The Boston Globe's failed "historic" Marathon finish line photo shooting

It was meant to be a big fiesta to celebrate "Boston Strong". One year after the Marathon bombings, the Boston Globe invited  “survivors, police, firefighters, EMTs, doctors, nurses, runners, political figures, store owners, the Boston Athletic Association, Red Sox and Bruins player” to be part of a "historic" photo shoot. The event took place in the morning of Sunday, April 6th, 2014.

The Globe writes: "Thousands of photographs had been snapped and there was no reason to stick around on the start of a glorious spring day. Yet there in the middle of Boylston Street, in the exact spot where there had been so much sadness and anguish almost a year ago to the day, now there were smiles, hugs and selfies. Nobody had to be there. They wanted to be there. Maybe even needed to be there."

This is, unfortunately, a flattering picture. One particular and prominent group is in large part missing on the photo: the hardest-hit survivors whose life has dramatically changed by the bombs. The Globe certainly invited them as the first. But alas, they didn't come.

Among the victims of the second bomb site the Richard Family, who has kept a low profile in the past, is a notable exception (David Yepez is another, less famous one). Here's a list of the prominent survivors who didn't want to come:

Heather Abbott

Roseann Sdoia

Adrianne Haslet-Davis

Jacqui Webb

Paul and J.P. Norden

Marc Fucarile

Aaron Hern with father Alan Hern

Also missing are the "heroes" of the second bomb site:

Matt Patterson

Tracy Monroe

Mike Chase and Dan Marshall

With so many Marathon Bombing "celebrities" missing - and the situation doesn't look better for the first bomb site -, one may contest the historic value of the picture. The fact that the photo shoot was attended by high-ranking officials like Carmen Ortiz, Thomas Menino, Ed Davis, and Martin Walsh doesn't change this diagnosis.

So why did the survivors, who were not that shy to speak with the media in the aftermath of the bombings, not come? This looks like a coordinated action, it almost resembles a boycott.

For the regular reader of this blog, one probable reason is obvious: it's the unsettled question where exactly the second bomb exploded - and the equivalent question whether Dzhokhar Tsarnaev was the bomber. Another reason might be the attendance of the Richard Family, who according to available photo and video evidence was not at the second bomb site. The official story has it that Matt Patterson, Mike Chase, and Tracy Monroe saved little Jane Richard's life. It would have been a wonderful opportunity to meet again, with many heart-melting pictures. But the lifesavers chose not to come.

The first 30 seconds after the second blast - a photo gallery

This is, one year after, the actual state of non-FBI photo evidence from the immediate aftermath of the second blast of the Boston Marathon Bombings, without comment, for documentary purposes. Most of these photos I have already posted within other contexts, they are compiled here to focus on the area of Boylston Street in front of the Forum. The times have been determined with the help of the Fred Land video and other sources. I've added the original URL and, if available, the photographer.

 

0.3-0.5 seconds after blast

http://mediad.publicbroadcasting.net/p/kenw/files/201305/Nova Boston Bombers jpeg.jpeg

2 seconds after blast (David L. Ryan)

http://clikhear.palmbeachpost.com/wp-content/uploads/2013/04/a001.jpg

 

2,5 seconds after blast

http://i2.mirror.co.uk/incoming/article1838547.ece/ALTERNATES/s2197/Bomb-explodes-in-the-crowd-1838547.jpg

2,5 seconds after blast (David Silverman)

 

7 seconds after blast (David Silverman)

 

 

 13 seconds after blast

http://i.imgur.com/Ot8xciz.png

     

19 seconds after blast (Kenshin Okubo)

 

19 seconds after blast (Bill Hoenk)

20 seconds after blast (David Green)

http://cryptome.org/2013-info/04/boston-bombs/pict91.jpg

 

30 seconds after blast

http://cryptome.org/2013-info/04/boston-bombs/pict90.jpg

Dzhokhar Tsarnaev case: Witness for the Prosecution? - Update

Update  4/14/14: the little stairway in the background belongs to the building beside the Apple store.

