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For subjects of new Boston Marathon documentary, a struggle that wears on

Patrick Downes and Jessica Kensky would seem to represent a powerful story of trauma and recovery.

A psychology PhD candidate and an oncology nurse, respectively, their lives were upended when they found themselves near the finish line of the Boston Marathon in April 2013. A bomb from the attacks that day sent shrapnel tearing through their lower torsos, causing severe injuries and leading to the amputation of each of their left legs.

Months of surgeries and rehab followed as the married couple sought to adjust to their lives without limbs. Their situation seemed to hit rock bottom when Kensky made the difficult choice to amputate her right leg as well after it stubbornly refused to heal.

If this was many documentaries, that would have marked the beginning of a comeback story. But as portrayed in the new nonfiction film "Marathon: The Patriots Day Bombing," it was just one of a complicated tangle of setbacks for the couple — part of what might be described as the aftermath of the aftermath, as victims struggle to recover long after public attention has shifted.

"When we agreed to cooperate with this film I had just amputated my second leg and I thought, 'The worst is behind me, and I'm just going to take off and become this very active bilateral amputee,'" Kensky said in a recent interview. "And that not what happened at all.”

Kensky had at least 10 surgeries over the course of filming as her suffering continues. More than 3 1/2 years since the bombings, the once-effusive nurse, 35, and Downes, 33, still live at Walter Reed Army Medical Center in Bethesda, Md., struggling with both physical and psychological pain.

The couple's story is one of three survivor tales documented in "Marathon," which also looks at the mother-daughter pair of Celeste and Sydney Corcoran (the former is a double amputee) and the thirtysomething construction-working Norden brothers, J.P. and Paul, who each lost legs. Directed by the veteran nonfiction filmmakers Ricki Stern and Annie Sundberg ("Joan Rivers: A Piece of Work"), the film is a gut-punch of a reminder that while the Boston attacks have faded from public view, those who experienced it continue to face enormous hardships.

When the movie debuts Monday on HBO after a limited theatrical run this past Friday it also will mark the beginning of a kind of cinematic period of marathon remembrance. Next month will bring the release of Peter Berg's "Patriots Day" starring Mark Wahlberg as a Boston police officer, while next year will see David Gordon Green’s “Stronger,” a story of the double amputee Jeff Bauman starring Jake Gyllenhaal.

All three films seek to memorialize that sunny spring day when a triumphant finish line became a carnage-filled death scene. Three people were killed, 16 lost limbs and more than 250 were injured as a pair of bombs placed by Dzhokhar and Tamerlan Tsarnaev tore through Boston’s Boylston Street.

But where "Patriots Day" and "Stronger" offer glossier Hollywood takes on the bombings, "Marathon" examines the story from the intimate and often raw perspectives of the victims themselves.

What became apparent to the filmmakers — and will quickly become apparent to viewers — is that for many survivors the hard part began once the news spotlight dimmed. Far from a heartbreak-to-hope trajectory, the movie shows how survivors lives are often filled with both.

"For many survivors, the mental, emotional and even physical struggle is so much more than anyone would suspect," Stern said of the movie, which was made in formal cooperation with the Boston Globe and drew from the paper's reporting. "A lot of these stories are bittersweet, and even though there are inspirational moments we wanted to show that it's an ongoing process. There are no pat finishes."

In some of the more potent scenes of "Marathon," the viewer is invited into the homes and bedrooms of the survivors as they go about the mundane but mountainous challenges of their routine.

Kensky and Downes describe even basic middle-of-the-night activities, such as a going to the bathroom or responding to a strange sound, as exceedingly difficult.

"To see two youngish people getting out of bed and transferred to wheelchairs and have a service dog and a drawer full of pills and our [prosthetics] are on can be shocking," Kensky said in a phone conversation, which she conducted alongside her husband from their room at Walter Reed. "It's 'That's how she wakes up? That's how he goes to bed at night?’"  She paused. “Sometimes we just wish we had one full body between us.”

Redemption does find its way into the film, as when Downes runs the Boston Marathon or when the Nordens start a construction business and help the first-responder who saved them build an addition to his house.

And heartwarming moments can come into the survivors’ lives off-screen: with Kensky's colleagues, for instance, who donated thousands of hours of vacation time so she could continue receiving healthcare, or the police officers who carried her and Downes into their Cambridge apartment so they could say goodbye to it one last time before moving out.

But “Marathon” quietly subverts what might be called documentary’s victim genre, in which viewers tacitly will accept pain and suffering if it comes with light and hope at the end. The title, indeed, is meant as a double entendre.

Not least is the survivors’ differing rates of recovery, which can put a strain on a couple. "I thought because I had suffered an amputation that I understood what Jess was going through,“ Downes said. “And eventually I had to be honest and submit to the idea that I didn’t know a lot of what she was experiencing.”

Survivors also describe encountering a kind of public discomfort that the recovery has taken so long. "It's kind of like 'compassion fatigue,'" Downes said. "No one does it consciously. But at some point people have to create a barrier between them and catastrophe."

The Corcorans are also depicted as a complicated and compelling family and help convey the toll the bombings took on family dynamics. Celeste Corcoran had her legs amputated and has undergone a painful recovery process.  Her husband, Kevin, had turned to alcohol, a fact captured with a quiet, fly-on-the-wall power in the film. Sydney must deal with the pain of being an early-twentysomething with a hole in her foot and two parents who will never be the same.

"There were similarities to what all the families went through with amputations. But the recovery and emotional challenges were unique to each one," Sundberg said. "What we wanted was to speak to the invisibly wounded, to the stress this places on relationships."

“Marathon” comes after a year in which domestic terrorism, from San Bernardino to Orlando, has made such stories all too common and makes all the Boston films all too timely.

In a bit of film crossover, Kensky and Downes are depicted in "Patriots Day,” seen in their apartment the night before the bombing and in the hospital cleaving to each other after the attacks. Though they were consultants on the film — Downes came to the AFI premiere and made a powerful call for peace during a post-screening talk — they also seem to harbor some ambivalence about the Hollywood adaptation, which focuses a lot more on the manhunt than the survivors’ recovery. "One of my friends described it as sugary cereal over your Wheaties," Kensky said.

"Their goal was very clearly to tell a much shorter period of time," Downes said, more understatedly.

Still, the couple hopes all the films convey the nature of their struggle, which they emphasize is, like the aftermath of so many tragedies, untidy and open-ended.

"When Ricki and Annie told me they were done, I was, like, 'No, wait; I'm not better.'” Kensky said.  “But that’s the thing about real life. You don’t always go on the journey you think you’re going on.”

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