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Mark has a tradition. Every year, he goes for his routine physical. He schedules the appointment for the morning, plans a lunch downtown with friends and finishes the day by donating blood.

He has another tradition — ongoing since 1980 — that an undiagnosed heart condition almost stopped for good. Every year, he runs the Boston Marathon.


In 2005, Mark went to see Nadim Khoury, MD, for his annual check-up. Dr. Khoury, who recently retired after 43 years at Northwestern Memorial Hospital and 32 as Mark’s doctor, ordered an electrocardiogram. This itself wasn’t out of the ordinary — Mark has a family history of heart disease and, a few years before, the test had revealed atrial fibrillation. This year, however, an additional echocardiogram showed a more serious problem: a leaky heart valve.

The leak was above average but it was not critical. Mark continued to run, continue to live his everyday life. But at a follow-up appointment in November, his leak had worsened — he would need heart valve replacement surgery within the next few months.

echocardiogram

Choosing Northwestern Medicine was a given for Mark. “This was uncharted territory for me — I never had heart surgery before — and knowing the reputation, just knowing I was going to a place with a great reputation gave me confidence and helped reduce the stress,” Mark said. “To know I was going to one of the best possible places and having one of the best heart surgeons in the country certainly calmed my nerves a great deal.”

To know I was going to one of the best possible places and having one of the best heart surgeons in the country certainly calmed my nerves a great deal.”

The Program for Atrial Fibrillation at Northwestern Medicine offers the most advanced medical and surgical techniques for treating irregular heartbeat. This includes, but is not limited to, a miniature remote cardiac monitor — 87 percent smaller than previous monitors — that is easily injected under the skin, transmitting data back to the care team at night. More recently, the team performed the first successful placement in Illinois of the WATCHMAN Left Atrial Appendage Closure (LAAC) device, a minimally invasive and potentially life saving procedure that reduces the risk of stroke.

Northwestern Medicine was also one of the first hospitals to offer a breakthrough alternative to the traditional catheter ablation, a non-surgical treatment option. Traditionally, heart rhythm specialists use electrodes to cauterize the abnormal heart tissue to prevent the pathway from initiating an irregular heartbeat, but Northwestern Medicine offers a newer treatment option that freezes abnormal electrical pathways instead of burning them.

Surgical treatment — both minimally invasive maze procedure and the classic, open maze procedure — may be appropriate when patients need coronary by-pass surgery, or, like Mark, a heart valve replacement surgery.

Mark met with Patrick M. McCarthy, MD, the heart surgeon that first drew him to Northwestern Medicine, and Pablo Denes, MD, who would become his cardiologist. When Mark and Dr. McCarthy met in mid-January of 2006, Dr. McCarthy gave Mark a four-month window to schedule the surgery. It was necessary, but not urgent.

The first date Mark asked about to schedule his procedure was April 21st — two days after the Boston Marathon. When Dr. McCarthy found out Mark planned to spend the intervening months training and running, he ruled that out. Mark’s second suggestion was that very day — to allow the most possible time to recover for the race. They settled on February 1.

“That was the longest two and half weeks of my life, waiting for the surgery,” Mark remembered.

The day before his open-heart surgery, Mark ran 10 miles. As during the preceding weeks and months, he was in no pain, he felt nothing wrong. His procedure lasted six hours. A test the following day confirmed that the leak was fixed, but Mark still faced an uphill journey if he was to start in Boston. Walking up the stairs felt like climbing a mountain and after surgery, Mark’s heart failed three stress tests. As late as March, he had to have a procedure to shock his heart into a normal rhythm.

On April 21, 2006, Mark would start the Boston Marathon. He had set rules for himself: If his heart rate reached 130 beats per minute he would stop immediately, seek help from the medical personnel on the route. But he never needed to, he crossed the finish line in 5:42:31 — an official finisher of his 27th Boston Marathon.

It was a race unlike any Mark had run before. For one, he didn’t exactly run. And at his slower pace, he appreciated and saw so much more of the race. He experienced the Boston Marathon outside the perspective of a runner. He saw people, buildings, things that he had never seen before.

“When you’re running fast, trying to set a personal record, you miss a lot of things, because your focus can be quite narrow,” Mark explained. “Having a more relaxed time, interacting with my fellow participants and the crowd — that was wonderful.”

The Boston Marathon was normal for Mark. To complete the race would mean he was back to his everyday.”

Along with new experiences, Mark was facing new goals. He very much wanted to keep his tradition of running the Boston Marathon alive: A newly minted member of the Boston Quarter Century Club, Mark didn’t want to give up a membership that demands 25 or more consecutive races so soon. But moreover, completing this race would prove to Mark that he had recovered. The Boston Marathon was normal for Mark. To complete the race would mean he was back to his everyday.

Still, this was the first time Mark faced the possibility of not finishing the race. He loves running, loves the Boston Marathon, and had seen challenges before: an especially cold or hot year, juggling work, family and everyday demands, but nothing like this. It was the ultimate challenge and Mark prepared accordingly.

He had, of course, a safety plan for race day, but he had also trained for this specifically, something that was also different to his usual race training.

“With running, you run fast and you’re done. When it’s taking you twice or three times as long, you don’t want to be out there by yourself,” Mark said. He set out to find someone who wanted to walk with him — an hour, two hours even three or four hours. Luckily, two friends — Veronica and Tom — were just the people for the job. “It was a wonderful opportunity and I was very appreciative to have somebody out there.”

