Long Mile Home: Boston Under Attack, the City's Courageous Recovery, and the Epic Hunt for Justice (12 page)

President Obama addressed the nation after 6:00, delivering a briskly paced three-minute statement. “We still do not know who did this or why,” he said, “but make no mistake . . . we will find out who did this, and we will hold them accountable.” He stopped short of calling what had happened terrorism; he would wait to use that word until the next day. The president reflected on the meaning of Patriot’s Day, “a day that celebrates the free and fiercely independent spirit that this great American city of Boston has reflected from the earliest days of our nation . . . a day that draws the world to Boston’s streets.” He invoked the city’s strength—“Boston is a tough and resilient town. So are its people”—and the empathy that had swept the country: “The American people will say a prayer for Boston tonight.”

The prospect of a bombing at the marathon finish line, as far-fetched as it might have sounded, was a threat that public safety and race officials had talked about in the past and actively tried to prevent. That was just the nature of things after 9/11—the same held true for any big public event that drew many thousands of people to a confined space. Early in the day on April 15, police had begun sweeping both the starting line and finish line area for bombs. After dawn, the Boston Police Department’s bomb squad started scouring the area around Copley Square, looking in trash cans, flower planters, and the windows of cars and shops. Once they had swept everything, seeing nothing, the squad took up positions around the marathon course, ready to respond if the call came. Right after the blasts, the bomb technicians raced to Boylston Street and began furiously cutting open hundreds of abandoned bags with knives, looking for more explosive devices, fearing for their lives the whole time. No one could blame them for not preventing the bombing—the terrorists, after all, had brought in the IEDs right before setting them off—but they still struggled with the feeling that they had somehow come up short.

The question of which law enforcement agency would lead the investigation was resolved with relative ease, thanks in part to the rapport between Davis and DesLauriers. An imposing figure at six-foot-six, Davis, fifty-six, had led the BPD since 2006, after a long career in his hometown of Lowell, the former mill city north of Boston, where he had worked his way up from beat cop to superintendent. DesLauriers, fifty-three, a native of Western Massachusetts, was a counterintelligence expert known for running risky,
diplomatically sensitive operations, including one that traded Russian spies for American agents held prisoner in Russia. He had taken over the Boston FBI office in 2010. The two men, along with other law enforcement leaders, agreed that the FBI, with its superior expertise on terrorism, should take charge of the bombing probe. City and state leaders promised the public there would be seamless cooperation.
Governor Patrick would later describe those initial conversations about jurisdiction as among the most important things that happened after the bombing. The potential for friction was huge; the collaborative start was a good sign. Besides, there wasn’t time for competition. There were terrorists to hunt down.

One of the first people who drew law enforcement attention was an innocent Saudi Arabian student in his twenties named Abdulrahman Alharbi, who had come to Boston on a student visa in 2012 to study English. Alharbi, who described himself as shy and focused on his studies, stopped by the marathon alone on his way to meet friends and was injured by the second bomb. He was thrown into the street, with burns on his head, back, and arms; an uninjured runner helped him to an ambulance. To his surprise, several police officers climbed into the vehicle with him. At the hospital, FBI agents surrounded his bed and interrogated him for hours. The frightened student handed over his address and Facebook password; that night, authorities swarmed his apartment and some in the media identified him as a suspect. In one of his past posts on Facebook, Alharbi had included images of the Saudi and American flags and written in Arabic, “Thank God, I arrived [in] the [US] after [a] long trip.” The media, he said, translated that to the ominous-sounding “God is coming to the US.” When his friends tried to reach him after the bombing, the FBI would not let them call Alharbi or tell them where he was, he said later. The young man said that he did not blame law enforcement. But he felt he had been injured twice, by the bomb and by the accusatory coverage. “I don’t know if I am gonna be safe . . . because I lost my privacy,” he said. “It’s not [an] easy thing to just forget.”

