Written By Michael Inverarity with contributions by Liz Beare and John Maxwell
In Australia, the odds of surviving an out of hospital cardiac arrest are 9%; the odds of surviving one and being neurologically intact are 3%. This is my story, as I’m one of the lucky 3%.
My memory of kilometres 37 and 38 of the 40th running of the Pichi Richi Marathon are not the best, mainly because I didn’t think I would ever need or want to know them in so much detail. I rang my wife, Liz, (through my Apple Watch via my Apple Airpods) somewhere between kilometres 37 and 38. The phone records would show that it was 10:58am when I rang. I remember telling Liz that I was struggling a little but I was feeling fine and that I would see her in 30 minutes. I had never not finished a race before. I rang her out of courtesy as she was waiting patiently at the Quorn community oval, the finish line, with our 3 kids, aged 7, 5 and 3.
At 11:23am Liz would receive a phone call from a police officer asking if she knew a Michael, who was running the Pichi Richi Marathon. The Police Officer would inform Liz that I was in the back of an ambulance and was being taken to Quorn Area Hospital. Liz’s only question was to ask, “is he conscious?”.
Looking back, I wasn’t overly confident about this run. A few days after the marathon I was reminded by my long-time running mate, Scott, that I sent two separate text messages to him leading up to the marathon saying that I wish I hadn’t entered this run. I still don’t know why I was feeling so apprehensive about this event.
Rewind the clock a few hours earlier. The alarm went off at 4:30am on Sunday 26th June 2022. It was a cold morning at Argadells Homestead, which is located 28km north of Quorn. My wife and I, and our 3 kids had spent the past 6 days in the Flinders Ranges. We had had an enjoyable time together and had already talked about the next holiday into the Outback. I was up early, ready to run in the Pichi Richi Marathon.
I had my usual toast and water. I jumped into the car to meet my father-in-law at 6am in Quorn, as he had kindly offered to drive me from Quorn to Port Augusta where the start line was located. I was nervous driving, as it was a dirt road for the first 8 km and there was always a danger of hitting the wildlife. I would narrowly avoid 2 kangaroos in the first 5 minutes of the trip.
After meeting in Quorn, my father-in-law, Robert, dropped me off at the start line in Port Augusta at 6:20am. If I wasn’t the first runner there, then I was the second. The event organisers were setting up and I made my way into the country club. I had to ask the staff to unlock the rooms where the runners would get ready.
I was feeling good physically about this run. A month earlier I ran a PB in the Barossa Half Marathon, and I have loved being part of the Run As One running club for the previous 6 months. Being part of the group is really motivating. Following all the runners, and the regular email chats with Riley and Izzi has made running thoroughly enjoyable. The program Riley put me on was improving my speed and my stamina, and I was regularly knocking off (running) 230km a month leading into the Pichi Richi event.
Running wasn’t new to me. I completed my first City to Bay when I was 11 years old and when I was 28 years old, I managed to break 4 hours (3:56) for the 2008 Berlin Marathon. I have always been a runner.
The 7:30am starter’s gun sounded and the 50-odd runners had begun the journey. Conditions were good for the run. However, once you completed the first 10km, which took you south, you turned onto the main road to Quorn, which was a predominately uphill component running east, meaning you were looking into the warm sun for the remainder of the journey.
Since it was a small field, I was running on my own for the most part, which I didn’t mind, as the music coming through the Airpods kept me motivated. I started out at 4:50 min/km which slipped out to 56 min/km as I tried to conquer the 28km, 550m elevation uphill component of the marathon. My Strava data would show that I completed kilometre 38 in 5 minutes and 22 seconds. This was the last kilometre I would run.
Doctors would later tell me that I suffered a cardiac arrest. An ectopic heart beat had sent my heart into a dangerously abnormal rhythm called ventricular fibrillation, which is almost always fatal. A fit, seemingly healthy, 42-year-old male, who had run most of his life was lying on the ground. I had dropped dead! The only thing that could save me was someone trained in first aid and who was carrying a defibrillator, and there just happened to be exactly that driving by.
Two St. Johns Ambulance volunteers (I want to stress they were volunteers) positioned at the finish line were doing their job, coming to the aid of the runners that needed help as they crossed the line. 10–15 minutes before I would collapse, they received a call on their radio that a runner had fallen, cut her head, and was bleeding. This runner needed some help and we know now that she would need stitches.
A course marshal asked on the radio if the two volunteers could come out to the 37km mark and help the runner with her injury. The volunteers were a little reluctant, as they might still be needed at the finish line, but they decided to leave and travel the 5km to help this runner. At 4km into their journey they saw me on the ground and came to my aid.
I was gasping for air in a pattern known as agonal gasping. One of the volunteers, with 30 years of experience with St. John’s, knew what was happening and could see that I was about to go into cardiac arrest. She ran back to her vehicle and grabbed the defibrillator. By the time she returned, my eyes had rolled to the back of my head and I had stopped breathing.
The volunteers rapidly commenced CPR and put the defibrillator pads on me. They shocked me once and managed to get Return Of Spontaneous Circulation (ROSC). My heart was back into a normal rhythm and I was conscious. I literally had a cardiac arrest in the arms of someone holding a defibrillator. If it wasn’t for the runner who had cut their head, the decision by the volunteers to leave their post, and me collapsing where I did, I wouldn’t be here today.
The volunteers were able to call for an ambulance, which came from Port Augusta. I was taken to Quorn local hospital and stabilised further. I don’t remember this ambulance trip, but I was told I was chatty with the paramedics. After 2 hours at Quorn hospital, I was flown by the Royal Flying Doctor Service to Adelaide. An ambulance was waiting for me at Adelaide Airport and I was taken to the Coronary Care Unit at Flinders Medical Centre. Within 5 hours of collapsing in the Australian Outback I was sitting comfortably in a tertiary level metropolitan hospital. How lucky are we in Australia!
I was transferred to Flinders Private Hospital and would spend 6 days in the Coronary Care Unit. I underwent 4 different investigations on my heart. I would leave with an Implantable Cardioverter Defibrillator (ICD) and learn that I have heart disease, which has gone unnoticed and undiagnosed. I would be told that I have a complete blockage of one of my arteries and scarring of my heart muscle. This scarring represents an old heart attack; one I didn’t even know I had had. This part of the muscle will never recover. Underlying all of this appears to be a hereditary cholesterol issue.
For the rest of my life, my cholesterol and heart will need to be managed and I will need to be disciplined when it comes to heart health. Running will definitely be part of the future and I look forward to starting that up again in late August.
I sometimes wonder if all of this could have been prevented. A simple blood test would have identified the high cholesterol and imaging of my heart might have shown early signs of trouble. However, most guidelines about screening for cardiovascular risks such as high cholesterol don’t recommend starting until you are 45 at the earliest, unless there is a family history of early heart disease. I had fallen into the trap of thinking because I am young, fit and healthy and run regularly I didn’t have to worry about my heart health until I was 50 or even 60.
I’m not sure what to make of the luck that came my way on Sunday 26th June 2022. I might need some professional help to unpack that. I have been told more than once not to buy a x-lotto ticket, because “you have already won”.
This could have been a story about a fit runner dying during a marathon. Instead, it is a reminder to get a health check-up and to have regular appointments with your doctor.
Lastly, thanks must go to the St. Johns Ambulance service and to the two volunteers who saved my life.
Michael with his family in the Flinders Ranges days before the marathon