It happened somewhere between mile 1 and mile 13.1. A complete stranger ran up behind Natalie Spiller, tapped her on the shoulder, and spoke the words she needed to hear.
“I’m the father of one of the kids in your program,” he said. “I can’t tell you how much this means to me.”
Spiller nodded and kept running, the telltale red shirt she wore flapping in the wind. Before the race, she had told her mother, “I know I’ve trained, but I don’t know if I can finish.”
All the doubts, all the weariness, all the mundane step after step after step faded in the face of a singular determination, rekindled by the words of a stranger.
Natalie Spiller wasn’t running for personal accolades or to prove something. She ran—and finished—for someone who couldn’t run. That someone was Moriah Bonner, a toddler running her own race against sickle cell anemia. Spiller's medal would be a physical way to honor Moriah’s fighting spirit—her mettle.
Run for a Greater Good
In 2003, Steven Isenberg, a head and neck surgeon in Indianapolis, ran the Chicago Marathon and then paid a visit to a friend in a hospital who suffered from prostate cancer. Isenberg gifted his friend with the marathon medal he had just won and reportedly said, “You are running a much more difficult marathon than the one I completed.”
Isenberg’s friend eventually died as a result of the cancer, but the simple act of awarding a runner’s medal for a patient’s mettle started a tradition that has run laps around the world. The Medals4Mettle program accepts medals donated by marathon runners, outfits the medals with a colorful band, and then distributes them to children and adults who are fighting for their lives against critical and sometimes life-threatening diseases.
In 2009, the program came to the University of Louisville School of Medicine. It was organized by then-student Riley Jones and supported by former UoL Chief of Pediatric Oncology and Hematology Salvatore J. Bertolone Jr. That first year, 11 medical school participants ran for pediatric patients in the Kentucky Derby Festival miniMarathon (13.1 miles) or Marathon (26.2 miles). The runners then gave their medals to patients who wanted to participate in the program. By 2016, the chapter included 87 UoL medical school runners, one of whom was Natalie Spiller.
Spiller had never done distance running before. In the fall of 2014, her first year in medical school, she received an email that changed more than just her schedule and her activity level; it changed an entire way of thinking.
“They asked if there was anyone who wanted to help kids get through hardship,” Spiller says. “If there was ever a reason for me to do something crazy, like run a half-marathon, then it would be for me to make a kid’s life better.”
Spiller started training, beginning with 3-mile training runs in January and eventually working her way up to 13 miles. In addition to distance runs three to four times a week, she also cross-trained with yoga or swimming that gave her muscles a chance to relax and stretch.
For normal folks who train for marathon-esque runs, the schedule can be grueling, but the students who have participated in the M4M have the added pressure of early mornings, lectures, hospital rotations, studying for exams, seeing patients, and meetings of all types.
For Spiller, though, working in the additional training schedule just seemed like the right thing to do.
For the 2014-2015 medical school year, Spiller was paired up with Mary Kate Dole, a 10-year-old cancer patient running a race against acute lymphoblastic leukemia.
“She was just an inspiration beyond anything in the history of the whole world,” Spiller says. “Here is this 10-year-old girl going through cancer treatment. She was so cute, so nice … she always wanted to know what was going on in my life, and she thought doctoring was the coolest thing ever. I couldn’t believe that something that seemed so simple to me—running for somebody and getting a medal for somebody—made such a big difference in her life.”
In Spiller's second year, Mary Kate’s cancer had gone into remission, and she insisted that Spiller run for another child who needed her more. Spiller was then matched up with Moriah, who will be 2 this year. The toddler’s sickle cell anemia causes her red blood cells to be shaped like a sickle. The trouble with sickle cell, Spiller explains, is that the cells can’t hold much oxygen, and they often stick together, producing painful and dangerous situations.
The chapter’s motto, “There is always someone fighting a worse battle than you are,” is on the back of its red team shirts. It’s also in the back of Spiller's mind while she trains and while she races.
“You think you might have something bad you are going through, but see that little 2-year-old over there? She has to have a blood transfusion every three weeks just so she doesn’t have a pain crisis,” Spiller says. “It’s helped me realize I’m very lucky, and because of it, I should give back.”
