All for One

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By Jim Duffy | Illustrations by Livy Long

Illustration by Livy Long

For all the destruction wrought by the Boston Marathon bombing, it only tightened Jessica Kensky’s circle of nursing friends

Friendships born in nursing school often take shape under great duress. The pressure isn’t just a matter of having so many things to learn in such a short, intense stretch. It’s the knowledge that each new morning might be a make-or-break affair when it comes to doing right someday down the line by a future patient in crisis.

But what happens when that patient is herself a nurse? On April 15, 2013, Jessica Kensky was standing with new husband Patrick Downes at the finish line of the Boston Marathon, his arms wrapped around her, when a bomb went off.

Both of them lost a leg that day. Kensky would lose her other leg down the line. The shrapnel that tore through their bodies left wounds that will last a lifetime. Both are still working to recover. These days, that process has them enrolled in a special program at the Walter Reed Army Medical Center.

Nursing school classmate Leah Pike was the first of Kensky’s nursing friends to arrive by her side after the bombing, but she would not be the only one. The list of angels is a long one, full of classmates from Kensky’s Wolfe Street days, colleagues from her time at the Weinberg surgical intensive care unit at Johns Hopkins Hospital, and co-workers at Massachusetts General Hospital in Boston.

Now more than ever, Kensky believes that nursing friendships are different from others, not least because of the profession itself and the quality of the people drawn to it.

Kensky’s visit to the School of Nursing on this day was prompted by her desire to share that idea with students and colleagues in her field. She arrived fresh from speaking at a commencement ceremony. “To come back here to

Jessica Kensky and a friend

this community and to talk about the things I’ve learned, it’s just perfect,” Kensky says.

Two other nurses shared thoughts about the bombing and Kensky’s journey in separate conversations. Kathy Hilburn, a 2009 classmate, is a research nurse with the National Institutes of Health in Bethesda. Erin Gilfeather became friends with Kensky while they worked together at Weinberg.

“My nursing friends played an enormous role in my recovery. I could give you a super long list of things…” –Jessica

Leah Pike: One thing I learned that day is that scrubs can get you anywhere you want to go. The whole city was in a panic. I ran down to Boston Medical Center to find Jess. Everybody saw 

Illustration by Livy Long

my scrubs, and then they just let me go wherever I wanted to go. I guess they figured I had come to help.

Jessica Kensky: I have little glimpses in my memory from those first days. I have stories people told me later. But the really painful stuff, it kind of fades away. It’s just too much. I remember writing the words “Patrick’s foot.” I had no idea at that point that I had lost a leg. The only thing I could think about was Patrick’s foot, laying on the ground. Then he wasn’t there. He was taken to a different hospital, and we didn’t see each other for five weeks.

Erin Gilfeather: I texted Jess, and tried to call. It was kind of normal not to hear back. She is notoriously bad about responding on the cellphone. I heard what happened later that night from a friend. I was so scared for her. Her family is in California. Her husband is in some other hospital. Who is with her? Is she by herself?

Leah: Trauma patients, especially when they’re intubated, don’t look like themselves. It can be a shock. If I wasn’t a nurse I would have freaked out at the way Jess looked. … You never panicked. You didn’t fight the ventilator. At one point, you actually made me write down what the vent settings were.

Jessica: That was the thing that stayed with me from my training—that the calmer I stayed, the better people would be able to take care of me. I was definitely worried about dying. That was part of why I needed to keep talking. One minute I wanted someone to find my husband. The next minute I wanted to tell everyone my blood type … whatever came into my mind.

Kathy Hilburn: In nursing school, Jess was the glue that held our group together. She was the one who sensed when the stress was too much. She introduced us to duckpin bowling. Did she tell you about rooftop yoga?

Jessica Kensky and Leah Pike

Photo by Danielle Kress |  Jessica Kensky, left, and Leah Pike during a visit to the Johns Hopkins School of Nursing. Other snapshots courtesy of Jessica Kensky.

Jessica:Leah had rented a place that had a rat problem. [The day they met] she was telling everyone on the shuttle about how these rats were not at all afraid of humans.

Leah: Yeah, that was the beginning of our little love story.

Jessica: We became study buddies. Leah got me through nursing school.

Leah: Back at you.

Erin: Jess and I started as new nurses on the same day in the same unit, Weinberg Surgical ICU. We hit it off. She called me her little sister. She gave me cooking lessons. We were gym buddies. I was very upset when she left me for Patrick and Boston.

Illustration by Livy Long

Erin: Her unit at Mass General was tremendous. All these people came out to stay with her in the hospital. They donated their vacations to a leave bank so there would never be any question about whether Jess had a job or insurance.

Jessica: My nursing friends played an enormous role in my recovery. I could give you a super long list of things, but maybe the most amazing thing was that every night I had a nurse friend stay over in the hospital with me. This went on for months. Leah organized that. … To always have a familiar face in the middle of the night, that was priceless. The peace of mind it gave to my family was priceless, too. My room had this awful, uncomfortable chair. I felt like I was going to end up paying chiropractic bills for everyone.

Kathy: I’ve seen cases as a nurse where friends and family were really good supporting a patient, but I’ve never seen anything like I saw in Boston. You know how something happens in a neighborhood and everyone rallies around? It was like this whole pop-up neighborhood appeared for Jess, people from all the different places she had been in life. I remember thinking, “Wow, this is incredible.”

