Boston Bombings Leave Doctors Using Wartime Surgeries to Fix Social Work Student's Ruptured Ear Cavity

By Tara Guastella

On April 15, 2013, Lauren Vulcano, then a 24-year-old school counseling graduate student, and her boyfriend Mark Snickenberger, also then 24, were watching Mark’s brother run in the 2013 Boston Marathon. The events that unfolded that day changed the way Lauren will hear forever.

The day was as pleasant as any until the first backpack containing a homemade pressure cooker bomb exploded. Lauren was standing just four feet away. “I first felt a very calming feeling, almost euphoric,” she says. “I could really feel the heat and it felt nice, like being on beach—but I was completely unaware of what was happening. It felt like five minutes but in reality it was only a matter of seconds.”

Mark panicked and grabbed Lauren to try and move her away from the scene. She stood still with both of her hands covering her ears standing perfectly straight—like a “telephone pole,” she says. Lauren tried to plug her ears as hard as she could since the extreme loudness and subsequent ringing in her ears (tinnitus) physically hurt.

Suddenly Lauren’s right ear started to bleed just as the second bomb exploded; she learned later that her eardrum had ruptured. “Mark put his arm around me and guided or dragged me down the street, pressing my injured right ear against his left shoulder to apply pressure,” Lauren says.  “Finally I snapped out of the state of shock and began to understand what was going on.” Once Lauren and Mark made it to a safe location in an AT&T store, Lauren noticed the eight-inch gash on the side of Mark’s leg with blood pouring out of it.

Lauren and Mark are circled in the above photo as they escaped from the Boston Marathon bombing.

Lauren began taking off her coat in an attempt to take care of her boyfriend’s leg. She then realized her own shoulder was bleeding. “Since we didn’t know what was in the air, I was instructed to put my coat back on,” says Lauren. “I felt so helpless because I wanted to do something to help Mark since he saved my life by dragging me out of the bomb scene.”

As she made attempts to scream and call for help, Lauren realized she couldn’t hear herself screaming, and she thought no one else could hear her screaming either. “In the AT&T store, someone brought a wheelchair in for me and then they ran Mark into the medical tent,” Lauren says.

    Lauren and Mark are circled in the above        photo as they escaped from the Boston                         Marathon bombing.

    Lauren and Mark are circled in the above        photo as they escaped from the Boston                         Marathon bombing.

While they were tending to Mark’s leg, Lauren left to find Mark’s mom. “After a quick discussion of who should go with him to the hospital, Mark’s mom said ‘no, you go. He needs you.’ I grabbed his stretcher and helped the first responders run it to an ambulance. When no one instructed us which ambulance to go to, I just picked one and started pulling his stretcher into its back entrance.”

Lauren was so worried about Mark’s leg that it wasn’t until they arrived at the hospital that she realized she also had a black eye and her forehead was bleeding. Once at the hospital, Lauren says she finally felt safe and laid down beside Mark to let the doctors care for them both.

“I was examined by the on-call ear surgeon who had an impeccable bedside manner, given the situation,” Lauren says. “I then learned that a BB from the bomb had gone straight into my ear, hit the cochlea, and bounced out, rupturing my eardrum and shattering the malleus bone [a small middle ear bone].”

Lauren was later released from the hospital and arrived home around 9 or 10pm that evening; Mark had to stay overnight. A piece of nylon from the backpack that contained the bomb had melted into Lauren’s hair and a portion of skin on the right side of her head was burned so badly from the explosive heat that her hair fell out. “Not wanting to be alone that night I made my mom give me a sponge bath and then stayed on the phone with Mark for the remainder of the night.”

The following day Lauren went to visit the ear surgeon at the surgeon’s office. Since the loud blast Lauren experienced is considered a military injury, not a civilian injury, her doctors continually consulted with military physicians.

Lauren’s doctor used an updated version of an old wartime surgery technique. In the past working out on the field, wartime doctors would place a piece of cigarette paper between the pieces of the eardrum in hopes some of the skin cells would "crawl" across the paper to make a skin graft. Today this surgery is more complex with better material used, but it didn’t work for Lauren’s ear. “For several months, my ear was just still too damaged for the skin graft to take,” Lauren says. “I had a real surgery in June and when that didn’t work, my doctor referred me to Massachusetts Eye and Ear Infirmary.”

Lauren had another surgery in August and when that didn't work, they tried a number of those "quick fixes" again. In each of these surgeries another piece of Lauren’s ear injury puzzle is revealed. “My next surgery will be where I receive a prosthetic malleus. It's frustrating that after a year of the best medical care, my ear hasn't gotten much better. It's just too damaged from the blast,” she says.

Even after undergoing three surgeries and still not being able to hear out of her right ear, Lauren graduated on time (taking extra classes) from her master’s program earning a dual license in school guidance counseling as well as school social work/adjustment counseling and will be a school guidance counselor this fall.

“As I was sitting in classes learning about things like post-traumatic stress disorder and depression, I began to become very aware of my own symptoms,” Lauren says. “I knew how to identify the signs and I knew what these conditions looked like.”

Living through the blasts, though taxing on health and personal life, has greatly benefited her career, she says. “This past year I had a full-time internship at an elementary school. Feeling things firsthand really helped me to become aware of children’s symptoms much more accurately since I knew exactly what to look for,” she says.

Another aspect that helped Lauren overcome the experience of the explosions and her hearing loss is being able to talk about it. “I am naturally a ‘chatty Cathy,’ so when I went back to classes after the bombing I didn’t want people to ignore the elephant in the room—that I was in a bombing. I wanted to lay it all out there and give them an opportunity to ask me questions so it was all out in the open,” she says. “So I asked my professors if I could give a presentation of how I escaped after the bombing and talk about it with classmates.” All of Lauren’s professors were incredibly understanding, she says.

As she first began sharing her experience, Lauren would sob through the entire narration of the day’s events. Now after being completely open about it for over a year, Lauren can recount that day without a tear in her eye. Lauren, Mark, and Mark’s brother ran the 2014 Boston Marathon with other marathon blast survivors, including the Campbell familyDave FortierLynn CrisciShannon Silvestri, and many others.

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