By: Benjamin Arthur, MD, United States Army, Fort Benning, Georgia
At the time of the Marine Corps Marathon in 2008, I was beginning my third year of medical school. I was a student at the Uniformed Services University of Health Sciences, the military’s medical school. I had been married for 4 years to my wife, Sara, and we recently had our first child, Mariella Rae.
I’m not sure what I dreamed about the night before the marathon, what I had for breakfast, or what was on my mind as I rode the Metro-rail into DC from my home. Maybe I thought about where I was going to meet everyone after the race or the chili that was going to be on the menu for dinner that night. I do know that the possibility of never seeing my wife and 6-month-old daughter again was not in those pre-race thoughts. No matter what I was thinking about, it took a lot of preparation by the Marine Corps Marathon Medical Staff and the “heat deck” team, and a heroic effort by Dr. Casa and his team, to save me from dying.
Beginning the marathon, I decided that I was going to try to beat my only other marathon time by roughly 20 minutes. I had trained for the previous 3 months and thought I was ready to run my goal time the morning of the marathon. Several high-ranking Marine Corps officers generated a lot of excitement from the crowd at the start of the race. There were thousands of runners, and there was an excitement in the air that only a huge race could cause.
I started the race fast. I was running under my pace each mile, but I felt good. The temperature was in the upper 50s and I wastrained; I thought I could handle it. It wasn’t until mile 16 that I felt like I had hit a wall. I thought mile 16 was too early to hit that wall, so I pushed harder. I maintained my pace through mile 20, then 22, then 24. During those miles, I started getting tunnel vision and becoming angry. All I could think about was finishing and how it was almost over. I thought if I finished strong and made my time, it would all be over soon. I didn’t know how right I was. I made it from mile 24 to 26 with my tunnel vision increasing and my general attitude worsening as well. I hit the final 0.2 miles and tried to sprint to the end. That is where everything went downhill in a hurry. I fell twice on the final hill and was helped across the line by my running partner as well as a race official. Looking down as my feet crossed the finish line was the last thing I remembered until the middle of my treatment for exertional heat stroke.
Next, cue Dr. Casa and his team. Twenty to thirty of the most important minutes of my life passed without me knowing how hard perfect strangers were working to keep me alive. The next thing I remember after seeing the finish line was looking up at the top of a blue tent as I was lying in the ice bath with people all around me cooling me off as fast as they could. I answered a few questions to prove that I was conscious, and continued to be cooled. From that moment, it was a whirlwind of activity, a short trip to the ER, and I was still home with time enough to eat that chili I probably thought about on the Metro-rail.
Dr. Casa and I have exchanged several emails, but I have had only one opportunity to meet him. It was a year later, when he and his team were gearing up for the next Marine Corps Marathon at a local restaurant. Over the course of the meal, he shared his perspective on my treatment as well as some new projects he was working on. It was evident that he has a passion for preventing deadly sports injuries and is one of the best in the world at what he does. He and I are connected forever because we both had heat strokes during a sporting event, and, through our profession, we have the opportunity to help others in similar situations.
Now, having just graduated from medical school, I am blessed with a unique opportunity. I will start my family medicine residency in Ft. Benning, Georgia -where, coincidentally, the most heat injuries in the Army occur due to the high temperatures and intense training programs. While in Georgia, I will have the opportunity to treat heat injuries at various training events, both immediately on site and after the initial incident away from the event.
It is a great honor to provide care for soldiers. One day I will be the senior medical provider treating heat injuries and will have lives depend on my training and care. Over the past several years, I have gained a new-found respect and professional interest in heat injuries and will hopefully provide excellent care -the same kind of care I received in my hour of need.
Excerpt from Preventing Sudden Death in Sport and Physical Activity, Edited by: Douglas J. Casa, PhD, ATC, FACSM, FNATA, Publisher: Jones&Bartlett