The Boston Marathon always promises to deliver a tale of against-all-odds triumph. Take the 1966 glass-ceiling-shattering achievement of Bobbi Gibb, the first woman to complete the race. Or the blockbuster 2014 triumph of 38-year-old Meb Keflezighi, who embodied the gritty resolve of a city bouncing back from the bombing a year prior. Or each of the 32 times Dick and Rick Hoyt crossed the finish line.
But this year, a miracle unfolded far away from the tape, way back at Mile 8, a tree-lined commercial stretch of the Marathon route in Natick.
Veteran marathon runner and fitness coach Meghan Roth, 34, of Minnesota, was cruising along at just over 6 minutes a mile, on pace to better the personal best that had qualified her for the US Olympic Team Trials in 2020. Checking her watch, she would see the name of her infant son scribbled on her arm — a reminder of the love and support she counted on to get through the grueling miles.
But suddenly, Roth went into cardiac arrest, stumbled, and then collapsed midstride. Within two minutes, an ad-hoc collection of medical professionals rushed to her aid. Among them, a nursing student who lived nearby; a retired ICU nurse from Milford; a California doctor running the course despite aching legs courtesy of the London Marathon he’d completed a week prior; an emergency room physician assistant who had tended to victims of the 2017 Las Vegas mass shooting; and a paramedic from Oregon who by coincidence had been introduced to Roth years earlier in Chicago.
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While on the balcony of his home, located on the Marathon route, Cameron Howe — the nursing student — was the first to see Roth fall. He was hosting a viewing party and among the guests was retired ICU nurse Marie Rogers. Together the two raced to Roth as she lay prostrate on the course. Neither could detect a pulse.
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“Marie noticed her earlobe had started to change to a purple color. A bad sign. So we turned her over and started CPR right there in the street with me on her airway and Marie on compressions,” said Howe. “We did that for a few minutes until a gentleman who identified himself as a paramedic said he could help out.”
The paramedic, Nick Haney, has run so many marathons he can’t even remember the official tally. As he neared the scene, he assumed Roth was suffering from a cramp or sprain. But when he noticed Howe administering CPR, he realized the situation was far more dire and sprang into action.
Another runner, David Pai, a kidney doctor from Sacramento, stopped seconds later. He, too, was a marathon veteran, having completed London a week earlier. Pai delivered a precordial thump to Roth, striking her sternum with the bottom of his fist in an attempt to get her heart back to its normal rhythm. Then, as Haney continued to administer CPR, Pai lifted her legs so that the blood flowed to her core.
Haney was relieved of his duties by Tanner Smith, yet another runner in the sea of 20,000 with a day job inside a hospital. Smith, who is from Las Vegas, said he’d been on duty as an emergency room physician assistant the night in 2017 when a gunman open fire at a concert. His hospital received 200 victims in a span of two hours that night.
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Together, the hodgepodge crew of five — Howe, Rogers, Haney, Pai, and Smith — tended to Roth until members of the Natick Fire Department arrived, having driven an ATV up the Marathon route against throngs of determined runners.
“Think of a salmon swimming up river,” Lieutenant Matt Mullen said.
When the ATV arrived, Howe and Rogers returned to their perch overlooking the route, and the three runners set back out on course, all cruising on to speedy finishes. The Natick first responders shocked Roth with a defibrillator once on the street, and again once she’d been moved inside the ambulance.
“She woke up and immediately wanted out of the ambulance,” said paramedic Scott Marcosa. “She’s going, ‘I need to finish.’ ”
Pai spent the remainder of the race with Roth’s bib number — 961 — seared into his mind. He feared the worst, knowing that even if she made it to the hospital alive, it was likely she’d suffered extensive brain damage. He looked up her name when he arrived at his hotel that evening.
“I found her on Facebook, and I see she’s holding a new baby boy from just months earlier,” said Pai. “And it hits me how sad this all is. It was a dark Monday night.”
But Roth had pulled through, although with no recollection of the scene that had unfolded at Mile 8. After being revived in the ambulance, she was taken to Tufts Medical Center.
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“I panicked not knowing what had happened to me. Waking up to a nightmare. Waking up to find out how very fortunate I am. How fragile life is & how quickly things can take a turn for the worst. How we can never take anything for granted & writing this to you now just being able to tell my story,” she wrote in a Facebook post that Monday night.
Three days later doctors placed an implantable cardioverter defibrillator in her chest. The battery-powered device, the size of a stopwatch, is capable of correcting life-threatening cardiac arrhythmias. Her medical history and exact diagnoses were not made public. By the end of the week, she was back home in Minnesota and reunited with her 9-month-old son. She has since spoken individually with Howe, Rogers, Haney, Pai, and Smith.
“At 9:44 a.m., my life came crashing down. You were there to save me. From the lifeless moments of despair, to the miracle of life, I am so blessed to be here today,” she wrote in a letter to first responders read aloud during a ceremony Wednesday at the Natick fire headquarters, 2½ miles from where she’d collapsed a month earlier.
“I want you to know I will never stop living my life to the fullest,” Roth wrote. “I’ll never stop dreaming big and pursuing everything I want in life. I want you to know that if it wasn’t for you, I just wouldn’t be here to write this message. I wouldn’t have the chance at the life I’ve always dreamed of. Thank you for giving me my love back.”
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And, this week Roth also posted a video to her Instagram of her on the treadmill running a “six easy miles.” A smile fills her face the entire time.
Globe correspondent Andrew Brinker contributed to this report.
Hanna Krueger can be reached at hanna.krueger@globe.com. Follow her @hannaskrueger.