In This Edition
Pace Setter : July 2024
Over the Edge: Life and Death and Life Again
by Bob Radliff
Bob Radliff running the virtual Boston Marathon in 2020 on the Mohawk Hudson River Bike Path
Photo Courtesy of Bob Radliff
Bob Radliff has been a runner for over 30-years and has competed in many road races, including the marathon distance, during this time. Bob was seemingly in good health but suffered a major cardiac incident during the Adirondack Distance Festival Half Marathon. Our knowledge about sudden cardiac arrest has grown and efforts by public health professionals and medical professionals has led to greater knowledge about how to respond to these events as well as easier access to lifesaving automatic external defibrillator (AED) devices. Bob is lucky to be alive, has made a full recovery, and has continued to compete in road races! Sharing Bob’s story will help to raise awareness within the community about sudden cardiac arrest and how to respond and potentially save someone’s life.
MY LIFE, AS IT WAS
September 2022 was a busy and beautiful month. I was doing my thing, in my own way: helping to run the household and nurture a family (at least I thought I was somewhat helpful), working full-time and making major exterior home improvements in my spare time.
As usual, the foundation for my life was built on long-distance running, typically running early in the morning before the rest of the day began (and lifting weights roughly every other day in the evening). Though I was not hyper focused on preparing for the October 9th Mohawk Hudson River Marathon (MHRM, which I have completed several times), I still thought sub three hours was possible (as the course is conducive to faster times and I was in decent shape). The MHRM was primarily for me to remain in marathon shape and get ready for my fourth consecutive Boston Marathon in April 2023 (in April 2022, ran 3:00:21).
My life was busy, and I liked it that way. At work, home and play I tended to give 150% and prided myself on endurance. September was pushing even my limits with lots of exterior housework (up and down ladders) added to the mix but going above and beyond is where I thought I shined.
If you are not living on the edge you are taking up too much space – anonymous.
ADIRONDACK DISTANCE FESTIVAL: SEPTEMBER 18, 2022
In preparation for the MHRM, I signed up for the half-marathon at the Adirondack Distance Festival in Schroon Lake (which I have run several times before; Adirondack Marathon Distance Festival). On September 18th, I took off with the rest of the runners around 10am and after the 1st mile, or so, knew it was not going to be one of my better runs, so I backed off a bit. My legs felt tired, and I attributed that to me having gone up and down ladders for the last two days as I stained the exterior of my house. After a few more miles I found a better groove and ran a few < 6:50 miles (miles 4, 5 and 6), which is where I like to be (my best pace was 5:42). I fell back into the 7:20+/- range for the next several, and 6:55 for mile 10, then 7:20+ for the last three.
Almost there, but fading…gone
As I turned the corner into the park where the finish line was present it was a relief to see the finish line. The race announcer said something like the following: “…here comes Bob Radliff from Stillwater, he looks like he could use some help getting over the finish line so let’s cheer him on…”
My legs began to buckle, I crumbled powerless and fell to mother earth’s floor…
I do not recall hitting the pavement. Only after hearing eyewitness accounts, and afterwards personally seeing the scrapes and bruises on my head, right shoulder, and both legs, was this near fatal fall affirmed.
As medical professionals have told me, that as a result of an electrical disturbance (not a heart attack, which is caused by a circulation problem when the heart is working fine, but blood cannot get to it due to some blockage), I flatlined. I had no pulse, my heart stopped beating. I was clinically dead for a period of about four minutes, an aborted sudden cardiac arrest that would have led to death had an intervention not taken place to prevent it.
Here’s an image of my heart rate from my Garmin watch, which continued to run, even after I could not; look at the valley and flat line just to the right of the 1:39:31 dot:
There is a 90% mortality rate amongst the general population who experience sudden cardiac arrest outside of a hospital. According to the American Heart Association, sudden cardiac arrest is less common with runners and only occurs in 0.54 per 100,000 half marathon participants; however, 70% do not survive.
