David Bruce said he started to feel a little worried as the Little Debbie Ironman Chattanooga approached.
Just like during Chattanooga's first two full Ironman events in 2014 and 2015, there would be 150 medical professionals from around the area under Bruce's direction on Sunday.
Only this time, it seemed like the heat was going to make a physically taxing day even worse for the 2,000-plus athletes attempting the triathlon, consisting of a 2.4-mile swim, 116-mile bike ride and 26.2-mile marathon.
So Bruce, an orthopedic surgeon at Erlanger hospital and Ironman Chattanooga's medical director, turned to his wife, Lisa Smith, who used her connections as an orthopedic surgeon at Erlanger Children's Hospital to recruit another 25 volunteers.
"That made a big difference," Bruce said. "It really did. It was unbelievable. It was so hot."
Erlanger officials said Monday that 611 athletes were treated in the Ironman medical tent on Sunday, mostly for heat-related illnesses as the temperature rose to 97 degrees and broke an 85-year-old local heat record for September 25. By comparison, 200 people were treated at the medical tent last year.
Fourteen participants wound up in the emergency rooms of Erlanger's downtown and east campuses, and more likely would have been sent that way if the emergency rooms didn't happen to already be having a busy day.
"Some patients, who we would have normally transported to the emergency room, we kept for an extra hour with more IV fluids, rather than get them to the hospital, because I knew they'd just wait for hours there," Bruce said. "So we may as well have them under our care, because we have doctors rotating in and out. And my volunteers really stepped up."
Bruce and Erlanger's Jerry McDonald estimated 350 fluid IVs were administered to competitors in the medical tent, which doubled in size when officials decided to annex the massage tent to get more space to treat the weary.
Men's professional winner Marino Vanhoenacker said that halfway through the bike portion of his race, all he could think about was getting back to the medical tent at Ross's Landing to drape himself in ice towels.
Many had to drop out miles away from that shady tent. Though the 2,716 registered athletes set a record in the third year of the event, just 1,651 finished in time to hear "Congratulations, you are an Ironman" at the finish line.
More than 2,000 athletes finished in both 2014 and 2015, when temperatures were cooler.
"We had so many drop out that I had to give three racers a ride back to downtown in my personal car," said local ultra-marathon runner Daniel Hamilton, who volunteered along the bike course with the LaFayette, Ga., high school cross country team he coaches.
Hamilton said he witnessed many competitors dropping out of the race and throwing up at their aid station, which was deep into Walker County, Ga., on the bike course.
"Purely from knowing what I know about physiology and how your body reacts, those Gatorades they were handing out to people had more sugar per milliliter than a Coca- Cola," Hamilton said. "That just shuts down your digestive system.
"I thought it was amazing how good of sports the athletes were. You didn't see people pitching a fit or getting mad. The people who had to stop, they knew it and just took it with a grain of salt."
Back in Chattanooga, those who survived to the run were greeted by a group of Fleet Feet Sports employees handing out iced towels near the intersection of Frazier Avenue and Tremont Street.
By early in the evening, Fleet Feet owner Steve Carter said the group ran out of the 200 towels they had brought.
"But people were still giving us their towels, hats and things to dip them in the water," he said. "Then we would chase them down and give them back.
"They looked so hot, and they loved those cold towels."
Contact staff writer David Cobb at email@example.com or 423-757-6249.