Fuld transskription af How Runners Can Save Lives

to you in just a minute. And then Dr. Matt Friedman is the medical director for New York Road Runners on the first Sunday in November when nearly 60,000 people run the 50th Five- Borough Marathon, keeping every one of them healthy across 26. 2 miles is his job. Dr. Friedman, great to have you back as well. All right. Well, lots to talk about here. We're going to start with you, Christopher. You wrote something about your marathon team that we thought was really interesting. You said that you're building a community of survivors and lifesavers. What do you mean by that? 00:05:51 Christopher Sheridan: Really what it's about is I meticulously read and review every single application that comes through. One of my biggest things that I like to do is learn people's why and their connection to the cause. We essentially prioritize those who have a very strong connection, whether they've lost somebody close to them or they themselves are a survivor. Every team member participating is because they care about the mission and not just the race. And that's something that I really pride my team on and something that I really try to coach them to as well is that we're not just here to run the marathon. Yes, that's wonderful, that's a beautiful accomplishment, but really it's to build this community together of people who have been through this shared experience. Sometimes people who have been through a cardiac event or someone who has saved someone's life from a cardiac event or lost somebody that can feel so isolating. So something that I like to do is I always create a group chat with all of them so everybody uses each other as also their greatest resource, not only for running tips or fundraising ideas, but also to just create that sense of community that they are not alone throughout the entire experience from training to race day and even afterwards. That is our main focus of the event. 00:07:10 Rob Simmelkjaer: Can you tell us, Christopher, about a few of the people running on this year's team, whether they're survivors or running in someone's memory? 00:07:19 Christopher Sheridan: So I would say that we have definitely a good even split of people who are running in someone's memory, someone who's a survivor. The first story that reaches out to me that I think about first when you ask me to talk about somebody is one of the things I do all the time is when somebody applies, usually I'll set up a phone call conversation with them. I'll read their application, I'll be like, " This is a beautiful story." Or sometimes they're a little

bit more closed off, I guess you could say, and not really saying everything about why they want to be a part of it, but I see something there. And there was somebody very special that I called this year and he let me know that he actually was running a marathon down in Florida where, and this was I believe three years ago, he was running a marathon down in Florida and while he was halfway through the race, he went into cardiac arrest. He was so lucky that a nurse had stopped to use the bathroom nearby him and she was able to save his life with CPR. They ripped open his t- shirt, put him in the ambulance and they saved his life. A year later, he was cleared by his cardiologist to run the same marathon again, and he stitched up that shirt that they ripped off him and he ran the marathon with that nurse again who saved his life, which when he was telling me that story, I was about to cry because it's wild to think that there are so many instances in life where if that woman just didn't stop to use the bathroom and know how to do CPR or if nobody nearby had acted, he would not be here with us today. He would not be on this team. And the fact that he is still willing to run the New York City Marathon, raise money for Team Heart and Stroke is really beautiful. And that was one of my favorite stories I heard this year. 00:09:11 Rob Simmelkjaer: Yeah, Christopher, thank you so much. And that leads me right to Jenny because Jenny, when you hear a story like that, it must remind you so much of the story you're living through right now when it comes to that kind of serendipity of who was nearby. So let's go back to this past June. Before we get to what happened, just take us there to the start of that evening. You were in Raleigh, North Carolina at a free community running event, a one- mile event, your specialty, on a Tuesday night pacing a heat of middle school girls. What was going on? 00:09:51 Jenny Simpson: Yeah, it was just a normal evening, June 16th, and a lot of the day I really don't remember. It was a very ordinary day. I was at work. I left work early with some coworkers to go join this evening track event. And again, just celebrating running with a lot of community here in the Raleigh- Durham area. And I mean, cardiac arrest and cardiac events don't announce themselves, right? There's not symptoms that take place often. Everybody's circumstances are different and everyone's story is their own and novel, but oftentimes cardiac arrest in particular really comes out of nowhere. And that

