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2000 BOSTON MARATHON

Many were knocked cold

Casualties kept staff working at brisk pace

By Shira Springer, Globe Staff 4/18/00

Wearing only shorts, singlets, and silver Mylar blankets, runners filed into heated medical tents at the Boston Marathon finish area yesterday. They limped off buses with Ace bandages around their ankles and blisters covering their feet. They wobbled, disoriented, through back entrances, suffering from dehydration and hypothermia. They all wondered what went wrong as they tried to battle the New England weather and the up-and-down course that stretches from Hopkinton to Boston. Many of the participants who finished the day draped in blankets with IV drips attached to their arms and hot tea in hand blamed the weather.

In all, 528 runners were treated by the medical staff in Boston, 28 were transported from the finish area to local hospitals (primarily for hypothermia), and the Red Cross reported 15 ambulance calls along the route.

``I was freezing and the winds were just incredible,'' said Abe Sitzer, a Brandeis student from Nevada City, Calif., who finished in 3:17. ``I foolishly ditched my warmups at the start. I came in and my temperature was 94 degrees. They gave me blankets and warm stuff to drink.''

Although doctors, nurses, and EMS personnel expected the conditions to dramatically increase the number of casualties, the figures represented only a small increase from last year (471).

Contrary to the usual pattern, the most hectic action in the medical tents came earlier rather than later. Among the most severe cases were a runner taken to the hospital with a core temperature of 89 degrees, one with a broken leg, and one possibly experiencing coronary problems. Any runner checking into the finish-line medical area with a body temperature below 94 degrees was sent immediately to the hospital.

``It seemed a little less busy than normal,'' said Richard Serino, chief of Boston EMS. ``Earlier in the day we expected to have a little bit more than normal with the wind and cold temperatures. But the wind died and it seemed to warm up for the period between 3:30 p.m. and 4:30, which is usually the peak. That seemed to help us out a lot.''

According to race organizers, the temperature at the start in Hopkinton was a chilly 44 degrees, with a 13-mile-per-hour headwind. That created a 26 degree windchill. When the elite men crossed the finish on Boylston Street, the temperature was 47 degrees, with a 10-mile-per-hour wind, resulting in a 37 degree windchill.

``You're training in 85 degree heat and then you come up here and it's like culture shock,'' said Tony Collins, 50, of Pittsburgh, Texas. ``I couldn't feel my legs the last 3 miles of the race. When I crossed the finish line [in 3:06] my legs just went out from under me. They got me in here and just warmed me up and did some physical therapy on my legs. They gave me hot tea. I think the steady wind had something to do with it, but I don't like to make excuses.''

In the chaotic emergency room, a team of biochemical experts tested the blood of runners, looking for abnormalities, including low sodium and improper electrolyte levels. The idea was to provide the most specific treatment (namely the most appropriate fluids) but the analysis also was part of a larger study designed to detect low sodium levels and learn about hyponatremia.

It is believed that runners who hydrate only with water put themselves at risk for low sodium levels and even seizures, coma, and death. With proper blood analysis, low sodium levels are easily detected and treated. As part of the study, healthy competitors gave blood samples as part of a volunteer control group.

But the real attention in the medical tent went to shivering finishers.

``After Mile 20 or 21, I didn't drink anything because it was so cold,'' said Gita Bhatia of Austin, Texas, as a volunteer helped her stand on sore legs. ``It's probably lack of preparation and not expecting the weather to be this bad, especially because Saturday and Sunday it was so warm. That might be the reason I feel like this. I've never felt like this before.''

And she was not alone.



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