Dying to Run

Looking back to high school, I really didn’t enjoy running. It was simply a means to get in shape for sports like football, basketball, and baseball. The only races I enjoyed back then were the shot-putters relay, which was an added feature of our track meets. Our coach would usually challenge the opposing team’s shot-put group to a relay race with the shot used as the baton. It was a good laugh, pretty funny to watch, and we usually won.

My attitude about running during college didn’t change much: it was still just a necessary component of conditioning and certainly not an enjoyable pastime. However, as medical school began and residency followed, the need to shed excess weight increased while the time available for recreational pursuits decreased and running became a more acceptable choice. It could be done with little or no planning, alone or with company, day or night. Still, at least for me, the thought of becoming addicted to running was far from a reality.

As time passed though, running grew on me, and when I had my knee arthroscoped at age 40 and saw the signs of developing osteoarthritis, I found it quite difficult to quit. I struggled for over a year to find an acceptable alternative in swimming and biking. To this day, I can’t say that I have experienced the mythical endorphin high that gets the running enthusiasts to do things their bodies say they should not.

Fast forward to Sunday, October 18, 2009, and the morning of the Detroit Free Press Marathon in Detroit. Three men, ages 26, 36, and 65, die during or after the half marathon race. All were thought to be cardiac events. How sad! Men trying to stay in shape by running and paying for it with their lives! There are risks associated with most sports, but usually the consequences are much less severe than death. That is a tough price to pay to keep the waistline down and feel good. I keep asking myself what went wrong here. With all we know about cardiac function in 2009, aerobic conditioning, maintaining cardiac health, and the ability to diagnose dangerous conditions, this should not have happened—yet it did. I can just hear the retort of my potbellied, beer-drinking buddies saying, “We knew that running was no good for anyone.”

The truth is that this should be a resounding wake-up call for many of us. Those of us who have risk factors from our past and have rationalized our lack of attention to them for years should pay more attention to our health. If we are overweight, have ever smoked, or had elevated cholesterol, it is high time to pay careful attention to ourselves. We might want to believe that our current exercise habits have erased all those sins of the past (too many brats or kielbasa earlier in life), but the three runners’ deaths have raised an emphatic warning. We need to be more concerned about our place on the risk curve.

Unfortunately, it does look like we need not reach middle age to think about the risks either; the youngest of the three runners to die was 26. Whatever our age, we need to find an appropriate level of exercise. Inactivity is clearly not the answer. Over 200 000 US deaths per year can be attributed to a sedentary lifestyle.¹ Consequently, we need to be honest with ourselves concerning our own condition, exercise history, and capabilities so that we do not put ourselves at undue risk while trying to do a good thing.

—Edward M. Wojtys, MD
Editor-in-Chief