NEW YORK — Rachel Apa’s mother was waiting for her at Mile 25.

It was Apa’s first marathon. She was 24, an athlete, a former Division I field hockey player at Bucknell University. She had trained for this race, the New York City Marathon, for months.

At Mile 14 on Sunday, in Queens, Rachel’s mother, Michelle Apa, had taken a video of her daughter, all smiles, flying by in her light green top and shorts, high-fiving toward the camera. Then Michelle Apa headed to Central Park, toward the finish line.

Back home in Lewisberry, Pennsylvania, Rachel Apa’s father, Steve Apa, was tracking her on the marathon app, texting her encouragement at every mile. At Mile 18, she texted back “Ow.” At 19, she texted back “Ow ow.”

At Miles 20 and 21 and 22, she did not write back, but she kept running. “Final stretch,” Steve Apa texted at Mile 23.

He never heard back.

Near Mile 24, in Central Park close to 85th Street, a spectator named Michaela Nicholas saw the woman in green run by with the bib No. 29977 and the name Rachel on it. “Let’s go, Rachel, you got this!” Nicholas yelled.

Seconds later, Rachel Apa collapsed.

Nicholas, a hospital social worker, ran over and could not find a pulse. Her fiancee yelled for a doctor. Three people, two of whom said they were physicians, took turns administering CPR, Nicholas said. She held Apa’s hand and told her she was not alone.

The marathon’s medical staff arrived and used a defibrillator on the fallen runner, said the New York Road Runners, which organizes the marathon. Soon, paramedics arrived in an ambulance.

On the marathon tracking app, Apa’s parents could see that she was still at Mile 24. After minutes went by, Steve Apa said, his wife headed over. She got to the scene as the ambulance was pulling away. She went in a second ambulance to Mount Sinai Medical Center, where doctors tried to save her daughter’s life for more than six hours but could not.

The cause of death, Steve Apa said, was rhabdomyolysis, a muscle condition that can be brought on by exertion in which muscle breaks down and can poison the body.

“It’s unfathomable,” he said. “Perfect health, perfect shape, 24 years old.”

Nicholas said it seemed to take forever for formal help to arrive. According to time-stamped photos and videos taken by spectators and shared with The New York Times, Rachel Apa collapsed at 1:33 p.m. By 1:40 p.m., a redshirted marathon medical crew had arrived, and the defibrillator was used between 1:40 p.m. and 1:50 p.m.

“It was an unacceptable amount of time,” Nicholas said. Neither New York Road Runners nor the Fire Department, which operates the emergency medical services system, have responded to questions about when their personnel reached the scene.

Rachel Apa, a product manager for an electrical component company who had just started a Master of Business Administration program at Charleston Southern University, was running to raise money to fight Parkinson’s disease, which had killed her grandfather.

“My grandfather was one of my role models growing up,” she wrote on LinkedIn. “He taught me to stay active, push my limits, and embrace challenges.”

The New York Road Runners said that the last time a runner at the marathon died after a medical incident was in 2024.

“We are deeply saddened by the death of one of our runners following yesterday’s race,” the Road Runners said in a statement. “Our thoughts and sincere sympathies are with the runner’s family, friends, and the entire running community.”

In rhabdomyolysis, the breakdown of muscle sends proteins and electrolytes into the blood that can harm organs, strain the cardiovascular system and overwhelm the kidneys. There are about 26,000 cases of rhabdomyolysis reported each year in the United States, many of them among competitive athletes, although researchers think that number is most likely an undercount.

Rhabdomyolysis can be fatal if not treated promptly, said Dr. Bradley Uren, an emergency medicine physician at University of Michigan Health who sees cases of it each year, typically in summer.

With Apa, he said, it appeared that “that worst-case scenario happened just very, very quickly.”

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This article originally appeared in The New York Times.

By Andy Newman/Hiroko Masuike
c. 2026 The New York Times Company