On a routine day at the Vinson Health Center, physician Keith Williamson spends time dealing with flu-like symptoms, sinus infections and allergies. But for a few days a year, he leaves the relative calm of dealing with normally healthy college students to serve as medical director of the largest century bike ride in the United States.

“Out here I am the king, and I have to make all the calls,” he said. “It’s like an emergency room. We treat everything here. However when I’m on campus, I have a lot of support. It’s a lot calmer considering it’s not an emergency room environment — it’s primary care.”

The excitement, spontaneity and alertness, in addition to the increase of authority, he said, is always an adventure compared to the steady and consistent flow of his job at the health center, noting that he has been working at the race since 2001.

Williamson recalled an instance when a lead rider was racing through Iowa Park.

“They go through there very quickly, maybe at about 30 mph, and a person stepped out in front,” he said. “The leader and the other guy both ended up with intracranial bleeding,” Williamson said. “The cyclist ended up having to go into surgery, and the other guy ended up just waking up and walking out of the hospital.”

Some “emergencies” wind up just being false flags, however, recounting a race a few years ago.

“About 10 a.m. or 11 a.m., I get like three dozen calls all at once requesting an ambulance, stating that someone looked like they were dead at stop six,” Williamson said, “Everyone was in a panic and all of the ambulances were out. When one of them was finally available for pick up, the man was nowhere to be found. A rider had gotten tired, pulled over into the shade and fell asleep.”

Williamson recounted that nurse’s assistant decided he was dead and started performing CPR. He said he imagined that this guy wakes up, everyone discovers that he is just fine and he rides away.

Heat cause of most incidents

But not all calls are false calls, and many of the real incidents are heat-related.

“The hottest ever recorded by the weatherman during a race was in 2011 at 109.5 degrees Fahrenheit,” Williamson said.

However, Williamson said he doesn’t rely on the temperature given on the local news. Instead, he has a meteorologist take the outdoor temperature every hour in Hell’s Gate and then rate the heat intensity by the heat stress calculations.

He said the highest heat stress during HHH was in 2002 when it was 96 degrees Fahrenheit.

“We still had people staggering in,” he said, noting that at some point, someone has to stop the race to prevent more injuries.

“If the temperature gets too hot, we use Hell’s Gate as the stopping point and instead of keeping the cyclists on the longer path, we block the road and they take the shorter route back to the finish line. It takes 40 miles off of the ride.”

Williamson said he has had to shut down the race and redirect cyclists about four times.

Student athletic trainers help too

In addition to Williamson’s service, athletic training students volunteered in shifts, two or three at a time, under direction of Ben Velasquez, chair of athletic training and exercise physiology. Velasquez said he has been working at the medical tent for four years, providing instruction to his students and services for wound care, heat exhaustion and muscle cramps.

“The students gain an array of experience working with a range of age groups and injuries while working in HHH,” Velasquez said. “They get to encounter heat related problems, wounds from falling off bikes and other general medical injuries that result in participating in HHH.”

Velasquez said that between 7 a.m. and 10:30 a.m. the students see fractures, sprains, road rash, heat exhaustion and general medical conditions.

“Some of the riders also have problems with their hearts,” he said. “The rest of the day is mostly filled with heat-related problems and cramps.”

During HHH the medical tent volunteers could potentially treat hundreds of people, yet, because doctors and nurses on the scene could provide definitive care, few had to go to the hospital.

“Throughout the day we had over 100 people injured that were documented, and 14 that I’m aware of that had to go to the hospital,” Velasquez said.

Velasquez said he was pleased with the students that worked in the tent at different shifts over the course of the day.

“They did an excellent job in assisting with cramps and heat exhaustion,” Velasquez said.

Velasquez also said it gives them the opportunity to work in a situation in which they do not and will not know what to expect.

Stormi Thomas, senior in athletic training, described the event as “busy and hot.”

“There were a lot of injuries like road rash and there was a guy with a broken clavicle. It was fun,” Thomas said.

Yet he said it wasn’t any specific injury that caused stress. It was more the number of injuries and dealing with multiple patients at one time.

“It required you to think on your feet, be hands on and quick,” she said. “It wasn’t just one athlete at a time.”

Madalyn Miller, senior in athletic training, claimed she got to experience a lot of heat illness and injuries.

Both Miller and Thomas agreed that the HHH experience was educational and beneficial to their training as students.

“Talking to the doctors there and getting their perspective on treating everyone was very helpful,” Miller said.