Carolyn Baker, clad in a neon pink top and matching sunglasses, smiled as she ran the Falmouth Road Race on the shore of Cape Cod, looking around for friends as she neared the end of a race she害羞草研究所檇 completed more than a dozen times before.
Suddenly, Baker collapsed, as her exertion on a sunny August day sent her internal temperature soaring. As medical volunteers rushed to her aid by plunging her into a tub filled with ice water, they measured it at nearly 107 degrees (41.6 Celsius).
For family members, the first sign of trouble was when their tracking app showed Baker moving backward on the course 害羞草研究所� as she was taken to the medical tent. Her husband, catching up with friends after finishing earlier, blurted 害羞草研究所淥h my god,害羞草研究所� after his daughter called to alert him, then rushed to the tent.
The heatstroke that felled Baker last year is a deadly , and climate change is worsening the risk. In the continental U.S., the frequency of dangerously hot days .
Exertional heatstroke happens during exercise when the body can害羞草研究所檛 properly cool, and triggering a central nervous system problem such as fainting or blacking out. It can be effectively treated by rapidly cooling a victim, but lots of races lack the resources or expertise to do it. And many runners, in a culture that esteems grit and suffering, may ignore conditions that put them at risk.
Muscles can break down, releasing proteins that damage kidneys. The lining of the digestive system may weaken and leak bacteria. Brain cells may die. It can damage organs and, ultimately, kill.
The Falmouth race is a magnet for heatstroke. At 7 miles, it害羞草研究所檚 long enough to give the body time to heat up dangerously and short enough that many runners are pushing hard. And with more than 11,000 runners, odds are good that some haven害羞草研究所檛 trained to acclimate to hot weather, or show up dehydrated. And some runners are simply more vulnerable.
But if you are going to have heatstroke, you could do it in a worse place than Falmouth. They have enough people, equipment and experience to handle lots of cases. And medical director John Jardine has documented nearly 500 cases of heatstroke in more than two decades 害羞草研究所� so many the race has attracted researchers.
The problem is lots of races don害羞草研究所檛 have the equipment or expertise to offer the right lifesaving care, said Douglas Casa, director of the University of Connecticut害羞草研究所檚 Korey Stringer Institute, named for the Minnesota Vikings lineman who died of heatstroke in training camp in 2001.
害羞草研究所淭hink of the local 5K races,害羞草研究所� Casa said. 害羞草研究所淭hey might have an ambulance there or they might have a nurse or medic or somebody there, but they don害羞草研究所檛 have a whole medical tent set up to be able to deal with heatstroke.害羞草研究所�
Keeping runners alive
Getting victims into a tub of ice water is the best way to quickly cool them. And it needs to happen fast, with quick diagnoses to treat runners on the spot. Medical staff need rectal thermometers to gauge temperature when skin can be deceptively cool.
害羞草研究所淚 can害羞草研究所檛 guarantee everything that is going to happen in the future,害羞草研究所� Casa said. 害羞草研究所淏ut based on over 3,000 cases we害羞草研究所檝e tracked, if someone害羞草研究所檚 temp gets under 104 within 30 minutes of the presentation of heatstroke, no one has ever died.害羞草研究所�
He said there isn害羞草研究所檛 good data on how many races do it right. From his decades of experience, very few do, although generally he said care is better now than when he started. Casa suggested governing bodies for racing should publish heat-related recommendations for safety.
Race directors must organize complex events for runners of all ability. Some are big races with lots of resources; others are small local affairs with a shoestring budget. Security, organizing workers and volunteers, tracking runners and medical care all must be assembled and paid for, said Dave McGillivray, who helps direct the Boston Marathon and also advises other race directors.
Runners bear responsibility, too. He recalls grabbing a mic at the 2012 Boston Marathon when it was , telling runners they needed to take it easy. It害羞草研究所檚 a hard message for runners who have trained months to meet goals.
害羞草研究所淲e cannot fit all of you in our medical tents,害羞草研究所� he remembered saying. More than 2,000 people needed treatment that day; roughly 200 went to the hospital.
