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Wearing a pink neon top and matching sunglasses, Carolyn Baker was all smiles as she ran in the Falmouth Road Race on the coast of Cape Cod, looking for friends as she neared the end of the race she’d completed more than a dozen times before.
Suddenly, Baker fainted as her body temperature soared on a sunny August day. When medical volunteers rushed to her aid and plunged her into a tub of ice water, they discovered her temperature was nearly 107 degrees (41.6 Celsius).
For family members, the first sign of trouble came when their tracking app showed Baker moving backwards on the course – even as she was taken to the medical tent. Her husband, who had already finished school and was with friends, suddenly exclaimed “Oh my god” when his daughter called to alert him, then ran to the tent.
Heatstroke, which caused Baker’s death last year, is a deadly illness linked to extreme heat and a risk that’s growing even more because of climate change. In the continental U.S., the frequency of dangerously hot days is expected to increase by about a third by midcentury.
Heatstroke during exercise occurs when the body is unable to cool down properly, obviously the day is going to be hot, which tells runners that they need to take it easy. This is a tough message for runners who have trained for months to achieve a goal.
He remembers they said, “We can’t put all of you in our medical tent.” More than 2,000 people needed treatment that day; about 200 went to the hospital.
“There was a lot of devastation out there,” McGillivray said. “But, you know, nobody got killed, people went home, and we dodged the proverbial bullet. Not every race can say that. If you don’t have the resources, you shouldn’t jump the gun.”
Stories of two athletes
Evan Hoptman, a multi-sport athlete in high school, decided to run in Falmouth at the age of 17. He wanted to finish the race in under an hour and was feeling good until a big hill at the end of the race made him dizzy. By then he could see the finish line and his competitive nature came out.
He collapsed shortly after finishing his meal. His temperature was the highest ever recorded at Jardine’s in Falmouth – 112.8 degrees (44.9 Celsius).
“This is crazy. This is not compatible with life,” said Dr. Samid Khatana, a professor of medicine at the University of Pennsylvania.
But Hauptman received treatment immediately, a half-hour stay in an ice bath brought his temperature down rapidly, and he went home the same day. Doctors were concerned about organ damage. Blood tests showed high protein levels from muscle breakdown, but they came down and he avoided permanent injury.
Two weeks later he started playing football again. But now he’s more aware of the dangers of the heat, and makes sure he stays hydrated and is aware of how he’s feeling.
“As an athlete, I can’t really let it stop me from competing,” he said. “I just have to learn from it, understand what I did wrong and understand what I can do better in the future to listen to my body.”
In contrast, Zoe Wallis was recruited to play college basketball at South Carolina. The summer before her freshman year in 2014, her team was told their mental strength would be tested by a 5-mile run that they would have to complete in under an hour. It was nearly twice the distance they had ever run.
In the second half, she first started to panic and then became nervous. Eventually, a teammate from each team held her back. She recalled that she wanted to stop, but was being pushed forward.
“I remember at the end I felt a surge of energy and felt like I was hitting runner’s high and was going to finish the race strong,” she said. “In reality, what happened was that I fell down completely, bruised my whole arms, elbows, knees.”
She was rushed to the hospital in a car, cradled in the warm arms of teammates. She regained consciousness in the emergency room, confused. She was told her kidneys and liver had failed. She eventually sued the school and received a settlement.
Wallis said it took about three months to resume practice. But the game never felt the same. Eventually, she quit the team, lost her scholarship and transferred.
“The mental aspect of the heatstroke ate at me. I felt so vulnerable, not only while practicing and actually playing my sport, but just being present. I was scared in so many ways,” she said. Ten years later, she’s in a good place, but it took therapy and time.
Keep running, but run smarter
Running may slightly increase runners’ chances of suffering from heatstroke or a rare event like heart attack, but doctors say participating in a race is definitely healthy.
“Runners and athletes have a lower risk than nonrunners of not only heart attacks, but all types of heart disease,” said Dr. Aaron Baggish, a professor at the Université de Lausanne and former medical director of the Boston Marathon.
Baker, now 61, has had a happy life.
She regained consciousness in an ice bath, which brought her temperature down to a safe level. She had a headache and felt weak, but family members eventually helped her stand up and she was able to go home. She had no memory of her fall, and when she later came across a gallery of race photos online and saw images showing her plummeting to the ground, she called it “terrifying”.
A week later, Baker ran the last mile to Falmouth wearing the same pink top, sunglasses and racing bib, passing the spot where she fell. Her husband’s photos show her smiling and hugging him at the end of the race.
“We have a big group of friends and family that participate in the race,” Baker said. “Everybody in our group had finished the race except for me. And I thought no, I have to do this. And I need to know that I’m mentally okay.”
This year, she returned to Falmouth again — and finished the competition safely.
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