was certainly the case for me. I had run the mile. I was pacing a bunch of young girls, which is a really dear and wonderful and important memory for me personally. But I wasn't in the race. I wasn't working hard when my heart started to struggle. I actually had completed the four laps around the track and was chatting casually with other people and then suddenly said, " I don't feel well," and collapsed. 00:10:56 Rob Simmelkjaer: I don't think you remember much. I know you don't remember much about what happened next, but what do you know of what happened next from what you've been told? 00:11:04 Jenny Simpson: Yeah. What's so important is that, again, there wasn't anything that really stood out to give me a lot of alarm leading into that moment to say, " Oh, you should be paying attention because today is something's different than any other day." But then the flip side of that coin is that what was really important and really important in my survival was that I'm so fortunate that this happened in a really public place. I know there's this idea... I mean, of course, of course, it's frightening to think that anybody has a cardiac event at any time anywhere, but in a race scenario out at a community event, honestly, it's about the best place for something like this to happen because no matter what level of incredible health, I mean, Rob, you mentioned I've trained my whole life as an elite athlete and a runner. I was still in really great shape, but no matter what kind of health you bring to the incident, to the table, you need people of courage to be there to step in to help. And I'm so lucky that that was the situation I was in. 00:12:08 Rob Simmelkjaer: Yeah, Jenny, it stunned me so much when I heard that this had happened to you, given who you are and the active, incredibly elite athlete that you were and still are, by the way. I want to talk about the people standing by you that day because there were two folks near you, Ivy Pointer, who is a pediatric ICU doctor and her husband, Joey, who runs the company that you work for, Fleet Feet. And they happen to have a defibrillator in their car, Jenny, because their child has a heart condition. Can you talk about that and what that ended up meaning for your survival? 00:12:52 Jenny Simpson: Yeah, this is a part of my story that's just really strange. And Christopher mentioned before that there was a nurse that stepped in for another survivor and another story. I mean, the people that step in, first of all, they're often... I don't know. I was just really lucky

because I knew these people so well. Like you said, my boss and then also his wife who is an ICU physician, but more importantly to me, also a really great friend and running buddy. There were also several other medical professionals around who stepped in, but the most important thing about the people that stepped in were they were people of courage. You don't have to be a medical professional to be somebody that saved someone's life. And so these people were the most critical to me because they were the most nearby and they were the people that were willing to step in when the circumstances were chaotic and crazy and really frightening. And so I'm really lucky. But in addition to their courage, they also had, I mean, like you said, they had a lifetime of preparation for a moment like this. I feel like God or fate or destiny plucked me out of a very random situation in life where my husband and I were traveling around the country and put us into this family. Liam, their son, was born with a congenital heart condition and they knew his whole life that eventually he would have to have surgery on his heart. And so with that kind of awareness, years ago, they outfitted his track team with an AED. And so running that night, there was an AED there kind of with a thought of if Liam would ever need it and I was the one who needed it. And so this family who had been preparing for a cardiac event, indeed there was one and it happened to be mine. And I'm just so fortunate that that family was knowledgeable, they were prepared, and all the stuff that they had done in preparation for their son really came, stepped in at the right moment to save my life. 00:14:57 Rob Simmelkjaer: Jenny, I hear your story. You and I talked a couple of months ago about everything that happened to you and people have different ways of interpreting these things when they happen to you. Why did it happen? Was this fate? Was this luck or bad luck? I mean, I listened to your story and we'll get into more of it later, including the causes of what happened to you. And it's just to me, it's a miracle that this was all lined up the way it was for you to be able to survive what was a really serious situation that it took you quite some time to recover from, which we'll talk about, but how do you think about it? 00:15:40 Jenny Simpson: Oh, I totally believe that there's not enough luck in the world to have all the dominoes lined up so perfectly. Rob, there's so many factors. Like you said, I've been an elite athlete my whole life, and so there's so many positives that I brought to the table, but ultimately at the end of the day, you need someone there that's courageous and willing to step in and help you when you have a cardiac event. And so the year previously, my husband and I had been traveling around the country in a van and we'd run to the bottom of the Grand Canyon and we'd run all over national parks. We'd done a lot of running, just the two of us or even solo. There's many, many training runs in my career. I had been out alone. And now spending some time in North Carolina, I was starting this new job at Fleet Feet, and it was really the first time in my life that I was really surrounded by that level of community at all times. And so to have people like that and especially medical professionals right there, and I mentioned the medical professionals, it wasn't just Joey and Ivy, there were other people there that stepped in hands and knees down in the dirt doing CPR. It took a long time for EMS to get there, and so they actively did CPR for somewhere between 20 to 30 minutes. And I just feel so fortunate that these people in the middle of the chaos, in the middle of the fear of everything that was going on, they really stuck with me for a really, really long time. My odds were not good going into the ambulance and headed to the hospital and was even transferred to Duke a day later for more advanced care. But the critical, critical moment in the whole chain of survival, the whole series of events was really that first few minutes when people responded right away and then stuck with me until more advanced help arrived. 