On the last weekend in June, more than 350 athletes gathered high in the Sierras to race one of the most renowned ultramarathons: the Western States 100. This 100-mile course takes runners from Squaw Valley to Auburn, Calif., on a grueling trail of steep switchbacks, swift-water river crossings and mountain passes. Competitors run through both thick snow and temps that can exceed 100 degrees.
To help each runner make it to the finish line safely, Lucas Marciniak leads the medical team at Mile 85. Marciniak is a nursing student in the Accelerated BSN program at Samuel Merritt University San Francisco Learning Center.
As medical captain, Marciniak's role is to oversee care of the runners and to make the determination on whether it is safe for them to proceed. The hours are long, starting at 4 p.m. and going throughout the night until the following morning. While a big responsibility, Marciniak said it is really a team effort.
"Everyone on the team has worked professionally in emergency settings and knows how to keep their cool under pressure and with limited sleep," said Marciniak, a former EMT for Yosemite National Park. "As each runner reaches mile 85 of the race, we assess them, paying close attention to their mental status and weight compared to their starting weight [as an indication of fluid status], along with addressing a host of other ailments."
While this year's moderate temperatures in the mountains decreased the number of runners needing medical attention, Marciniak and his team still saw a host of problems. Among the medical conditions fielded by the team were hypernatremia, hypoglycemia, dehydration, muscle/skeletal injuries, potential renal failure, medication toxicity, exhaustion and extensive blister care.
The race has an extensive set of medical protocols that combine both front-country and back-country medicine. Most of the aid stations are remote and a long way from the nearest hospital.
There are no lab tests, teams of specialists, or high-tech equipment, so it is crucial to have competent medical teams with great assessment skills.
"Our goal is to get runners to the finish line, but our priority is their safety. As fit and finely conditioned as these runners are, the nature of this endurance marathon pushes the participants," said Marciniak, "and as the athletes drive themselves to such extremes, the body responds in ways not commonly seen."
This was Marciniak's third year providing medical aid at the race, and he was excited to be able to fit it in during the intensive 12-month accelerated nursing program.
"Volunteering is extremely important to me. I love giving back to the community; in this case helping hundreds of elite athletes push the bar of human endurance, safely."
Yet to squeeze this in, even on the drive, Marciniak was busy studying his notes for the midterm the following week.
"I was constantly applying what I learned," he said.
Along with a rigorous class schedule, Marciniak continues to volunteer for Bay Area Mountain Rescue, focusing on wilderness medicine and rescue in remote settings. He loves the challenge, pressure and teamwork of responding to emergencies, and chose nursing because he was inspired by nurses' ability to touch more lives than any others in the medical profession.
"SMU has been an amazing place for me to learn," Marciniak said. He will be starting his preceptorship soon and graduating in November.