A Mystery
Victoria St. John had always been quick – that was for sure. While she participated in the full gamut of youth team sports—from basketball to soccer and volleyball—it was apparent from an early age that the tall and athletic Holy Trinity sophomore belonged on a track.
“I'd say it was in the sixth grade that we realized she had potential as a sprinter,” remembers Linda St. John, Victoria's mother, who enrolled her daughter in CYO Track & Field as a kindergartener. “She was growing taller and people were asking her if she wanted to play basketball. She tried basketball and didn't really like it. After that she just sort of settled on track.”
St. John ran CYO meets until seventh grade, strutting her natural talent, but more importantly to her at that stage, having fun. “I ran from kindergarten to seventh grade,” recalls St. John. “In the CYO we didn't even have block-starts or know our times. At that point, I didn't know how serious track could get. It was a lot of fun.”
But something wasn't quite right. While St. John was outrunning her competitors almost every meet, some exertions left her dizzied and breathless. The fainting spells, which always followed aerobic activities, first began in fifth grade when a carefree warmup jog in gym class caused St. John to lose consciousness. It would be the first of three such incidents that year.
St. John and her concerned parents sought medical advice. “Vicky's pediatrician simply said she was out of shape,” recalls Linda.
Unsatisfied with the diagnosis, an array of diagnostic imaging were undertaken, including X-rays, MRI and CT imaging. But, frustratingly, the battery of tests yielded no clear answer.
The episodes, however, kept coming. “It happened again in sixth grade when I was warming up before a basketball game,” said St. John. “In seventh grade it laid dormant, but in eighth grade I passed out a few times. During winter of my freshman year I had my worst episode and I wasn't cleared to rejoin [the track team] until the spring.”
“She kept going to these hospitals, but the doctors could never tell us what was going on,” remembered Linda. The uncertainty of the condition—both as to its nature, and when it would strike again—was maddening. “Every time she competed in a race, I made sure I had my cellphone, because I never knew when it would happen again.”
The electrocardiograms (EKGs) always had normal readings, and Victoria's hospital discharges began to pile up. The type of physical exertion leading up to the blackouts was always the same: easy, repetitive cardiovascular activities, such as jogging. The diagnoses were equally constant: always ambiguous; never giving the St. Johns a clear course of treatment.
Nevertheless, amidst the looming medical concern, St. John continued to excel on the track. Missing the majority of her freshman indoor season, she was able to return for the outdoor season and take the CHSAA by storm, lowering her 100-meter dash from 13.24-seconds to 12.69-seconds in the span of just six weeks. St. John's brief frosh campaign culminated in a fifth-place 100-meter finish at the CHSAA Varsity Intersectional City Championships.
“Freshman year was a very good year,” reminisced St. John when asked about her competitive outlook heading into her sophomore year. “Leading into this year, I was very excited and optimistic, looking to improve.”
There was a giant caveat, though.
“I was extremely happy and eager, but also kind of paranoid due to the constant fainting and collapsing,” St. John qualified. “Every time a season began I got this leery feeling that something would go wrong.”
An Anomaly
Buoyed by her freshman year breakout, St. John decided not to participate in a fall sport, electing instead to focus her energies on preseason conditioning with Justin Renna, Director of Track & Field at Holy Trinity.
According to St. John, the workouts were voluntary, offering an opportunity for dedicated athletes to set a foundation for the winter and spring.
“Some of the girls come out for preseason,” said St. John. “It wasn't mandatory – just basically conditioning – nothing intense. We did a couple of 200s at most.”
Most sessions were unremarkable, but neither St. John nor Renna will ever forget the afternoon session of September 17, 2013.
It was supposed to be a “moderately intense workout,” composed of the usual regimen of repeat 200s. But Renna would later describe the experience as “a coach's worst nightmare.”
“I started jogging with a friend, warming up for the workout,” said St. John. “After about 150-meters I became tired and started feeling very out-of-it.”
St. John told her running-mate that they should probably slow down, but both girls maintained the pace. “I kind of wanted to finish my lap early, so I actually sped up towards the end,” recalled St. John.
