Boston Marathon runner Elizabeth Obih-Frank had trained for months chasing her sixth World Marathon Majors star, but this year's race nearly cost her far more than a finish-line photo. Her body temperature spiked to 105 degrees as she reached Boylston Street, and she has no memory of actually getting there. She was rushed to Tufts Medical Center in Boston, where doctors diagnosed her with severe rhabdomyolysis, a condition that soon pushed several of her organs toward failure.
According to WCVB, Obih-Frank had already completed more than a dozen marathons, including five of the six World Marathon Majors, before this race, and she was attempting to earn her official sixth star. The Six Star Medal, awarded only to runners who finish Tokyo, Boston, London, Berlin, Chicago and New York City, is considered one of distance running's premier civilian achievements, according to MarathonGuide.
A Health History Decades in the Making
Obih-Frank's medical history predates her running career by decades. She has lived with sarcoidosis since the late 1980s, a disease that left lasting damage to her lungs, and she entered heart failure in the 2000s at age 36 because of a congenital heart defect, per the WCVB report. She did not start running until her 60s.
At an expo panel called Team Abbott: Stronger than the Diagnosis, she described competing while managing heart valve disease and roughly 60 percent lung capacity, according to MarathonGuide. In 2021, before she could run the race in person, she had already completed a virtual Boston Marathon by tracking her 26.2-mile run via GPS, according to Mirth and Motivation.
Mile 19: A Body in Revolt
Around mile 19, Obih-Frank began to feel strange, stopping, walking and leaning as she tried to keep going, and she said she felt she was losing control of the right side of her body. She continued the race with help from her coach and other runners along the route, at one point asking her coach, Cheri, not to let her fail, WCVB reports.
At the finish line, medics stripped away her clothing and submerged her in an ice bath in an effort to revive her, according to the outlet's account. Boston Marathon organizers maintain roughly 1,700 medical volunteers at the finish, including a dedicated 'heat deck' stocked with cold-water immersion tubs meant to rapidly cool runners suffering heat stroke or hyperthermia, according to RUN, powered by Outside.
Diagnosing a Rare and Dangerous Condition
Doctors at Tufts Medical Center diagnosed Obih-Frank with rhabdomyolysis, a condition WCVB reports nephrologist Dr. Daniel Weiner defines simply as uncontrolled muscle breakdown. Weiner said it can be triggered by exertion and can be difficult for runners to recognize because it often begins as ordinary muscle soreness. He advised athletes to know their limits and pay attention when symptoms feel out of proportion to their effort, the outlet reported.
That kind of muscle breakdown threatens the kidneys specifically. Myoglobin, a protein released when damaged muscle fibers degrade rapidly, can block the kidneys' filtering tubules in high concentrations and trigger acute renal failure, according to a pathophysiological review published by MDPI. Severe cases like this remain uncommon among marathoners, typically requiring a convergence of extreme muscle stress, heat strain, dehydration, underlying health conditions or NSAID use, according to research published in Sports Medicine.
A Condition Tufts Has Seen Before, and a Course Known for Weather Swings
Tufts Medical Center has treated rhabdomyolysis clusters before. In September 2024, 12 Tufts University lacrosse players were hospitalized with the condition after an intense team conditioning session, according to a Facebook post from Tufts Medical Center.
Warm or weather-challenged race days can overwhelm the marathon's medical stations; on some editions of the race, up to 9 percent of all runners have sought care at course or finish-line medical tents, with dozens requiring hospital transport, according to Brookline Patch. Boston's course is known for swinging temperatures between the Hopkinton start and the Boylston Street finish, a volatility Hoodline detailed in its marathon weather gamble preview ahead of this year's race.
Focused on Recovery, With an Eye on a Sixth Star
Obih-Frank is now focusing on her recovery, which she credits to a fast diagnosis and treatment at Tufts, per WCVB. Two months after her hospitalization, she received medical clearance to return to racing and completed the B.A.A. 10K, the second event in the Boston Athletic Association's three-race Distance Medley, in June, according to a Facebook post she shared. She has not ruled out another attempt at Boston, though for now she says she has learned to stop before reaching her limit.
