The family of Martin Richard, the 8-year-old boy killed in the Boston Marathon bombings, said today that his sister Jane, 7, has undergone 11 surgeries in the last 23 days and soon may be ready for rehabilitation.
Their parents, Bill and Denise Richard of Dorchester, Mass., were among the approximately 200 people who suffered injuries that day.
In a statement released today by a family spokesman, Larry Marchese, the parents said that their daughter Jane was making improvement.
"While she has more trips to the O.R. ahead of her, last night's operation marked an important milestone, as doctors were finally able to close the wound created when the bomb took her left leg below the knee," wrote the Richards. "Part of the procedure involved preparing Jane's injured leg to eventually be fitted for a prosthesis.
"By closing the wound, the incredible medical team at Boston Children's Hospital laid the groundwork for Jane to take an important step forward on the long and difficult road ahead of her."
Family members said that through the trauma, they have learned "not get too high or too low. We take today's development as positive news and look ahead with guarded optimism."
They are hopeful that Jane might be ready for rehabilitation in the coming weeks.
"Getting to this point has not been easy for Jane," they said.
The little girl has fought off infections and other medical complications.
"After not being able to communicate with Jane for the first two weeks, she woke up with difficult questions that needed to be answered," her parents said. "There are not words to describe how hard sharing this heartbreaking news was on all of us."
One of the questions was about her brother, Martin, who died in the explosions at the finish line of the marathon. Friends said he was a typical boy who loved to ride his bike and play baseball. They called the boy's death "an unfathomable loss."
His parents are prominent members of the community, and Denise Richard works as a librarian at the Neighborhood House Charter School, where Martin was a third-grader and Jane attends first grade.
The Richards were discharged from Beth Israel Deaconess Medical Center a week after they were admitted, according to the statement.
Denise Richard, 43, still has no sight in an injured eye, but doctors have said they are "pleased" with how she has healed from surgeries.
"Bill is healing from the shrapnel wounds and burns to his legs, and we remain hopeful there will be improvement over time from the hearing loss he suffered," said the family statement. "It will be several months before we know what, if any improvement Denise or Bill will experience."
Their 12-year-old son, Henry, is now back at school, "which gives him a needed sense of routine and normalcy," according to the family. "We will continue to stay together in the Longwood Medical Area until Jane is discharged. Our focus as a family remains on healing from our injuries, both physical and emotional."
The family admitted that it faces challenges ahead, and psychological experts agreed.
Some of the most difficult times will be adjusting to their "new normal," according to Dr. Paula K. Rauch, a psychiatrist and founding director of the PACT (Parenting at a Challenging Time) program at Massachusetts General Hospital in Boston.
"If you imagine some of what it's like to be managing so many medical complications and emotional issues, it's like climbing a rock face: You are not feeling all the feelings until you are done with that mountain climb," said Rauch. "Often, we get to emotional safety and then the feelings percolate up. They have so much to manage day-to-day and hour-by-hour - that's where the focus will be. When the family ultimately settles in to their new normal, there will be waves of emotion to cope with."
The family members thanked the community for all its support, saying it had been "uplifting … in this most painful and difficult time."
They also credited first-responders and "Samaritans" who "stabilized and comforted" them at the scene of the bombings.
"We particularly want to thank the people who quickly got to Jane and addressed her injury in the street because they saved her life," they said. "We also salute those who stood guard over Martin's body so he was not alone."
They acknowledged that well-wishers wanted to "do more" to help the family, but they asked that their privacy be respected.
"As hard as it is for us to do so, we ask for your continued patience as we work through something for which there is no roadmap, and there are no instructions," they said, promising more updates about Jane's recovery.
Psychiatrist Rauch said that the family's statement demonstrated "how hard they are working to stay together as a family, and how appreciative, on one level, they are for the outpouring of care and support, but how much they need their privacy.
"When families face terribly difficult experiences, they often feel they have to take care of their well-wishers," she said. "One of the errors of kindness is doing something intrusive. … Give people the time to focus on day-to-day, small victories, and it sounds like there have been lots of wonderful victories in their daughter's care. I am sure there have been moments of relief as well as moments of great sadness and frustration."
Many well-wishers have been struck by the strength of a family that has suffered so much loss, but Dr. Eugene Beresin, director of training and adolescent psychiatry at Massachusetts General and Mclean hospitals, said people can be resilient.
"Resilience is not intrinsic," he said. "It's not something you are born with. It includes biological attributes. But, apart from your own nature, the most important elements are engagement with others, awareness and self-reflection.
"That's why families, community and spiritual support are important," he said. "They need to reflect on their past and present and where they go now. And people need that space to reflect."