just about everyone who walked past them, thanked them for being there.

A surreal day

Thursday was the most surreal day. That morning, there was a church service in Boston that President Obama and the first lady attended. There were rumors that he would make a visit to Massachusetts General and the first lady would visit Brigham and Women’s and Boston Children's. My cases on Thursday were still burn and blast patients who were on their second and third surgeries. The president came and visited our ICU and spent a few hours seeing all of the injured patients. A few of our ICU anesthesia residents got to meet him. I guess there were Secret Service, machine guns and bomb dogs everywhere in the ICU.

I was on call Thursday night and got out of the hospital around 11 p.m. Walking home to Cambridge over the bridge, I saw about 50 marked and unmarked police and FBI cars come screaming across the bridge, responding to the MIT police officer who was killed in Cambridge about three blocks from my house. The two suspects stole a car at that scene, which ended in a shootout with other bombs being exploded a few miles away and the older brother getting killed.

With the younger brother on the loose, the governor put the whole city of Boston on lockdown, which was a little surreal. I was post call, so I was at home, but everyone in the hospital was locked in. No one was supposed to enter or leave MGH or any of the other Boston hospitals. I took my golden retriever out for a long walk, and everything in Boston felt like an uneasy creepy ghost town. On Friday night, when they caught the younger brother, it was like a huge weight of stress and fear was released from Boston. People were cheering and hugging. The next day on Saturday was a beautiful spring day; there was a celebration at the Red Sox game, sailboats out on the Charles River ... It was really amazing.

This whole event made me really sad, humbled, and proud to be a physician at MGH and in Boston right now. I hope everyone back home in Portland is safe and well.

David Frazer, M.D.
Massachusetts General Hospital
Department of Anesthesia and Critical Care

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