00:17:36 Rob Simmelkjaer: That's a great segue, Jenny, to Dr. Friedman. And Matt, you and I spend lots of time talking about these situations and you spend a great deal of your time thinking about and preparing for these situations. And there's three things that kind of jump out at me about what both Christopher and Jenny have said in the stories they've told. First of all, just the fact that you're so much more likely to survive an event like this when you are in a race or an event that is well prepared, like one of these events is, when there are people nearby who hopefully have been trained in hands- only CPR, there's defibrillators nearby. So in a way, how fortunate one is if an event like this happens in a race. Number two, just from Jenny's point, the incredible importance of having people nearby, the people who can perform CPR, people who can get to a defibrillator, just the role that

every person at an event can play in saving a life. And then three, in Jenny's case, the fact that it really can happen to anyone. I mean, we're talking to Jenny Simpson here, eight time New Balance Fifth Avenue Mile champion who had this happen at a middle school girls community run, right? It can happen to anyone, anywhere, anytime. Dr. Friedman, how does that all factor into the way that we prepare for these events happening in our events at New York Road Runners? 00:19:10 Dr. Matt Friedman: I have to start by saying that I just told Jenny's story to a group of 150 medical volunteers before our last big race, which was the Bronx 10 Mile, and it is inspiring on so many levels. The community aspect is inspiring, everyone's sort of will to work, and really the length of recovery. In best case scenarios, the heart starts again within a few minutes and your dedicated friends and community members really were working for 30 minutes in excess. It is really inspiring just as the beginning of it. The thing is these skills, everyone can do them and we're here to make people aware of how to do them. Over the years, we have data from 2000 to 2009 where the survival rate is about 30% from endurance medicine, from long distance races. The risk of cardiac arrest, the survival rate was 29%. Thanks to efforts by Jenny and by other people who have made more aware, more AEDs throughout the course, that survival rate is now 70%. So it's a dramatic climb from 29% to 70%. And let me just, just for comparison's sake, without an endurance medicine event, without a large community around, the survival rate is fairly abysmal. It's less than 10% in a typical 911 public setting environment. So we're close to 70% now thanks to the public awareness efforts, thanks to the multiple AEDs along the course, and people like Jenny who are advertising the story about what to do in that environment and how to help. 00:20:50 Rob Simmelkjaer: Dr. Friedman, Jenny mentioned someone nearby had a defibrillator. We all walk by defibrillators, we see them in parks and at events. Of course, we have a lot of them in the hands of trained professionals at our races, but for someone who isn't familiar with them and maybe is even scared by the idea of using one of them, talk about those things and how easy they are to use and what the risk is of using one as a bystander. Can they hurt someone? Talk about that a little bit. 00:21:23 Dr. Matt Friedman: Sorry, I have to start with saying a medical joke, which is an AED is sort of like the kidney. It's smarter than the greatest physician in human, meaning it is impossible to hurt somebody with an AED. The AEDs are designed that once you apply them, it will tell you what to do next. There are voice prompts along the way which inform you, connect the probes now, place the pads on the chests and on the left side of the chest underneath the heart. It's really hard to get it wrong. Even if you're off, it will still deliver a shock if it is indicated. And these things are nearly perfect. It does not deliver a shock if it's not indicated and it absolutely does if it is the right thing to do. 00:22:10 Rob Simmelkjaer: Yeah, you've done demos. I've seen many of your demos about them in our offices and they really are just about foolproof and then lifesaving. But of course, Dr. Friedman, for most people in most situations, it's that hands- only CPR, which is going to be the go- to first available remedy for someone. And we've trained now thousands of people in hands- only CPR at our expos, through videos we've put together. Jenny is going to be a part of us helping to train more people going forward in hands- only CPR, which we're very grateful for. Can you just, Dr. Friedman, for anyone listening, what's the best way for them to learn it? Is there a video they can watch and what do they need to know about the basics of hands- only CPR? 00:22:55 Dr. Matt Friedman: There is many videos. We offer one at the New York Road Runners. AHA, the American Heart Association offers one as well. I think the major thing, there's really two teaching points. When people suffer a cardiac arrest, and this is sort of well documented, it looks like they may be having a seizure. There is seizure- like activity, and there's a critical delay because people are like, " Oh, they're having a seizure. Let me just turn them over, just give them a few minutes to recover." And that is unfortunate, but that is what it looks like. So our job, bystanders, medical professionals, we go over to the patient, we say, " Hey, hey, are you okay?" We shake them a little bit. It's okay to be rough. It's okay to shake their shoulders. If there's no response, you feel for a pulse. And somebody should feel for a pulse for 5 to 10 seconds, no longer. The hardest step is the step that starts working up and resuscitating a cardiac arrest. If there's no response, then start compressions. And the rate is 100 to 120 compressions per minute at a depth of about two inches. Everyone knows the song Staying Alive, but that's really the beat that you want to go to. It's a pretty