Beyond the Race
One way of giving back is to run, but another way is to take on a leadership role in the program, which is exactly what Spiller did in her second year. Now, she is the chapter chair of the UoL organization and actively encourages others to use their running gifts to help patients. This year, the chapter opened up the M4M to include not only medical students, but also students in the dental, doctoral, nursing and public health programs. This year marks the largest UoL M4M group to participate, with more than 100 runners signed up.
Second-year medical student Andy Sims learned about the program from Spiller. This year is his second miniMarathon for the M4M Louisville chapter.
Sims is an Owensboro native, interested in becoming a surgeon but keeping an open mind throughout his schooling. He runs for Logan Collins, a 6-year-old with acute lymphoblastic leukemia.
“Some days, you are going to run, and it will be crappy weather. Or you’re just tired, and it’s a mental thing to go out and run, but it is pretty often that I think of my little buddy, Logan, and then I realize I’m complaining about a little bit of rain, and he’s going through chemotherapy,” Sims says. “It helps to put things in perspective and gives me an incentive and extra motivation.”
The difference the program has made in Logan’s life is something for which his parents, Josh and Laura, are grateful.
Logan was diagnosed with ALL on June 6, 2014, when he was 3. Over the years, Josh says that Logan’s “acute leukemia was met with acute treatment” to rid him of the cancer.
Logan is pretty much like every other 6-year-old in terms of hobbies and favorite things. He loves superheroes, Pokemon, Power Rangers and dinosaurs. The difference, of course, is that unlike most other 6-year-olds, he takes a handful of chemotherapy pills every night and has endured so many blood transfusions that his parents run an annual blood drive in Shelbyville for the Red Cross in Logan’s name.
His treatments are scheduled to end on Aug. 12, and his family is planning a big party. But for now, they take one day at a time and relish the thought of the annual medaling ceremony after the marathon. The ceremony usually takes place at UofL’s Kosair Charities Clinical & Translational Research Building.
The day of the race, the runners begin their endurance challenge around 7 a.m. Most racers finish the 13.1 miles within a few hours, and then have a chance to rest and clean up before the official medaling ceremony begins in the early afternoon. In 2016, Isenberg himself was included as one of the speakers, and then the runners presented their medals to their “buddies.”
Spiller says the event often includes tears and joy on both sides—the medical students who run and their buddies for whom they race. The parents also feel the effects.
“I can’t speak highly enough of Andy. The training, mental and physical strain of such an event are overshadowed by the relationship he has developed with Logan,” Josh Collins says. “He has attended numerous treatments with us, sometimes long days, sitting and playing with Logan.”
Where True Mettle Lasts
Sims can remember the first time he met Logan. It was an October morning after an important gross anatomy test.
“I got lost going to the clinic, and I was using my maps on my phone and went to the wrong place. And it was raining,” Sims recalls as he tells of meeting Logan at the clinic. “In the beginning of the program, it’s kind of weird. It says, ‘Hey, let this stranger come to your son’s doctor appointment,’ which can sometimes be a tense or stressful time, and a really vulnerable place. But Josh and Laura were so welcoming and nice.”
Logan was nice, too. Despite his illness, he taught Sims how to get down and play with dinosaurs. One of their favorite games was Don’t Break the Ice. It’s still a favorite today.
“Knowing I was running for him was awesome on so many levels because, as a student and as a future physician, I’m assuming we won’t get to spend time with families in this kind of capacity, getting to know them and getting to know the context of their life,” Sims says. “Usually, we will see them in a hospital setting or in an outpatient setting.”
Spiller agrees that having an opportunity to meet and interact with the patients they’re seeing in medical school has added a perspective unlike anything she has learned in a traditional classroom.
“The person is not their diagnosis,” Spiller says and then explains that knowing patients and their life outside of a clinical setting helps the medical professional determine the best course of treatment. This extra context includes the often-important social aspect and familial support, or the lack of such things, in a patient’s life. “It has helped to open my eyes to look at a patient holistically.”
Sims is also taking mental notes for the day when he leaves medical school and ventures into his own community.
“They tell us at school that we are leaders. We can impact the community more than just staying and treating patients,” he says. “Depending on where I end up and what the community is like, that could look a million different ways on how I can make the most impact. But the important thing is being on the lookout for those opportunities.”
For Spiller and Sims, as well as for their buddies, Moriah and Logan, the opportunity to honor the mettle that makes life worth living comes in April this year. Running for hope and running for help is a race like no other.