The bombing of innocents at the Boston Marathon will forever be remembered alongside similar tragedies such as 9/11, not only for the resulting gruesome injuries and deaths that’s been engraved into our minds by the media, but for the sheer shock of witnessing something so unfathomable actually happening in reality.
But as shocking as it was, the local healthcare response was surprisingly prompt, efficient, and effective. What we witnessed in the immediate aftermath of those 2 deadly bombs exploding, was a clear demonstration of several important learning points for the rest of us.
The first thing that struck me as I watched some of the video clips capturing the explosion of the first bomb, was not the motionless bodies lying near the bomb, but rather all other people around them. Instead of running for cover (who knows how many more explosive devices could be waiting to go off?), strangers to the victims went immediately to help the fallen and injured with seemingly no regards for their own safety. This innate reflex to help others, even complete strangers, has been well documented in other situations, and is the focus of much study. The example I really like:
Psychologist Michael Schulman of Columbia University likes to pose the thought experiment of the kindergarteners who are taught two rules: it’s not OK to eat in the classroom and it’s not OK to hit other children. Tell the kids that the teacher has lifted the no-eating rule and they’ll happily eat. Tell them that the teacher has lifted the no-hitting rule and they’ll uniformly balk. “They’ll say, ‘Teacher shouldn’t say that,’” says Schulman. “That starts at a very young age.”
It seems, thankfully, there is underlying good in human nature to want to help.
And beyond the immediate bystanders, it would appear that the healthcare professionals at the hospitals receiving the casualties also let their natural instincts take over to deliver the best care they could above and beyond expectations in such a potentially chaotic circumstance. Atul Gawande observed in his hospital how everyone seemed to “just knew exactly what they had to do”, and fell into some sort of rhythm – the incoming flood of patients were organized and attended to in a coordinated effort with little confusion/fuss.
However, what we witnessed was not purely driven by a natural instinct or innate moral willingness to help that coincidentally fell into place; but rather, the result of well practiced fluidity.
Those who were working at the heart of the healthcare response in Boston all reported that it is no accident that they were prepared. Shocking that a bomb blew up at a marathon? Absolutely. Was it something the American healthcare system has never seen before? Sadly not. 9/11 and similar attacks have served as a wake up call for hospitals across the country, and many have practiced repeatedly for such an incident.
Wish we could say the same for the Canadian healthcare system.
We seem to be living behind an imaginary wall of protection, north of the 49th parallel. Despite repeated CRBNE (chemical, radiological, biological, nuclear, and explosive) events south of the border in the past years that should have served as sobering wake up calls for Canada, we have been somewhat lethargic in our training. As an example, even the majority of physicians and health professionals working in the tertiary care trauma center of our nation’s capital have no proper training in CRBNE situations; have no idea how to don high level personal protective equipment (PPE); and have had no practice in mock situations.
It’s like trying to ask a surgeon to perform a surgery without having read about it and practiced it first.
There is no doubt that Canada has been fortunate thus far. However in this day and age, we are naive to believe that we are immune to similar events, when we share the world’s longest international land border with one of the most targeted countries for terrorist attacks in the history mankind.
The Marathon bombing needs to be the last wake up call for the rest of us. We need to get our butts in gear so that – god forbid – if something was to happen, we too can translate our innate will to help into coordianted action, and exhibit the practiced fluidity we saw in those heroes in Boston on April 15th.
Edmund Kwok
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