Inside the Loudest, Rowdiest, Fastest Track on Earth

The morning of May 28 will begin in Indianapolis the way a Hallmark movie opens: all peaceful and beautiful. Julia Vaizer ’16MD will be wide awake as the darkness gives way to light. She envisions the first few hours going like this:

“There’s a thin layer of fog over the ground. The horizon turns into pretty colors. It’s quiet. And then the gates open. The sun rises and the crowd grows until you finally hear those sounds: ‘vroom-vroom!”

Her voice rises. “Just thinking about it gets me excited.”

On that Sunday, Vaizer gradually becomes a speck at the center of the largest and loudest single-day sporting event in the world: the Indianapolis 500. As the medical director for INDYCAR and for Indianapolis Motor Speedway, she’s one of the most important specks of all. It doesn’t matter that Vaizer is 33 years old and INDYCAR’s first female medical director ever. Under her leadership, a 200-person team of doctors, nurses and paramedics will care for a crowd that turns the speedway into second largest city in Indiana. At the forefront are the 33 racecar drivers traveling within inches of walls and each other at 230 mph. At least 220 pit crew members scramble around the braking cars. There are 230,000 fans in the grandstands and another 75,000 watching from the infield.

“We have to keep an eye on the Snake Pit, too,” Vaizer says, referring to the 30,000 people jammed together for an electric dance music concert near turn three, most of them oblivious to the cars circling them faster than single-engine airplanes.

That’s about 335,000 people and exactly one Julia Vaizer. She carries four radios and a ton of responsibility.

“It’s a big day,” she says, “and it goes by fast.”

Saturday Night: 14 hours to Green Flag

Vaizer’s medical teams practice every possible scenario, repeatedly, for a year. How do we respond to a multi-car accident? What if a spectator has a heart attack? What about heat stroke? How do we move an injured fan through the crowd and to the infield care center?

“The night before the race, I’m more confident than anxious. Our team is a well-oiled machine. I look forward to being at the track with these world-class doctors, therapists, and emergency workers, and also seeing our beloved athletes do what they do best. We’re all medical professionals, but we’re all race fans, too.”

Vaizer stresses the importance of sleep, but honestly?

“I don’t sleep much the night before.”

Sunday 5:45 a.m.: 7 Hours to Green Flag

Hydration is crucial. Temperatures at Indianapolis Motor Speedway can reach the 90s on Memorial Day weekend. All members of the track response team are required to wear the same racing suits the drivers wear, down to the socks, shoes and helmets.

“We need to feel the same heat and same weight that the drivers feel. It helps us understand how to treat them when something happens.”

By race day the team has simulated dozens of possible situations, tending to each other on tables and in actual Indy cars. They’ve worked in tight spots together.

“We’ve clunked helmets,” Vaizer says. “We need to know what that’s like, too, before it happens for real.”

Sunday 8:45 a.m.: 4 hours to Green Flag

Spectators steadily pour through the gates. Dozens of medical carts roam the open spaces. The 18 first-aid tents stand as rescue beacons for the afflicted. It won’t be long before someone needs stitches or attention for a diabetic emergency.

“Our goal is to handle as many needs as possible at the track and alleviate pressure on the local hospital. They’re busy enough with patients from the community.”

Vaizer knows this because, in addition to being INDYCAR’s medical director, she’s also an emergency medical physician and instructor at Indiana University Methodist Hospital, the largest trauma one care center in the state.

“It keeps me moving,” she says without a hint of exasperation. Her INDYCAR responsibility alone extends 17 races, starting with St. Petersburg in March and ending in California six months later. She also coordinates medical staffing for nearly 70 testing and event days at Indianapolis Motor Speedway.

“There are a lot of big weekends,” Vaizer says, “but there’s nothing like the day of the Indy 500.”

Sunday 10:45 a.m.: 2 hours to Green Flag

When the first spectator collapses, an emergency worker will arrive in seconds.

“Our responses become like muscle memory from practice,” Vaizer says. “My job is to make sure we’re keeping up with demand. How many beds are still available? Do we need an overflow tent? What’s the data on our patients?”

She occasionally pulls out one of those radios to ask a question:

“How are things over in the Snake Pit?”

