April 12, 2023 at 6:30 a.m. EDT
Another Boston Marathon approaches Monday.
“I think about it all the time and think about being out there that weekend. And as much as I say, you know, I want to run the marathon, I’m like, should I run the marathon? Would it be better as a spectator? But then I also think, you know, of running and, you know, I didn’t finish,” she said, her voice breaking.
“It’s really emotional. I just think at 7.4 …”
Although Roth has resumed running and coaching the sport, she won’t be running in the Boston Marathon this year, planning to run it instead in 2024 as she continues to navigate her way back. But she will still be in Boston on race weekend, helping race organizers with a campaign that aims to empower others to save lives the way hers was saved that day on the marathon course.
“How much more powerful a message can you send,” said Chris Troyanos, medical coordinator for the Boston Athletic Association, “than someone that was actually saved by the system?”
Most of the time, it’s almost as if Roth’s Oct. 11, 2021, collapse near the Natick-Framingham line never happened. Since then, she has been physically fine, she says, with “no sign of irregular heartbeat since last April.” Even that incident wasn’t enough to activate her ICD, which transmits data to medical personnel who could warn her of any problems. It gives her peace of mind, as does the testing she has undergone with several cardiologists.
Roth, then the 34-year-old mother of a then 10-month-old son, Jaxon, was thinking the race that day in 2021 “would be the next step in my running life after my Olympic qualifier [in Boston] in 2019, and [I was thinking] about all the work I did coming back postpartum, and I was just so excited. For me, it would be the worst way almost for me to pass away. Obviously I’m so grateful that everyone was there to revive me.”
What happened to her is “still a mystery; a storm of things is all they can really pinpoint with it,” she said. “We did further testing, everything came back, and the doctors were telling me my heart looked beautiful. It’s still very healthy and strong, and they have told me I really don’t have anything to worry about. I didn’t really damage my heart.
“… I’m so blessed because it’s so scary what can happen and the survival rate is so low [about 9 percent for cardiac arrests experienced outside of a hospital, according to the American Heart Association] that I really am just grateful that I’m okay. It’s crazy to think of my life any other way. Every day with my son, I just feel so, so fortunate just to be with him. And I just look back — it’s just a really hard situation.”
While a 2012 study in the New England Journal of Medicine places the incidence rate of sudden cardiac arrest among long-distance runners at 0.54 per 100,000 marathon or half-marathon participants, Boston Marathon officials are prepared with expertise that comes from having staged the race 126 times before this year. There are 1,800 medical volunteers along the 26.2-mile course and heightened preparedness from public safety, police, fire and EMS personnel at towns along the way. Still, ensuring essential immediate attention for a runner who collapses among 30,000 participants is a challenge for medical personnel.
“Several years ago, a 62-year-old male from Louisiana, running through Kenmore Square with his son, went into cardiac arrest,” Troyanos said. “He happened to drop right next to a tent that Dana-Farber [Cancer Institute] put together. It was more or less a cheering tent, a place for people to watch, but a physician and a nurse in the tent jumped over and started immediate CPR.
“Boston EMS arrived within minutes on a bike and started the defibrillator. He was taken to Beth Israel Deaconess [Medical Center], was in the [cardiac catheterization] lab within 25 minutes of the arrest, and the guy went home three days after the event. I went to visit him, and it just dawned on me that with all the things that we do and the assets that we have, it’s still not enough. So I determined that the best thing I can do is leverage the most amount of people, which are my runners out there.”
That’s why the BAA annually puts on a demonstration at an expo during race weekend, and this year Roth will be a big part of it. The BAA plans to use her and others to show people how to perform hands-only CPR, and she recorded an updated version of an instructional video Troyanos and the BAA send to all 30,000 runners and 10,000 volunteers every year.
“The last year we did the expo was 2019 because of covid, but we had 1,000 people go through that booth,” Troyanos said. “We’ve had runners come back to us to say: ‘Look, I’ve done it. I’ve actually saved a life based on what you showed me.’ ”
Troyanos, an athletic trainer who also is a concussion monitor during NFL games at New England’s Gillette Stadium, sees in Roth another opportunity to use a personal story to increase awareness of the need for quick action when someone’s heart stops.
“I told her I’d like her to be the face of it and talk about what happened and how important it is for runners, if something happens, to, as we call it, bridge the gap with hands-only CPR until medical people arrive,” Troyanos said.
Roth is eager to participate in the expo and CPR campaign but experiences lingering emotional trauma even as her physical health has rebounded. “It’s just so hard when you’re doing something that you love more than anything and something like that happens to you,” she said. “I think I still have trauma from it, but I’m trying to just do my best, to focus on moving forward and hoping for the best for the future.”
She has eased back into running, finishing third in a half-marathon in September, and is working on “Run with Me,” a start-up that would also emphasize CPR awareness and education.
“I didn’t know a lot of the conditions that people tend to have that they never know until something like this happened,” Roth said. “I’d like to emphasize promoting preventive screening for things that could be hereditary or something that could put someone at risk but might not show up on an annual physical rather than have it turn out to be complicated when people go through something really traumatic.”
In Boston this weekend, she’ll be greeted warmly by familiar faces from the running community — fellow runners who stopped to revive her, a retired nurse who was watching the race at her brother’s home when Roth collapsed and hospital workers who became good friends as she recovered.
“And a lot of my athletes will be out there,” she said, “and I feel like with all the love and support it’ll help me to focus on the positive and not get too emotional.”