Runners are used to toughing it out. A warming climate can make that deadly

Racing may slightly increase the chances a runner will suffer a rare event like heatstroke or cardiac arrest, but doctors say it's healthier to show up anyway.

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’d 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 — as she was taken to the medical tent. Her husband, catching up with friends after finishing earlier, blurted “Oh my god,” after his daughter called to alert him, then rushed to the tent.

The heatstroke that felled Baker last year is a deadly illness associated with extreme heat, and climate change is worsening the risk. In the continental US, the frequency of dangerously hot days is expected to grow by roughly one-third by mid-century.

“We cannot fit all of you in our medical tents,” he remembered saying. More than 2,000 people needed treatment that day; roughly 200 went to the hospital.

“It was a lot of carnage out there,” McGillivray said. “But, you know, no one passed, people went home, and we dodged the proverbial bullet. Not every race can say that. If you don’t have the resources, then you shouldn’t be firing the gun.”

Two athletes' 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 – 112.8 degrees (44.9 Celsius).

“That’s crazy,” said Dr. Sameed Khatana, a professor of medicine at the University of Pennsylvania. “That is not compatible with life.”

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's more aware of heat's danger, and makes sure to stay hydrated and aware of how he is feeling.

“As an athlete I can’t really let it stop me from competing,” he said. “I 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.”

In contrast, there’s Zoë 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.

“What I remember happening was getting a jolt of energy near the end and feeling like I was hitting this runner’s high and was going to finish the run strong,” she said. “In reality, what happened is that I completely collapsed, skinned my entire arms, elbows, knees."

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.

“The 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,” she said. Ten years later, she's 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's almost certainly healthier to show up anyway.

“Runners and athletes are at reduced risk of having not only cardiac arrest, but all forms of heart disease compared to non-runners,” said Dr. Aaron Baggish, a professor at the Université 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 “eerie” 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’s last mile, striding past the spot where she collapsed. Her husband’s photos show her smiling and flexing at the finish.

“We have a big running group of friends and family," Baker said. “Everybody 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’m going to be OK mentally.”

This year, she was back at Falmouth again — and finished safely.