Poor Callum Hawkins. He's delirious.
In temperatures nudging 30 degrees Celsius (85 Fahrenheit) on Australia's Gold Coast, Hawkins was ahead by more than two minutes when his legs buckled and he plunged onto a kerb.
Commonwealth Games organisers defended the medical response but criticised the bystanders for snapping the pictures.
Former athlete Steve Cram, commentating for the BBC, said it was a "disgrace".
"I'm just concerned for his welfare", Cram said.
Hawkins was quickly back on his feet but no more than 100m further on he hit the deck for a second time, only just missing a metal roadside barrier with his head as he fell.
On passing the distressed Hawkins, defending champion Shelley told reporters: "I wasn't sure what was going on. He's going to hurt himself and there's nobody anywhere near", he said.
This is a guy in real distress and someone needs to recognise it.
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"Where on earth is the help?" he said.
"I thought hopefully I can get to the finish line because I was starting to get cramps in my hands".
In response GOLDOC confirmed medical staff were posted at 500 metre intervals in the final kilometres of the course with radio communications.
Marathon world record-holder Paula Radcliffe tweeted that there were "big questions" for the organising committee and medical staff.
"Congratulations to all the runners who finished and fearless running from Robbie Simpson and Kevin Seaward but big questions for LOC [local organising committee] and medical support". "That should never happen", she said.
"Sometimes the medical people arrive and the athlete has to make a decision as to whether they go on or not and I understand that was a part of the discussion. The athlete will always want to finish but isn't able to think rationally at that point".
Mark Peters, chief executive of Games' organisers GOLDOC, promised to investigate the lack of immediate on-course medical care for Hawkins.
But he did say officials would review whether the response time was reasonable.
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"Certainly there's no reason for a deliberate delay". As you know the global rules are very clear in that an athlete has to declare themselves unfit to race (before they can receive any medical attention).
There are also strict rules around accepting medical help with athletes facing potential disqualification if they are assisted.
In the statement Peters said he "was concerned about the behaviour of a small number of bystanders who chose to take images". "This is not in keeping with the spirit of GC2018", he said.
In a heartwrenching moment, the Scot watched Australian opponent Michael Shelley run past him and claim gold.
"I saw him (Callum) on the Sundale Bridge and ... just tried to hang on".
Australia's Michael Shelley ran past the stricken leader, who by this point was being tended to, shortly after as the hometown athlete went on to triumph, with Hawkins' fellow Scot Robbie Simpson also passing him to take third on the line in a time of 2:19.36, nearly three minutes behind Shelley.
The Scotland team released a statement which revealed that Hawkins will be kept in hospital overnight as a precaution before follow-up checks by its medical team on Monday.
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