fast beat. This is New York. If you start compressions on somebody and then they wake up and say, " Hey, what are you doing? Get off of me." That's a win in my book. We're all okay with that. You did the best thing for that patient. And unfortunately, more often than not, it's going to be real cardiac arrest. We want people to get on the chest and start compressions. We start compressions. And ideally, compressions are hard work. I'm really in awe of Jenny's colleagues and workers who did compressions for 30 minutes. We would like people to rotate every two minutes for compressions. It is exhausting. It is physically exhausting. It is mentally exhausting. So ideally, there's enough people around to time two minutes and then circle out to another person to give a full set of vigorous compressions. 00:24:57 Rob Simmelkjaer: Christopher- 00:24:58 Jenny Simpson: Rob, do you mind if I step in here? 00:25:00 Rob Simmelkjaer: Yeah. 00:25:01 Jenny Simpson: I also, Dr. Friedman, thanks for everything you're sharing. And I also just want to reinforce what you're saying about how anyone can help, and if somebody goes down, anything you do is going to help, even if you're just getting somebody's attention to see if they're okay and wake them up. But if you start compressions, you're not going to hurt somebody ultimately by doing compressions. If somebody is in critical need of help, anything you do to step in is going to increase their odds of survival. Not only are you checking on if they're okay, not only are you starting compressions, but you're bringing attention to the situation, what often then brings other people into the situation to help. Like Dr. Friedman said, if you really are beginning compressions and CPR, you don't really ultimately have to meaningfully understand what you're doing. You just have to act and step in. And from being on the side of somebody that needed people to act, that's the biggest hurdle for me is just encouraging people not to be afraid, not to hesitate, but to get in there, bring some attention to the situation and start doing something until someone else can come and help. 00:26:09 Christopher Sheridan: And I just want to second that, Jenny, that what we always say too here is that bad CPR is better than no CPR, that even if you are not fully sure or confident about what you're doing and all you know is to press hard and fast in the center of the chest, you're giving that person a chance at life that they didn't have before you started doing anything. 00:26:30 Rob Simmelkjaer: Yeah. Thank you so much, Jenny and Christopher, for that. Christopher, this is a lot of what the American Heart Association does, what all this money that you're raising in the marathon goes to. Talk about that a little bit. We were talking about these events that happen in public where there's more likely to be someone around, but three quarters of these cardiac events of course happen at home, which means the person who's going to have to act is a family member. How do you work with people to train for that? 00:27:01 Christopher Sheridan: One of our biggest, I guess, I'll say the signature events is the Wall Street Run and Heart Walk. It's something that we do every year, and it's really what we're doing is using those funds to create a Nation of Lifesavers. That is our biggest goal. That is what we want to do. They say even to have one person in each household be equipped with the skills for hands- only CPR, but truthfully, what I always say is that it's two because what if it's you that ends up going down and the other person doesn't know what they're doing? Right now, I think the scariest statistic is that the survival rate of cardiac arrest is 10% outside of a hospital. So that means that 90% of people who experience a cardiac arrest outside of a hospital will die. What we're looking to do is we just want to double that number by 2030. And what's even, I would say, astronomical is that that's only 20% and that's not even a large- enough number. We would like to triple that, quadruple that. And the only way to do that is by teaching people this life- saving skill of hands- only CPR. Something that we also see that people really register with is the fact that in New York City, it takes about 12 to 14 minutes for an ambulance to get anywhere, and that's just from door to door. So that's from when you call to when figure if you spend a lot of time in your office, if it gets to the office building, that's not even taking into consideration going up an elevator, getting to where the floor is that you have to go, finding the person who's in that cardiac emergency. We are the first responders, the people who are around our loved ones every day, the people who are at work, the people who are on the street, we are the ones who are the first responders when it comes to a cardiac emergency. And that's really where we're putting a large portion of our funding for the Wall Street Run and Heart Walk is towards those initiatives. And I will say the feedback that we get from all of the place that we go into, the communities