害羞草研究所淚t was a lot of carnage out there,害羞草研究所� McGillivray said. 害羞草研究所淏ut, you know, no one passed, people went home, and we dodged the proverbial bullet. Not every race can say that. If you don害羞草研究所檛 have the resources, then you shouldn害羞草研究所檛 be firing the gun.害羞草研究所�
Two athletes害羞草研究所� stories
Evan Hauptmann, a multi-sport athlete in high school, decided to run Falmouth at 17. He wanted to finish in under an hour and felt fine until a big hill late in the race made him light-headed. By then he could see the finish line and his competitive nature kicked in.
Soon after finishing, he lost consciousness. His temperature was the highest Jardine has seen at Falmouth 害羞草研究所� 112.8 degrees (44.9 Celsius).
害羞草研究所淭hat害羞草研究所檚 crazy,害羞草研究所� said Dr. Sameed Khatana, a professor of medicine at the University of Pennsylvania. 害羞草研究所淭hat is not compatible with life.害羞草研究所�
But Hauptmann got immediate care, with a half-hour in the ice bath bringing his temperature down quickly, and he went home that day. Doctors worried about organ damage. Blood tests showed high protein levels from muscle breakdown, but they came down and he avoided lasting injury.
Two weeks later he started playing football again. But he害羞草研究所檚 more aware of heat害羞草研究所檚 danger, and makes sure to stay hydrated and aware of how he is feeling.
害羞草研究所淎s an athlete I can害羞草研究所檛 really let it stop me from competing,害羞草研究所� he said. 害羞草研究所淚 kind of just have to learn from it, realize what I did wrong and realize what I can do better in the future to listen to my body.害羞草研究所�
In contrast, there害羞草研究所檚 Zo毛 Wallis, recruited to play college basketball in South Carolina. The summer before her freshman year in 2014, her team was told their mental strength would be tested with a 5-mile run they had to finish within an hour. It was about twice as far as she had ever run.
By the second half, she started feeling hazy, then panicky. Eventually, a teammate on each side held her up. She recalled saying she wanted to stop but being pushed forward.
害羞草研究所淲hat I remember happening was getting a jolt of energy near the end and feeling like I was hitting this runner害羞草研究所檚 high and was going to finish the run strong,害羞草研究所� she said. 害羞草研究所淚n reality, what happened is that I completely collapsed, skinned my entire arms, elbows, knees.害羞草研究所�
She was taken to the hospital in a car, laid across the warm laps of teammates. She awoke in the emergency room, disoriented. Her kidneys and liver had failed, she said. She eventually sued the school and receive a settlement.
Wallis said it took about three months to resume practice. But the sport never felt the same. Eventually, she left the team, lost her scholarship and transferred.
害羞草研究所淭he mental aspect of the heatstroke consumed me. I felt so fragile, not only when I was practicing and actually playing my sport, but also just existing. I was just afraid in so many ways,害羞草研究所� she said. Ten years later, she害羞草研究所檚 in a good place, but it took therapy and time.
Keep running, but be smart about it
Racing may slightly increase the chances a runner will suffer a rare event like heatstroke or cardiac arrest, but doctors say it害羞草研究所檚 almost certainly healthier to show up anyway.
害羞草研究所淩unners and athletes are at reduced risk of having not only cardiac arrest, but all forms of heart disease compared to non-runners,害羞草研究所� said Dr. Aaron Baggish, a professor at the Universit茅 de Lausanne and former medical director of the Boston Marathon.
Baker, now 61, had a happy ending.
She regained consciousness in an ice bath that brought her temperature down to a safe level. Her head hurt and she felt weak, but family members eventually helped her stand and she was able to go home. She had no memory of her collapse, and called it 害羞草研究所渆erie害羞草研究所� afterward when she came upon a gallery of race pictures online and saw photos that showed her falling to the ground.
One week later, Baker dressed in the same pink top, sunglasses and racing bib to run Falmouth害羞草研究所檚 last mile, striding past the spot where she collapsed. Her husband害羞草研究所檚 photos show her smiling and flexing at the finish.
害羞草研究所淲e have a big running group of friends and family,害羞草研究所� Baker said. 害羞草研究所淓verybody in our group had finished the race except for me. And I was like nah, I need to do it. And I need to know I害羞草研究所檓 going to be OK mentally.害羞草研究所�
This year, she was back at Falmouth again 害羞草研究所� and finished safely.
___
The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP害羞草研究所檚 environmental coverage, visit
Michael Phillis, The Associated Press
