Michael is really suffering as more and more runners pass him.
And then Toby wins! Kelly, at the finish line, doesn't even notice him, so Toby has to congratulate himself: "And the winner is, Toby Flenderson!" He waves his arms in the air and everything, and for once it's more cute than pitiful. Kelly, texting on her phone, mumbles that she sees him and she'll write it down. Toby staggers into a chair next to her, looking around, and asks where they are. Kelly shrugs that they're five kilometres from the office. Toby: "You couldn't have made it a circle?" Isn't spending every other day spinning in circles enough?
Michael has stopped at the side of the road, his lips white and dried-out, to tell the camera that he's not going to finish, and that he can't beat rabies. Around him, the rest of the participants either stagger to the end (Kevin), get dropped off at the end (the beer-drinking cheaters), or bleed to the end (Andy, and ew).
Jim and Pam are wandering along the sidewalk, kidding around holding hands, when they notice Michael and detach. He tells them he can't finish. Jim says he's probably dehydrated. "What do you want me to do?" pouts Michael. Jim suggests a glass of water, but Michael's too busy self-pitying to drink: not only has he been defeated by rabies, but he's also upset about people who are deformed and diseased, and about underfunded symphonies and public TV. Jim tries to cheer him up by telling him what a great day Jim and Pam have been having (yeah, that...never works), and then Pam crouches down next to Michael to tell him that he'll probably never get rabies, so he doesn't really need to think about it. Michael mopes that if everyone felt that way, nothing would get done. Pam tells him gently that there are better people out there who can help. Michael chokes that Pam just doesn't think he can do it, and Pam says she knows him: "I saw you naked." Michael mumbles that she doesn't know him: "You've just seen my penis." He insists that he can make a difference; he started everything by hitting Meredith with his car, and he owes it to her to finish the run. He painfully staggers to his feet, refusing help, and sobs as we hear his concluding voice-over: he ate more fettucine and drank less water than he could have imagined, and the result was a triumph not of the human spirit, but of the human body. We watch him slowly make it to the finish line, get applauded by his co-workers, hold Pam's horrible lamp over his head like a trophy, and finally vomit up his fettucine on the sidewalk: "And while I eventually puked my guts out, I never puked my heart out, and I'm very, very proud of that." Of which sight is worse -- the dribble of creamy vomit on Michael's lip, or the dangle of his squishy bits under his shirttail -- only Pam can say.