“I also personally did a lot of work with family members who were trying to be strong for their children but at the same time were falling apart behind closed doors,” said Ms. Smith, who made sure all the patients and their families had a list of mental health specialists to contact if they felt the need.

Dr. Scott Ryan, chief of orthopedic trauma at Tufts, said he could not stop thinking about how traumatic it must have been for the victims, most of whom remained conscious after the blasts, to see the extent of their wounds as they were raced to hospitals.

“The most disturbing thing for me in treating these patients is that they were awake after it happened and looked down and saw these terrible wounds,” he said. “Most of the time, patients with that bad injuries, they’re from a car accident or motorcycle accident and by the time they get to hospital they’re not with it enough to look down and say, ‘Oh my God, look what happened to my leg.’ ”

Those still hospitalized include Heather Abbott, 38, whose left foot, mangled in the first blast, was initially saved by doctors at Brigham and Women’s Hospital. She chose to have her leg amputated a few inches below the knee this week, after doctors essentially told her that life would be harder with the foot than without it.

“I walked maybe 10 feet today on a walker and everybody was so proud of me,” Ms. Abbott, a human resources manager from Newport, R.I., told reporters at the hospital on Thursday. “And I thought, ‘Oh gosh, this is going to be a long time.’ ”

Fund-raising Web pages for some victims describe their physical and emotional ordeals in raw detail. A page for Christian Williams, 41, an art director whose legs were gravely injured as he stood near the marathon finish line, included a note from Mr. Williams in which he described how he felt after his fourth operation on Monday. Although the doctors “managed to get my right leg closer to being closed,” he wrote, “the meds weren’t working and I couldn’t hide from the pain.”

A video posted on a fund-raising page for Celeste Corcoran, 47, who lost both legs below her knees, shows her meeting with Sgt. Gabe Martinez, a Marine who lost his lower legs and came to give her a pep talk. “I can’t do anything right now,” Ms. Corcoran told him tearfully.