NOT Sports Medicine

April 16, 2013 by sportingjim

I don’t think any of us in sports medicine got into the field expecting to be involved in an event like that which transpired in Boston yesterday.

Like many people around the world, I became riveted to TV, internet newsfeeds, and Social Media yesterday as I tried to make sense of what was occurring in Boston: at 2:50 p.m., a little over four hours after the start of the Boston Marathon, two bombs exploded near the finish line, creating a chaotic scene resulting at this moment in three deaths and over 100 casualties. A scene of sporting joy and celebration had been turned into mayhem.

In the days ahead and as the investigation into this event unfolds, we will likely learn ‘who’ was behind this and for what supposed purpose. It is my hope that ‘they’ become a footnote in history, and that instead the names of the victims and the athletes and the first responders persist in memory.

Boston has played a big part in my life. I went to university and medical school in Boston, and all told have lived about a dozen years of my life in that city. When you live there, the Boston Marathon becomes part of the background of your life. When I was in training for track or cross-country, I would often rack up miles by pounding on the pavement of the Marathon Course: Heartbreak Hill is a familiar nemesis. And when Patriot’s Day comes, whether you are running or spectating or simply present in the city, it is a special moment. It is a civic holiday with the celebrations beginning in the wee hours of the morning, with a re-enactment of the first battles of the Revolutionary War taking place on the town greens of Concord and Lexington. And the day proceeds in celebratory mode with sports: the Marathon is the central event, but the city’s beloved Boston Red Sox also inevitably play a game, and the evening usually ends with a hockey (Bruins) or basketball (Celtics) game.

My association with the Boston Marathon is actually quite intimate. I began my career in sports medicine as a fellow at Children’s Hospital, Boston (CHB), where I trained under Dr. Pierre d’Hemecourt, the Co-Medical Director for the Boston Marathon. One of my favorite memories of the year I was a Sports Medicine Fellow at CHB was staffing the tent at the marathon. We were busy with the sort of stuff you’d expect: dehydration, minor orthopedic issues, hyponatremia. It was set up like a MASH tent, but without the expectation of trauma. It was a busy, educational, and exhilarating day.

Last night, I was thinking so much of colleagues who I know must have worked their tails off yesterday afternoon and evening to take care of the victims of this attack. All the reports I’m hearing from the media and directly from those friends and colleagues on site in the medical tent is that the effort and response of the first responders was exemplary.

Unfortunately, we in sports medicine who are involved in organizing and staffing these sorts of mass participation events need to attend to the possibility of such horrible acts of violence. I understand the London Marathon, taking place on April 21, is now on ‘high alert.’

Boston 2013 does not, of course, represent the first time there have occurred attacks associated with high profile sporting events (though I am hard pressed to recall ‘successful’ attacks occurring directly in the midst of the field of play): there were the bombings in the aftermath of London’s Olympic Bid Success, the bombings in the 1996 Atlanta Olympics, the horrible kidnappings and killings of Israeli athletes in the 1972 Munich Olympics. Keeping athletes and spectators safe and preparing for the eventuality of traumatic injuries like the ones we saw yesterday is a reality for those planning for and staffing these mass events. There is sure to be more coming out in the sports medicine literature in the wake of this event in Boston; last night I reviewed such an article in Current Sports Medicine Reports readers may want to check out.

I wonder if our readers have any thoughts on these events or on planning for safety in general in mass participation events? I am looking forward to the dialogue.