Marathon Bombing Survivors Face A World That Still Feels Out Of Control

It's just the crumb of a muffin, but Martha Galvis must pick it up. Lips clenched, eyes narrowed, she pushes it back and forth across a slick table, then in circles.

"I struggle and struggle until," Galvis pauses, concentrating all her attention on the thumb and middle finger of her left hand. She can't get them to close around the crumb.

"I try as much as I can, and if I do it, I'm so happy — so happy," she says, giggling.

Galvis has just finished a session of physical therapy at Brigham and Women's Faulkner Hospital, where she goes twice a week. She's learning to use a hand that doctors are still reconstructing. It's been two years since she almost lost it to the explosions at the Boston Marathon.

On April 15, 2013, Martha and her husband, Alvaro Galvis, stopped to watch the marathon from three different spots along the course; they enjoyed the race and boisterous crowd. Their last stop was near the finish line.

Watching the race was a ritual that began in the mid-1970s when the Galvises, who are both from Colombia, met in Boston. Their three children grew up celebrating the marathon as a family holiday, and Martha and Alvaro Galvis had planned to continue the annual event after retirement.

"But not anymore," says Martha, waving both hands in front of her face. "I don't feel secure to do this."

The former preschool teacher tries not to think about the moment when, just as she was reaching into a bag at her feet, a pressure cooker bomb on the ground nearby exploded, hurling nails and BBs into her left leg and hand.

"My hand," she says, "was destroyed — destroyed, it was so bad."

Dr. George Dyer, an orthopedist with Brigham and Women's Hospital, began rebuilding Martha Galvis' hand about 30 minutes after that bomb went off. Dyer was able to save everything except her ring finger.

"She had a very beautiful wedding ring that was two fine bands, kind of wrapped around each other," Dyer says. "The force of a bomb going off right next to your hand — it's kind of like a miniature hurricane. It unwrapped these fine gold bands, and then wrapped them together very tightly around her finger, and just cut it off in place."

Dyer picked pieces of the ring out of bone and tissue and saved them for Galvis. He salvaged parts of the ring finger to replace joints and tissue missing from its companions. In Galvis' 16th surgery, Dyer took bone from her hip, where the marrow has the best potential to stimulate healing, and grafted it to a joint in her pinkie. Doctor and patient are waiting to see if she'll need further operations. Galvis calls Dyer a magician.

There were just a few serious hand injuries that day, because the deadly spray went sideways, not up. The bomb also severed nerves in Galvis' left leg. After two years of surgery and rehab Galvis says she feels worn down.

"But then, I'm thinking about when I was going to the marathon and I was cheering the people," she says, "and I say, 'Come on, keep going, keep going; one more mile.' So, I look at my hand and I say, 'Come! Come on, keep going. You can do it, this is like a marathon.' And I can feel people in Boston say, 'Yes, you can do it! Come on, keep going. Keep going.' "

The jeweler in Boston who made Galvis' original wedding ring took the shattered, twisted pieces and molded a new band. But Galvis says that for a long time, she was afraid to put it on.

"It's silly, maybe," she says with a sheepish shrug. But she couldn't shake the worry that, "something might happen, and I could lose my hand again — the other hand."

For some survivors of the marathon bombing, the emotional and psychological scars are healing more slowly than the physical ones. Galvis pauses and reaches over to stroke her husband's back.

"People tell me time heals," says Alvaro Galvis, a health insurance salesman. "But it's a very slowly turning clock to me." He had two surgeries to repair his right leg; doctors removed from it a piece of the exploded pressure cooker — 1 inch by 2 1/2 inches. That hunk of metal became evidence in the trial of now-convicted bomber Dzhokhar Tsarnaev.

"I don't know if we are wired as human beings to be able to deal with tragedies like this," Alvaro says. "I don't know if we will ever be able to. We're trying ... we keep trying."

Alvaro Galvis struggles with flashbacks; he's jittery and anxious. He says he can't get used to the feeling that he has no control over his surroundings.

"You think about a lot of things, you know, in two years of trying to understand," he says. "That's part of the healing."

Neither Alvaro nor Martha Galvis has been able to return to work since the bombing, and they aren't sure if they ever will. They say they were getting better, before the trial. But with the verdict last week, the anniversary of the race this week and sentencing next week, they are constantly on edge. So Martha Galvis prays.

"I ask God," she says. " 'Please, in my heart, I don't want to hate him.' I don't want to hate him because it's no good for me to feel I hate him. And I ask God for him. But he has to be punished. Because he did horrible things, and he has to be punished."

Martha and Alvaro Galvis stop the interview. This is too much for them. They leave the hospital, arm in arm — supporting and protecting each other as they enter a world that they've learned they cannot control.

This story is part of NPR's reporting partnership with WBUR and Kaiser Health News.