Mass General, as it's colloquially known, treated 39 marathon victims. Exhausted and reeling at the end of the week, the staffers on shift when Friday's "shelter in place" order was imposed because of the citywide manhunt for the second suspect had to keep working.
One of the results of that brutally difficult stretch: a messaging system for all employees that can be used in similar emergencies.
Dr. David King, a trauma surgeon and veteran marathoner, commended surgical residents for their intensity and made a distance running analogy.
"You always have something left in the tank," he said. "So after Monday, you think, 'There's no way I can come back and do this on Tuesday.' On Tuesday, you think, 'There's no way I can come back and do this on Wednesday.' Then the president wants to visit. 'No way can we squeeze this in on top of taking care of all the patients.' Then [after the shelter-in-place order], 'There's no way we can request that everyone stay in and work.'
"This is just another example of how it can look bad at [Mile] 18, but it looks great at Mile 26."
In the hospital lobby closest to the Red Line T stop, there was wordless commemoration of the day. A pianist and a violinist played soothing classical selections while next to them a woman in blue scrubs tied a "prayer ribbon" to a bare-boned tree that blossomed with others in the blue and yellow colors of the marathon.
The Boston Public Library's grand exterior was the backdrop for much of the footage taken in the moments after the bombings. Medical Tent A, where many victims were triaged and loaded into ambulances last year, is installed every year parallel to the Copley Square façade, alongside the statues representing Art and Science, with the inscription "built by the people and dedicated to the advancement of learning" overhead.
That tent will increase in square footage this year and the medical staff will swell by several hundred, not because organizers fear another violent act but because there are more runners starting -- 36,000, compared to 23,000 last year. Those who didn't finish were invited back, as were others directly affected by the events.
The library remained closed until 4 p.m. Tuesday, another concession to the security measures. Several dozen people, their coats sodden in the downpour, looked eager when a man came to unlock the heavy iron gates. "Give me a minute," he said in a friendly tone. "Give me some room."
Most of the people who streamed in headed for a hall to the left, where items from the temporary memorial that mushroomed in Copley Square are being exhibited -- a fraction of the collection now stored in the city's archives.
Handwritten notes, artwork, ball caps, crosses for the dead, photographs of toys and messages written on the pavement in chalk are arranged in displays around the centerpiece, a platform almost completely covered with rows of neatly arranged running shoes left by people paying their respects.
A woman with short, salt-and-pepper hair stepped to the edge of the sea of shoes and seemed to be searching for something. She hugged her sister and cried, approached the platform again, leaned against a pillar and took it all in.
Janet Fink knew she probably wouldn't spot her old pair of Nikes with the pink swoosh here at the library. It didn't matter. There were plenty of others imbued with the same sweat and sentiment as hers.