Rebirth
I was extremely fortunate to go down where I did. Paramedics and first responders, as I have been told, were on me within a matter of seconds, not minutes, and for this I will always be grateful. I cannot describe the scene on the ground (about a tenth of a mile before the finish line) but I can imagine that it must have been quite disturbing and chaotic.
Joel Friedman, the race director, informed me that a nurse (Laura Montayne from Glens Falls) was across the street and was the first to get to me. She performed Cardiopulmonary Resuscitation (CPR). An emergency room doctor, Noah White, who had completed the run, was next (he is trained to look at clocks and used the race clock to determine that I had no pulse for about four minutes). Then the Schroon Lake Emergency Medical Service (EMS) followed in a minute or two. They used an Automated External Defibrillator (AED) to reset my heart (not clear whether the AED was used once or twice). I cannot recall anything from these five minutes, or so. I thank all these incredible folks for providing me with a second chance.
(To date, I have been unable to reach Ms. Montayne, but was told of her address and sent her a card and plan to keep trying to meet her. I have spoken with Noah White, who is very kind and, just as importantly, a fast runner. Finally, I have talked to Tony at the Schroon Lake EMS and provided them with a donation, in addition to paying my ambulance bill).
I awoke in an ambulance, relatively coherent, staring at the vehicle ceiling. One of the first responders stated to me that out of ten, or so, prior flat line situations I was the first she ever helped bring back. She seemed excited and proud (and I was glad to be her first). There was another paramedic in the ambulance (Tony), who, in my hazy view, presented himself as somewhat more experienced than his colleague, and the two of them worked very well together.
One of the ambulance personnel asked if there was someone they should call. I gave them my wife Alison’s number (which I recalled with little problem). Alison decided to accept the unknown caller even though she and Abigail (my daughter) were in mid-Pennsylvania (attending an event for a group that Abigail hopes to receive a service dog from someday). I cannot imagine how uncomfortable absorbing this unexpected information, and then processing the possible complications, must have been for the next four and a half hours of riding in the car.
As the ambulance departed Schroon Lake, my calves began spasming and one of the paramedics was kind enough to pull me up on my feet to alleviate that distress (common for me after half marathon, or longer, races). I just came back to life, and I was still seeking runner’s dehydration relief, while laying half-naked on a stretcher rushing to Glens Falls.
GLENS FALLS HOSPITAL
Emergency Room
I was taken to the Glens Falls Hospital Emergency Room. I remember a flurry of activity that involved a lot of doctors and nurses, but it seemed to tone down relatively quickly after they may have assessed that I was relatively stable. I was able to sit up.
The first relative I saw was my mother, Margaret, around 1pm, who walked in with her cane hunched over from her many years of back arthritis. I sat motionless in my sweat drenched shorts. When she started to show off her flip phone to hospital staff and state that her phone needed a charge, I asked her to swap with my uncle, Joe Kinner, for a while (who had driven her to the hospital). Joe was his usual compassionate and always reliable self and handed me his new Samsung phone. I called Alison and Abigail. They were relieved to hear my voice and the contact eased their travel worries a bit.
Shortly afterwards, I began thinking I may be able to go home. My theory was that this was like a computer restart – my heart shut down, cleansed and repaired itself, and now was good to go once again (nobody even entertained my theory, but I still thought it was plausible). Those dreams of a hospital departure were assertively dissuaded by a doctor (Dr. Iqbal Bashir) and a Physician’s Assistant (Mark Van Dien), with concurrence by my uncle. They both explained that though I was stable now it was obvious that something major malfunctioned. We needed to figure out what happened. I did not put up much resistance. I was subsequently admitted and spent the evening in a hospital room, grateful that evening I did not have a roommate (my peanut allergy worked to my favor).
Don’t Tell Me This Town Ain’t Got No Heart: Dempsey King & Alexis Conners
By now my son Schuyler, living in Tacoma, WA, was in the mix. Prior to the race, he let me know that two of his friends – Dempsey King and Alexis Conners – were running and volunteering, respectively, for the race and that I should look for them. My amazing son has always had unbelievably (to me) responsible and mature friends, so I made a note to look for them after the race. They apparently were doing the same and though they saw and heard the commotion at the finish line they did not initially realize that it was me. They kept checking the race times to see when I came in but, alas, I never crossed that finish line.
