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Inside the Chicago Marathon Med Tent With Medical Director George Chiampas

We asked Chicago Marathon's medical director George Chiampas about marathoner maladies and his advice to runners on race day.

While runners at the Bank of America Chicago Marathon on Oct. 8 worry about their pre-race rituals and mile times, Dr. George Chiampas will be focused on making sure all 40,000 competitors go home healthy. As the race’s medical director, Chiampas, 46, leads a team of 1,500 medical professionals and volunteers that spring into action to help sick and hurting competitors during the Chicago Marathon. From minor muscle strains to serious heat-related illnesses, they are prepared to deal with it all. At the 2016 marathon, Chiampas and his crew treated an estimated 2,000 runners. A Chicago native, Chiampas first got involved with the race as a volunteer when he was in medical school. He continued to volunteer when he was emergency medicine resident before becoming the race’s medical director in 2007. Competitor caught up with the busy physician to chat about marathoner maladies, his toughest year as director and his advice to runners on race day.

What was your most challenging year and why?

“The 2007 race was challenging due to the extreme weather and the concern for runners and the public. The humidity is a component which is extremely difficult to overcome, especially with thousands of runners and the marathon distance. The decision to cancel and stop the event was one made in the interests of our runners, volunteers and public.”

(On Oct. 7, 2007, high heat and humidity during the marathon caused scores of runners to develop heat-related illnesses. In addition, runners encountered chaos at aid stations, where they were told there was no water left, according to news reports. Race officials, including Chiampas, decided to halt the event as the temperature soared into the high 80s. At the end of the day, one runner died and more than 300 others received medical attention.)

“While it was a decision that was difficult, we absolutely knew it was the right decision. We initially received quite a bit of criticism, however as time has passed, our decision, as well as how we responded collectively—from medical and public safety—has highlighted our event as a key leader and model for marathons globally.”

What are your biggest concerns as medical director as this marathon approaches?

“Weather is a key piece and a constant factor that determines our overall needs and how busy we might be as a medical team. I am constantly cognizant of ensuring areas across the course are prepared and no potential incident hasn’t been thought through. We have so many moving pieces and these keep me up at night sometimes.”

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Supplies. What kinds of medical supplies do you need to be stocked up on for the event?

“We staff our medical tents to address minor issues to very severe cases. We have thousands of gauze, IV fluids, wraps, lubricants, Band-Aids, tape and countless other medical supplies across the course. Finally, we have critical care equipment in key areas for severe cases and work collaboratively with Superior Ambulance and our private EMS services, as well as the Chicago Fire Department.”

What are the common health problems you see among marathoners both during the race and immediately after?

“Musculoskeletal issues tend to be the most common injuries we see on race day such as strains, or overuse type injuries. We also see quite a few skin or blister type injuries, which we address immediately to allow the runners drive through the 26.2 miles.

“Some of the more serious matters, and the ones where most fans or spectators rarely see, are runners experiencing significant heat-related matters, such as heat stroke, which requires a rapid diagnosis and immediate on-site response.

“Other issues such as hyponatremia where runners consume large amounts of water while dropping their blood salt content is (also) a very serious matter which we occasionally see and need to address immediately.

Cardiac incidents are rare, (but) having over 45,000 runners with their own unique medical conditions we do see, at times, a runner experience a significant cardiac event on race day. For all of these reasons, we have established key algorithms specific to the medical conditions seen in endurance events and have developed educational programs for all of our medical volunteers. We additionally offer CPR training to all runners and all 12,000-plus volunteers.”

What advice would you give runners on how they can avoid the medical tent?

“First and foremost, each runner has to run their individual race based on how their training has led up to race day and if they have any limitations, they should adhere to them.

“Second, adjust based on the weather forecast, meaning if it’s unusually warm, set realistic expectations and be prepared to adjust. Stick to your own hydration and nutrition plan—this is not the time to try something new or experiment.

Finally, listen to any new aches or pains and address them prior to race day. On race day, if any worsening issues or new injuries or symptoms arise, please stop and have our medical staff work with you in reaching that goal of completing the race.”

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