Sunday noon: 45 Minutes to Green Flag

As if the world’s biggest one-day sporting event doesn’t provide enough action, there also has to be a daylong concert in the middle of it all. The Snake Pit is everything you imagine it to be. Bodies slamming. Ankles twisting. Partygoers overindulging.

“If someone is in need, we wade into the crowd and move them to a field medical tent where EMS specialists care for them,” Vaizer says, as if describing the work of a special-ops unit. While they work, the music continues through pre-race buildup and all 200 laps of racing.

Sunday 12:38 p.m.: “Drivers, Start Your Engines”

The rumble of horsepower mixes with the roar of more than 300,000 fans. Even the coolest medical professionals are not immune to goosebumps.

“None of us does this ‘just because,’” Vaizer says. “We genuinely enjoy the racing scene.”

Let’s tap the brakes right there and ask the obvious: How did Vaizer arrive here anyway?

“It’s hard to pinpoint,” she says.

Vaizer came to the U.S. from Eastern Europe on Christmas Day in 2005, knowing only a few English words. She jumped right into classes at a junior college a few days later. To learn the language, she listened intently and read nonverbal cues, which in hindsight made her a better doctor. Then, as a pre-med student at the University of Florida, she volunteered as an emergency medical technician and bought a Kawasaki Ninja 250.

“Parking spaces were limited. The motorcycle was convenient. And I like to go fast.” She joined a motorcycle club, learned about safety, and watched MotoGP races on TV. During those races, she’d wonder, “When they crash, how does the medical response work?”

12:45 p.m.: The Green Flag Flies

Vaizer keeps at least one eye on the track at all times. In 106 runnings of the Indy 500, there has never been a crash-free race.

“When an accident happens, our trucks go out immediately. No one walks. We sprint. A driver might have only so much time. During practices, we put a fully-geared person in a tub [the capsule where a driver sits] and go through real-time situations. Do we need to pull the driver out? Are they conscious? Are they stuck? What’s the best way to cut the car to extract them? Every person knows what to do because we’ve rehearsed it.”

2:00 p.m.: The Cars Are a Blur

Every type of medical training will be used today, which points to how Vaizer emerged as INDYCAR’s medical director. During medical school at UCF, her mentors, James Sanders and Mänette Monroe often said, “Pick what you like to do and we’ll back you up.”

“I’m not sure they expected me to choose motorsports medicine,” she says. “But they helped me find opportunities to learn and advance.”

Vaizer became the only person in the world to complete dual fellowships in motorsports medicine and EMS, doing them at the same time. She also spent a two-week vacation in Germany doing something very un-vacation-like: cramming in an intense motorsports training course and learning about medical management at a local track. When longtime INDYCAR medical director Geoffrey Billows decided to step down in 2022, his assistant with the attentive eyes and ears was a natural successor.

“My training could be exhausting at times,” Vaizer says, “but it prepared me for this.”

2:45 p.m.: The Indy 500 Winner Rolls Into Victory Lane

On TV we watch the milk celebration. Behind the scenes the medical team has to check the drivers who have fought heat and g-forces for three hours, ensure no more fans collapse as they head to the exits, and tend to the final patients in the Snake Pit.

One of Vaizer’s most trusted deputies, Angi Fiege, will have her back to the very end.

“I worked with Angi when she was an INDYCAR physician and medical director for NASCAR. I was always asking her the same question: ‘How do you do that?’ Now she’s supporting me. Passion and perseverance are important, but I could not do what I’m doing without my mentors.”

This is why she launched the first motorsports medicine fellowship in the world, so emergency medical trainees can ride in the trucks, practice over the tub, learn first-hand, and become another Julia or Angi.

“That’s my dream,” Vaizer says.

3:30 p.m.: Final Laps to the Finish

One scenario raises the urgency to another level: fire in the car. The team has choreographed this, too.

“The first medic out of the truck runs to the driver and shields the driver from the flames,” Vaizer says. “Then the first firefighter runs to shield the medic. They have exactly 26 seconds to suppress the fire or pull out the driver before second-degree burns set in.”

Once everyone is safe, they hustle off the track so the race can continue.