Trauma and The Boston Marathon Bombings

Trauma Essentials, The Go To Guide, by Babette Rothschild, WW Norton and Company, 2011.

When we turned off Storrow Drive Saturday, right onto Beacon, then left over to Copley Square, things suddenly changed and the beautiful, intelligent, historic town that we had both gone to school in and loved, felt different.   Spring was finally, finally here and out the car windows we saw lovely pastel trees in bloom against the blue blue sky reflected on the Charles.  And there were runners, as always, on the Esplanade, sailboats in the Boat Basin, and up ahead the John Hancock Tower reflecting it all.  But I felt suddenly sad, weepy.  The Innocents.

 Today more of the 26 hospitals who took in Marathon Bombing victims – if anything positive stands from this tragedy, it is that Boston is gifted with incredible medical resources, all within blocks of the explosions – released their patients to the Spaulding Rehab Center, or to other recovery journeys.  As someone who has been grinding away since July at re-learning how to walk, I have deep sympathy for The Innocents who must forever grind away with prosthetic devices and terrible memories overlaid on the most innocent, the most hopeful event we have in Boston – outside of the Red Sox’s rise (and fall) – the Marathon.  Over 20,000 people.   20,000…

This is trauma as I have never experienced it.  The iconic photos of spectators being rushed to the Med Tent, and now long lines passing silently by the Marathon Memorial in Copley Square, do not tell us how hurt and innocent individuals ever recover from their losses and pain.  As an observer, I want to know that, like the trauma surgeons we watched on CNN those first few hours, we have other healers who will step in and triage the trauma. 

That’s why I picked up this book for review in Blue Heron Journal.  Because I think in Boston we can use all the help we can get, and certainly we have learned much more about this kind of post-traumatic shock and pain than we knew when my Uncle returned from Bataan in World War II unable to do anything but cut out paper dolls and pencil in crossword puzzles. 

The author of Trauma Essentials, Babette Rothschild, is an experienced psychotherapist who presents examples of individuals who have suffered grave personal trauma.  She demonstrates through these case histories what the immediate impact of the trauma is, as well as subsequent physical response to memories, associations, and follow-up treatment, all issues that the Boston Marathon victims and their families may encounter. 

Rothschild tells us that in the immediate wake of a traumatic incident, individuals first need copious amounts of support and attention to their basic needs – medical care, shelter, food, financial assistance, help locating loved ones, etc.  But beyond that Rothschild references Maslow’s Hierarchy of Needs as a guide to what works – and what is needed – next.  She makes the point that the injured need certain levels of assistance at certain times, and that each level of help only works, or is well received, when delivered at the appropriate time.  We cannot speed up the movie, we can’t skip basic healing steps to get to a happy ending. 

Fortunately there is a wide range of treatments – some pharmaceutical and others simply human – now available since PTSD (post traumatic stress syndrome) became a diagnostic category.  This book presents the most necessary and relevant information in a compact and accessible format, serving both as a review for therapists and a straightforward, easy-to-use guide for patients. Topics covered include definitions and symptoms, accepted treatments, physiological explanations, and treatment evaluation strategies, all written in Babette Rothschild's clear and  accessible style.

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