Dempsey began communicating with my wife and uncle while I was still in the emergency room and offered to drive my vehicle down from Schroon Lake to Glens Falls. In fact, not only did he and his friends do that, but they also purchased a ton of chicken parmesan, salad, and bread from an eatery somewhere between the two destinations. The food was a great hit and there was so much that we provided two trays for the hospital nurses and staff for their evening consumption (several came into the room expressing their appreciation). My mother, in her generosity, tried to give Dempsey cash to offset some of the expense, but he subsequently left that cash on the seat of my car. Dempsey and Alexis (who live and work in Schroon Lake), and their friend(s), were so supportive that day. We will never forget their kindness.
Sixth Floor
Alison and Abigail rolled in around 4:30pm.
The day after the incident, Monday, September 19, I again naively thought I would be going home. After waking up, I began sitting in the windowsill of my hospital room already antsy to get outside. I even teased my daughter that I may go running later that day.
Rather than go home, I agreed to Cardiac catheterization, an exploratory procedure in which a thin, flexible tube (catheter) is guided through a blood vessel (in this case, through my right arm) to the heart to diagnose or treat certain heart conditions. Recommendations can vary from receiving stents (tube-shaped device placed in the coronary to keep the arteries open) to open heart bypass surgery. It turned out for me that it was a worst-case scenario with my heart performing at about 40% ejection fraction[3] and at least two critical junctions possessing significant blockage. These medical professionals thought open heart bypass surgery was the preferred option.
That dramatically changed my thought process. I now began to envision myself spread out on the table with my heart laid out for all to see (after they break my sternum). Although there were certainly fears, I rather simply accepted this fate and became anxious to get it done and over with. This did not feel like a time for pause and contemplation but a time for hope and faith. And I wanted to get home.
Meanwhile, this song, I Don’t Want to Wait[4], infiltrated my mind, as I repeatedly went over its lyrics and melody. It became life sustaining:
So open up your morning light
And say a little prayer for I
You know that if we are to stay alive
Then see the peace in every eye…
Here’s a live version (Late Show with David Letterman): https://m.youtube.com/watch?v=xuRgxW08jnA
ALBANY MEDICAL COLLEGE
Hospital beds are apparently difficult to find these days so when Albany Medical College said they had one available the Glens Falls staff had me out the door in about an hour the evening of Monday, September 19th. Again, I was put into an ambulance, but this time during the hour-long ride I was not in any significant distress.
Surgery
On September 20th, I finally met Dr. Patrick Chan regarding open heart surgery. While I was anxious to get this done and over, of course the surgery schedule was not only about accommodating my needs. I believe on September 21st we learned that the surgery was scheduled for September 23rd. Besides being scared out of my mind that COVID would somehow introduce itself into the equation, there was a more imminent challenge ahead.
On September 21st, I had an episode where I was shaking uncontrollably. I kept telling people that it was because I was losing it mentally staying in the hospital too long and waiting for surgery. It turns out the shaking was more likely a bacterial infection that my body was attacking. On my right arm there was an intravenous therapy (IV) that was put in the day of my tumble, and I think that became infected as there was distinct redness above that area for a few days (ultimately, I had three IVs at the same time, one in each arm and one in my neck).
Dr. Chan had warned me that some blood work indicated there may be bacteria and, if that was the case, surgery would need to be delayed. This further freaked me out as the September 23rd scheduled surgery was on a Friday, which would allow me to be in the Intensive Care Unit (ICU) over the weekend and then upstairs for a few days and then get out of there. If surgery was delayed to the following week, I would continue to lose my mind. New bloodwork was ordered, and the results confirmed a bacterial infection, but they came in too late – I was already in the operating room. Surgery proceeded with some reluctance from Dr. Chan.
The operating room was very spacious, well lit, super clean and well-staffed. The group of folks appeared to get along well as they bantered back and forth and stated they had a 90s music theme that morning (I said the Spice Girls was where I drew the line). I recall talking to one of them about drummers Neal Peart (Rush) and John Bonham (Led Zeppelin) before my life was entirely placed in their hands. The anesthesiologist then “walked me to sleep.”
