Man down in the half-marathon

Yesterday was a great day for a road race. And then quite suddenly, it wasn’t.

I went to Hamilton. I ran a half-marathon, faster than expected. I finished. And I was happy not to be racing the full marathon, because it was cold and windy.

So I jog back down the course to cheer for my fellow runners and clubmates. The sun is shining, even if it is only a few degrees above zero. The waves of Lake Ontario are crashing on the shore of Hamilton Beach. I’m jubilant and ready to share my good cheer.

In a matter of seconds, that all changes. As I reach the bike path that is the final kilometre of the race course I spot a runner face down on the pavement. He isn’t moving. I run towards him, but another spectator gets there first and yells for medical help.

I run back up the hill to the finish line medical tent, just a few steps away but out of sight of because the course makes a big loop at the finish. I sound the alarm and then run back to the scene. The St. John’s ambulance volunteers arrive a minute later and roll the middle-aged man over. A few seconds later, one of them starts CPR.

What to do? Another spectator and I notice an immediate problem. The downed runner is smack in the middle of the narrow race course and runners are now pouring directly towards the emergency scene. We start diverting them around the obstruction, and recruit several more volunteers to the task.

“KEEP LEFT! MOVE OVER!” we yell, while glancing sporadically over our shoulders at the crisis unfolding behind us.

The St. John’s volunteers are working furiously. I have never seen CPR in action, and the brutality of it is shocking. The woman crouched over him crushes his chest with each compression. The runner is motionless, his body absorbing each thrust like a foam pillow.

The approaching runners are confused. They think we’re high-fiving them as we motion with our arms. They’re about 500 metres from the finish of a nearly two-hour race, and most are a little dopey. They funnel past the chaotic scene, quite unaware of what’s really happening beside them.

Now there are five or six people clustered around the runner. They strip his shirt off. Someone arrives with a defibrillator. We hear a tense voice barking orders as they apply the electrodes and jolt his torso with electricity.

More rapid CPR. The half-marathon is at the 1:50 mark, and the majority of the 1,750 racers are now approaching the scene. There’s no question of moving the man off the pathway. Next comes a ventilation bag. The first aid leader is also calling for intravenous tubes and bags.

After 10 minutes, an ambulance pulls up and two paramedics jump out. This helps with our traffic direction because the flashing lights alert the oncoming stream of runners. The paramedics join in on the CPR. but I still see no response from the runner.

If you didn’t know what was going on, you might suspect a gang was beating up an unconscious man on the ground, the procedure is so violent. I have two running friends who do this sort of thing for a living (ER nurse and firefighter), but I’ve never seen them in action. Up close, it is simultaneously scary and impressive.

My running clubmate Maria approaches, slowing down at the scene. “Keep left,” I tell her without explanation. She glances right, and says, “Oh no.”

The paramedics unload a stretcher, and push it alongside the river of runners, who now realize what’s going on. They stop the chest compressions and remove the ventilation. Our runner is loaded onto the stretcher and then wheeled back to the ambulance.

I watch as he goes by. He’s motionless. No colour in his face, his head slumped to the side. He doesn’t appear to be breathing. I assume he’s dead and they’ve all but given up as they load him into the vehicle.

The ambulance disappears and all that remains is a mess of packages, gloves and wrappers. It looks as if someone turned over a garbage can in the middle of the bike path. The St. John’s people clear that up quickly, and the race returns to normal. The whole crisis has lasted maybe 20 minutes, but it now fills my mind with images.

I return to the finish line and quietly watch the runners come in, including my next door neighbour Carolyn, who is a doctor. After she recovers, I mention what just happened. She noticed the commotion as she ran by but couldn’t see what it was about.

The finish line mood is festive. Several of my long-time training partners have run personal bests in the marathon, but they’re beaten up by the wind. In fact, Allen is temporarily blinded with extremely dry eyes and goes to the medical tent for help.

I celebrate with them, but it’s not like a usual race finish. I feel glum and shocked by how badly things have turned out for one runner. I drive home with my friends and try not to dwell on the experience.

I heard earlier this year that in TV hospital dramas, 75 per cent of CPR rescues turn out favourably. But also that in real life, the success rate is more like 8 per cent, and almost half of those result in crippling brain damage.

Two hours after the crisis, CBC news online reports that CPR did restore the 50-something man’s pulse and breathing, and that he is unconscious in a Hamilton hospital. They try to put a positive spin on the story by focussing instead on the heroics of the CPR volunteers and their quick action. Race organizers say they hope the incident does not “cast a pall” on the event.

But when I ask Carolyn about our case she says that even a few minutes without a pulse “does not bode well” for our runner. I’m hoping he has the fortune of my friend and neighbour Ajay Heble, who had a heart attack on a transatlantic flight several years ago, was unconscious for 10 minutes, but was resuscitated by CPR and has recovered completely.

As I go to sleep last night, I’m not replaying my own race in my head, as I would usually do. Instead, I’m thinking about the fallen runner and how quickly things went horribly wrong for him.

(Note: the photograph above is not from yesterday’s event.)