1. THE MARATHON SURVIVORS From April 20 th to July 24 th, thirty-two survivors rehabilitated at SRH. Occupational Profile of 7 Marathon Survivors STRENGTH AFTER TRAGEDY Samantha Conley, MS, OTR/L Spaulding Rehabilitation Hospital, Boston, MA Marathon Monday, April 15 th, 2013 will be embedded in our memories forever. At 2:49 p.m., two bombs exploded within seconds of each other near the finish line of the Boston Marathon. The explosions killed three people and injured more than 200. These horrific attacks rattled the entire city and changed the lives of many innocent people forever. APRIL 15 th, 2013 “Collaboration can be a powerful force. When strong partners push toward a common goal, amazing things can happen.” 1 Communication, collaboration, and teamwork began in the acute care hospitals, continued between the acute care and rehabilitation, and persisted within Spaulding Rehabilitation Hospital (SRH). TEAMWORK Ongoing team discussions throughout the day were essential. Each survivor’s recovery varied both physically and emotionally, sometimes with hourly changes. The Communications Director and Security personnel also played a vital role in the survivors’ daily care. Teamwork created friendships. We were strong together. *References available upon request. Following one of Boston’s darkest hours, the benefits of using meaningful, occupational-based, and client-centered rehabilitation were reinforced. The Boston Marathon Bombing survivors’ strength and determination motivated me to not only become a better occupational therapist, but has improved my strength as an individual. OT STRONG This OT experience made me… A minimum of 10 separate crews daily 17 press conferences Broadcasts in 70+ countries 5,365 media hits OPPORTUNITIESCHALLENGES Promoted survivor healing.Security risks were heightened. Encouraged “if they’re okay, we’re okay” healing for many Bostonians. Spaulding transitioned into a new building at the same time. Created the BOSTON STRONG presence throughout the community. Staff needed to “learn” the new facility in the spotlight. Increased communication and collaboration through the entire Boston medical community. Reporters, camera crews, photographers present during therapy sessions. Displayed our new hospital.Potentially compromised confidentiality. Portrayed the important role of rehabilitation, especially OT, in recovery. Created a “media circus” which affected Boston Marathon Bombing survivors, non- involved patients, as well as staff. Inspired amputee awareness and advocacy. “Ultimately, practitioners can help victims of disasters in all stages of emergency situations by creating realistic goals, ‘empowering them to regain their independence and move from being a victim to a survivor’.” 3 OT & RECOVERY Study of previous disasters helped to support and guide our therapeutic approach. The world began to see that “occupational engagement reduces the intensity of stressful events and helps reestablish a sense of mastery in a situation in which a person feels a loss of control.” 2 Goals were achieved through client- centered and occupation-based OT interventions. A “new normal” brought new challenges; however, OTs know that hope still glimmers in the darkest hour. ROLE OF THE MEDIA The entire world was exposed to the events and injuries that occurred on Marathon Monday. Media presence and involvement at SRH was intense: “When lights dim and cameras go away, know that our support and love for you will never waiver.” - Former Mayor Thomas Menino “America will never stand down… We are Boston. We are America. We respond. We endure. We overcome and WE OWN THE FINISH LINE…” – Vice President Joseph Biden A NEW NORMAL THROUGH OT Continuity of Care BIDMC BWH BMC MGH TUFTS Marathon Survivor GOAL Community Re-Entry SURVIVOR PERSPECTIVE - Survivors were apprehensive to begin “new normal” outside the safe hospital environment. - Fear of crowds and how the community would respond to the “new normal”. - Barriers: balance impairment, poor endurance, functional mobility required use of wheelchair, walker, crutches, or cane. INTERVENTION - Obstacle course in gym, navigated crowded cafeteria, and walked outdoors through “Strength Garden” for simulated uneven surfaces. - Community outing to Boston’s North End to navigate uneven grounds, hills, and busy area. - Encouraged survivor and family outings (i.e. New England Aquarium, Boston Bruins game, local restaurant, mall) with OT and PT present for guidance and support. - Therapeutic leave of absence for survivor with family or friends to break the “security blanket” hospital and staff provided.