Mummified
After the approximately five-hour surgery, I was sent to the ICU. Alison and my sister, Elizabeth, were allowed to come see me and only they could accurately describe what I looked like. My understanding is that I continued to have tubes down my throat and in my nose. I had four drainage tubes in my stomach. My legs were entirely wrapped as this is where they took out the veins used for the bypass.
I could not open my eyes but was able to squeeze my wife’s hand and I could hear the medical staff and my wife and sister talking. They were trying to ascertain my needs and I was squeezing my wife’s hand to tell them they were off base, but she thought it was an affirmation that they were on the right path…it did not matter, it all worked out.
The ICU medical staff was top notch, and my wife and sister were very impressed by the way they were monitoring me and adjusting medications on the go. I felt safe and comfortable there even though I was completely helpless and vulnerable.
Mind Trips
While in ICU I was having vivid mind trips. I was seeing various colors in various formations. I saw many different animals and abstract features. I could take the colors and formations and go down different paths. My body was not under my control, but my mind was. Taking these walks with my mind was all I could reasonably do at that time, so I went with it.
Inspired by the song Down the Road, I did have a brief mental visit by Jerry Garcia (8/1/42-8/9/95):
From the corner of my eye I saw the sun explode
I didn't look directly 'cause it would have burned my soul
When the smoke and the thunder cleared enough to look around
I heard a sweet guitar lick, an old familiar sound
I heard a laugh I recognized come rolling from the earth
I saw it rise into the skies like lightning giving birth
It sounded like Garcia but I couldn't see the face
Just the beard and the glasses and a smile on empty space
Recovery: Eighth Floor
In contrast to the high-level care and comfort of the ICU, I dreaded going back to the 8th floor. But sure enough, because I was relatively stable, and because they had staffing shortages for the ICU, they shipped me upstairs around 5am on Sunday, September 25th.
I felt vulnerable to sickness and disease the whole time I was in the hospital. In fact, on one of my walks around the 8th floor with Alison a nurse pointed out that this room and that room had COVID patients, another MERS, etc. I constantly feared getting COVID before or after surgery, making my stay even longer. I wanted so badly to go home (but I also knew I had to play the game to show I was worthy of departure).
From September 25th through September 28th this was my general routine: try like hell to stay in my bed until the sun rose, look forward to breakfast (not the food, but the act) around 8am, get excited about Alison’s arrival around 10am, go for a walk with Alison (to show staff I was capable of going home), eat lunch around noon (more choices than breakfast), go for another walk in the afternoon, eat dinner with Alison in the room (usually from Panera’s), dread when she had to leave by 8pm, and then try to sleep an hour or two at a time throughout the night before we did it all again the following day.
The entire time I had telemetry hooked up to me through my gown. Cardiac telemetry is a way to monitor a person’s vital signs remotely. The 8th floor of Building C is a cardiac telemetry unit. Vital sign monitors continuously transmit data, such as heart rate, breathing, and blood pressure, to a nearby location. They also track your location. On one walk, Alison and I traveled a bit too far and one of the (better) staff came and retrieved us. (On another occasion, one of my roommates decided to wander off the floor; upon his return the staff told him he was being kicked out and needed to go back to the emergency room to be readmitted…he did not act surprised and seemed like he may have been an experienced patient. I was also not sad to see him go as, among other things, he did not wash his hands each time he used our shared bathroom).
The hospital was inhospitable. They woke me every two hours to get vitals, do an electrocardiogram (or an EKG; records the electrical signals in the heart; used to quickly detect heart problems and monitor the heart's health), give me meds (approximately ten different ones), take blood, whatever they could do to disrupt…many of the staff thought it was funny that no one gets any rest. I thought it was pitiful that the place was not very patient centered.
There were, of course, many extremely professional and caring people that I met along the way, and I will always be indebted to them for their skills and care. I cannot imagine working 8- or 12-hour shifts and having to wear a mask the entire time, while putting up with patients and their complaints, while also dealing with institutional bureaucracy. I hope to find the opportunity to visit them and thank many of them for their hard work and dedication.
