Marathon memories

Recently Cam Levins from Black Creek, BC, crossed the finish line of the Toronto Waterfront Marathon in 2 hours, 9 minutes, and 25 seconds. He broke the previous record held by Canadian Jerome Drayton, set 43 years ago in Japan in 1975 at 2:10:09.

The excitement about Levins’ marathon record took my mind back to 1954 when the British Empire and Commonwealth Games were held in Vancouver. That year I was in my third year of medicine at UBC and the whole student body was buzzing because a recently graduated doctor, Roger Bannister of the UK, had just run the 1-mile sprint in 3:58:8, beating world-record holder John Michael Landy of Australia by 0.8 seconds. I remember how, an hour later, our excitement hit the ceiling when a medical drama unfolded at the conclusion of the marathon. 

In those days the 46-km race was the crowning event of the British Empire and Commonwealth Games. Jim Peters, the English marathon-world-record holder, was already within the oval track of Empire Stadium, which stood on the Pacific National Exhibition site at Hastings Park in Vancouver. One of his two closest rivals fell earlier and was out of the race. The other was resting at the side of the road trying to cool off in the 26 °C temperature. A crowd of 35 000 people in the stands were on their feet, urging Peters to the finish, hoping to witness another record-breaking event. At 385 metres from the finish line Peters staggered, fell, got up, staggered, fell again, and remained in the shade for a few minutes. Up, but stumbling, he reached the 350 metre mark, and fell again. The crowd went wild. Watching, Bannister reportedly yelled to stop the race. Peters got up. A physician nearby said the man’s face looked like death. But Peters staggered to the 200 metre line. At that moment the team masseur ran up to him and dragged him off the track. Peters lost consciousness. He was taken by ambulance to Shaughnessy Hospital. While this was going on, Joe McGhee, who had fallen more than five times during the race, was able to stagger to the finish line and won the event. Of the 16 runners who started, only 6 finished the run.

The first medical bulletin from Shaughnessy Hospital implied that Peters was close to death. Then at school we heard that our very own professor of medicine, Dr Robert Kerr, entered the scene and became the central medical authority in Jim Peters’ emergency care. Clinical examination found that Peters was semiconscious and unaware of his surroundings. He was pale but not cyanosed. He was hyperventilating. His skin was warm and he was sweating profusely. His eyes were sunken; his tongue was dry. His pulse was a regular 110–120, blood pressure 110/55 mm Hg. Rectal temperature was 39.4 °C. Laboratory findings indicated hypernatraemia and elevated haemoglobin concentration. There were some indications of myocardial changes but they were nonspecific. Dr Kerr concluded that Peters suffered severe heat exhaustion. He received glucose and saline solutions intravenously.

Six hours later Peters regained consciousness, gradually became fully rational, and started responding to questions. It was an exceptionally hot day in Vancouver, yet Peters, in line with his usual practice, had not ingested any fluid, glucose, or salt during the race. 

Peters’ collapse is still the subject of discussions among sport medicine experts. It is now suspected that his altered state of consciousness might have been caused by exercise-associated postural hypotension with hyperthermic and hypernatraemic encephalopathy. 

The Duke of Edinburgh awarded Peters with an honorary gold medal, but Peters’ medical experiences were so marked that he was advised to retire from athletics and he never ran again. 
Earlier in 1954, before the Vancouver race, Peters had been the first runner to finish a marathon in under 2 hours and 20 minutes—considered an achievement as impressive as breaking the 4-minute mile. 

Moving forward 64 years to September 2018, Kenya’s Eliud Kipchoge established a new marathon world-record in Berlin: 2 hours, 1 minute, and 39 seconds. Nearly 19 minutes faster than Peters’ accomplishment, and 9 minutes faster than Levins’ recent victory. Will we keep breaking running records? If yes, how? If not, why not? Potentially a topic for a future blog post. 
—George Szasz, CM, MD

Suggested reading
Beck J. The miracle mile: Stories of the 1954 British Empire and Commonwealth Games. Caitlin Press Inc. 2016.
Noakes TD, Mekler J, Pedoe DT. Jim Peters’ collapse in the 1954 Vancouver Empire Games marathon. SAMJ 2008;98:596-600.

This posting has not been peer reviewed by the BCMJ Editorial Board.

Leave a Reply