Fred Langa/ Huffington Post

Jarrod Clowery in front of the Apple Store

Jarrod Clowery in front of Fidelity Investments

Jarrod Clowery is a potential key witness for the prosecution in the Tsarnaev trial because his various public accounts seem to confirm that the second bomb exploded near the metal barriers, not on the Forum's patio - which would indicate that Tsarnaev's bag was the bomb. I have analyzed his statements in a blog entry from August 2013 and mentioned the problems coming along with them.

In this article, I stated that the photo with Clowery sitting on the street, apparently injured and treated by two first aiders, was taken at the crossing Boylston Street/Ring Road. I based this conclusion on the zebra markings in the background which seemed to be the ones in front of the Forum.

After a closer scrutiny, I have to retract this discovery. The photo was not taken in front of Forum/Starbucks Coffee (755 Boylston Str.), but in front of the Apple Store (815 Boylston Str.). Several details in the background make this conclusion inevitable:

1 - there is no stop line marking parallel to the zebra markings
2 - there's a striking gap in the zebra markings (far left)
3 - there's no scrap from the explosion on the zebra markings
4 - the pole has a square socket

Apple Store 815 Boylston Street

Second Bomb Site 755 Boylston Street

(Image source: Google Street View)

All of these details fit the site at the Apple Store, but not the second bomb site. Additionally, the photo with Clowery standing upright is clearly taken in front of Fidelity Investments (801 Boylston Str.) right beneath the Apple store. You can see the italic "Fi..." writing in the window, and the patterns of the pavement and the walls match the location 1-1.

Jarrod Clowery has recently launched a charity, the "Heroes Hearts Foundation". On a speech at the founding assembly, he reiterated his story: he was blown onto the street by the second bomb, stood up in bewilderment, looked around for a couple of seconds, and was compelled to sit down by two off-duty policemen who cared for him afterwards. While it is theoretically possible that all of this happened at the Forum and the scene at the Apple Store occurred a bit later, like kind of a dejà vu, he never has mentioned the Apple Store episode.

Clowery himself has authenticated the first photo (using it on his Facebook page), and he will also not deny that he's the person standing in front of Fidelity Investments. The photographer of both pictures was Kenshin Okubo. Clowery wears a grey jacket - the Boston Red Sox Fashion Therma Base Premier Jacket: 

This jacket has some striking unique features:

-  a writing RED SOX on the front
-  red stripes at the elbows
-  a red stripe at the collar
-  a "red socks" logo on the left sleeve
-  a small logo on the back, below the collar

There is an individual identifiable on photos and videos of the second bomb site wearing the very same jacket, with torn pants and a striking similarity to Clowery. For convenience, I name this man "Red Sox Jacket". His actions can be reconstructed very well with the help of the footage:

7 seconds after blast: Red Sox Jacket runs away from the Forum, in the photo left (source: David Silverman)

24 seconds after blast: Red Sox Jacket enters the Fred Land video area near the Mandarin Hotel, in the lower left corner of the snapshot
27 seconds after blast: Red Sox Jacket leaves the video area

 
30 seconds after blast: Red Sox Jacket is on Boylston Street in front of the Mandarin Hotel looking back to the bomb site, in the photo right (source unknown)

In this diagram, the black stars represent the positions of Red Sox Jacket at the respective moments:

Either Jarrod Clowery is the man with the Red Sox jacket, then there are some irreconcilable discrepancies between the footage and his narrative; or it's a different person and only a remarkable coincidence, but in this case the question arises: where is Clowery on the footage of the aftermath of the second bomb? He must be somewhere.

The prosecutors have declared that they have thousands of photos and hundreds of witnesses for proving Dzhokhar Tsarnaev's guilt. In case they intend to summon Jarrod Clowery to the trial as a witness, he should be prepared for some uncomfortable questions from the defense team.

New Second Bomb Site Evidence: The Silverman Photos

Update 4/6/2014: better determination of the time of photo A added in the middle of the text.

Photo A

Photo B

David Silverman is a professional photographer. He was at the finish line on Marathon Day 2013, witnessed the two blasts and happened to shoot some photos of the second bomb site immediately after the explosion. Two of them he posted on his website on April 17th, 2013. They are most interesting and the subject of this blog entry. Considering their significance for the Tsarnaev case, it is astonishing that they have been overlooked for nearly a year. The credits for uncovering them go to "justfacts" from the letsrollforum website where I picked them up.

