When the Boston Marathon gets underway Monday, Dr. Howard Palamarchuk will be there, right beyond the finish line, ready to finish what he started last year.
“We’re going to go back and when we hit that point, we’re going to finish the job this time, just like many people are going back to finish the race,” Palamarchuk said.
That point is the point in the day last year, when two bombs went off, killing three people and injuring 264. It was well after all the elite runners had come through, and right as the biggest group of runners -- what Palamarchuk and some of his students call the ordinary runners-- were about to start crossing the finish line. Many had family and friends who’d gathered there to witness the triumph of making it 26.2 miles.
“You have to almost wonder if they [the alleged bombers] planned it that way,” Palamarchuk said. Although he tries not to dwell on what happened next, there are still triggers that parachute him back into moments of anxiety. Stretchers. The smell of gunpowder or fireworks. A beautiful, clear blue day. The commanding tone of a voice over a loud speaker.
“Going back? It’s feeling very strange,” Palamarchuk said from his office at the Temple University School of Podiatric Medicine four days before the race. This will be his 29th year working the Boston race. Each year, Palamarchuk, who is Director of Sports Medicine at the school, takes a group of 10-12 podiatry students up to work the race. Most are getting ready to graduate.
“These are the students who’ve given a hard four years of work. It’s like a road trip for them. They have fun,” Palamarchuk said. The Temple group, along with other medical professionals, all work under a tent that runs the size of a city block. After runners finish the race, they can take a detour into the tent to get checked over and treated, if necessary. Palamarchuk fondly refers to it as blister patrol, “because normally that’s really about as bad as it gets.”
But last year, one bomb went off and then another, turning their blister-patrol tent into more like a wartime trauma center.
“When we heard that first explosion, we really didn’t know what it was. There was a lot of confusion at the beginning. And then the second explosion,” Palamarchuk remembers. “It was quiet. Then we started hearing screaming, and then lots of screaming and crying."
Matthew Rementer, one of the Temple podiatry students, remembers those initial moments of uncertainty too. The image that comes back first to his mind is heroic – people running to ground zero, running straight toward whatever was happening.
“The Boston EMS, police and fire personnel took the lead and ran into the street to help bring in the victims,” Rementer said. “You know, most people’s instinct would be to run away.”
Inside the tent, Matt, Palamarchuk and everyone else got a glimpse of what type of injuries were headed their way when regular programming was interrupted for breaking news on the television monitors set up among the workers.
“A student looked at me with pleading eyes, ‘Should we leave? Are we in danger?” Dr. Palamarchuk said. “You fight back fear. It’s just like war, I guess.” He distinctly remembers the voice of a man named John Anderson, the announcer in the medical tent, focusing everyone in that moment of panic.
“He simply said something like, ‘This is not the time to panic. We are all professionals. This is what we’ve trained for.’”
Matt, 26, quickly contacted his mother to let her know something was going on, but not to worry, that he was fine. "I knew she'd be worried." He remembers “everyone coming together; how well everyone functioned in that tent. . .The trauma surgeons and ER doctors helped lead the treatment while everyone stayed calm and just did what they had been trained to do.”
The most critically injured were rushed to trauma centers. People inside the tent gave a lot that day and "we saw some horrible things that day," Palamarchuk said.
After the last patients were moved through, the medical tent was turned over to authorities as part of the crime scene. Matt and the other students headed back to Philadelphia.
“It was difficult coming home that day and I just wanted to stay busy and focus on my daily routine to keep myself distracted. The 10 of us that were up there helped each other heal by discussing that day and how we all handled it. The school also brought in therapists to help us deal with the situation,” Rementer said.
Ally Bress, who was also a third-year podiatry student who wasn't able to make the trip, said it was a very solemn time when Matt and the others returned to school.
“You could tell that they had been through something traumatic and I personally, was not going to ask them about it and waited for them to come talk to me when they were ready. After a few days, everybody started to get back into the regular routines and eventually, some of them started opening up about their experiences,” Bress said.
Dr. Palamarchuk had a week of vacation when he returned, so he spent that time at his home in Bucks County, counting on the comfort of routine. "I have a good family. Good support. My kids are my therapy," he said at the time. Over the past year, he has found that even with a lot of support, there are times when his mind takes him to places he doesn't want to go. For weeks he kept up with the news of the bombings, "almost obsessively. And there were images that I went online and looked at, not in the beginning, but after a little time had passed and sometimes I wish I hadn't, you know. And there are those triggers that will bring the experience back to me. . .I would say it's been an up and down year of good and bad moments."
Eventually, talk at school turned to making the trip back to Boston for this year’s marathon. This will be Ally’s first trip. When people ask her, “Why go?” her answer comes without hesitation. “To put it simply, why not?”
“I was ecstatic when Dr. Palamarchuk and Matt Rementer said they wanted to return. This is the culmination of four years of hard work and dedication and now, we’re going to be a part of something really special.” And this year, their trip is paid for in full because the school chose Temple's Sports Medicine Club as one of 8 projects to feature on the Owl Crowd fundraising website.
Ally, 26, said she considers it an honor to be involved. “Unfortunately, these types of threats are a part of our daily lives now and I don’t think we can live in fear every day; if we did, we would be bunkered down in our houses forever.”
Matt, who has always wanted to be a doctor, loves working big races. “I wanted to go back this year to show that we are strong and that nothing will stop us from going out and doing what we love. This race is one of the top marathons in the world and it is a very unique experience to work it.”
Dr. Palamarchuk never questioned whether he’d return either. “Even still, I’m nervous. What bothers me is that what I see now when I imagine walking into that tent is that the stage will be set again for whatever could happen. That’s all I can see. I can’t see the runners coming down the street yet.”
But he can see closure.
“I think it will be like therapy. The idea that we didn’t finish our job, we need to go back and finish what we were meant to finish.”