The Boston Marathon's medical tent last Monday was filled with exhausted and dehydrated runners, but the atmosphere had started to turn festive as the race wound down.
Then the bombs went off.
"The first patients you see are a double amputee and this woman they were doing compressions on," says Emi Larsen, a nurse who volunteered at the tent. "It was sheer panic."
But the panic subsided. A medical coordinator named John Andersen offered instructions over a public address system in a calm voice, reminding the doctors and nurses, "This is what you've all been trained to do."
Every medical center in Boston had a protocol in place for coping with some sort of major public safety event. Personnel at the scene were able to work with the equipment they had and do triage to send patients to the right hospitals, so no facility was overloaded.
"First responders include hospitals, which people don't normally think of," says Frank Cilluffo, director of the Homeland Security Policy Institute at George Washington University.
The Boston Marathon bombing was the largest homeland security operation the nation had seen since the terrorist attacks of Sept. 11, 2001. Hindsight will doubtless reveal some flaws, Cilluffo says, but he and other experts are giving the response effort in Boston high marks.
"We've learned as we've gone along," says Lee Hamilton, a former Democratic congressman from Indiana who co-chaired the 9/11 Commission. "We've had several disasters since 9/11 and we seem to be improving."
Command And Control
You can't prepare for an extraordinary event on the fly. Boston had engaged in two city-wide disaster drills over the past two years.
"One of the big changes is the fact that the first responders at every level — federal, state, local — have these protocols and they know what is expected of them before the incident occurs," says Rudy deLeon, senior vice president of national security and international policy at the Center for American Progress.
Carrying out the investigation and Friday's daylong lockdown of the Boston area was the result of close coordination not only between the FBI and state and local police, but also other agencies such as the Secret Service. Part of the "package" that came with federal involvement, says deLeon, was a Navy bomb squad stationed in Newport, R.I.
All these various entities seemed able to speak with one voice throughout the week.
"Normally, in an event like this, you'll hear about friction over who's in charge and who's coordinating," says Rick "Ozzie" Nelson, who worked on terrorism issues with the National Security Council. "We haven't heard any of that."
The various agencies were also able to enlist the help of the wider public, first in tracking down images of the event and then in using them to help identify the suspects.
"Law enforcement has made this transition to the digital environment," says deLeon, a former Defense Department official. "Once the name is identified, they have Facebook and YouTube and you are suddenly able to look at all of this digital forensics."
Prepared To Be Flexible
By definition, an event such as this is chaotic. Although planning is paramount, some flexibility is needed. Preparation makes that possible.
Members of the National Guard were in place to help monitor the race. Once the bombs went off, two Guardsmen were among the first people tearing down the fence along Boylston Street that was separating help from the injured.
Later in the evening, the Guard helped the police force create the perimeter around the crime scene. All their various training and capacities kicked in as needed throughout the day.
"What we're seeing is how in the middle of one of the biggest cities in America how quickly you can deploy, so that if an event happens at 3 p.m., by 6 all these pieces are fitting into place," deLeon says.
Offering A Reminder
Hamilton notes that he and his fellow 9/11 Commission co-chair, former GOP Gov. Tom Kean of New Jersey, have "testified constantly" that an incident like this was bound to occur.
"We had a decade of no bombs going off, although we had some close calls," he says. "The event in Boston will bring into focus the security problem for every major event now for many months to come."
Hamilton counts that as a positive development. He notes that homeland security had lost much of its salience as a political topic in recent years.
The type of training and other preparation that appears to have made the response to the bombing in Boston essential is vulnerable, like most federal programs these days, to larger questions about the budget.
"At a time when these budgets are getting tight, you saw here in a real-world situation how these processes save lives," says Cilluffo of George Washington University. "This can't be done on game day. It takes time to build up these capacities."
Questions Of Prevention
If the response to the bombings in Boston has largely been applauded, one aspect of the aftermath will be questions about whether such a thing could have been prevented.
It may be difficult. People who reside in the country for long periods of time, leading seemingly normal lives, are inherently harder to guard against than threats from abroad.
"The important thing is not to take the wrong lessons from this event, that because something like this has happened, we're not going to allow backpacks," says Nelson, now the vice president for business development at Cross Match Technologies, a biometrics company.
Some people will inevitably ask whether the country is wasting billions of dollars, Nelson says, when individuals can still build destructive bombs from plans downloaded from the Internet.
But an open, public event such as the Boston Marathon can never be completely secure. You can never protect everyone everywhere at all times, says Hamilton.
"Here you have two fellows walking right through the middle of the crowd with law enforcement all around them," he says. "You cannot check everybody along a 26-mile route."