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19 Days: Caring for the caregivers

In the 26 days leading to the Boston Marathon on April 21, ESPNBoston.com will share inspiring stories, detail important logistics and go inside the planning for what promises to be an event like no other in the wake of last year's bombings. There are 19 days until the race.

Caregivers, from doctors and nurses to ambulance drivers and wheelchair-pushers, are often thought of like one-way streets: they give, with no mention of taking.

But, of course, caregivers are people too, only separated from the patients they care for by circumstance (and often years of training). Even doctors get sick and go to their doctors.

So after the bombings at last year’s Boston Marathon left three dead and more than 260 wounded, many severely so, first responders at the scene and doctors, nurses and staff at the city’s hospitals did what they have been trained to do and cared for them the best they could.

Though multiple victims lost limbs, and many suffered hearing loss or underwent surgeries to remove pieces of shrapnel, remarkably not a single life was lost among those transported to hospitals.

The experience didn’t end there, though. As patients entered recovery, the spotlight squarely on them and what they’d lost, the caregivers were left to cope with what they’d seen and experienced on their own.

“It affected me pretty bad,” said Christine Landry, an ER nurse at Massachusetts General Hospital. “I mean, I’ve been a trauma nurse in the emergency room for 19 years. I mean, I’ve seen limbs come off. I’ve seen explosions, I’ve seen that kind of accident before, but never to that level. And not the Marathon. I mean, Boston, we’re so well-known for our marathon and we’re proud of it.

“To have something like that, some type of terrorist event in our own backyard, it was tough to take,” she added.

Luckily, there was help.

“When the bombings happened, obviously and understandably there was a lot of concern about the people who were injured and the people who died,” said Petra Langer, senior director of communications at the Schwartz Center for Compassionate Healthcare. “We immediately thought about the first responders, the doctors and nurses at the scene and the hospital staff who were taking care of these patients. This was really an unprecedented situation. A lot of them talked about, ‘It was like being in a war zone,’ which was something they had never experienced before.

“We knew there would be repercussions from that.”

A nonprofit organization based at Mass General, the Schwartz Center specializes in caring for health care providers -- holding guided discussions for hospital personnel, from doctors to clergy to cafeteria workers, on specific patient cases and the emotional issues that arise from them.

Six months after the bombings, the Schwartz Center held sessions specifically for marathon caregivers.

“In the fall, the sessions were very emotional,” Langer said. “There were a lot of tears. A lot of people were still pretty traumatized by the experience.”

As both the anniversary of the bombings and the 2014 edition of the Marathon approach, the Schwartz Center -- thanks to a large financial donation -- is holding more sessions for people affected by the tragedy of April 15, 2013, and the aftermath. And while the Schwartz Center typically deals only with health care professionals, the marathon sessions are open to all: hospital workers, Boston Athletic Association employees and race volunteers.

“We both want to learn how they’re doing now and see what kinds of feelings are being sparked by the one-year anniversary,” Langer said. “And give them a chance to share those feelings with people who understand exactly what they went through.”

That was exactly what Landry, a native of Chelsea, Mass., and a Revere resident who was volunteering in Medical Tent A on Marathon Monday, needed.

“You kind of feel like you’re alone in this,” she said. “And [you feel] ‘Did I do enough? I’m kind of feeling guilty that I wish I could’ve did more. If we knew the extent of what was going on outside the tent, maybe we should’ve ran outside and helped outside.’ But we needed to be inside because that’s where all the patients were coming in.

“To go to those meetings and realize that you’re not alone [is important]. There are hundreds of other people who feel the same exact way that you do.”

Though the Schwartz Center plays a role in helping caregivers cope, Langer emphasized that the goal of the sessions isn’t to produce a prescription for how to deal with the feelings brought on by the trauma itself or the approaching anniversary. That’s better left to professional counseling, which many first responders have taken advantage of.

William B. Evans is one of them.

Though he had finished the marathon and returned to his native South Boston when the bombs went off, the current Boston police commissioner, who was then a superintendent, raced back to the finish line, where he played an integral role in securing the scene and beginning the work of collecting evidence. He saw the devastation the bombs wrought firsthand: the shattered windows, toppled barriers and bloodied pavement.

“Our officers saw a lot of terrible things that week, we got a lot of ‘em counseling,” Evans said. “My wife was pushing me to go talk to someone.”

Evans’ wife, Terry, was concerned that he wasn’t sleeping. She thought he seemed drained, emotionally as well as physically.

“And finally after about two weeks of her saying it,” Evans said, “I had someone come into my office who is a top-notch trauma-type counselor, and I spoke to him for about an hour.”

What the counselor said to Evans no doubt would resonate with many, especially as the 2014 Boston Marathon approaches.

“It was sort of interesting because he was running me through all this and I asked him his advice, and you know what he said to me? ‘Just keep running,’” Evans said. “That’s all he kept saying. He said, ‘That’s your medicine.’ And it’s true, that is my medicine. If I get my run in every day, there’s nothing I can’t do or overcome.”

Jack McCluskey is an editor for ESPN.com and a frequent contributor to ESPNBoston.com. Follow him on Twitter @jack_mccluskey.