The bombing at the Boston Marathon yesterday left me with a range of emotions and a flood of thoughts. As with every other decent human being on the planet, I watched the news reports with deep sadness. Along with thousands of others, I also experienced those brief moments of concern wondering about the safety of my friends who were running and my extended family living in Boston. As a marathoner, although one not quite fast enough to qualify for Boston, I also worried about the sport I love, and what it would mean for our iconic Boston Marathon to be forever associated with such vicious cruelty. I was also plenty upset at the unknown individual who perpetrated this cowardly and violent act.
Unlike most people, however, I observed events in Boston with a professional interest. I am in the business of healthcare emergency and crisis management, meaning that thinking about mass casualty events is part of my job. In fact, almost all of what I do involves building resilience among healthcare providers and organizations so that they may take better care of folks like you and me when something awful happens. So when I watched those videos and photos of the explosion, I kept a close eye out for the markers of resilience that may not keep us safe, but allow us to bounce back as a community and go about our business. Of course my vantage point is limited. I'm not on the ground in Boston, am not overly familiar with their plans/protocols and I don't have any inside knowledge about events there. But I sifted through dozens of grizzly photographs pulled by our Intelligence team off of social media platforms and readily observed the resilience I was looking for. I saw pictures of pre-hospital providers performing what appeared to be sophisticated and street-hardened triage (in one photo you may have seen a medic is checking the carotid pulse of a lifeless-looking woman while simultaneously scanning the victims around her). I saw marathon volunteers and runners helping out victims. I saw the ubiquitous use of tourniquets, suggesting an army of trained healthcare providers or an impressive group of lay volunteers. I saw rapid transport of critical victims by any number of means, including wheelchairs and two-person carry maneuvers. I saw law enforcement and other public safety officials rescue individuals while simultaneously drawing their weapons and looking for the source of the explosion.
Throughout the evening I monitored reports, mostly public, from the hospitals in the area that absorbed hundreds of patients in very short order. Their ability to flex and adapt to accommodate this "medical surge" appears to have been textbook-perfect as well. I'm sure it didn't feel that way to them, and there will be lots of findings and areas for improvement identified in the coming months. But there seems to be little question at this point that the hospitals in Boston, many of which are world renowned for their extraordinary patient care innovations, demonstrated real resilience in the face of terror yesterday. We underestimate the importance of this resilience at our own peril. Consider that the end point of any rescue operation is usually a victim who is delivered safely to a hospital. We frequently assume these hospitals have infinite resources and can adapt and take on any challenge. This is of course not the case. Hospitals are, in many ways, some of the most fragile institutions in our society - they are highly dependent on external support (power, water, communications) and that they already contain some of the most vulnerable people among us (the sick).
I was reminded of a lot of things last night watching the news reports, including just how important our collective work in this area really is. Over the next four days at TEDMED I will be networking and co-learning with over 1500 thought leaders from around the country, all of us seeking to find ways to improve healthcare and the quality of our collective lives. It seems a trite thing to attend a TED conference while so many suffer and an entire community begins the arduous work of recovering from an intentional act of terrorism. But I am convinced that the spirit of innovation and entrepreneurship that defines TEDMED provides the ideal platform to promote healthcare resilience and radically re-think how we approach this important work. As we have seen, the health of our community depends on it.
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