The homeless woman was nauseated, dizzy, drenched with sweat, dehydrated and sobbing with fear. She had heat exhaustion and was on the verge of heat stroke.
But she had come to the right place, a church turned into a refuge from the overpowering heat.
"She was out of her mind almost, just mentally, emotionally and physically drained," said Arlene Atkin, a registered nurse and pastor at North Hills Church. "She was absolutely at the point of going under."
Atkin put the woman under a shower and gave her all the water she could drink — actions that may have saved her life that searing day last summer. Not everyone in the same situation is so fortunate.
In recent years, deadly heat waves have killed dozens to hundreds of people at a time in various U.S. cities, often catching local officials unprepared. Climate scientists say more killer heat waves lie ahead with global warming, and city officials are taking note.
A number of cities — especially those hard-hit in the past, such as Chicago, Philadelphia and Phoenix — get aggressive when a heat wave emerges. They open cooling centers, hand out water bottles, go door to door to check on people, and even ask utilities not to shut off electricity to late-payers during a heat wave.
In recent days, much of the country has experienced dangerously high heat.
Denver just shattered a 134-year-old record of temperatures topping 90 for 19 days in a row. An excessive heat warning is in place for Phoenix, which is expected to top 110, with lows falling only to around 90.
Nashville was forecast to reach a near-record 98 on Sunday. High humidity made it feel like 100 degrees in much of South Carolina and 107 in Austin, Texas.
More extremes 'already started'
"It's already started," said Gerald Meehl, senior scientist at the National Center for Atmospheric Research in Boulder, Colo. "As the average climate warms up, the heat extremes will become more extreme, and we'll have more intense, more frequent and longer-lasting heat waves as we progress through the 21st century."
So far this year, roughly 50 people have died from the heat, according to news reports.
Heat waves lack the dramatic destruction of earthquakes, floods, hurricanes and tornadoes, but at 8,015 deaths, heat has killed more people in the U.S. than all those other weather events combined in the 24-year period ending in 2003, according to data from the Centers for Disease Control and Prevention.
"It's sort of been the quiet killer for many years," said Tony Haffer, meteorologist in charge for the National Weather Service in Phoenix.
Many cities have learned that the hard way.
Most of Phoenix's now extensive efforts began after the summer of 2005, when temperatures hit at least 110 on 24 days; 80 people died.
Chicago's 'awakening' a decade ago
A decade earlier, it was Chicago that was suffering with more than 700 heat deaths. During that heat wave, the morgue got so full that bodies were kept in refrigerated trucks. Most of those who died were elderly, living alone and without air conditioning.
"It was a real awakening," said John Wilhelm, who was deputy commissioner of public health. "There were a number of days where the body count kept increasing and there was absolutely nothing you could do because the heat had already taken its toll. It was a helpless feeling."
Now other cities are acting before they get to that point.
Seattle has begun educating the public about the dangers of heat and directing people to seek air conditioning. At large public events, Boston has begun putting up "rain rooms," giant, portable, tent-like structures that spray a mist. In the San Francisco Bay area, the National Weather Service recently implemented a heat/health watch warning system.
George Luber, an epidemiologist who studies heat wave deaths for the CDC, pointed to Philadelphia as a pioneer at preventing heat deaths.
Philly system a worldwide model
After a 1993 heat wave killed at least 118, Philadelphia became the first in the country to begin a heat/health watch warning system. It's now a worldwide model for forecasting heat, with 18 other metro areas copying it.
During a three-year period that began when Philadelphia instituted its system, an estimated 117 lives were saved because residents knew there'd be a dangerous heat wave, according to an article published by the American Meteorological Society.
Luber said about 18 to 20 cities nationwide have plans similar to one in Chicago, which opens cooling centers, holds news conferences and sometimes opens a command center with public safety and health officials.
There have been successes. Last summer, one man in St. Louis became so concerned about his elderly neighbor that he broke in when the man didn't answer his door, said Pamela Walker, director of St. Louis' public health department.
Walker said the elderly man was severely dehydrated and unconscious. "Another 24 hours, and he would have died," she said. He didn't.