April 21, 2014
It’s Patriots Day, a very special holiday celebrated in New England but revered throughout the world as Marathon Monday: the running of the Boston Marathon.
There are few people today who won’t be remembering the events of the 2013 running. My hope, and strong sense, is that the 2014 version of the BAA Marathon will be known for great competition only, with Lelisa Desisa hoping to defend his title in the men’s event and Rita Jeptoo hoping for the same thing on the women’s side. Right now, it looks to be a near perfect day for both the runners and spectators, with the only worry that afternoon temperatures may trend a little on the warm side.
We are, as sports medicine providers, used to dealing with the possibility of hypo- or hyperthermia in such events, dealing with hyponatremia and exercise-associated collapse….I commend to you a number of excellent studies we have published over the last decade about such medical events. The illustrious Tim Noakes has written about fluid replacement in marathon running, Bill Roberts has published original research on risk factors for developing hyponatremia during marathon running, and last year Lawrence Hart wrote about marathon-related cardiac arrest. We all need to be up-to-date about such issues; they represent the typical challenges we will face in the medical tent at such events.
Last year the running of the Boston Marathon reminded us that we must also be prepared for mass casualty at such events. The New England Journal of Medicine published a short piece by the medical providers on the scene, The Boston Marathon and Mass Casualty Events, which I encourage you to read. Preparing for the worst, hoping for the best: a mantra that can serve us well in medical coverage as well as life in general.
I know several of the doctors who are on the course and at the finish line this morning, and I know they are prepared for all eventualities. But I hope the only trauma they have to deal with might be from a fall on the course, a twisted ankle…….
Here’s to the safety of the runners, the spectators, and the staff of today’s great sporting event!!!!!!!