that we teach, the corporations that we go into and work with their employees has been wonderful. And they are basically all like, " We didn't even know that we could do this. We thought that you still had to do mouth- to- mouth. We thought that it's too scary to do that." And one of, I think, the biggest takeaways that we actually had somebody from one of our companies where we taught hands- only CPR two weeks after he came to the session, somebody on the train went into cardiac arrest and he saved their life. And if he had not come to our hands- only CPR session, he would not have known what to do and that person wouldn't live, wouldn't be alive. So it's really just kind of what we've all been saying today. I mean, Jenny has mentioned it, Dr. Friedman has mentioned it, is that everybody in our community needs to look out for each other. And whether your best friend or your boss, it doesn't matter. It's still a person's life and the fact that we have the opportunity to give them a second chance, nobody should skip out on that. 00:30:10 Rob Simmelkjaer: Jenny, I want to go back to you and your story. So you get out of this track, you get to the hospital, and in many ways that was just the beginning for you because you were in for what turned out to be a really tough fight from that point forward for your life. And I'm sure, again, you don't remember a lot of this, but from what you know, talk about what it turned out you were facing. 00:30:38 Jenny Simpson: Yeah. So I had CPR on site. I had multiple AED shocks to get my heart started again. And then once I got into the ambulance, had several more AED shocks on my way to the hospital. When your heart goes into V- tach, in my case, it was kind of this runaway train. You have an interruption to the electrical pulse in your heart, but then you also have an injury to your heart because it's had this shock event. And so when my heart would start back up, it would have to contend with both the electrical interruption, but then also the shock that it had been through. And so it was really hard for me to overcome that, but I had incredible, incredible help at the hospital. I mean, one of the things, Rob, that I come out of this experience that has really blown me away and wrapped up into this is also a lot of gratitude for Dr. Friedman and all that he represents, not only in the awareness, but also as a medical professional. But the lengths that so many people went to save my life. I mean, Rob, like you said, it wasn't just the people that stuck with me on the infield. And as Dr. Friedman said that this happened to me, the rotation, there were people rotating every few minutes, switching out and doing CPR. And so there was a really meaningful, immediate coordination of people to try to save my life. But then when I got into the hospital setting, that persisted for several more days. And so the folks at Rex Hospital, and then later on the next day I was life flighted to Duke for more advanced heart failure help. And all of those people, I mean, I was in the ICU for several days intubated, just trying to give all of my internal systems the best fighting chance possible to rebound. And again, I'm so fortunate. This event has been so interesting because when you have a cardiac arrest out while you're doing an activity like running, it can trigger a fear in you. They're like, " Oh, I was running when this happened and so now I'm afraid to run." I really, really want to encourage people to resist that fear because it was so many years of physical activity and it was so many years of healthy choices about sleeping and eating well and all of those things that gave me foundational help that really resourced my body so that when the other advanced medical help stepped in, they were working with a strong body, a fighter, somebody that was going to stick in it with them. So between the medical staff and between myself, like you said, Rob, this was not something that just happened for 20 minutes on an infield. The fight was ongoing for several days. 00:33:28 Rob Simmelkjaer: Jenny, what was the condition that you had that led to this cardiac arrest event and how long have you had it? 00:33:36 Jenny Simpson: Yeah, so days later, and that's another reason why I'm so impressed with all these doctors. I mean, you come in and they triage a situation that they have no idea what this young person has and they kind of take care of you with a lot of unknowns. But several days later, I was diagnosed with an inherited heart condition called ARVC, arrhythmogenic right ventricular cardiomyopathy. And that means that a section of my heart, when it breaks down due to just normal exercise, we exercise our muscles, the muscle breaks down and then it rebuilds. There's a portion of my heart, a segment of my heart that when that muscle breaks down, it rebuilds in a dysfunctional way. And so the material that it uses to rebuild doesn't properly conduct electricity. And so accumulated over a long period of time, that scarring or that dysfunctional tissue in my heart eventually