The first step is to determine the time when they were generated. It is immediately apparent that both photos must have been shot within seconds after the second bomb exploded. By matching them with already published photos and videos it is possible to pinpoint the time very exactly.

Here's the photo which was the earliest one after the blast up to now. I've already posted it in previous blog entries. Let's name it photo C.

By matching it with the Fred Land video (taking the running policeman on the left side as reference), I determined its time stamp as 13 +-1 seconds after the blast. I marked four individuals through colored squares:

-  black: a man with a black jacket and a black backpack. This man appears in many aftermath photos which I've gathered here. Many believe he is Bill Richard, the father of the killed boy Martin Richard, but this is very unlikely.

-  blue: a man in a blue jacket with dark pants running away from the Forum.

-  white: a bald man wearing a white shirt.

-  red:  a woman with a green short-sleeved shirt and dark pants.

All of these persons appear also in photo A, and it is clear that photo A precedes photo C: the man in black has moved from the middle of the street (photo A) to the curb (photo C), and the man in blue starts running from the mailbox (photo A) across the street (photo C). The man in white, who is lying beside the mailbox (photo A), is standing upright in photo C.

Taking the time that the man in blue needed to cross the street as reference, the time difference between A and C must be at least 3 seconds, which means that photo A must have been shot within the first ten seconds after the blast.

Update: just right of the man in black, there is a man with a blue jacket and a white cap jumping over the barrier. This man can be spotted in the Fred Land video at 1:07, i.e. the photo ist shot 7 seconds after the blast:

The time stamp of photo B can be determined very precisely with the help of this photo (David L. Ryan) and this video of the second explosion. Here's an enlarged cut-out from the photo:

The female runner within the light-green square and "Mr. Poseidon", the bare-chested man with the mask and the spear appear in photo B at the very same position, i.e. the photos must have been shot within fractions of a second:

A match-up with the video shows that photo B and the Ryan photo are taken 2 - 2,5 seconds after the blast. I leave it to the reader to check this as an exercise.

Photo B bears more interesting details: first, there are two or more people on the street near the mailbox, marked by a purple square. It is impossible to identify them, but they are probably identical to the people highlighted in photo A. They don't seem to be heavily injured, because all of them move away quickly.

The most interesting detail however is the man in the white shirt. In photo A, he was lying at the mailbox; in photo B, he's not at the mailbox, but seems to be jumping over the metal barriers via the junction box. This might look like an overinterpretation, it is supported by the video however. At 0:05, after the camera has pivoted to the second bomb site, you can see a little, but distinct white spot in the background moving vertically downwards. This is - most probably - the white shirt of our man as he jumps over the barrier. I've marked his position in this still at 0:05:

You can follow the white dot/shirt after the jump for a very short time: he moves towards the mailbox. Then the camera sways away from the scene.

To sum up:

Photo B: 2 seconds after blast
Photo A: 7 seconds after blast
Photo C: 13 seconds after blast

The benefit of having established this timeline may not be obvious at the first look; for a reconstruction of the events however it is absolutely necessary. The value of the Silverman photos and the potential to utilize them for the Tsarnaev trial must not be underestimated and will certainly manifest itself in the future.

The account of witness "Danny" according to the criminal complaint

The criminal complaint against Dzhokhar Tsarnaev was the first official paper with detailed information on the case, published on April 22th, 2013. It contains the earliest account of the victim of the alleged carjacking (later identified as "Danny"). I transcribed the crucial passages (19, 20, 21) for documentary purposes and added section 22 for completion, which is not part of the victim's account.

19. Near midnight on April 18, 2013, an individual carjacked a vehicle at gunpoint in Cambridge, Massachusetts. A victim of the carjacking was interviewed by law enforcement and provided the following information. The victim stated that while he was sitting in his car on a road in Cambridge, a man approached and tapped on his passenger-side window. When the victim rolled down the window, the man reached in, opened the door, and entered the victim's vehicle. The man pointed a firearm at the victim and stated, "Did you hear about the Boston explosion?" and "I did that." The man removed the magazine from his gun and showed the victim that it had a bullet in it, and then re-inserted the magazine. The man then stated, "I am serious."

