Nursing The Chicago Marathon

Today I was a nurse.  A full fledged, steth-and-sphyg toting, head-to-toe assessing, comfort-giving, oh-shit-this-is-super-real, nurse.

It was amazing.

—

A few months back I was sitting at the ED desk chatting with my coworkers.  Many of them were describing their past medical missions to other places around the world.  Somehow we moved from that conversation to volunteering at the Chicago Marathon.  My ears perked up.

“Do they let student nurses participate?”

“Absolutely!  Let’s go to the website to see where you sign up…”

And so I did.

—

This morning I woke up at 3am.  Maybe I shouldn’t even call it waking up.  I got up out of bed at 3am, having had a restless set of naps.  I was way too excited.  Today was marathon day.

At 4am I was standing in front of a local 24-hour restaurant in the gayborhood.  Two of my RN friends were on their way to meet me to inhale a big breakfast before we’d spend the day as medical volunteers at the marathon.  I’d been to this place countless times, but usually at the end of a night of drinking.  It was in full swing, packed with folks fresh out of the clubs, dressed for the night out, their breath sweet with booze, temperaments slightly skewed to drunk.

I was wearing a pair of grey REI convertible cargos, my dusty worn-in New Balance, and a white Duo-dry tee with a stethoscope on my neck.  One of those nicer metal disposable ones.

Needless to say I stuck out.

A fay little lad sauntered up to me.  He asked me a few polite questions, told me I was cute, and asked if I’d like to join him for breakfast.  On any other night the answer would have been yes.  But this wasn’t my night.  It was the start of my day.  The cutie asked for a hug and I obliged.  He told me he’d like to see me around and maybe we could play doctor.

Note to self: wear a stethoscope out more often.

My RNs showed up.  We ate and caffienated, hopping on the train afterward to descend into the check-in chaos.  By the time the dust settled we were in a van heading back to our med tent at Mile 8.  Which just so happened to be right in the heart of the gayborhood again.

I swear that wasn’t planned.

Five MDs, six RNs, a couple medical students, and a PT made up our little group.  Four chairs, two cots, a table with various supplies and a kiddie pool of ice packs surrounded us.  We were ready.

During the check-in chaos earlier, since we were relatively close to the start of the race, we had to get through the line quickly.  Some folks corralled us up front and quickly checked us in.  Instead of a white medical student hat, I got a red one.  Red was for all med pros.  And as we were running to catch our van, someone handed me a blue RN bib.

Suddenly I was a nurse.

—

We saw the wheelchair marathoners first.  They sped by with their cyclist escorts.  So much power in their torsos, arms rippling with muscles, thick necks pitched forward in determination.  Some hand cycled their chairs forward, some directly drove their wheels.

It was the beginning of a very humbling day.

—

We had vaseline blobs on long pieces of outstretched cardboard for the marathoners to grab as they went by.  Apparently they slather it on whatever bits are chafing.  At first, everyone was out there offering it up to the masses as they ran by.  

Then we had our first patient.  Then two.  Then a steady stream began to trickle into our tent.  A cramped calf here, a seriously chafed pair of thighs there.  Tape this, ice that, mostly we saw ortho stuff.  Our PT was busy stretching, helping to knead, and manipulating parts.

We had clipboards with a pretty simple head to toe assessment sheet.  Get their flag number, name if possible, presenting complaint, any treatment, dispo, and they’re off.

Then I heard the magic words “we need vitals over here.”

I grabbed her wrist while someone was getting her oral temp.  Shouted the pulse and respirations to the recorder. I cuffed her arm and did my first BP in the field despite the racket around me.  Temp was good, pulse high, bp a bit high for her, breathing fast.  Suddenly there was another body on the cot behind me.  “Need vitals!” said one of the docs.  I looked down at that first patient, looked her straight in the eye, and told her we were here to help and she was in good hands but I needed to work on the other person next to her.  She squeezed my wrist and thanked me.

And so it began.

—

Sometimes I took vitals.  Sometimes I started and finished the H to T, sometimes I passed it along to the MDs who recorded.  I tried to chat with all the patients, offer Gatorade, a bag of ice, an Ace wrap, whatever they wanted.  About an hour or so in, I could tell what they needed just by the way they walked over to the tent.  For the most part, we fixed them up in ten to fifteen minutes.

The saddest cases were the people who had to drop out and leave via EMS.  The hollow look in their eyes broke my heart.  I held quite a few hands.

Three hours later we started to pack up.  We headed back to the main medical tent.  Little did I know it was about to get more intense.

—

When we arrived in main medical it was pretty slow.  Our doc said we should relax, have a bite to eat, and stick around. The four hour mark is where things would start to heat up.

In the interim, we walked over to the finish line.

I’ve written this paragraph three times now, trying to describe what it felt like to see them cross.  Since I cannot seem to put it into words, I’ll just say I teared up a bunch of times and tell you what I saw.

There was an older gentleman who ran the final with his family hand in hand.  The way they all embraced in a big pile on the other side of the finish hit me hard.

Scores of people with shirts in memoriam of someone they lost.

Two older women in pink, crying as they crossed.  I’m not sure they were tears of joy.

The looks of exhaustion and exhilaration on faces as they raised both arms up to cross.

Two RNs on either side of a limping runner, his face contorted in pain, helped him across the finish.  He collapsed as they went through the gate.

So many tears.

—

By the time we returned to main medical, it was much more serious.  We were by the ambulance entrance.  If they didn’t need the ICU tent and we had a free bed, they stopped at us.

The massage therapists and PTs hovered close for the scores of extreme cramping.  Transporters from the finish were bringing people in who needed attention.  MDs were all consulting the RNs and each other.  The lab techs were busy in front of their machines.  

A lot of our patients needed IV access.  My RNs rocked the angiocaths.  There were iStat draws for lytes and gasses.  Frequent vitals and assessments.  I saw many liters boluses run wide-open, pouring into the dehydrated marathoners.  Didn’t realize how fast an 18ga can pump it in to a person.

I watched people go from very confused, shivering, pale, and diaphoretic to warm, pink, and smiling.  I also saw some people on monitors not getting better, whisked off to the nearest ER.

Intense.

—

As I was on the train heading home, I realized I helped bring people back to health today.  It didn’t happen in a vacuum either.

It wasn’t just spiking bags and priming tubing.  Not just vitals and hand-holding.  Not simply chatting in Spanish or offering more Gatorade.

It was working as a part of a team to bring patients back to health.  It was nursing.

And damn it, I was doing it.