interrupted the electrical pulse. And so it's a little bit confusing. There's a lot going on there, but the important thing that I want to share is this was an accumulation of scar tissue built up over a long period of time. This is why I didn't have a cardiac arrest as a young person at 10 years old or 15 years old or 25 years old. And this is part of the unpredictability of these sorts of conditions. You can present as a really healthy person for so long like I did until 39 years old, there's this accumulation of scar tissue in my heart and it did eventually interrupt that electrical pulse. And so what comes to me out of all of this is no matter how much preventative care you do, no matter how much great maintenance you do, there's always going to be the necessary need for excellent emergency response. And I loved what Christopher said, he's totally right from the American Heart Association. Bystanders are often the first responders. And so we can't always predict. Running didn't cause my inherited disease, but it revealed it. And in that moment I needed people of courage to step in and start compressions. 00:35:52 Rob Simmelkjaer: Yeah. Dr. Friedman, this is why I'm in awe of you and your team and all the medical volunteers and everyone who comes out for our events, including of course the TCS New York City Marathon is what Jenny just said. Somebody comes in and we have cardiac arrests every year. Something will happen at the marathon at other events, even shorter events. These things happen on a fairly regular basis in very small numbers, and it's your team's job to deal with it having no idea what the underlying cause of that is. But having, I guess, enough of the common treatment elements, CPR and the defibrillators to know, " Hey, we got to get an electrical current back in this heart and then let a hospital figure out down the road what's really going on here with this patient." 00:36:48 Dr. Matt Friedman: Yeah, we're mostly a medical team, but we're also logisticians. We figure out how to put the less logistics in place. We have a responding asset, as we like to call them, throughout the course at the most infrequent, every half a mile, and we go up in frequency as we get closer to the end of the course. Towards the end of the course, we have a responding asset every couple hundred feet, whether it's a BRU as we like to describe it, which is a bike response unit, which has an AED and it has a tech bag with airway equipment and tourniquets. We have 15 to 20 bikes along the course. We have

FRUS, which are foot response units, and those are just littered for the last mile and a half. Every couple hundred feet, we have a foot team with all of the necessary equipment. And then we also have these gators, which are utility task vehicles with stretchers, and they can really get into a patient quickly, have a stretcher, apply the AED. And really the goal is, as in Jenny's case, is to work up a cardiac arrest and resuscitate the patient on site and get that pulse back right away. And we have about nearly 20 gators throughout the course as well. So we are very comfortable with our responding assets. Our goal is to get to somebody within three minutes and apply that AED in this scenario. 00:38:12 Rob Simmelkjaer: That's what it's all about is just getting an AED there as quickly as possible and having a bystander apply CPR in that interim period of time before an AED can get there. 00:38:26 Dr. Matt Friedman: And Rob, it happens every single time. Every single time we've had a cardiac event, there is always a bystander. Sometimes it's a doctor, sometimes it's a nurse, sometimes it's an EMT or paramedic, but frequently it's the guy who was running his race who has no medical training whatsoever. And we are so thankful and appreciative to those runners. 00:38:45 Rob Simmelkjaer: The one that I'll never forget, Dr. Friedman, of course, we've been through a few of these and almost all of them with happy endings, some unfortunately without. But the one that I will always remember was the cardiac arrest that occurred on the Verrazzano- Narrows Bridge a few years ago, the first mile of the race. We had a cardiac incident. And think about this, you've got runners who are just starting their marathon. They've been training for months and they've been looking forward to this day and they're just on the bridge on their way up to the top in the first mile of the race and someone next to them goes down and they stopped and they started applying, started CPR on this individual. And fortunately we got there and we had a successful outcome. But I mean, it can happen anywhere, Dr. Friedman. 00:39:35 Dr. Matt Friedman: It absolutely can happen anywhere. The data shows it happens in the last one quarter of the course. And as Jenny says, you don't really know it's coming. Especially in a warmer day, we don't like people to overdo it. We like people to run to moderation on warmer days and to run to moderation the last couple of miles and not to overdrive their heart, but we don't really know when it's going to happen. 00:40:05 Rob Simmelkjaer: Yeah. And the fact that it's generally toward the end is to that point. You got people who already have put a lot of stress on their bodies and a lot of them are looking at maybe a time they're trying to hit and they're thinking more about that than maybe how they feel. And that's where we have to make sure we keep in people's mind the importance of listening to their bodies and taking care of themselves. All right. I want to ask each of you guys the same question as we come close to the end here, which is what do you want people to think about having heard this? Whether they're running the marathon or maybe they're a spectator, but especially for the runners who are lining up and getting ready to run this race, maybe it's their first marathon, maybe it's their 31st. But Christopher, to you, what's the message that you want your runners or runners in general to think about having heard this conversation when they get ready to start the TCS New York City Marathon on November 1? 