I'll use this for the start of what is going to be a rather lengthy reply.
I have two prefaces to that reply. One is a bit of a scolding, the other is my bona fides so you know I'm not just "some guy" on the Internet, but actually have some experience with this.
The scolding. I'm very taken aback at some of the "Me, Me, Me" comments that I've read here. I expect them on some other forums, but one of the reasons I spent (too) much time here is that the level of maturity is much higher than other internet firearms forums. This attack isn't about gun control or anything else. It's about terrorism. Those are real people who are dead and injured. Let the craven politicians use this as a platform for their goals. We're better than that, when the time comes, we'll counter them. This attack is also about the people who had to respond, and are still responding. Think about them as well in preference to thinking about yourself and the impact on them.
Part two. Bona Fides. I worked for the City of Boston EMS system for 34 years. Since we do the 9-1-1 responses in the city the Marathon is "our" event. It's one of our biggest events of the year, but I'll get to that in a bit. I worked at probably 25 or more Marathons from back when it was a small event up until last year. Many of those years I worked in the main medical tent at the finish line. "Alpha Tent" is what we call it. Planning for that goes on from a few weeks after the previous Marathon up until the days just before it.
We've been training for terrorist attacks since 1997, before most other systems even thought of it. We do drills, classes, more drills, and the Marathon and other events are considered Mass Casualty Incidents, although they are planned events. They are in one respect training events, in another they are a slow motion disaster.
All of which is to say I know the medical response at the Marathon very well. I know the police response a bit less well, but I'm familiar enough with it to offer some observations.
About the police. It's a big day for the Boston Police since most of the spectators are congregated in the 2.8 miles of the route that is in Boston. Everyone works. All of the bomb guys are in, including the dogs. Not just the BPD either. MA State Police, Transit Police, outlying agencies with bomb squads or dogs, federal agencies, the National Guard. Think of a federal agency, they probably have people there. While they may be telling people that it's a drill, they take this very seriously. Still even with all those dogs, someone can carry in a device or devices and that seems to be what happened. Thousands of people lining the route, many of them with back packs or brief cases or something like that.
Now the medical part. This is one of the days that everyone that works for Boston EMS can work if they want. In addition to the 400 bed capacity Alpha Tent, there are other medical tents along the way from the Newton line inward. There are a lot of volunteers staffing some stations, but they are volunteers. They don't have to be there and I'm going to guess that some of them left the tent after the explosion. Not that I blame them, they don't train for this and it's not what they signed up to do.
The Boston EMS people are trained and are paid to be there not only for the runners, but just in case this sort of thing happens. We have all sorts of equipment for handling mass casualties, much of which probably got used to today.
We have a lot of extra ambulances because Marathon day is very, very busy. So, we need extra ambulances. Plus we have bikes, John Deere Gators, and other stuff I won't bore you with.
The Alpha Tent has enough equipment and staff that a lot of the less seriously injured where brought in there, triaged, and treated. Some of the where moved to hospitals, some were likely treated and released from the tent. In a normal year, most of the patients treated in the tent are discharged by a doctor and don't go to the hospital. Same principle.
This no doubt helped with the response as on another day, they would all have gone to hospitals.
Speaking of hospitals, Boston has five Level 1 trauma centers. Most cities don't have any. Some states don't have any. In addition there are a number of none trauma center hospitals that can treat patients that are less severely injured. As a result patients were moved to trauma centers and into Operating Rooms, if needed, in a matter of minutes and not hours.
Keep this in mind as well. Time does not stop when this type of thing happens. In addition to the race, there are the normal 9-1-1 calls coming in that need to be handled. The hospitals are still seeing patients with heart attacks, seizures, car accidents, headaches, and probably a few shootings and stabbings as well.
Finally (I think), pay no attention to the media. They have no idea what's going on. They can look at video and guess what someone is doing, but I can look at that same video and know what they are doing. Hell, I can tell you the names of some of the people that are on TV because I worked with them. The local TV stations are making stuff up and the national networks are just parroting that misinformation. It will be a few days before we know what really happened and who did it. Still, they have air time to fill and laundry detergent to sell, so they have to put something on the air.
Hopefully that gives you folks some insight into what was really happening before, during, and after the Marathon and the attack.
I'm thankful that at least as far as I can tell, none of my friends and former co workers are among the injured.
For the benefit of the moderators, none of what I wrote here is confidential. It might not be common knowledge, but there are a good number of people who could have written this post.