Home
Around noon on Wednesday, September 28th, Dr. Chan, my surgeon, came in with two of his staff and said I looked well enough to be discharged. I was elated. It took another four hours to finally be released. They let me walk out of there with no wheelchair or hospital escort. My walk through the hospital lobby and into the parking garage was surreal. I was free.
MOTIVATION: MY FAMILY
Of course, between September 18th and September 28th there was plenty of time to think and reflect. Though there were many reasons to live and keep trying to contribute positively to society, my primary motivation to survive became my need and desire to provide additional support and love to Alison, Abigail, and Schuyler.
Alison had her hands full, but she is an incredibly strong woman. She provides stability for all in her orbit and does not ask for much in return. She is amazing and I will be forever grateful for her love and care during this difficult period.
Our daughter, Abigail (cerebral palsy), needs a village even in the best of circumstances to support her and that village begins with her parents. I needed to stick around to help provide Abigail with her highest quality of life. And what’s unique about Abigail is that she provides much more in return. She is the most sincere and pure bundle of love in the universe.
Abigail prefers routine so she asked that we exchange text messages first thing in the morning and last thing at night. Here’s a sample daily exchange:
Good morning Dad. I love you (with emojis).
Good morning my beautiful girl. Love you so much (no emojis).
Schuyler was struggling through much of this endeavor because he wanted to be closer to our home, but we kept advising him to stay put (Seattle-Tacoma area).
Text message: Love you with all my failing heart. So proud of all you have accomplished. Keep the course. Love you, dad.
We had some tearful conversations. I will never forget when he said “Dad, I don’t know what I would do without you.” Even though I know he has already done just fine without me, comments like that made me want to stick around and give back to those who have given me so much, like my only son.
Text message: Dad, Keep your head up. Ik this sucks but everything happens for a reason. Tough times don’t last, tough people do, and you’re the toughest motherfucker I know. I love you.
He also said that my open-heart surgery scar would make me look like a “badass.” I wanted nothing more than to be able to pal around town with him and show off my badass scar while he shows off his badass tattoos.
GRATEFUL
Thank you to my family and to our concentric circles of community (see below) for your positive energies and collective support. I am extremely grateful to still be here with you and can only hope to support you in some small way in the future. Stay well and enjoy every step.
So open up your morning light
And say a little prayer for I
You know that if we are to stay alive
Then see the love in every eye…
COMMUNITY
Throughout this journey my immediate family and I were constantly inspired by family, friends, and colleagues, all playing critical roles in my sustenance and recovery. Thanks to my family’s various communities for the visits, food, cards, flowers, plants, texts, and calls.
Mother, Sister, and Cousins
My mother, Margaret, and sister, Elizabeth, were there the whole time, especially providing Alison and Abigail with the additional support they needed. My sister and I come from the same cloth so it was a unique time to be reminded of our permanent bond over the course of those few weeks.
My cousins Gregg, Cynthia and Mark Zeman said the right things at the right time (and sent fruit). Thanks always to the Harris and Brady families (Cyndi’s knowledge of the health care system is extensive) for their support and sense of humor. For example, Abigail was with her cousin Devin one evening when they called me just before my surgery. Devin said: “If you don’t make it, can Abigail have your i-phone?”
Erie Canalway National Heritage Corridor (Erie Canalway National Heritage Corridor :: Home)
My work colleagues were fantastic. Our Commission Chair, Kal Wysokowski, and Heritage Fund Chair, Judy McKinney Cherry, along with other executive officers, and the entire Commission and Board, had been nothing but supportive.
Our staff, with Andy Kitzmann and Jean Mackay stepping up to provide even more leadership than they usually do, along with Diane Jennings, Rosemary Button, Mona Caron, Ashley Quimby Simoni, and Patrick Stenshorn deserve all the credit in the world for keeping our organization performing at a high level. Though my heart may have missed some beats, the organization did not.