 • • • 

A
s darkness fell on Monday, Shana Cottone was still working. Hours had passed since her harrowing ride from the finish line to the hospital in a police van. Now the van—so recently pressed into service as a makeshift ambulance for bombing victims—was being used to transport a police bomb squad as it roamed the neighborhood responding to suspicious bag calls. Shana had stayed with the vehicle after it carried her back to the finish line. Its driver, veteran officer Jim Davis, had an unflappable air that had steadied her through the awful afternoon. He had seen that she was shaken, and he hadn’t made her feel stupid about it.
After all this is over
,
kid
, he told her,
you need to take care of yourself
.

Shana had made one quick detour before heading out again with Davis: back to her parked car to get her bulletproof vest. She could not believe she had been caught without it. Once she had it on, she felt a little better. Still, she longed to get away. She was staggered when she got to Kenmore Square and saw people standing around in the street taking pictures. She couldn’t imagine why they would choose to be there, when everything felt so unsafe. She stuck to the widest-open spaces she could find.
Leave now
, she told anyone who asked her advice.

When she finally got home to Hyde Park around midnight, her dog was waiting for her by the door. He had been acting strangely all afternoon, her roommate told her, whimpering as if he knew something was wrong. Shana looked down at the beagle and started to cry. The relief she felt at being home was overwhelming. But her tears signaled a deeper realization, too. Everything was different now, Shana understood. She might never leave the darkness of this day behind.

 • • • 

K
aren Rand had arrived at Massachusetts General Hospital by ambulance, one of the severely wounded spectators hit by the bomb outside Marathon Sports. She had been standing near her close friend Krystle Campbell and had suffered massive damage to her left leg. Rand was given a patient number and rushed into an operating room. The handbag that came with her was put in a bag and labeled with the same number. The ER staff looked through it, searching for something to confirm the woman’s identity. They found a driver’s license with a name: Krystle Campbell. Word that Krystle was apparently at Mass General somehow made it to Patty and Billy Campbell, who came to the hospital believing their daughter was being treated there. Around 2:00
A.M.
Tuesday, nurses led the Campbells into an intensive care room, where they expected to see Krystle recuperating.

“
That’s not my daughter!” Billy exclaimed. “That’s Karen! Where’s my daughter?”

The hospital staff was shocked. The mistake was innocent but the effect was cruel, and it would be a cautionary lesson about correctly identifying patients going forward. Less than an hour later, a detective from Boston arrived with a photo of Krystle. Her family learned that she was already gone. Krystle had been one of three people killed in the bombing. Billy nearly collapsed to the floor. Instead of greeting his daughter at her bedside, he would soon have to formally identify her body.

 • • • 

B
ack on Boylston Street, the silence deepened with the night. A chill settled in. Two figures still lay on the ground where they had fallen, covered with tablecloths from a nearby restaurant. The bodies of Martin Richard and Lingzi Lu would remain there until 2:00
A
.
M
.
as investigators painstakingly collected evidence around them; Krystle’s body had been taken from the street already. Several Boston police officers had promised to stay at the scene, as long as they were needed, keeping a last watch over the bodies. Their vigil comforted Martin’s father, Bill, who had been distraught at the thought of leaving his son there.

Not far away, a couple blocks east of the blast sites, Dave McGillivray, Rich Havens—the finish area coordinator for the marathon—and other race officials had spent six hours Monday night lining up yellow bags on Berkeley Street.
These were the bags runners used to stow their personal items until after the race—clothes, wallets, plane tickets, money, phones, food. Race organizers put out word that anybody who hadn’t yet collected theirs should come there to claim them. As McGillivray and his team spread the bags out, they could hear, from time to time, cell phones ringing inside them, each chirp and tinny melody a loved one’s vain attempt to reach a runner. They listened to the phones singing in the darkness, a melancholy sound track to their solemn labor.

Saving lives, against the odds

H
eather Abbott opened her eyes. She was in a hospital bed, her mother beside her. She didn’t know how long she had been unconscious, but memories came back to her in fragments: Waiting at the door of the bar on Boylston Street. The sound of the first explosion; turning her head to look and seeing billowing smoke. Then, searing pain and mounting desperation. She remembered choosing not to look at her foot, knowing from the expressions on her friends’ faces that she shouldn’t.
I wonder what happened to it
, she thought. She let the thought stop there. Part of her wanted to know and part of her wanted to linger in the uncertainty. Her mother seemed calm and collected, relieved to see her awake. Her father, she would quickly discover, was more upset than she had ever seen him. Watching him struggle, realizing the depth of his devastation, Heather was taken aback. He had always been so sturdy. It was not how she would have imagined his reaction.