By the time St. John joined her teammates at the pre-workout huddle, that familiar, uneasy feeling was coming over her.
“I got this very bad feeling. Normally I am able to come out of it by taking deep breaths, but this time I couldn't. Coach [Renna] looked at me, and we both realized what was happening. I collapsed in his arms.”
Renna, who called 911 within seconds, immediately assumed the worst.
“I thought we would have to do CPR – it was that scary,” remembers Renna. “She was passing in and out of consciousness. It was the scariest moment of my coaching career. I thought I was going to lose one of my athletes.”
St. John's teammates, who at Renna's instruction had moved to the other side of the track to make room for emergency personnel, huddled to form a prayer circle.
After a few minutes, St. John finally regained consciousness; finding herself surrounded by Renna, the Holy Trinity Athletic Director and numerous emergency personnel. An irregular heart-rate reading prompted rescuers to perform a field EKG.
“Normally they do an EKG when I get to the hospital, not at the scene,” said St. John, who would only later realize the importance of this early reading. “I don't remember what happened. I woke up and I was in an ambulance.”
St. John was transported to an area hospital for treatment and hopefully, finally, a diagnosis. Once at the hospital it was the typical series of questions and tests, including a second EKG. Business as usual, St. John readied herself for yet another hospital discharge. But just before she got the go-ahead to leave, there was a development: something, in the doctor's words, was “irregular.”
“The doctor came in and told me that I had an abnormal coronary artery,” recalls St. John. “The artery was wedged between my heart and a muscle.”
By comparing the field EKG with the hospital EKG, doctors were finally able to identify the problem.
“Anomalous coronary artery” is a blanket term for any abnormality or malformation of a coronary artery. In St. John's case, whenever she put stress on her heart, causing hypertrophy, her left coronary artery became choked off. Since coronary arteries are responsible for delivering blood to the heart muscle, St. John's heart would eventually become ischemic, or oxygen-deprived, causing her to lose consciousness.
Suddenly, it all made perfect sense. Since the onset of the condition, St. John's intense sprint efforts had left her unfazed, while seemingly easy, aerobic activities caused her to lose consciousness. Because high-intensity sprint sessions tap almost exclusively into an anaerobic energy system—requiring minimal transport of oxygen to her working muscles—St. John could blaze short distances without over-stressing her heart. It was a different story when the distance lengthened and St. John began to rely on aerobic energy pathways.
St. John's heart was working against itself, depriving itself of the oxygen it needed.
It was a moment of ambivalence. On the one hand, St. John finally had a firm diagnosis. On the other hand, the prognosis rocked her world.
“The doctor told me I would probably never run again,” recalls an emotional St. John. “That teared me up.”
Nonetheless, running career aside, St. John considered herself very fortunate to have finally identified the culprit. Individuals with anomalous coronary arteries who engage in strenuous activity are always at risk for sudden death. In fact, between four and fifteen-percent of young people who experience sudden cardiac death are found to have an anomaly of the coronary artery.
A Comeback
Open heart surgery was performed on September 26th to correct the anomaly. It was an invasive procedure requiring surgeons to reposition St. John's left coronary artery. Then the long road to recovery began.
“After the surgery I didn't feel much pain,” said St. John. “As the days went on, though, I began to feel bad. My dad stayed in my room with me, and it was a very emotional experience. It was torturous for me and I could see my father was upset.”
According to St. John, it was an ordeal she will never forget. Eventually, after one week of postoperative care and rehabilitation, she was discharged. On October 12th St. John returned to school, and to her fellow track teammates' embrace.
Of course, at this point, there was no talk of St. John lacing up the spikes in the foreseeable future. The prospect of St. John competing for Holy Trinity ever again remained a long-shot, let alone during the fast-approaching indoor season. These odds did not prevent St. John from being on the track in some capacity.
“Within a week of surgery, Vicky was on the track supporting the team,” recalls Renna.
