Under a tent, just past the finish line of the Quad-City Times Bix 7, bags of IV fluids hung from poles above rows of cots — an open-air field hospital at the ready.
An hour before the starter pistol was fired from a riser on Brady Street, about 100 volunteers, mostly from Genesis Health System, prepared the place no runner wants to see.
About 15 minutes before race time, chief of staff for the treatment center in the street, Dr. Edwin Motto, gave his team of doctors, nurses, EMTs and others a piece of parting advice: "Get 'em better; get 'em home."
The medical tent at 3rd and LeClaire streets is the primary-care center for injured and overheated Bix runners. Volunteers take to the streets near the finish line, evaluating runners by sight. Some are scooped up from the ground while others are urged into wheelchairs, headed for the tent. It doesn't take a medical professional to spot some warning signs: wobbly legs, white or grey skin color, vomiting and blank stares on faces that aren't sweating.
"We're looking for people who appear disoriented, show signs of dehydration and exhaustion," said Brandon George, Saturday's triage nurse for the med tent. "We never know how many we'll get."
Standing next to George and looking at his phone for temperature and humidity stats, Medic Chuck Gipson offered a report, "The temperature is down from last year, but the humidity is up, so it's cooler but wetter."
The overcast skies were a good sign, the pair agreed — nothing like some of the blistering heat that downed so many runners in previous years.
"In 2011, it was super hot," Gipson said. "I think we treated 100 people. Last year, we only had 55 in the tent and three transported."
Added George: "I remember five years ago, because we were starting to run out of IVs."
While the medical tent is equipped with IV fluids, oxygen, inhalers and people to administer it all, one of the most important supplies is ice.
"We have 5,000 pounds of it," said Al Loeffelholz, emergency preparedness coordinator for Genesis. "If we don't use it, our supplier will take it back. We plan never to run out of ice."
In some years, Genesis staff has reported treating runners whose core temperature was as high as 106. The goal of the hospital volunteers is to get those temps down fast. Bags of ice are loaded into 50-gallon garbage cans and water is added. Then towels are thrown in, and the medical staff wrings them out, bathing runners in ice-cold water.
Six teams staff collections of cots, keeping track with clipboards of runners' bib numbers and their vitals. Doctors have to sign off before they are permitted to leave the tent.
"Each team has a doctor. Each team has a nurse who is specialized in hard IV starts," Loeffelholz said. "People who are dehydrated are hard to get IVs started in."
On Saturday, the pace of runners heading for the medical tent was consistent but far from overwhelming. Several patients clutched injured leg muscles, the pain showing in their faces. Some couldn't catch their breath and others appeared to be out of it — offering no protest when strangers gently steered them into a wheelchair.
In more serious cases, a doctor is always nearby to evaluate, and a team of EMTs are staged at the rear of the tent, ready to make a run for the hospital. Behind them, a smaller, air-conditioned tent is a makeshift intensive-care unit.
"When Dr. Motto determines the patient is too hot, they're taken into the A/C tent to cool off and be re-evaluated," Loeffelholz said. "We've been involved in this for a long time. Three months before now, we started meeting every other week — our medical tent staff, police, fire, emergency management and public health. When we're done here today, we'll have a debriefing. We've got it down, but that doesn't mean we can't learn something to make us better."
For instance, this year the medical tent had twice as many wheelchairs as in previous years.
As several dozen medical volunteers watched the clock for the arrival of the first runners at the finish line, a burst of cheers erupted, heading their way. The Bix's first corporate runner in the Isle Casino Beat the Elite challenge is one of theirs — Genesis Chief Financial Officer Mark Rogers, who came through with a Beat the Elite time.
"Mark!" one of the nurses shouted. "Mark, come get your free rectal temperature."
The end of the race marked the start of the real action for the medical tent. One of its first patients was a 16-year-old from Wisconsin, Hayden Fredrickson. His parents were notified in a phone call by a Genesis nurse that he was being treated.
While his mother said she was surprised he ended up in the medical tent, given he runs 10 miles a day, Fredrickson's stepfather concluded that he had simply pushed too hard.
As a doctor released the teen from care, and he was handed back his running shoes, another patient was pushed by him, headed for a cot.
The medical staff had a clear rhythm, watching the finishers, picking out the ones in trouble, then steering them into the tent. Walking alongside just about every wheelchair, George worked his role as triage.
"What's going on?" he leaned in and asked one runner.
"You OK? How you doing?" he asked another.
And walking backward in front of a stumbling runner, he smiled at him, saying, "Congratulations! How are you? Let's help you out."
The adrenaline at the finish line is contagious. As runners elatedly throw their hands in the air, stagger toward the water stations, high-five one another or are fingered by Genesis volunteers for their too-pale appearance, the energy in the air is unmistakable. The cheers, congratulations and community are the combination that keep the volunteers coming back.
"It's fun!" George said over his shoulder as he headed back into the street from the tent. "It's what we do — help people."