Boston Marathon Bombing: Caring for the Suspects

After hearing the news of the Boston Marathon bombing, what nurse didn’t think about what it must be like to care for a flood of victims with such traumatic injuries? But think for a moment about those who cared for Tamerland and Dzhokhar Tsarnaev, the brothers suspected of planning and carrying out the attack. It is an aspect of the bombing that did not receive much media attention. What special challenges did these health care providers face?

When law enforcement officials captured Dzhokhar Tsarnaev, Boston residents cheered and the nation uttered a collective sigh of relief. This dangerous suspect had been apprehended in one of the most intense and televised manhunts ever witnessed by the American public. For most of us, it seemed the ordeal had ended. Not so for the nine trauma nurses and other health care providers at Beth Israel Deaconess Medical Center where Dzhokhar Tsarnaev was taken. After caring for 24 victims of the bombing, they now were faced with caring for a patient that everyone believed had caused their injuries and suffering.

Earlier the same day, emergency department (ED) personnel had tried unsuccessfully to save Tamerland Tsarnaev, Dzhokhar’s older brother. Tamerland arrived unconscious at Beth Israel Deaconess in cardiac arrest with burns on his chest and shoulder and a large gash on his torso. The trauma center staff immediately began CPR, inserted chest tubes, administered massive blood transfusions, and then opened his chest to see if blood or other fluid was pooling around his heart. Despite all attempts to save his life, he was pronounced dead shortly after his arrival.

It wasn’t until after Tamerland was pronounced dead that Dr. David Schoenfeld, an ED physician at Beth Israel Deaconess Medical Center, took a good look at the patient’s face. That’s when he realized he had been treating one of the suspected bombers. Ironically, Dr. Schoenfeld had attended a memorial service at the Cathedral of the Holy Cross to honor the victims of the Boston Marathon bombing just hours before.

That evening, Dr. Schoenfeld was at home in Watertown, Mass., when he heard gun fire. Suspecting that it may have something to do with the marathon bombing, he alerted Beth Israel’s ED staff to expect casualties and rushed into the hospital.

Minutes after Dr. Schoenfeld arrived, Dzhokhar Tsarnaev, bleeding heavily from gunshot wounds, arrived in the trauma center. At the time, the ED staff wasn’t sure who he was. In a story reported by the Boston Globe, Dr. Schoenfeld said, “There was some discussion about who was coming. Is it the suspect? Is it a victim? Is it a police officer?” Any discussion ended quickly. “It doesn’t matter who’s coming in,” Dr. Schoenfeld said. “We’re going to treat them as best as we can, because you really don’t know who it is until the dust settles.”

Caring for the Surviving Suspect

Once again, trauma team members went through their skillful paces, administering to their patient as best they could and without regard for who he was. Dzhokhar survived and was eventually moved to an intensive care unit. All of the nine nurses who were asked to care for him agreed to do so voluntarily. One nurse told the Boston Globe, “I did it because I’m a nurse and I don’t get to pick and choose my patients.”

Still, it could not have been easy. Dzhokhar’s ICU room was guarded by FBI agents with Boston and state police stationed throughout the ICU area. Nurses involved in Dzhokhar’s care had to present ID and were searched by FBI agents at four checkpoints before being allowed to enter his room. Some nurses worried about what other people would think of them if they knew they were helping the bomber. In fact, some of the bombing victims, including Paul Norden who lost his right leg in the bombing, were in patient rooms just down the hall and their family members were uneasy about having the suspected bomber so close by.

Tragic and Trying

Dr. Schoenfeld, describing the experience as physically and emotionally exhausting, told the Boston Globe that “this has been a very tragic and trying time.” One nurse felt that the time between shifts was most difficult. She described her experience this way: “When you’re in the room, it’s just a patient. You’re here to make sure they’re feeling better. When you step away, you take it in. I am compassionate, that’s what we do. But should I be? The rest of the world hates him right now. The emotions are like one big salad, all tossed around.”

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