St. John stuck diligently to her rehabilitation plan, which only permitted her to jog easily for very short distances. “I never really got clearance from my doctor to run indoors – she said I could jog here-and-there, but she never really gave me the go-ahead.”
But with each follow up visit, the doctor's prognosis became more-and-more optimistic. What was once a ban on future competitive running had suddenly turned into a brief hiatus from the sport – the length of which lessening with each visit.
“When she came out of surgery, her father told me there was a chance she could be back next year,” recalls Coach Renna. “I was thrilled that there was talk of her even coming back at all. From that point, it seemed like after every doctor's appointment her recovery time went down like two months.”
By the time indoor track practice officially began late-November, St. John was on the track, vying for a spot on the team's vaunted short relay teams.
“She found out around Halloween that she'd be cleared for Thanksgiving,” said Renna. “And then the week after Thanksgiving, she was there and running. The entire team was lifted. Without Vicky we were missing a key element. When she came back, everyone just kind of looked up to her.”
While the return, coming just two months after open heart surgery, seemed inexplicable to her teammates, St. John didn't make too much of it, at least at first. “Everybody was talking about how they couldn't believe I was back. I didn't read much into it, but then it struck me. It was such an overwhelming feeling.”
While, by virtue of the fact she was training again, St. John already considered the indoor season a success, her competitive drive began to stir. “I was very fortunate just to be back,” remembers St. John about her early-season mentality. “However I really wanted to pick up where I left off. I was scared that surgery would weaken me. I know it was done to make me stronger, but I felt like I would never be the same.”
St. John would only have to wait for Holy Trinity's first meet of the season, the CHSAA Relay Carnival at the Armory, to allay that concern. Running the second leg of the 4x200 relay, the final race of the evening, St. John was reluctant before taking the baton. Her parents watching proudly from the seats above and her coach leaning eagerly against the trackside railing, doubt crept in.
“A lot of thoughts were going through my head. I didn't want to let my team down, that was the main thing. I wanted to give them everything I had. But when I got the baton, I stopped worrying. I just took off.”
A Lesson
The past six months have redefined St. John's approach to training and competition. Before the surgery, every stride was a leap of faith for the young sprinter – never knowing which bound could mean collapse. With the enigma finally solved, St. John can now train and compete with vigor, instead of relying entirely on her natural talent.
“As an athlete I became more motivated than ever,” said St. John about her post-surgery competitive outlook. “Freshman year I was good, but I didn't work hard because of my condition. I felt fast, but I didn't feel like I earned it. But now that I overcame surgery and I'm racing again, I feel like I can earn it”
St. John sure earned it in her first race back at the Armory. Grabbing the baton in a fury, the young sprinter blazed to a 26.5-second split: her best time ever.
“When I took the baton, I just tried to have fun with it. I had a lot of flashbacks to surgery and all the fainting. Normally when I run longer races like the 200, I slow down toward the end because of the condition. This time I just ran through it.”
St. John was back in a big way. After handing off the baton, she was overtaken with emotion.
“It was overwhelming,” she remembers. “I wanted to cry.”
St. John's parents had similar sentiment. “Having her back on the track confirmed my faith in God,” said Linda St. John. “Anything is possible if you believe.”
St. John recently capped off her comeback season at New Balance Nationals in New York City. A bad handoff would not prevent her from achieving a personal record 26.1-second 200-meter leg in the Emerging Elite Spring Medley Relay.
Based on her freshman times, Coach Renna believes St. John can be one of the state's premier short sprinters by graduation. “We are looking to get her under 12.5 in the 100-meter. If she keeps this up, she could be one of the fastest girls in the state by her senior year.”
St. John shares the aspiration, but is currently focused on the collective success of Holy Trinity's 4x100 meter relay squad. According to the quick sophomore, her team is poised to be “dominant” this spring.
But even if the team disappoints, and she is never crowned fastest runner in the Federation as a senior, St. John will be just fine.
“This experience has taught me to open my eyes. It was a life lesson – you never know when it can be your time. Do everything you can. Value your life”