War veteran doctor experience vital
Brennan, a doctor with Seacoast Orthopedics and Sports Medicine and the team doctor for the University of New Hampshire athletic program, was helping to lead the medical team in tent B at the Boston Marathon on Monday, just two short blocks from the finish line.
About 200 doctors, nurses, athletic trainers, sports medicine practitioners and other medical staff were treating a nearly full tent of runners with blisters, cramps, and some hypothermia due to the day's cold temperatures when the first bomb went off.
Brennan immediately recognized the sound of an improvised explosive device, and when he heard the second blast, he knew it was no accident. He told his team to get ready.
Brennan served for 12 years on active duty with the U.S. Army. In 2001, he did a four-month stint in Bosnia.
Less than two years later, he was on the front lines in Iraq, activated and deployed with the 28th Combat Support Hospital right after the war began. He helped to set up the first combat support hospital in the country and spent six months in the desert treating casualties.
He spent another six months in the "Green Zone" in Baghdad. Again he was setting up a combat support hospital and treating civilian and military injuries caused by explosive devices.
When he returned to New Hampshire five years ago, he began volunteering with the Boston Marathon.
And on Monday, he was again treating shrapnel injuries, and helping others deal with the trauma of being in what felt like a war zone.
When Brennan returned to New Hampshire he joined the New Hampshire Air National Guard and serves as a Lieutenant Colonel with the 157th Medical Group.
"I have to admit, with me staying in the military in some capacity, I realized I could always be deployed again, and if that were the case, I could possibly see that trauma again, but I certainly did not expect to see it in Boston, that's for sure."
Marathon Monday started out much different than last year, when temperatures soared into the high 80s causing thousands of heat-related issues for runners.
"This year it was beautiful weather - nice, cool," Brennan said.
He went to the race with some people from the University of New Hampshire and his 18-year-old daughter Alyssa, visiting from Virginia and shadowing him for a school project.
In the past, volunteers in the tent had no chance to see the race, so this year, televisions were brought in, allowing them to catch glimpses of the finish line while treating patients for nausea, blisters or cramps.
But they did not need the TV to tell them about the bombs. They heard them and felt them.
"I said, 'we need to get ready. We need to get ready to receive some casualties'," Brennan said.
He said his biggest role was helping to prevent panic, and to update the team so they remained calm and ready.
He kept staff in the tent who wanted to go to the scene to assist, worried about more bombs, or dirty bombs that could have released deadly chemical agents.
People began running by the tent, screaming, trying to get away, or looking for loved ones.
Brennan said Medical Tent A, right at the finish line, received the majority of the casualties. He saw a couple of patients with shrapnel injuries to their lower extremities, and people suffering from the psychological trauma of the event, petrified about what had happened.
"We were ready. We got everything ready. We took all the patients we had and tried to treat them and get them out of there to someplace away from the area once they were warmed up enough and restructured the tent. People with experience in emergency medicine prepared for trauma patients," Brennan said.
When it was all over, three people were dead - eight-year-old Martin Richard of Dorchester, Mass., Krystle Campbell, 29, of Arlington, Mass., and Boston University graduate student Lingzi Lu, 23, of China - and more than 170 were injured.
Dealing with tragedy
Brennan said his ability to remain calm and handle the situation at hand on Monday was the best thing to come from his military experience in Iraq.
Now, he is still processing what happened, but said he is doing OK. He has learned from his experience, and said he advised other guys in the marathon medical command to talk about what they had seen and gone through with loved ones and friends.
"The last thing you want to do is harbor it. You've got to talk it out, let people know what you saw and show how you felt and that will get you through it," Brennan said.
As a sports medicine doctor, he is also looking ahead, and said advancements in rehabilitation and prosthetic devices, as well as treatment of post traumatic stress disorder, as a result of the wars in Afghanistan and Iraq, will benefit the victims of Monday's violence.
"The folks that are going to have these injuries are going to get state-of-the art, cutting edge care, because we have learned so much in these conflicts," Brennan said.
He is also looking ahead in his own life, with a son on the way, a young daughter, another graduating high school and a son at the University of Virginia. He said he definitely plans to return to medical tent duty at the marathon next year.
"I remember walking out on Tuesday morning . it was a beautiful sunny day, the birds were chirping, the grass is turning green and you just pray for the families and victims and realize the sun does come up and life keeps going and we have to keep going," Brennan said.