20. The man with the gun forced the victim to drive to another location, where they picked up a second man. The two men put something in the trunk of the victim's vehicle. The man with the gun took the victim's keys and sat in the driver's seat, while the victim moved to the front passenger seat. The second man entered the victim's vehicle and sat in the rear passenger seat. The man with the gun and the second man spoke to each other in a foreign language.

21. While they were driving, the man with the gun demanded money from the victim, who gave the man 45 dollars. One of the men compelled the victim to hand over his ATM card and password. They then drove to an ATM machine and attempted to withdraw money from the victim's account. The two men and the victim then drove to a gas station/convenience store in the vicinity of 816 Memorial Drive, Cambridge. The two men got out of the car, at which point the victim managed to escape.

22. A short time later, the stolen vehicle was located by law enforcement in Watertown, Massachusetts. As the men drove down Dexter Street in Watertown, they threw at least two small improvised explosive devices ("IEDs") out of the car. A gun fight ensued between the car's occupants and law enforcement officers in which numerous shots were fired. One of the men was severly injured and remained at the scene; the other managed to escape in the car. That car was later found abandoned a short distance away, and an intact low-grade explosive device was discovered inside it. In addition, from the scene of the shootout on Laurel Street in Watertown, the FBI has recovered two unexploded IEDs, as well as the remnants of numerous exploded IEDs.

The smothered arrest of a Boston Bombing suspect on April 17th

In two blog entries (here and here) I already have highlighted the turbulent news releases two days after the Boston Marathon bombings. John King of CNN has played the most prominent role here: first, he reported that law enforcement had identified a suspicious dark-skinned male on a surveillance video who placed a black backpack in front of the Forum restaurant. An hour later, he reported that an arrest had been made, in succession of a twitter message from Associated Press.

As an instant reaction to this AP tweet, several hundred journalists gathered in front of the Boston federal courthouse in anticipation of the arrival of the arrested suspect. Some of them, like Kelley Tuthill of the Boston TV station WCVB, went inside. Court staff told her that a courtroom (Nr. 18) was prepared for "some kind of appearance". But soon authorities denied that an arrest had been made, and at the same time the courthouse was evacuated due to a "code red" security alert, a very rare event. A bomb threat was later given as an explanation, but without any details.

After the crowd was forced back from the entrance and the street, a white van with tinted windows and a US marshal clinging to the passenger door passed by and entered the building via the back driveway. This incident was quickly brushed under the carpet and has raised no queries by anyone afterwards, but it is well documented by photos, video footage and twitter messages. In this WCVB video

http://www.kaltura.com/index.php/kwidget/wid/_557781/uiconf_id/21039792/entry_id/1_mzq8y0f4 

you can see the van right from the start as he arrives at the courthouse, turns left and drives into the building.

These circumstances don't allow any other conclusion than that the van transported an arrested and potentially dangerous person to be arraigned at the courthouse. The conclusion that the courthouse was evacuated to expel the journalists inside lest they got a glimpse at the arrested individual is nearly inevitable. The presence of several Homeland Security cars in front of the building shows that the arrest was terror-related. The timely correlation to the messages of the arrest and their retraction strongly suggests that the person in the van was the subject of these messages - almost certainly the dark-skinned male reported by King.

The events of April 17th have been accompanied by several real-time online accounts. For a better oversight, I have compiled three timelines:

- a timeline of WCVB twitter messages
- a timeline of Boston police scanner messages, passed on real-time by three websites
- a summarized timeline with the most important points

The noted hours in the time designations on the websites are dependent on the time zone. The context of the messages however unambigously points to the real hour; I adjusted the times respectively.

WCVB Timeline - all times are p.m.

http://livewire.wcvb.com/Event/117th_Running_of_Boston_Marathon?Page=33

http://livewire.wcvb.com/Event/117th_Running_of_Boston_Marathon?Page=34

http://livewire.wcvb.com/Event/117th_Running_of_Boston_Marathon?Page=35

1:26  Janet Wu says an arrest is imminent and may have already taken place.
1:43  AP: suspect to be brought to court

1:48  Janet Wu reports it is a man who was arrested.

1:49  The official says the suspect is to be taken into custody by federal marshals and taken to a Boston courthouse.

1:53  CNN reports the arrest has been made.

1:56  A source tells Newscenter5's Janet Wu that one male suspect delivered both bombs.