Beth Sciumeca, of the National Park Service, who hired me in 2013 and quickly became a friend, expressed concern early and often, as did (retired) Peter Samuel. Sharon Leighton, Lela Katzman, Susan & Michael Lynch, and Ken Claflin were all kind enough to lend their words of encouragement.
Also thank you to Brian Stratton, Rebecca Hughes, and my friends at the NYS Canal Corporation for their understanding and support.
Waterford Halfmoon School District
Alison was instrumental in getting our family through this. The faculty and staff at Waterford Halfmoon School District were extremely supportive and for that we are most appreciative. Alison’s colleagues, led by Vicky Kelts, provided gift cards to Panera, Stewart’s, and Starbucks, among other places. Kaitlyn Nardino helped reduce stress by taking over the classroom and plans. And thank you to Alison’s 2nd graders, and their parents, for giving us the time and space we needed to recover.
Affordable Housing Partnership (AHP Homeownership Center), Albany Community Land Trust (http://albanyclt.com/index.html) and Community Loan Fund of the Capital Region (https://mycommunityloanfund.org/)
From 1987 through 2013, I spent my days engaged in community economic development efforts in Albany and the Capital Region with several outstanding colleagues who have been family to me for many years: Roger (and Maria) Markovics, Louise McNeilly, Eric Dahl, Susan Cotner, Kirby White and Kirsten Keefe. This community development family grew over the years to include Paul Stewart, Walt Brady, Linda Chandler, Dorian Wells, Willow Olson, Joe Landy, and many others. Many of them provided timely and meaningful support. They will always be near and dear to me.
Sustainable Saratoga (https://sustainablesaratoga.org/)
Two more close colleagues who have always been there for me are Amy Durland and Harry Moran and I received perfect messages from both during this crazy ride.
Friends
Thank you to our long-time good friends who were there throughout with their support: Marty (early hospital visit) and Judy Abbott, Randi Walker (who hung with Abigail quite often, including taking her to a special event), Maureen Gannon (made lasagna), Peri Crowley, Susan Kosinski and Henry Spliethoff.
And special thanks to Abigail’s personal assistant, Candice Whalen, who stepped up, as always, during these difficult few weeks.
Running
My running coach, Tom O’Grady, provided me with moral support during these times. (Tom finished second overall in the Adirondack Distance Half Marathon with a blistering time of 1:18:45. He won a coveted hand carved bear). Darryl Caron, publisher of Adirondack Sports (https://www.adksports.com/), has also provided me with key support for many years.
HINDSIGHT AND FUTURE
Were there signs? I may have felt a heart flutter here or there that day, or in prior days, but nothing to alarm me.
My bad cholesterol had been borderline high for many years, but each year my primary physician and I would agree that “yes, while it’s high, you do most everything else right and you are in good shape, so let’s just keep an eye on it…” I also was pre-diabetic, but my doctor and I again agreed that it was something to simply monitor. I did not need to be convinced of medical procrastination as I was proud of my exercise regimen and eating habits.
I had an arrhythmia (electrical problem) that caused my heart to go into cardiac arrest. Upon testing, it was discovered that I had blockages in my right ventricle. The blockages caused the blood flow to be insufficient which led to an arrhythmia. My heart blockages appear to be hereditary.
My approach to health care will certainly be more accepting of medication(s) now, while still pursuing prevention first and trying to get to the root causes of any issues before relying on medications (or surgeries).
Born to Run
My goal is to run again. And that sub three-hour marathon (ran 2014 New York City Marathon in 2:58:39; the 2015 MHRM in 2:56:57; and the 2019 MHRM in 2:58:17) is an obsession I will have difficulty letting go of, but, quite frankly, at this time I am content to simply get myself out of bed, walk up or down stairs, go outside, and inhale the earth’s fresh air. Only time will tell how I may be able to adapt to my new circumstances.
Written in OCTOBER 2022
Editor’s Note: Bob has since returned to running and is even competing in races again. Most recently, Bob won the 10-mile Erie Canalway Race in 1:05:38 at 59 years old. We wish Bob continued success in his recovery and return to racing. We also thank him for sharing this personal story with the running community so that it may help another athlete in the future.
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