Her left leg appeared to be in traction, elevated up above the bed, with a white sheet draped over it. From her small room in the Brigham and Women’s Hospital intensive care unit, she could see through a glass wall to the busy nurses’ station. Patient rooms fanned out around the station in a circle. A nurse told her they were filled with others who had been hurt at the marathon, but for the moment Heather asked few questions. She knew instinctively she couldn’t handle the whole story—not right now. For the moment, the pain demanded most of her attention. She had to concentrate on getting through it, the same way she had narrowed her focus the previous day, after the blast, to the necessity of getting to the hospital.

Already, through the pain and the fog of medication, she knew her friends and family were gathering, bracing to support her through whatever lay ahead. Her mother told her that after she left Boylston Street in the ambulance, her friends had walked to Massachusetts General Hospital to find her. When they learned she was instead at Brigham and Women’s, another elite teaching hospital about three miles across town, they took a cab there and waited for hours, in their blood-smeared clothes, to learn her condition. Her friend Julie, a former bartender at Forum who had returned for a Marathon Day shift, had found Heather’s wallet lying in the middle of Boylston Street and brought it to the hospital, worried that Heather would need her insurance card. Her friend Al’s boss had told him to stay in Boston, and then paid for a hotel room. Everyone was sticking close, and wanted to know the same thing: Would her foot be okay? Would she?

 • • • 

A
cross the city, at Boston’s six major trauma centers, similar scenes were playing out. At Boston Medical Center, Celeste Corcoran, forty-seven, a hairdresser who had never been to the marathon until Monday, lost both of her legs below the knee. Her seventeen-year-old daughter, Sydney, whose femoral artery was ruptured by shrapnel from the first blast, had been saved by a bystander who fashioned a tourniquet. When they were finally reunited, neither could stop crying; they would share a room as soon as they were stable, the beds pushed together so they could hold hands. At Beth Israel Deaconess Medical Center, in the city’s Longwood medical corridor near Brigham and Women’s and Boston Children’s Hospital, Paul Norden, thirty-one, a construction worker, struggled to accept the loss of his leg and learned that his older brother JP, thirty-three, admitted to the Brigham, had lost one of his, too.

Altogether sixteen people—eight women, seven men, and one young girl—would lose limbs as a result of the bombing. All of them had been close to the bombs, but so had others who’d escaped with less severe injuries. It was, in many cases, a matter of feet, or even inches, that determined one’s degree of injury. Flying shrapnel added to the randomness. Later, Heather would wrestle with the knowledge that people closer to the bomb than she was had walked away unscathed. Her own two friends, standing next to her at the door of Forum, had not suffered a scratch—though one of them later found a blade-shaped shard of metal shrapnel in her handbag. Two people at the first bomb site would lose both legs—Celeste Corcoran and Jeff Bauman, the stoic, ashen-faced twenty-seven-year-old man aided by bystander Carlos Arredondo, the “man in the cowboy hat,” at the bombing scene. A photograph of Arredondo racing down Boylston Street, pushing Bauman in a wheelchair while gripping the tourniquet on his leg, had become one of the week’s iconic images. Bauman’s father, unable to reach his son after the blasts, only learned that Jeff was hurt when he saw the photo. “Unfortunately my son was just in the wrong place at the wrong time,” the senior Bauman wrote Tuesday morning on Facebook, breaking the news to his friends and family.