2:02  Law enforcement official: Boston Marathon bomb suspect in custody, expected in federal court.

2:03  Intense security at federal court. Anticipating arrival of suspect in bombings.

2:07  Suspect arrested Boston Marathon bombings, heading to Federal Court now.

2:20  Tons of media outside federal courthouse

2:21  Still anticipating arrival of possible suspect in bombings at federal court at any minute... Arrest may have been earlier this morning

2:23  One homeland security guard: " very good day for us "

2:24  There are now conflicting reports on whether the suspect in custody has been formally arrested.

2:32  Several sources are now reporting that no arrest has been made. However, several sources report that a suspect is in custody.

2:34  One federal police officer says arrival expected " within the hour ". Not official word

2:39  Boston Police says no arrest but high security at courthouse and Fed police say suspect arrival soon according to reporters there.

2:48  Federal officials deny that Boston Marathon bombing suspect is in custody.

3:00  Now all media and others moved across street from courthouse.

3:00  Despite all the denials, the Associated Press is standing by its story of a suspect in custody: The official who spoke to the AP did so on condition of anonymity and stood by the information even after it was disputed.

3:04  Evacuation federal courthouse. Code red called on loud speaker.

3:07  The Boston Federal Courthouse is being evacuated. The reason is not clear. US Marshal vans arrived with heavily armed personnel.

3:07  Media pushed across the street from Moakley courthouse and now many people are leaving the building.

3:10  A white van with a police officer clinging to the rear has pulled into the Moakley Courthouse.

3:15  There is a great deal of police boats and Coast Guard boats on the harbor side of the courthouse.

3:38  Kelley Tuthill reports that court personnel were preparing a courtroom for some kind of appearance.

3:55  Kelley Tuthill: I know a lot confusion out there. I can only tell you I was sitting there when court staff told me they were preparing courtroom 18.

3:59  US Marshal: The evacuation was due to a bomb threat received at the courthouse. The building is being swept at this time.

Police Scanner Timeline - all times are p.m. 

http://www.justicequest.net/forums/showthread.php?t=72966&page=28 

http://www.blowoutcards.com/forums/off-topic/494233-reports-explosions-boston-marathon-finish-line-18.html 

http://www.landthieves.com/board/showthread.php?54092-Boston-Marathon-Bombing/page19

 

1:21

2:01

 

2:03 Near MIT, looking for motorcade driving from MIT towards courthouse? Not sure why they would mention looking for this.

2:07

 

2:09 Someone from the US Marshall office. Huge motorcade with police contingent in Kendall Sq. area.

2:13

2:17

2:24

2:34

Summarized timeline - all times are p.m.

ca. 1:30  The suspect is arrested

ca. 1:50  First media reports that a suspect is in custody

ca. 2:00  The suspect is moved from MIT via Kendall Square and Interstate 93 to the federal courthouse, accompanied by a police motorcade

ca. 2:20  The convoy with the suspect arrives at the courthouse, but cannot move on because a journalist crowd has gathered in front of the entrance

ca. 2:30  Beginning denials that an arrest has been made

ca. 3:00  The courthouse is evacuated due to a "code red" alert. The crowd is forced back from the street. AP still stands to its story - for the last time - that a suspect is in custody.

ca. 3:10  A white van with an US marshal clinging to the passenger door - and most probably the suspect inside - enters the courthouse via the back driveway.


Questions arising:

Why was the arrest of a suspect denied in spite of being extensively reported on the Boston police scanner?

What was courtroom 18 prepared for (Kelley Tuthill), if not the arraignment of a suspect?

Who was the obviously arrested person inside the white van?

Why was the white van driving into the courthouse in spite of the fact that the courthouse was evacuated shortly before under a "code red" threat?

Krystle Campbell died of cardiac arrest

It is unknown if the defense team of Dzhokhar Tsarnaev is still struggling to obtain autopsy records of the three expired victims of the bombings. In the case of Krystle Campbell - unlike the other two victims -, they are in part substitutable by the report of Allan Panter, the physician who was accidentally at the first bomb site, was unharmed, and tried to save her life. His account is somewhat surprising, in his own words: puzzling.


Update 12/30/13: CNN aired an interview with Dr. Panter on the evening of April 15th, earlier than O'Reilly and probably the earliest TV interview with him at all.