00:41:01 Christopher Sheridan: Well, something that I always speak to my runners about is the difference that they're making, obviously. I mean, you think about the fact that they are raising funds for the American Heart Association while also running this marathon. I mean, even currently right now we are at about $ 356,000 raised with a goal of $400, 000. And I believe that my team will blow that out of the water and we have such dedicated people here. And I think what I want them, and I think also for everybody else who isn't even part of Team Heart and Stroke to think about and to know is clearly to see that New York Road Runners cares about their lives and that the American Heart Association cares about their lives and that we have people who are lifesavers along the way of you doing this for a reason, that we're here because people are running their, like you said, how many, I'm sorry, I forget the exact number, but how many charities are running in the New York TCS Marathon? 00:42:03 Rob Simmelkjaer: Well over 600, Christopher, yeah. 00:42:03 Christopher Sheridan: Yeah, 600, which is wild. And the fact that New York Road Runners even gives these charities that opportunity to raise funds this way and to make such a difference while also, I mean, for us, I will say, displaying what prevention looks like in a healthy way and keeping your body in good shape and staying active and having that intersection of research and prevention, research benefits because the funds and awareness generated by the event help fuel the next

generation of discoveries. And it's just something that I'd want everyone to think about going into this is that there are lifesavers along this route and you can also be one too. 00:42:49 Rob Simmelkjaer: Dr. Friedman, what do you want our runners to think about on the morning of November 1st? 00:42:54 Dr. Matt Friedman: I want everyone to be aware of their surroundings. I want everyone to appreciate their surroundings. I mean, the crowd is just wonderful, so it's really hard not to. And I think that's what people's sort of greatest joy is, is the crowd as they run the TCS New York City Marathon. I also want people to gain the necessary life skills at the expo we have before the marathon. We offer hands- only CPR training. It'll take you five minutes to understand the skills involved, and then you'll walk away with this recognition and this newfound skill, which you may or may not use, but it's important to have, it's important to teach. And I really want people to listen to their bodies, especially on warmer days. And I want people to reach out if they have any questions, see how we can help them further in their journey, medically or otherwise. 00:43:47 Rob Simmelkjaer: Jenny, to you now, and you've been telling your story for the last few months since you got better and were able to start talking about it. I know it's complicated for you, right? I mean, you spent your life as a runner. You don't want people to hear your story and cause it to make them worry about running and the safety of running. So what is your message for all these incredible people out there about to run 26. 2 miles in New York City? 00:44:17 Jenny Simpson: Yeah, there's one thing that I would like people to take away from what I've shared today. It's that the odds that you are going to have a cardiac arrest or a cardiac event are very low, but the odds that in your lifetime you'll be in a position to help somebody that is having a cardiac event are higher. And so Christopher talked about the Nation of Lifesavers. The way that we can increase survival rates is by increasing that Nation of Lifesavers. People that raise their hand and say, " I'm willing to step in. I'm willing to be courageous and chaos, and I'm willing to take the five minutes that Dr. Friedman mentioned to learn hands- only CPR. And if there's an AED available, I'm going to rip it open and I'm going to follow the instructions." And so it's unlikely you are going to be the patient, but in your lifetime, it is much more likely that you're going to be in a position to help. And so as a part of Nation of Lifesavers at the New York City Marathon, if you go to the expo and visit the CPR booth, you can receive a heart sticker to put on your bib on race day. And I'm going to be running around all over the place the week of the New York City Marathon, encouraging people to put that heart sticker on their bib as we all go out and flood the streets of New York to really symbolize, " I'm one of those people that's willing to raise my hand. I'm willing to go from a bystander to a life saver." And not just on the race day in the race event, but as you go out into your communities, in your grocery stores, kids' soccer games, all the other places in your life, having that five- minute training and just that awareness of the difference that you can make to be courageous and step in, that's how we're going to increase the number of survivors from cardiac arrest. 00:45:55 Rob Simmelkjaer: And Jenny, it's so you to take this thing that has happened to you and turn it into a mission to help other people. You've been trying to help people and doing it through running for your whole career. You've been one of the most involved people in your career in rising New York Road Runners. In all the years you won the Fifth Avenue Mile, you were coming and running with kids, and sure enough, that's exactly what you were doing when this happened to you. And now you're not able to run because of what happened to you, unfortunately, but you are able to spread this message, and it's just exactly what I would expect from Jenny Simpson. 