Julianne Vasichek was exhausted.
She'd been running for four hours. And she wanted to stop.
But she was running a marathon, and the finish line she was determined to cross was still three miles away. So Julianne moved forward, one agonizing step at a time.
Then she heard her name.
"Julianne!" called a familiar voice. "I found you!"
The voice belonged to Doug Simonetto, M.D., a transplant hepatologist at Mayo Clinic. He recognized Julianne by the date written on the back of her T-shirt: 2/28/15. It was the date of her liver transplant.
"Can I run the final three miles with you?" Dr. Simonetto asked.
Julianne offered a grateful yes. "Dr. Simonetto helped me keep jogging along," she says.
It wasn't the first time she'd benefitted from his support.
Julianne first met Dr. Simonetto in 2015. She'd been diagnosed with primary sclerosing cholangitis seven years earlier. The disease had initially remained relatively stable, but in February 2015, Julianne developed an infection that required hospitalization. Eventually, it would require a liver transplant.
Dr. Simonetto became part of her care team after her transplant.
Recovery was painstakingly slow for Julianne, a competitive athlete who was used to an elite level of fitness. She was a cross-country runner in high school, part of a team that won three championships in her home state of Montana. She'd seen even more success as a hockey player, playing for the University of Minnesota — Duluth and the U.S. Women's National Team.
None of Julianne's training could prepare her body for the impact of a transplant.
"When you are at square one of recovery, mustering the energy to get to the elevator or sit up and eat is challenging," she says. "Everything takes longer — and takes will and patience — in recovery."
Julianne had patience and will. And day by day, she grew stronger. But her recovery was not without setbacks, including four additional surgeries and losing 40 percent of her colon.
Still, she was determined to move forward. And nearly three years after transplant, she was able to leave Rochester and return to her adopted hometown of Duluth, Minnesota, where she was part of the College of St. Scholastic women's hockey coaching staff.
By the summer of 2018, Julianne was ready to reclaim her identity as an athlete.
"My first run was something I called a 'wog,'" she says. "I jogged so slowly that anyone could walk faster than me."
In August of that year, she competed in the Transplant Games of America, running the 5K.
"My goal was to run the whole race without stopping," she says. "It was a great honor to run among other transplant recipients, family members and donor families."
Last year, Julianne set another goal: She would run the 2022 Grandma's Marathon.
She'd run it twice before, in 2007 and 2009. This time, covering the 26.2 miles would have a new meaning.
"The marathon is a great metaphor for a lot of things in life," she says. "There are so many fascinating stories there. Everyone there has attached a different meaning to make it to 26.2 miles."
For Julianne, this marathon would be a reminder of her marathon recovery after transplant.
"When you're running a marathon, sometimes you are just working mile by mile, similar to working hour by hour with recovery," she says. "It's uncomfortable to run the marathon, and it's uncomfortable to recover from a transplant."
The race would also be an opportunity to do something else she's passionate about: advocate.
She wore a "Donate Life" T-shirt, serving as a walking (or running, in this case) billboard for organ donation.
"People were congratulatory and expressed awe for what it meant," Julianne says. "I wanted to inspire people to have the conversation about becoming a donor and to realize that their gifts can make a significant difference in the lives of recipients."
That's something Julianne knows firsthand, of course.
"I've had seven years of life and memories because of my donor," she says. And because of the care team that helped make the miracle of transplant possible.
"I cannot imagine the feeling that comes from saving lives, but I do know the other side —what it feels like to have your life literally saved," she says. "It's really hard to thank my care team enough."
Julianne's gratitude compelled her to reach out to Dr. Simonetto when she learned he would be running Grandma's Marathon, too.
"I thought it would be special to have a picture with him as a way for the care team to be reminded that their efforts do such good," she says.
The two had hoped to connect for a photo at the starting line but did not find each other before setting out on the course.
Which made their late-race meet-up even more meaningful.
"Seeing her running and making the most of her second chance at life after transplant was truly inspiring," Dr. Simonetto says.
And crossing the finish line together?
"It was emotional," he says. "We both teared up. Seeing Julianne get back to doing all the things she used to do before transplant, no matter how physically challenging, is incredibly gratifying."
The race was gratifying for Julianne, as well.
"Running a marathon was hard, but it will never be as physically and emotionally hard as what I have been working through for seven years," she says. "Running that day felt like a celebration of making it."
Editor's note: You can read more about Julianne's journey here. And the marathon wasn't her only race this summer. She also competed in the 2022 Transplant Games, winning gold medals in her age group in the 5K run, 20K cycle, corn hole (with her teammate and fellow Mayo Clinic patient, Carly Kelly, a three-time transplant recipient), and pickleball (with her teammate and fellow Mayo Clinic patient Cherie Ausk, a heart-lung transplant recipient). Julianne also won a silver in pickleball mixed doubles.