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Death on the Run

What a Way To Go!

Published November 23, 1998, in The Post-Standard.

By Dr Kamal Jabbour, Contributing Writer

Every time a runner dies in the pursuit of fitness, pundits call into question the safety of our sport. They remind us that jogging twenty minutes three times per week is healthy, but racing and running marathons stresses the heart.

The most ironic running death of yesteryear was that of Jim Fixx, the seventies writer credited with launching the jogging craze. Recently, Irish Olympian Noel Carroll collapsed and died while running, and the Chicago Marathon was marred by the death of a runner.

After walking on the moon, Astronaut Neil Armstrong commented that each heart was born with a pre-determined number of beats, and that he had no intention of wasting any of them on running. Although a simple arithmetic argument could refute Armstrong's theory, his famous voice added fuel to the fitness controversy.

George Sheehan described racing as a blood sport. He cautioned that the health benefits of running could be lost to the hazards of competition. However, the human body was designed to sustain the stress and the challenge of competition, and running deaths were the exception not the rule.

Looking at the causes of running deaths, many can be attributed to heart failure from the stress of distance running. Most of these heart failures have their origins in genetic malformations or environmental damage to the epicardial arteries.

Prior to his conversion to running, Fixx smoked heavily and lived on a dangerous diet. Conversely, Oswego runner Bill O'Brian had rhumatoid fever in childhood, causing permanent heart damage. In both cases, running stressed a damaged heart and may have contributed to failure.

Genetically, some infants are born with defective hearts ranging from gross anatomical deformities to smaller anomalies in the arteries supplying the heart muscle. If detected early, gross deformities are corrected, or at least identified as a limitation to physical activity. Obstructions in smaller arteries may go undetected for a lifetime, and fail catastrophically during an endurance event. Autopsies on athletes who die during intense exercise often reveal anomalies that escaped detection with traditional medical tests.

Heart failure is not the only way in which runners die. Dehydration ranks on top of the list of preventable causes of death. In hot, humid weather, a significant loss of body fluid may lead to dehydration, heat stroke, brain damage and death.

At the other extreme lies the risk of blood dilution due to over hydration. A runner who drinks too much water over an extended period of time may lower the concentration of electrolytes in the blood, resulting in impaired nervous system function and ultimately death. In cold weather, a wet runner loses the ability to retain heat and control body temperature, suffering potentially fatal hypothermia.

Drug use and blood doping may have adverse effects on vital organs. Increased blood thickness can cause clogging of arteries, strokes and death. Also, steroids enlarge the heart muscles and damage the valves, increasing the danger of heart failure.

Besides anatomical and physiological failures, accidents prematurely kill many runners. Collisions with motor vehicles are seldom settled in favor of the runner. Similarly, slips and trips carry some risk of fatal injury, especially along deep ravines.

Runners who escape the city to the safety of trail running encounter danger of another kind. The story of the Californian runner mauled by a feral cat remains vivid in our memory. Equally rare, bears, deer, snakes, allegators and scorpions have claimed the lives of a few runners.

The fear of animals turns into a fear of firearms during hunting season. Since staying alive is a better alternative to making a point, runners are well advised to yield the woods to hunters during turkey and deer seasons.

Finally, in the absence of a systematic study on the effects of running mileage on domestic violence, spousal homicide during marathon training remains an occupational hazard worth taking.

In a society where longer life expectancy increases the risk for many debilitating diseases, the prospect of dying with our running shoes on remains one of the more delightful ways to die. Only Viagra victims can lay claim to a more enjoyable death.

Kamal Jabbour runs in bright orange in the hills of Pompey. His RUNNING Column appears in The Post-Standard on Mondays. He maintains The Syracuse Running Page and receives email at jabbour@syr.edu.


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