The day of the Boston Marathon was ideal for a 26.2-mile run. Oh, maybe a little warm, but Meghan Roth, running in her first marathon since she gave birth to her 10-month-old son, wasn’t going to complain.

Roth, a running coach in Minnesota and a familiar face in the running community, just wanted to “go out and race well and have fun being back in Boston,” she would say later. The 34-year-old hoped to improve on her personal best of 2 hours 44 minutes, but she wasn’t stressing about it. Then, eight miles into the race, she suddenly, terrifyingly fell to the pavement.

Roth hadn’t fainted or tripped in the crowd or torn a ligament. She had had a cardiac episode.

“It happened so quickly that I wasn’t even able to — I just collapsed,” Roth said. “I don’t even remember hitting the ground, so when I woke up in the ambulance, I didn’t realize the seriousness of it.”

Others immediately did. Marie Rogers, a retired critical care nurse, was cheering on the runners from her brother’s home along the marathon route when she “looked out the window and noticed this runner who fell down,” Rogers recalled later in an email to The Washington Post. “She got up with the help of another runner, but she appeared to be going down again.”

Rogers and her brother’s roommate, who is a nurse, went out and found Roth “lying face down, making incoherent sounds,” Rogers wrote. “At that point I didn’t know if she had hit her head, or was extremely dehydrated. But then I noticed her earlobe turning blue so I asked Cameron [Howe, a Boston College student], the other nurse, to help me roll her over. At that point, she was having agonal [gasping] breaths and neither one of us could find a pulse, so I started CPR and called to a woman on the sideline to call 911.

“After a few minutes, a runner stopped, introduced himself as a paramedic. He checked for a pulse, couldn’t find it, so I continued with CPR. Another runner stopped, an ER paramedic and then a physician, and from there they took over. EMS arrived [and they] had to shock her three times.”

For a distance runner accustomed to long runs, often alone or in underpopulated areas, the situation could have been even more devastating. But this was the Boston Marathon, with spectators along the route and medical personnel on standby.

“It was a total team effort, and it gives me great pleasure seeing people come together for the sake of someone else,” Rogers wrote.

After she regained consciousness, Roth began to try to connect the dots to determine what had happened. She had fainted several years ago while running on a treadmill and thought that she had experienced that again when her head began to feel “fuzzy.”

“I think my mind immediately went to: ‘I just passed out. I didn’t think I went into cardiac arrest, right?’ I was just, I was thinking I passed out, and I wasn’t exactly sure what had happened,” she said. “So when I woke up, I was instantly devastated and like: ‘What just happened to me? Why?’ Because it happened so early in the race.”

Her growing awareness gave way to another realization: “‘Oh, my gosh, I was so lucky to be here,’” she said. “I felt like I could be dead right now. It’s just amazing and unbelievable. I think of myself, and if I look at my situation, I think I know how to give CPR, but it’s not something that I’ve ever done before. It’s just all the circumstances of it. I don’t know if I would have been that fortunate if it hadn’t happened there or even if it had happened while I was at home.”

For the first time in a race, Roth was wearing a watch with a heart monitor, another fortuitous thing, and it supplied important information.

“My heart rate monitor showed that my heart rate was never at zero — it was always at least in the 30s,” she said. “It was explained to me that my heart was just in a different rhythm and I didn’t wake up until everything was kind of fully circulating again, and that was in the ambulance.”

Roth was taken to Tufts Medical Center, where all she could think about was her son and how she was supposed to be on a flight home to him that day. “I’m like, ‘I just want to get home with my son’ — we haven’t been away from each other.”

But she was persuaded to have a procedure done immediately and, as a single mother, to take care of herself. “They kind of gave me the timeline and said they could get it done right away and have me home by Friday,” she said, growing emotional. “So I was like: ‘Two [more] days and then I’ll be home. It’s important now that I be healthy.’ So I FaceTimed with Jaxon, but still it was our first time away from each other, and he didn’t know what was going on. I’m so happy to be here.”

On Oct. 14, three days after the race, an implantable cardioverter defibrillator was placed in her chest, and the next day she was home in Edina, Minn., happily reunited with her son. Helped while hospitalized by a GoFundMe account, she has returned to coaching full-time. Her recovery continues, and she is following doctors’ orders and planning short walks while pushing her son’s stroller.

“I can’t even think of how many days it’s been since I went for a run, but at the same time I’m just so aware of being alive and I know the future. Everything will be okay to come back to my training and pursuing my goals and dreams,” she said. “It’s long term, of course, but I’m very hopeful because I’ve heard from a lot of people that have gotten through this, that they’ve come back stronger and they’ve been able to resume their regular activities.”

It remains unclear what caused her problem. Among the possible factors she said her doctors cited are heredity — her father died at 53 — a family history of heart disease and myocarditis, a mild cardiac inflammation that has been associated with covid-19. (Roth had recovered from a mild case of covid-19 in August and had been vaccinated after her recovery.) She will continue to heal, and the ICD will remain in place, easing some of the fear she might experience as she begins training again and just living her life.

“People have been so amazing, and I’m just overwhelmed with the kindness that people have shown me,” Roth said. “I’m just overwhelmed with gratitude with the love and support. The running community is so amazing, and people you never would have expected have reached out to say they have a defibrillator. I continue to get messages and support from people, and it’s just such a happy ending.”

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