Leah: It wasn’t that we didn’t trust her nurses. It wasn’t a question about their skills or commitment. It’s just that we know from experience that hospitals can be crazy places. What if another patient in the unit starts to have trouble? What if there is some kind of emergency? Nurses are human, you know?

Erin: So many people were so selfless. I think that’s a real testament to the kind of person Jess is, to her character and to Patrick’s character and to their families.

Jessica: What did I learn about nursing? It’s interesting, the things that really stand out in my mind are simple acts of kindness, little above-and-beyond things. I had burns all over my back that were full of dirt and metal. The pain during dressing changes was excruciating. I’ll never forget the nurse who kept singing to me during this—the Fleetwood Mac song “Don’t Stop [Thinking About Tomorrow].”

Leah: That first night, Jess’s nurses let me go everywhere with her. They even let me stay while she was getting pan-scanned, which is really unusual. The nurse kept saying to everyone who asked, “No, she stays. My patient is more stable when she’s around.” … I remember one time when she was still intubated and they were working on those wounds, I said “Jess, I can step out of the room.” She made this gesture, pointing to her eyes. It was like, “Stay! You are my eyes here!”

Jessica: Patrick and I were separated for five weeks. I was the one who got stable enough first. My nurses helped me get ready to go see him. I remember a nurse washing my hair for my “big date.” You can imagine what this is like. We are both missing limbs. He is looking so very sick. I had to go to the bathroom during this. It was his nurses who helped me get up on a commode. I’m not their patient, but here they are working so hard to make everything as comfortable and as dignified for me as possible.

Leah: Your commode, that’s a whole topic by itself.

Jessica: I didn’t know until this happened that there is a hierarchy of bedside commodes. The one I had at first was very cushioned and very plush. They are super expensive. When I got to rehab, they didn’t have any commodes like that. It turned out that I had started with the Mercedes of commodes, and then I had to make do with a regular one. My old nurses from Boston General showed up one day, on their own time. They had loaded up my old commode and brought it to me.

Jessica's friends with her commode

Kathy: There is something about being a nurse and then seeing a nurse go through something like this. You see yourself in there. You want to do everything you can.

Jessica: I have a million acts of kindness I could tell you about. They made this video with friends from all these different places, and they each filmed themselves doing a yoga pose that I could do in a hospital bed.

Erin: I thought I had prepared myself for the first visit. I was a nurse, you know? … She had shrapnel pieces in places no one should ever have shrapnel. Seeing her was a lot harder than I ever thought it would be.

Jessica: I lost so much privacy. The way my nurses helped me maintain my dignity and the way they made me laugh through everything, these are just priceless gifts.

Erin: I’ve always tried to go the extra mile for my patients, but now I can feel myself getting a little more involved, trying to be more in tune with their needs. I hope maybe I am being more attentive to things that tend to get overlooked, like how good it feels after you wash your hair, and painting people’s nails, that’s another one.

Jessica: It’s natural for newly graduated nurses to focus at first on doing the basic things, getting the dose and the medication right. But you are going to hit a point in your career where you have the time and energy to do some of these extra acts of kindness. You are going to need to learn to read the patient—and the family. You’ve got to get really good at picking up on social cues.

Erin: I was in Boston when she was just getting into rehab, and it was very apparent that she was at one of the lowest points she could be at. She was really struggling.

“I’ve always tried to go the extra mile for my patients, but now I can feel myself getting a little more involved…” –Erin

Jessica Kensky at rooftop yoga

Jessica: In the hospital, you tend to try and pump your patients up as they move through the system. It’s like, “You’re getting out of ICU—that’s so great!” My nurses told me things like that. I remember saying things like that to my patients. Sometimes the experience is really different for the patient. … In the ICU, I had nurses bathing me. When I got out of there I was forced to look at my injury. Literally, I had to wash and clean it. I was in denial for a while. The first time I took a shower, it was so weird. My leg wasn’t just atrophied or broken. It was gone. Your head literally cannot take it in. Everybody around me would be celebrating the progress I was making, and yet it was a devastating time for me.

Erin: After Jess went into rehab, I didn’t hear from her for a long time. It seemed like she needed time to herself. When I saw her again, she and Patrick were picking me up at the airport, both of them standing up and vertical. It was such a gift, seeing that.

Leah: Jess got her new running legs yesterday. We’re all very excited.

Jessica: I have a video on my phone of me running around the track. Here, let me call it up. It was the first time, so they had me in a harness. … They don’t mess around at Walter Reed. … It’s not about how to work your wheelchair or how to transfer your body over to a shower chair. No, it’s about them helping you to become all you were before—and more.

AWARD FOR HEROES

On May 5, Jessica Kensky and husband Patrick Downes will be given Hero of Military Medicine Ambassador Awards by the Center for Public-Private Partnerships at the Henry M. Jackson Foundation for the Advancement of Military Medicine.

The couple, seriously injured in the 2013 Boston Marathon bombing, have received extensive care at the Walter Reed National Military Medical Center in Bethesda, which treats thousands of soldiers who have lost limbs in combat.

The event begins at 6:30 p.m. at Andrew W. Mellon Auditorium, 1301 Constitution Avenue NW, Washington, DC.

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