On marathon day, he had a different partner at his side. A veteran of numerous Boston Marathons herself, Mark’s wife Barrie accompanied him for the last ten miles and they crossed the finish line together.

“To this day, I still consider that my most treasured and hardest athletic accomplishment,” Mark said. It was, as he likes to say, a Personal Slowest, but not a Personal Worst; not a Personal Fastest, but a Personal Best.

What drives someone to run a marathon after open-heart surgery? Tradition is a powerful motivator, and at the heart of tradition is history.

August 25, 1974 was the first day of cross-country practice at Gordon Tech High School and a young Mark arrived with a plan that did not include a future in marathons. He had his sights set on hockey, and cross-country would be a means to get there. With no particular hockey skills, he planned to wow the hockey coaches with a fitness level they couldn’t pass over.

Meanwhile, cross-country was trial by fire. Mark’s freshmen year, 110 of his peers went out for the team. By the end of the season, there were nine runners. There were no cuts, peers just gave up. Self-attrition. The coach knew this, and knew he would have those nine runners for the next three years.

At the end of the season, Mark asked his cross-country coach if he knew when hockey try-outs were. His coach said Mark had missed them.

I always liked to run, but I liked hockey even better. But, hockey never came, and running never stopped.”

“I always liked to run, but I liked hockey even better,” Mark recalled. “But, hockey never came, and running never stopped.”

Mark was good at it, too. After high school, he went to run at Oakton College. His sophomore year he faced what would become the most impactful race of his life. Qualifying for the national cross-country championship was on the line and he knew going in he would either just make it or just miss it.

The race was in New Mexico and Mark’s dad came with him. Every time Mark would come around the track, he would see his dad cheering him on. On the final straight away, he saw his dad and he was silent. Mark would miss qualifying for the cross-country championships by less than 22 seconds.

After the race, Mark was wrecked. Deflated, depressed. It remains one of the saddest days of his life. But his coach offered him a distraction.

“My coach said, Mark, you missed it, you did your best, but I want you to take the next ten days and run long distance, really long distance,” Mark remembered. “Take three days off, then run the Hinsdale Illinois Marathon.

“Did it get my mind off things? Nah ... Maybe a little.”

On November 17, 1979, Mark ran the Hinsdale Marathon. One of maybe 200 or 300 runners. He ran a 2:49:38 — two hours, 49 minutes and 38 seconds. He beat his previous time — a 3:11:13 — and he was happy, his spirits were, in fact, picking up.

A little over a month later, Mark was with some of his high school teammates, all home and exchanging stories over the holiday break, talking about who was still running, who had “retired.” Mark mentioned off-handedly that he had run a 2:49:38 at the Hinsdale Marathon and, with some laughter, his friends pointed out that he had qualified for the Boston Marathon by exactly 22 seconds.

He went back to school, asked his coach if he really had qualified — and if he could go to the Boston Marathon. “He said, you gotta train like you’ve never trained before,” Mark said.

At 19, Mark ran the first of his 36 — and counting — consecutive Boston Marathons: 2:39:54.

After the race in New Mexico, Mark asked his dad why he had stopped cheering. His dad explained: He lost his voice. He wanted to cheer, but he couldn’t.

“I’m sure that if he didn’t lose his voice, I would have made it,” Mark reflected. “So maybe somebody took away my dad’s voice. If he had yelled and cheered, I would have made the national championships and never went to Hinsdale, never started my Boston Marathon experience.”

Mark running the Boston Marathon in 1991

Boston opened Mark’s world up to marathons and shaped the course it would take for the next thirty years. He continues to race and started a training program and running camp, writes for running magazines, coaches and gives educational seminars on training and running. In fact, it was at one such seminar that he met his wife, with whom he celebrated his twelfth wedding anniversary in August.

This February, he’ll celebrate another anniversary: 10 years since his open-heart surgery. The cow heart valve that saved his life is commemorated with a cow ornament on his Christmas tree every year. He volunteers as a member of Mended Hearts, giving encouragement and answering the non-medical questions of patients going through heart surgery.

Of even greater impact is the number of runners who have approached Mark to share how his story saved their lives. From before Mark was diagnosed until the day of his procedure, he could run — he felt fine. It was only his annual physical, a tradition he is as committed to as Boston, that revealed his heart condition and led to his life-saving valve replacement. If you’re born with a bad heart, your level of fitness doesn’t matter, only your commitment to your health can make that difference.

“My biggest satisfaction is not running and completing the Boston Marathon less than 11 weeks after open-heart surgery,” Mark said. “It’s that I’ve been very public with what I went through and I’ve helped save other people’s lives. When someone comes up to me and says, Mark, I had the same experience, I would have never known if not for your article, that’s priceless.”

“My father would tell me, if you’ve got something, if you’ve got a gift, that’s wonderful,” Mark continued. “Now make it really special and share it with others.”

Mark keeps his traditions. With his annual physical on the calendar, when he runs the Boston Marathon in April 2016, it will be his tenth with the cow heart valve, 37th overall.

There’s a party planned for the anniversary in February — red wine on the menu — and he will keep training, coaching, following the path marathon running has set for him.

And when it’s time to relax, Mark will go for a run: a light ten miles instead of twenty.

Making an #ImpactEveryDay