As Rachel Foster turned onto Boylston Street for the final stretch of the Boston Marathon Monday, she and her running partner, Tim Altendorf, clasped hands as they ran stride for stride. When they crossed the finish line, they raised their arms in joy.
In a race defined by hope and resilience, it was a touching moment of shared triumph. But what no one watching could have imagined is that just five months earlier, Foster, 35, had been in a coma for 10 days after a devastating electric scooter accident.
In what doctors described as miraculous, she woke up the day before she was to be taken off life support.
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For Rachel and her husband John Foster, 36, date nights were far and few between. The owners of a bustling Italian restaurant, where Rachel worked as head chef, they spent most of their waking hours running the business. But in November, the couple decided to take an evening for themselves and took a ride through their quiet neighborhood in Oklahoma City on electric scooters.
Rachel was just a few feet ahead of John when she seemed to lose consciousness. He watched in panic as her grip tightened on the handlebars and the scooter accelerated. A moment later, she fell and hit her head on the pavement. Rachel was rushed to the University of Oklahoma Medical Center a couple of miles away, where doctors said she had broken 17 bones and suffered a traumatic brain injury.
Through his shock and grief, John prayed for her survival. The doctors said they needed to perform emergency surgery and remove half of Rachel’s skull.
“That was a scary thing because she could die on the table,” John recalled in an interview this week after the race. “They basically said that was the big gun surgical intervention” needed to lower her brain pressure.
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After the surgery, Rachel remained in a coma for days in the intensive care unit. Her brain pressure didn’t fall. As her family waited desperately for any signs of improvement, the doctors delivered shattering news — her brain injury was so catastrophic that even if she did pull through, her life would never be the same, John recalled. She would require a feeding tube, a ventilator, and around-the-clock care. She might remain in a vegetative state forever.
As the days passed, the medical team tried everything to wake her up, but nothing worked. She had no brain activity. With her family’s support, John arranged a time the following afternoon to remove Rachel from life support. A deeply religious man, John felt at peace with the decision, despite his heartbreak.
Then, as John and Rachel’s sister looked on, her hazel-green eyes flashed open.
“We were freaking out,” John said. “It’s an impossible thing to happen, but I wanted it so badly and I was hoping it would, that when it happened, I wasn’t surprised. It just felt good.”
A nurse ran in, and then the doctor, who instructed Rachel to blink twice if she could hear him. She did. He told her to squeeze his hand and move her feet on command. She did. The doctor turned the ventilator off and asked her to breathe on her own. For the first time since the accident, she did.
When a neurosurgeon who had operated on Rachel visited her hospital room a few weeks later, watching as she interacted with the nurses, he was stunned, John said.
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“I looked at him and I said, ‘Isn’t this amazing?’ He went to approach her bed and he said, ‘No, this isn’t amazing. This is a miracle, and nothing that I did and nothing that my team did would cause an outcome like this,’” John recalled.
Rachel remembers waking up in her hospital bed, utterly confused and blinded by pain. She had no memory of the scooter accident, no idea she undergone brain surgery. She recognized her loved ones, which brought some comfort. But learning the names of everyone on her medical team while regaining her memories felt like piecing together an unsolvable puzzle.
“I felt very uncomfortable. I pride myself to be the kind of person that likes to prepare for things ahead of time, and I just felt utterly, completely unprepared for what was happening to me,” Rachel said. “Just trying to piece together things that I didn’t have enough of the pieces to piece them together. It was a waiting game but a very, very frustrating one.”
But she made remarkable progress. By mid-December, the director of emergency medicine at the hospital used a “Star Trek” reference to describe her recovery. If people were starships, she told the couple, then Rachel was traveling at warp speed.
Around that time, Rachel went to the Shepherd Center in Atlanta to continue her rehabilitation. But one month after her surgery, she developed a painful complication known as sinking flap syndrome and required a second operation to restructure her skull and alleviate the discomfort.
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The surgery was a success, and as Rachel embarked on a grueling rehabilitation, she set her sights on a seemingly impossible goal — to run the Boston Marathon in April. She had run nine marathons and had qualified for Boston a second time by finishing the 2022 Oklahoma City Marathon the previous spring with a time of 3:17:15.
Now, she wanted to reclaim her love of the sport, her desire to compete against herself and others, as part of her recovery.
“I felt like nobody can take this away from me. All I need to do is put on some shoes, and off I go,” Rachel said. “I just wanted that so much. Running has been a passion for me for as long as I can remember. I knew that I was in rough shape. I knew my body had been through this crazy accident, but I just didn’t know the extent of it.”
At first, the smallest movements took an immense amount of willpower. She learned how to stand, keep her balance, and walk. Therapy lasted for hours a day, followed by more exercises at home.
In the hospital, her muscles had atrophied and her weight had fallen to just 80 pounds. To build up her strength, she did countless squats and lunges and ate as much as she could. At the same time, she worked on improving her cognitive function with a range of tasks involving memorization, problem solving, and deductive reasoning. She was constantly exhausted but determined to push through.
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“All of the work that I had put in before the accident, all of the hard work of running all the time and training my body, it all seemed to just kind of disappear,” she said. “The thought of the [Boston] Marathon pushed me to do better. If I didn’t follow through, I was never going to make it to this marathon.”
After staying at the center for rehab in Atlanta, she was released to outpatient therapy from the end of January to the end of March, a little more than three weeks before the race. Above all, it was John who inspired her to keep working, like the crowd at a marathon.
“You’re almost there. You got it. Go, go, go. Be strong,” Rachel recalled him saying. “John was my cheering squad, and honestly I just felt so loved. To this day, he is my knight in shining armor.”
Rachel met her running partner, Tim Altendorf, at the local YMCA in 2014. The two were taking a spin class, and she recalled how he seemed eager to outperform her.
“It just caught my eye because he’s older,” she said with a laugh. “Here I see this guy trying to beat me. Like no way you’re gonna beat me dude, what are you thinking?”
Altendorf, 66, said he was awed by her vigor and endurance. He figured if he couldn’t best her on the bike, maybe she could help him improve his running performance. They agreed to meet for a run one weekend and have run together since.
Over time, their friendship developed into a father-daughter type bond, where they could enjoy each other’s company without needing to say a word. No one fully understood her drive to compete or love for running, Rachel said, until she met him.
Altendorf was devastated by Rachel’s accident. He was the only person outside the family they invited to see Rachel while she was in a coma. When she awoke, he made repeat visits to the hospital to check up on her.
Over the summer, Rachel had convinced Altendorf to run Boston again with her, and he joined a charity team and “reluctantly” started a training program. The plan was for them to run the race at their own pace, then meet up to celebrate.
But the accident changed the equation. They decided to run side by side the whole way.
“She’s the most determined person I know. She doesn’t take no for an answer,” Altendorf said.
Most of Rachel’s training was at the Shepherd Center, where she ran laps around the track above a basketball court. Her longest run was 10 miles, far less than her usual long runs leading up to a marathon.
When she returned to Oklahoma City, she and Altendorf ran together just once, a few weeks before the Marathon. The next day, Rachel suffered a groin injury that forced her to modify her training and bothered her throughout the race. She also continued to struggle with her vision and coordination, and during the Marathon Altendorf would ask how she was feeling.
