Dr. Jeffrey Luk, the medical director for the Cleveland Marathon, joined 3News to discuss how his medical team plans to keep runners safe at the 2026 race. The conversation centered on the preparation that goes into medical coverage for a long-distance race, work that happens mostly out of sight before the starting gun fires.

In a marathon, the medical director is the person responsible for the health of every runner on the course. The job includes deciding where aid stations sit, how many medical staff the race needs, and which hospitals partner with the event. It also covers the emergency protocols that kick in when a runner collapses, overheats, or needs urgent care. For the 2026 Cleveland Marathon, that work belongs to Luk, who laid out his team's approach in the 3News appearance.

The medical operation rests on a fact familiar to anyone who has raced 26.2 miles: sustained exertion takes a serious toll on the body. Runners lose fluids through sweat, produce heat they have to shed, and keep their legs and heart working for hours at a time. Most of the field finishes without incident. Some portion of any large race needs help, whether that means a seat in a medical tent or, in the worst cases, a trip to a hospital.

Race medical coverage at an event like this works in layers. Aid stations spaced along the course handle minor injuries and dehydration, and they catch early signs of trouble before small problems become emergencies. A larger medical area near the finish line functions as a field hospital for runners who struggle after they stop moving. Behind both is an emergency plan that includes ambulances on standby and relationships with local hospitals. The layers exist so that a runner in difficulty is never far from someone trained to help.

Much of what the medical team handles is routine. Blisters, chafing, muscle cramps, and stomach trouble bring runners to the aid stations in a steady stream. The staff treat those problems quickly and let runners decide whether to keep going. The routine work matters as much as the emergency work, because it keeps small issues from turning into bigger ones.

The medical director's work starts long before race morning. Deciding where emergency vehicles can reach the course, calculating how many staff each aid station needs, and reviewing forecasts for heat or storms are all part of the job. A course spanning more than two dozen miles leaves gaps in coverage that the plan has to close, and the plan has to assume that the worst cases, cardiac events and heat stroke among them, will happen somewhere along the route.

Weather is part of the calculation. Heat pushes the body harder and forces more careful monitoring at every station. Cold and rain carry their own risks for runners who slow down after hours of effort. The coverage has to work in both conditions, and the people running it only find out which forecast they face in the final days before the race.

The finish line comes with its own set of problems. Runners who stop suddenly after hours of running can find their blood pressure dropping quickly, which is why fainting and dizziness at the finish are common enough that the finish area includes staff ready to respond on the spot. Other runners cross the line, collect their medal, and collapse minutes later. The finish-area medical team is ready for exactly that sequence.

The rare emergencies get the most planning attention. Sudden cardiac arrest during a marathon is uncommon, but when it happens, minutes matter. Major races stock defibrillators at medical stations and train staff to respond to cardiac and heat emergencies. Heat stroke, which can be fatal if untreated, is another condition that race medical teams screen for at the finish and along the course.

Race day medicine is also a volunteer operation. Physicians, nurses, paramedics, and physical therapists give up their race days to staff the tents and stations, and their work turns a marathon route into a small medical system spread across a city. By the time the starting gun fires, the team has already worked out where people report, how supplies move, and what happens when a runner needs a hospital.

For runners, the payoff of that planning is simple. If you feel wrong at any point on the course, there is a trained person nearby whose only job is to help you. The system works so you do not need to be a medical expert to stay safe. You only need to speak up when something is not right.

Runners also carry their share of the responsibility. Start the race hydrated, be honest with yourself about injuries and health conditions, and do not push through dizziness, chest pain, or confusion. The medical team can treat a problem it knows about. It cannot help a runner who hides the warning signs.

Marathon medicine rarely makes headlines. The value of a public appearance by the medical director is the confirmation it offers: the planning for runner safety at the 2026 race is already underway, and the person in charge is speaking openly about the work. The visible drama of race day, the nerves at the start and the exhaustion at the finish, sits on top of a larger operation. The 2026 Cleveland Marathon will test the endurance of its runners. For the medical team, it is a test of preparation.