Jim Peter's Collapse in the 1954 Vancouver Empire Games marathon
Review of his hospital records recently made available to the authors indicates that Peters may not have suffered from exertional heatstroke, which classically produces a rectal temperature of > 42°C, cerebral effects and a usually fatal outcome without vigorous active cooling. Thermal balance calculations also suggest that the environmental conditions were probably not sufficiently severe to induce heatstroke even at the high rate of energy expenditure sustained by Peters for 2 hours and 22 minutes.
Although Peters was unconscious on admission to hospital approximately 60 minutes after he was removed from the race, his rectal temperature was 39.4°C and he recovered fully even though he was managed conservatively and was not actively cooled.
We propose that Peters collapse was more likely due to the combination of hyperthermia-induced fatigue which caused him to stop running; the onset of exercise-associated postural hypotension as a result of a low peripheral vascular resistance immediately he stopped running; the combined cerebral effects of hyperthermia, hypertonic hypernatraemia associated with dehydration and perhaps an undiagnosed hypoglycaemia. But none of these conditions should have caused a prolonged period of unconsciousness, raising the possibility that Peters may have been suffering from a transient encephalopathy, the exact nature of which is not currently recognized.
Dan Tunstall Pedoe, DPhil, FRCP,
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Date published: 2008-08-04
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