MORGAN: Thanks very much. I want to bring in Dr. Alan Painter and his wife, Theresa. Alan Painter is a doctor at the E.R., Boston -- treating the Boston Marathon victims today. His wife actually ran in the marathon today. An extraordinary day for the family. Welcome to you, Dr. Painter. Can you tell me when you first heard what had happened today?

DR. ALAN PAINTER, TREATING BOSTON MARATHON VICTIMS: I was standing about 20, 25 feet from the initial blast, so I knew immediately what was going on.

MORGAN: Obviously you knew that your wife Theresa was running. Your first thoughts I guess must have been where on earth she was and was she safe.

PAINTER: It was. And I would like to commend the Boston Athletic Association and the police, paramedics here, they did an outstanding job. My wife was about two-tenths of a mile from the finish line and they pushed her back from the second blast area so it was pretty impressive, their response.

MORGAN: Theresa, you were running in the marathon. You were near the finishing line. What was your reaction when you heard the first explosion go off? THERESA PAINTER, BOSTON MARATHON RUNNER: Well, I really wasn't paying attention and then when I heard the bomb and saw the reaction of the spectators, I was just alarmed. And then I was pushed back by a spectator, and Boston Athletic officials grabbed a bunch of us and pushed us back. So it was pretty upsetting.

MORGAN: And Dr. Painter, you actually went to the Harris Regional Medical Center, I believe. Is that right? Were you treating people there today?

DR. PAINTER: No. I was treating people on the streets and assisted transferring them into the medical tent. I work in Harris Regional Medical Center in (INAUDIBLE) North Carolina.

MORGAN: So you were actually treating people on the streets. What were you seeing? What was the type of injury, how many people did you see injured there?

DR. PAINTER: I saw at least six to seven people down next to me. They protected me from the blast. One lady expired, one lady -- one gentleman lost both his limbs, lower extremities. Most of the injuries were lower extremities. I could not figure out why the young lady had expired, could not find any injury on her thorax. The other people I saw were mainly lower extremity injuries.

MORGAN: Have you ever seen injuries like this in your time working in Boston?

DR. PAINTER: No. I have not had experience with blast injuries in the past. I'm not military, so basically I'm used to more gunshot wounds.
 
 
http://transcripts.cnn.com/TRANSCRIPTS/1304/15/pmt.01.html




O'REILLY: So first tell us about the woman who eventually died, Doctor - were you the first on scene there?

PANTER: I was one of the first, I don't know if I was the first one. Several people converged on the mass of bodies. We pulled a gentleman out from under her and then began working on her, too. She was basically in an arrest at the time. We thought we had a faint pulse. We started CPR (unintelligible) pulse or not. We started to kind of breathe her using an ambu bag. We ended up transporting her to the medical tent where she unfortunately expired.

O'REILLY: So she went into cardiac arrest, did she have other injuries from the bombing?

PANTER: She had injuries that we could visualize of her lower extremities, but could not find any obvious injury to her chest or abdomen, which was kind of puzzling. There was no evidence of shrapnel wounds to her chest that we could find on a cursory examining that we did. It was kind of puzzling. I don't know were these totally blast effects or what that caused the arrest.

http://video.foxnews.com/v/2306084131001/the-human-toll-of-terrorism/


Cardiopulmonary resuscitation (CPR) is an emergency procedure for manually preserving brain function until further measures to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. (Source: Wikipedia)


Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes.
 
Overview

To understand SCA, it helps to understand how the heart works. The heart has an electrical system that controls the rate and rhythm of the heartbeat. Problems with the heart's electrical system can cause irregular heartbeats called arrhythmias.

There are many types of arrhythmias. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. Some arrhythmias can cause the heart to stop pumping blood to the body—these arrhythmias cause SCA.

SCA is not the same as a heart attack. A heart attack occurs if blood flow to part of the heart muscle is blocked. During a heart attack, the heart usually doesn't suddenly stop beating. SCA, however, may happen after or during recovery from a heart attack.

People who have heart disease are at higher risk for SCA. However, SCA can happen in people who appear healthy and have no known heart disease or other risk factors for SCA.

(Source: http://www.nhlbi.nih.gov/health/health-topics/topics/scda/)