Staying prepared, embracing lessons learned: Reflecting on MGH’s response to the Boston Marathon bombing

Ten years ago, on April 15, 2013, Paul Biddinger, MD, then the vice chairman of Emergency Preparedness in the Mass General Emergency Department, started his Marathon Monday as he had in previous years – staffing a medical tent on Heartbreak Hill, the final ascent of the Boston Marathon. Within a matter of hours, however, two bombs were detonated near the finish line and Biddinger rushed back to Mass General’s Emergency Department, where runners and spectators – many severely wounded – were brought for treatment.

Many memories and emotions arise when Biddinger thinks back to that day – and the weeks and months that followed. It is impossible to forget the sadness, uncertainty and stress felt by staff throughout the hospital. Yet now, a decade later, what Biddinger concentrates on most is his overwhelming appreciation for his fellow MGHers, who never wavered in their commitment to save lives and take care of one another during that chaotic and distressing time. Biddinger, who now serves as Mass General Brigham’s chief preparedness and continuity officer, also focuses on helping to improve health care emergency preparedness initiatives across the United States through several federally funded research programs within the MGH Center for Disaster Medicine.

Biddinger says toolkits for evacuation, hazardous materials response, biological agent preparedness and resources produced within the Center for Disaster Medicine for hospitals across the country have leveraged Mass General’s interdisciplinary successes and extraordinary work.

“Our hospital system has changed in many ways since 2013, but the core of what we do has always been the same,” Biddinger says. “Our role will always be to be there for our community on really good days and really challenging days.”

Biddinger attributes the hospital’s quick response on that especially challenging day to its longstanding commitment to training, providing staff with an understanding of how mass casualty incidents unfold and what immediate responses are needed. Because staff in many role groups had participated in training drills and had reviewed and prepared for emergency situations, they were ready to take action, which resulted in the delivery of urgent, and in some cases lifesaving, care.

Josh Baugh, MD, now the medical director for MGH Emergency Preparedness, was a junior medical student in Brigham and Women’s Hospital Emergency Department at the time. He remembers his amazement at how quickly the ED came together in response to the hectic situation and says it played a key role in what led him to a career in emergency medicine and emergency preparedness.

“We hope nothing like this ever happens again, but the tragedy of the marathon bombing keeps me motivated to ensure we are prepared to respond if called on again to care for our community,” Baugh says.

The Center for Disaster Medicine staff stay prepared by continuously learning from past emergencies. Their response to the marathon bombing helped to inform processes in the Mass General Emergency Department and in hospitals around the world.

“After that experience, we tried to take a tragedy and turn it into something that helps everyone be prepared to face something similar in the future,” Biddinger says. “It was important for us to evaluate what we did well and what we could have done better.”

Regular training exercises also help the Center for Disaster Medicine, and MGH leaders and staff, strengthen the hospital’s response to disaster events. Tabletop trainings are hosted several times a year to simulate disasters and help staff from across the MGH plan and practice a unified response. Jen Shearer, director of MGH Emergency Preparedness, says collaboration is key to continued readiness – whether during exercises, in synthesizing experiences from other institutions, or responding en masse when a disaster strikes.

“As health care continues to change, it is important that our plans transform to meet the needs of our community and to keep our staff, patients and visitors safe,” Shearer says. “There is an incredible breadth of knowledge and expertise across Mass General – partnerships across roles and departments buoy our ability to respond to any challenge we may face.”

For Biddinger, participating in these regular tabletop exercises is a reassuring and encouraging reminder that MGHers remain committed to doing whatever is required of them during disaster situations to ensure the safety of themselves and all of those around them.

“To still have that much energy and buzz and interconnectedness after all we’ve been through speaks volumes,” he says. “I’m confident that if our staff were asked to step up again as we were 10 years ago, they would have the willingness and training to do so successfully.”