The Boston Marathon is the oldest and most prestigious of all the annual marathons and one of the six world marathon “majors.” It began in 1897; today it attracts more than a half million spectators on the third Monday in April, which is called Patriots’ Day and is a Boston-area holiday. During the past decade, approximately 20,000 qualifying—and I repeat qualifying—runners have competed every year. The Boston Marathon is the “darling” of all marathons because you have to qualify by finishing another marathon within a certain time for your age group, like 3 hours and 15 minutes.

In 1996, its centennial year, more than 38,000 runners qualified, making it also the largest marathon. In 2011, an unofficial record of 2 hours and 3 minutes made it the fastest marathon ever run.

My race and results
How did a trudger like me even get into such an elite marathon? I trained rigorously, following Galloway’s manual on how to run a marathon. My time didn’t improve, but my running shoes began to smell like a real distance-runner’s shoes, which was encouraging! As race day got closer, I got more nervous. What if I “pulled something” or got the flu or an intestinal virus?

I started wearing disposable gloves in the office when examining patients. One of my children had a cold, so I wore a surgical mask at home and ate with disposable plates and utensils. I stretched more vigorously than usual before a run. Then, while standing in line at the airport on my way to Boston, I got jabbed by a briefcase that slid into my Achilles tendon. I thought it was ruptured, but it was just a false alarm. I guess I looked pretty silly doing a Thompson test on myself while standing in line.

The morning of the race, we boarded old Boston school buses—the yellow bulky ones. There must have been more than 1,000 buses to take runners to Hopkinton, the start of the race. To me, it seemed as though it took those old buses forever to get there—I could have “run” there quicker! (It really took only an hour.)

Because of the elite competitors in this race, I was prepared to come in last. I had my own homemade map of the course through each little town (Ashland, Framingham, Natick) so if I lost sight of all the other runners, I wouldn’t get lost. I also had NSAIDs and a tape recording of the song “One Moment in Time” by Whitney Houston to use as motivation and inspiration in case I thought about quitting.

We started in Hopkinton and ran through 12 towns straight into the middle of Boston—26.2 miles. Along the way, the crowds were cheering and, because of my ego, I thought it was for me. I later found out the cheering was for John A. Kelley, the perpetual legend of the Boston Marathon. At the time, he was 82 years old and still racing and just happened to be running near me at one point. But there was some cheering for me.

In Wellesley, the students formed a narrow “chute” or “scream tunnel” that runners pass through. They were shouting, “Go, Terry, go,” and “Go, Memphis, go.” I asked a fellow runner, “How did they know who I was?” He explained, “They saw your number, had a program, and looked up your name and city.” His tone of voice clearly conveyed the unsaid, “stupid”!

A racewalker pulled up next to me at about the 11th mile. He’s racewalking, I’m running (trudging), we talked. It turns out he is the New England champion racewalker. He politely said, “I’ll see you,” and motored right away from me, leaving me in his dust.

At 13 miles, I saw a guy sitting in his yard, watching the race on television. I still had 13 miles to go, but he told me that the first runner had already crossed the finish line. So as not to be discouraged, I asked if he had seen a tall, thin, bald Kenyan go by and, if so, which way did he go because I was trying to catch him!

At mile 21, someone congratulated me for just ascending Heartbreak Hill. But I found out he had tricked me because the next ascent was the real Heartbreak Hill—boy, did that hurt.

At the finish line in Copley Square, I felt great thinking about my “One Moment in Time” with my Boston Marathon medal (Fig. 1) and my silver foil warming poncho, while I was hanging around the medical tent looking for admiration and attention. OK, so more than 4,000 runners finished ahead of me, but I was still the 4,383rd fastest runner in the world that day.

The medical connection
So how did a tortoise like me even get into a race with all those hares? Well, I had run a marathon in Memphis 6 months earlier in just over 4 hours. I was informed that, as a physician, I could join the American Medical Runners Association (now called the American Medical Athletic Association [AMAA]) and get a qualifying exemption for Boston if my time was near 4 hours. So I joined the AMAA, paid a fee, and got a qualifying exemption.

Medical and paramedical personnel (doctors, nurses, physical therapists, athletic trainers, and others) in the AMAA get this exemption because the AMAA is responsible for the volunteer health professionals who provide care in the medical tent at the finish of the race.

And that is what this editorial is really all about. It’s not about my trudging 4 hours to get to the finish line. It is about the volunteers who, for more than 50 years, have taken care of the dehydrated, maimed, limping, pulled, strained, sprained runners, as well as those with stress fractures, bunions, shin splints, nausea, vomiting, fainting, and even atrial fibrillation—all free of charge.

But this year, at “one moment in time,” these volunteers went from first responders at a marathon to first responders in a terrorist attack.

In this issue of AAOS Now, Jennie McKee has written a front-page story about the volunteer orthopaedic surgeons who were in the medical tent triaging and acting as first responders and who were probably responsible for saving many limbs and lives. Medical personnel went from handing out water for dehydration and ice for sprains and strains to suddenly starting IVs and applying tourniquets to treat hypovolemia, shock, major open fractures, large soft-tissue wounds, and amputations. What a job they did, with story after story of heroism!

AAOS Now salutes our members, all medical personnel, and all first responders for your heroic actions this past April 15. We are proud to tell the story of your own “one moment in time” when you were more than you thought you could be.

S. Terry Canale, MD, is editor-in-chief of AAOS Now. He can be reached at aaoscomm@aaos.org