00:46:39 Jenny Simpson: Well, thank you. And I really want to thank you, Rob, so much your leadership and your crew at the New York Road Runners and Dr. Friedman. I came to your team with this idea of having the heart stickers on the bibs. I mean, New York City, you guys are logistically the most complicated, you're the most magnetic, more people come to this race and want to come to this race than anywhere in the world. And so to have a partner like you saying, " How can we help you get the word out?" I have this chosen responsibility, but you guys have been incredible partners in thinking up ways that we can together make not just the racecourse, but our entire world a much safer place. So thank you for your leadership in that. 00:47:19 Rob Simmelkjaer: Well, thanks for saying that. I want you, Jenny, to also think about what our runners should think about when it comes to the gift that they have to be able to run this race. You spent your life doing this and you're

not able to do it going forward. How does that make you think about the gift of being able to run the marathon? 00:47:48 Jenny Simpson: Yeah, on this conversation is that as a result of my diagnosis with ARVC, after a lifetime of running as an elite athlete, it's kind of unbelievable. I'm still wrapping my mind around the reality that it's not going to be safe for me to return to running really at any level. And so I'm now marching out into the world as a walker and will be joining people in lots of walking activities, but not in running. And the one really common question I get is it hard for me to watch people go out on a run? And honestly, Rob, I'm sure there will be ebbs and flows in my life, but I watch people launch out on a run and I think, I know how great it feels. I know how good it is and I want that for those people. So when we have 50, 000 plus people head out into New York City for the New York City Marathon, what I want them to think about and know is that their opportunity to go out and run, that joy is now my joy. There are people that aren't able to go out and do the whole distance on their own for lots of various different reasons. And so don't just enjoy the marathon experience for yourself, but also enjoy it for someone like me that isn't able to participate moving forward. 00:49:08 Rob Simmelkjaer: Jenny, I need you to teach me how to watch people run a marathon and not get FOMO and want to run it myself because I still haven't figured that out. I went to the Sydney Marathon, didn't run it, but got such an itch. I had to run a half- marathon a week later in Australia. So that's a skill I need to learn from you as I'm still- 00:49:28 Jenny Simpson: I feel very, very, very lucky. I ran the marathon in 2024. Of course, that was the last race that I ran. I wrapped up my whole running career right there in Central Park with all of you and New York Road Runners. So it's a great gift of mine knowing that I won't be able to run the marathon in the future, to be able to close my eyes and have the memories of such a beautiful New York City weather day, a beautiful marathon, all the struggle and the difficulty getting through those miles, and then the incredible sense of fulfillment and joy you get finally getting through that finish line and knowing that you've completed the TCS New York City Marathon. 00:50:06 Rob Simmelkjaer: I'm so glad- 00:50:07 Jenny Simpson: I'm really, really, really looking forward to watching people's joy and having accomplished that again this year. 00:50:12 Rob Simmelkjaer: I'm so glad you got to have that experience once in your running career. 00:50:17 Jenny Simpson: Absolutely. 00:50:18 Rob Simmelkjaer: It certainly will help you relate so much better going forward to what our runners are experiencing. I want to thank all three of you, a great, really important conversation. Christopher, where can folks go if they want to support your team of runners on November 1st? 00:50:34 Christopher Sheridan: They can go right to our website, which is heart. org or what I found to be really easy, super simple, is just Google Team Heart and Stroke. It takes you right to the donation page. You can go through and see every single runner. And also every runner has their personal stories attached to it, why they're running and why this means something to them. So if people would love to support, I would greatly appreciate that. 00:51:03 Rob Simmelkjaer: All right, Christopher, Dr. Friedman, Jenny Simpson, thank you all very much. And we look forward to seeing all of you marathon week for what will hopefully be a very safe marathon day in New York. 00:51:17 Speaker 3: Peloton has got something for whatever running mood you're in. Try instructor- led runs and walks that are built to fit into your routine with classes that help you stay consistent, build speed, and be in the moment. Track your metrics, see your progress, and train smarter. We've got it all to help you reach your goals and stay on track. Peloton, the official digital fitness partner of New York Road Runners. 00:51:42 Rob Simmelkjaer: All right, that does it for another episode of Set the Pace and a really good and important one. We want to thank our guest today, Christopher Sheridan from the American Heart Association, Dr. Matt Friedman, and of course the great Jenny Simpson. Make sure you leave us a review, tell your friends, send a comment as well. Love having everybody chime in on all of the various platforms. Thanks for joining us. If you're out there training for the marathon, as you listen to this, keep going, get those miles in. Hope it's all going well. Enjoy it, and we will see you next week.