Within twenty minutes of the blasts, thirty of the
most critically injured patients had been “red-tagged”—marked as urgent cases for immediate transport—and distributed roughly evenly among the city’s largest hospitals, through a central dispatch center at Boston EMS. At the Brigham,
the first patient from the finish line had arrived at 3:08
P.M.
Monday, eighteen minutes after the first bomb exploded, followed by eighteen more in the next thirty minutes.
Mass General took in thirty-one in the first hour, including five patients with amputations, received just minutes apart at 3:04, 3:15, 3:20, 3:22, and 3:27
P.M.
At Boston Medical Center, surgeons performed a total of seven amputations on Bauman, Corcoran, and three other patients.
It made for a nightmarish scene in the ER. Badly wounded patients lay on gurneys looking at one another as they awaited surgery, blood everywhere and agonizing screams—“Oh my God, my foot!”—ricocheting off the walls. There were three amputations at Beth Israel, two at the Brigham, and one on a seven-year-old girl at Children’s Hospital. In some cases, the decision to amputate was uncomplicated, because the patient’s foot or leg was gone, completely destroyed, or nearly severed. With others, the decision was less clear. At Boston Medical Center, surgeons consulted with one another to make sure more than one doctor reached the same conclusion. “
What we like to do before we take off someone’s leg—it’s extremely hard to make that decision—is often we get two surgeons to agree,” Tracey Dechert, a trauma surgeon at the hospital, said that day. The consultations—“Am I right here? This can’t be saved?”—gave doctors reassurance, she said.

The array of other injuries was dizzying. Patient admission logs kept at Tufts Medical Center showed the relentlessness and range of the damage:

3:33
P.M.
Female with third-degree burns and shrapnel wounds

3:35
P.M.
Male with shrapnel and ruptured eardrums

3:35
P.M.
Male with a complex penetrating wound

Soft tissue injuries, nerve injuries, bone fractures, abrasions, and embedded foreign bodies—nails and ball bearings—followed. In the midst of the onslaught, Tufts officials were forced to evacuate their ER because of a bomb scare; bomb-sniffing dogs brought in to check out a suspicious package appeared to confirm that it contained explosives, forcing all emergency patients into the hospital lobby for thirty minutes. Another bomb scare disrupted at Mass General, where the hospital was briefly placed on lockdown because of a suspicious package in a parking garage. Meanwhile, well into Monday night, patients were still showing up at the hospitals—at Tufts, a runner suffering from exposure checked in at 6:14
P.M.
; a spectator with hearing loss arrived at 7:01; more burns and abrasions followed at 7:23. The following day, new patients with hearing loss and head injuries arrived—along with the first wave of those seeking help for invisible wounds, like the “witness with anxiety and depression” noted in the Tufts log at 3:30
P.M.
Tuesday. In all, 275 people would be treated at hospitals.

In the midst of so much pressing need,
there were inevitable inconsistencies, and patients who experienced gaps in the level of care. Allison Byrne, who had just run the marathon and had a large piece of shrapnel lodged in her left leg, sat in the ER holding her own tourniquet for hours after being brought in a police car to Boston Medical Center. She had just run twenty-six miles, but she wasn’t given much water, couldn’t get to the bathroom, and had to beg for Tylenol. In the case of some of the doctors and nurses, she found their bedside manner and communication wanting.

As the hours crept by Monday night, and as dawn approached on Tuesday, the tally of the wounded mounted. City officials and shaken, sleepless residents waited for the death toll to creep upward, too. It seemed inevitable, given the power of the explosions and the witness reports from the scene, the videos and photographs and bloodstains on the sidewalks. Yet the number of fatalities remained at three. The first identified was Martin Richard, whose name had begun circulating in the city, and on social media, before 9:00
P.M
.
Monday; at 1:00
A.M.
Tuesday, the
Boston Globe
confirmed it via Twitter. The world learned Krystle Campbell’s name later Tuesday. Boston University said Tuesday the third victim was a student, though it took until Wednesday for Lingzi Lu’s name to be made public. It was hard to believe there would be no further fatalities, but hopes grew with each passing day. Every injured person who had been transported alive from the scene to a hospital—even a few who had lost all or nearly all of their blood, who may have come within minutes of death, like Marc Fucarile—had survived. It only seemed more stunning the longer it stayed true, a tribute to the frenzied medical response at the bombing scene and the skill and readiness of Boston hospitals.

