Heartbreak Hill

For many runners, the most grueling stretch of the Boston Marathon comes around the 20th mile: Most call it “Heartbreak Hill.”

But it was the final stretch of the 26-mile race that brought searing heartbreak for the entire city on April 15: A pair of bombs exploded at two locations near a finish line full of racers and bystanders, and left a trail of glass, blood, and body parts in the middle of downtown Boston.

By the next day, U.S. Defense Secretary Chuck Hagel called the attack “a cruel act of terror,” as FBI agents and Boston police worked to identify suspects and motives.

Meanwhile, the explosions had killed at least three victims, and wounded more than 140. At least 17 remained in critical condition. Many had lost arms or legs. Doctors said they would perform many more surgeries in coming days.

Alasdair Conn, chief of emergency services at Massachusetts General Hospital, said he had never seen “this amount of carnage in the civilian population” during his 25 years at the facility: “This is what we expect in war.”

For some medics, the bombs’ devastation was the kind of carnage they’d already seen in war. Jim Asaiante, an emergency room nurse in Boston, was working in a medical tent for runners suffering from minor injuries when the bombs exploded. The Iraq War veteran braced himself.

“I heard the first IED [improvised explosive device], and I know there’s never one,” he told CNN. “The bad guys always set up two or three.” Asaiante spent two hours tending to the severely wounded, including a man with calves and feet blown off, and blood pumping from his knees. “It was mayhem,” he said.

Asaiante was one example of a common thread at Boston’s massacre: A number of witnesses already had endured violence-related trauma.

That experience now extends to thousands of Boston’s citizens and visitors, and brings challenges for churches, aid groups, and others who want to help those suffering in a nation increasingly familiar with trauma.

At the crime scene, past experiences with violence varied: One woman told reporters she had been in New York’s financial district on the morning of 9/11.

A group of six racers from Newtown, Conn., were running in memory of the 26 victims in December’s mass shooting at Sandy Hook Elementary School. Race officials had observed 26 seconds of silence at the beginning of the marathon to honor the 20 children and six adults killed at the school. None of the Newtown group was injured, but Ed Lucas told his hometown newspaper his wife had been standing at the bombing location when he finished the race earlier in the day: “She missed it by an hour.”

For Boston residents Carlos and Melida Arredondo, witnessing the explosions and carnage firsthand brought horrific associations: Their 20-year-old son died in a sniper attack on U.S. soldiers in Iraq in 2004. Six years later, their younger son succumbed to grief over his brother’s death and hung himself at age 24.

The couple had been at the finish line on race day, waiting for a group of participants from the National Guard. The racers were part of Run for the Fallen Maine, a group that honors all military members killed since 9/11.

Like others onsite, Carlos Arredondo didn’t let personal fear (or past tragedy) drive him away from the scene. Instead, he jumped the fence and rushed toward victims with bleeding wounds and torn limbs.

Indeed, some of the most stirring images of the day showed police rushing toward the explosions to help the injured, and runners in shorts and sneakers holding makeshift tourniquets on the bleeding wounds of strangers.

By the end of the day, thousands of Boston residents had joined an online spreadsheet offering rooms in private homes to anyone stranded at the race and unable to return to hotels. Entries included names, phone numbers, and email addresses, and information like “Guest bedroom + extra bathroom. Please don’t hesitate.”

Meanwhile, a handful of aid groups also worked to offer relief. Within 24 hours, the Salvation Army had supplied more than 2,000 meals, snacks, and beverages to survivors, families, and first responders. The group also sent chaplains to local hospitals to help families coping with injuries or loss.

Major Ivan Rock—the group’s general secretary for Massachusetts—said he spent the first evening talking with survivors in the Family Assistance Center downtown. He conducted similar work in New York after 9/11. “Many folks were simply in shock,” he said in an interview from Boston. “They just needed someone to listen to them.”

Churches across the city planned prayer vigils and joint worship services. Stephen Um, pastor of CityLife Presbyterian Church, urged his congregation to be good citizens and good neighbors, and to “pray and adopt a heart posture of love and service for our city.”

In a phone interview, Um said the congregation would also explore ways to help victims. The church’s deacons were already working to raise funds for the family of Martin Richard, an 8-year-old boy who died in the attack. (Several of the church’s families live in the Richards’ neighborhood.)

A family friend said Martin was watching runners cross the finish line when he was killed by the blast. The boy’s mother sustained brain injuries, and his 6-year-old sister reportedly lost a leg. In a statement, his father, Bill Richard, said: “I ask that you continue to pray for my family as we remember Martin.”

The family—which attends St. Ann’s Catholic Church—also released a photo of Martin on the church steps. The image shows a smiling boy wearing a white suit and white tie, and holding a felt banner bearing his name and a series of images: a cross, a heart, a dove, and the Greek letters Alpha and Omega—the symbols Christ used to describe Himself as “the beginning and the end.”