It was a strange truth that many would acknowledge in the days and weeks that followed: If there had to be a terrorist attack somewhere in the US, the finish line on Boylston Street, with the medical tent already in place and six of the top hospitals anywhere within a mile or two, was about the best place it could happen. Such a concentration of skilled surgeons, nursing staffs, and operating rooms was extremely rare.
The underpinnings of Boston’s medical infrastructure had been established early, in the eighteenth century, giving the city a huge head start on its evolution into a health-care mecca. Harvard Medical School had been founded in 1782. Massachusetts General Hospital, one of the first hospitals in the country, opened its doors in 1811. In 1846, the first demonstration of ether anesthesia took place in the so-called ether dome at Mass General. During the famous surgery, the patient on the table suffered no pain—an internationally heralded breakthrough. Its success was further confirmed a month later when MGH doctors amputated an anesthetized patient’s leg. The use of ether would transform the practice of surgery and profoundly improve public health, cementing Boston’s place as a center of innovation. After Harvard’s medical school relocated, in 1906, to five marble-fronted buildings on Longwood Avenue in Boston, a medical building boom followed. The new campus was surrounded by marsh and farmland, open space filled by new centers for treatment and research. The growth led to more medical milestones, including the first fertilization of an ovum in a test tube and the first successful human organ transplant.

The hospitals had a rich history, but their preparedness for mass casualties on Marathon Day was
largely due to recent training. In the decade since 9/11—since the nation had been forced to accept that terrorist acts could happen in America—hospital leaders and public health agencies had incorporated that reality into their planning for emergencies. They reviewed the latest literature on mass casualty events and hosted conferences on how to respond. They updated their communications systems. When reports of the bombing began to spread via Twitter and text messages, the hospitals had some idea what to expect. They sprang into action, emptying their ERs of less serious patients, preparing operating rooms for vascular and orthopedic procedures, and ordering additional blood supplies from outside the city. When the day nursing shift at the hospitals ended at 3:00
P.M.
, those nurses were asked to stay, doubling the size of the staffs on hand when victims began showing up. Many off-duty staff members showed up to help even though they weren’t scheduled to work. In part because of the grim legacy of 9/11, it was understood from the first reports that this event would be unprecedented and all-consuming.

 • • • 

T
hree miles away from the hospital room at Brigham and Women’s where Heather had awoken on Tuesday, David King was facing families’ urgent questions at Mass General:
Will my daughter live? Will she need more surgeries? Will they have to take more of my son’s leg? Will he walk again? When?
They craved certainty, but with so much still unknown, that was more than King could give. There would come a time when answers would be clearer, but with some of the victims facing more surgery or sedated, the time for such projections was still days or weeks away. The families needed someone to sit down with them now, to hold their hands and explain what was happening. King didn’t have time for that. He was moving too quickly, consulting with colleagues, evaluating patients, assessing which ones should head back to surgery and which ones needed to rest. He relied on the ICU nurses to engage with the distraught family members. As distracted as he was by the work, he registered how compassionate they were, the pains they took to make terrified parents and spouses and friends feel calmer and more comfortable.

It had been a long night for the trauma surgeon. His work had begun the previous day, just as he was heading home after the marathon. He had run twenty-six miles in three hours and twelve minutes and he was ready to rest, to sit down and drink some Gatorade. After finding his family at the finish line, he had lifted his six-year-old daughter onto his shoulders, while his wife, Anne, pushed the two-year-old in her stroller. They had planned to take the subway, but the lines were long, so they piled in a cab and headed home to Cambridge. The ride across the river took less than ten minutes, but by the time they got there, King had received a swarm of text messages. He always got supportive notes from friends when he had a big race—he liked to save them to read when he got home, after he had showered and swallowed some ibuprofen—but this looked like an unprecedented influx. While his wife went around the corner to pick up a pizza, King brought the kids upstairs and scrolled through his messages.
Are you okay?
one of the texts asked. Another mentioned an explosion. King tapped the screen to call up some breaking news from Fox or CNN. The websites wouldn’t open—another bad sign. Something had happened. He had to get to the hospital. Anne had seen the news on the TV at the pizza place; she arrived home ready to drive him to work.