Friday, August 20, 2010

'Tis The Season

Although I have been meaning to post for the past week, the end of summer and a stack of shifts have kept me from fulfilling my intentions. I had no problem posting three times a week during this past school year and can only hope that my writing resumes as the kids return to school and the household takes on a familiar, old calm. Thank you, friends, for your patience.

That being said, it seems that another return-to-school season is upon us. Advertisement fliers, spam emails, classroom notifications, clothes and sneaker shopping, and the accompanying pressure to squeeze in every last unfulfilled summer moment during these final few weeks are at an all-time high. Fun, yes, but not how I would choose to spend a sunny, warm, lakeside day--fighting off the crowds at the local sporting goods store to buy a heavy-duty, cool-looking knapsack before they run out.

At work earlier last week, then, imagine my surprise when I realized that within the hubbub of excitement of school's return and summer's ending, I missed the approach of yet another season--football season. A season filled with devoted fans and amazing plays and incredible athleticism. And, if you happen to work in an emergency department, you know the other truth--it is a season sometimes filled with unfortunate injuries.

I walked into Room 30 to see my next patient, a fifteen year-old male coming straight to us from his school's football field. His first "official" football practice, full pads included, had just finished. Practice was six hours, from 8 a.m. to 2 p.m.

Somewhere around noon, this patient had taken a hard tackle and had gotten knocked to his left side, injuring his left shoulder. Despite his pads. And despite his pain, the patient had kept quiet about his discomfort and had finished out practice. He hadn't wanted his friends or coaches to think he was "wimping out." When his mother arrived to pick him up, however, he told her his shoulder "wasn't feeling right." That's when they decided to visit us.

The patient was a big, husky boy, from the corn-fed, steak-and-potatoes species. He lay in his cot, on his right side, while his mother and father and younger sister hovered near him. He greeted me with a smile as I walked into the room.

"Hi, Seth," I said, shaking his right hand after introducing myself to his family, "what the heck happened to you on your first day of practice?"

His head, topped with a mop of curly brown hair, shook with disappointment. "I don't know," he answered, his half-boy, half-man voice cracking, "I practiced all summer without pads and today, the first day of practice with full pads on, I get hurt. Go figure."

After reviewing his history and performing an exam, which revealed intense shoulder pain (at the proximal humerus), we sent him for x-rays. While he was gone, I checked in with the family.

"What do you think, doctor?" the father asked me. "Honestly," I replied, "I think he broke it." The parents shook their heads. "I knew we shouldn't have let him play," his mother mumbled before turning to me to explain, "this is his first year doing this sport." It seems he had grown significantly in the past year and wanted to give football a try.

Sure enough, his x-rays revealed a horizontal, transverse (a clean line), non-displaced fracture of his proximal humerus. Although treatment for this type of injury is a minimum of 4-6 weeks of wearing a sling, Seth's football season, by the look on his mother's face, was probably not going to resume after that time.

It's a tough call, this sport. I think of Charles Dicken's famous line, "It was the best of times, it was the worst of times... ," when it comes to football. Although the sport is awfully exciting, it does come with an increased risk of injury. We've all seen those clips of devastating injuries. In fact, I'm sure many of us know someone personally who may have gotten hurt playing this great Americansport. For me, it was my tough, older brother, Johnnie, hospitalized when I was a kid from sustaining a head concussion during a football game. And between me and you, I still don't think he is right (a "little brother" dig there). What to do?

Despite my hesitations, three years ago, when my nine year-old son approached my wife and I about playing, we hmm'ed and hah'ed over our decision. Ultimately, we chose to let him play. Being a good athlete, we watched him successfully play running back the past three years, taking his share of hits but never losing a game during this time. This year, though, he wants a break. And we're fully supporting his decision. Instead of football games, it will be soccer games for him this fall. Somehow, we think watching three of his friends get hurt last year (a concussion, an ankle injury, and blunt abdominal trauma) may have influenced his decision.

I have to be honest, though, I will miss the cheering crowds, the steaming hot dogs, the warm ciders and hot chocolates. I will miss the camaraderie with other parents and the announcer's voice providing the play-by-play and cheap jokes.

And I will miss the football action.

As I am finishing this post, I am reminded of a local high school football star who I treated a few years back. He was one of several children of a single mother who had gotten a full scholarship to one of our prestigious private schools to play football. Unfortunately, he had come to our ER, with his mother and coach, after sustaining a head injury during football practice. "They said," his mother voiced, love and concern dripping from her words as she stood trembling beside her son's cot, "that he was knocked out cold for five minutes." The coach, who had witnessed the injury, nodded his agreement.

Fortunately, this respectful, young man, he with the caring mother, did not show any significant injury on his CT scan. Because of the significance of his impact, his loss of consciousness, and his flattened, groggy affect, however, I did not want him to practice or play any football for at least two weeks, until he was cleared clinically and with cognitive testing by his private doctor. Another head injury layered on top of this one could potentially have had a catastrophic outcome.

The coach took the news worst of all. "He has several college scouts coming this Friday to watch him play." I shook my head "no." Call me conservative or overly-cautious, I don't care. I didn't want this young man taking another hit like the one that brought him to us. At least not in the near future.

The patient took the news quite well, but it was his mother that I was most impressed by. "Doctor," she said with earnest, "I promise you that Tyler will not be playing for the next few weeks. It is more important for me to have my son around for a long, healthy life than it is for him to play a few risky weeks of football. No victory is worth those odds." She turned to the coach. "If those scouts want him bad enough, they can come back another time."

Wise woman. Wise words.

I followed him the rest of the season via the sports section in our newspaper. As Mom had promised, Tyler didn't play for those two weeks. Tyler did, however, go on to have a full recovery and receive a full Division I football scholarship.

To all the football players, coaches, and fans, I salute you with a personal toast. To you, I wish the merriest and healthiest of football seasons.

As always, big thanks for reading. C, thanks for the kick in the pants via email today. I hope you all have a great weekend.


Anonymous said...

As a momma to sons and a nurse educator, I have some real "bones to pick" with football at the high school and collegiate levels (pun intended). It hurts my heart to see these young men punishing their bodies to the point of permanent harm, only to be tossed away like yesteday's milk carton if they can no longer play. Meanwhile, many [not all, don't shoot, but far too many] are sacrificing their education on the altar of football. As a nursing student at a large state university, we shared a building with the football team. Listening to the tutors work with the team was an eye-opener. Many of these boys could barely read at a third grade level, yet they were eligible to play as students "making academic progress?" We were memorizing drug doses while some next door were memorizing the "sevens" times tables.....

Pattie, RN

Anonymous said...

Have you seen the recent research (and popular press) about the long term neurological effects of sub-concussion brain injuries in football? Scary stuff and not limited to college or the pros.

Empress Bee (of the High Sea) said...

already? sigh... i have two grandsons that play. i worry all the time. they play basketball too but that doesn't worry me so much. and i don't fear a broken bone, i fear much worse.

we leave tomorrow for a much longed for cruise for a week. be back then! oh, and i did tell my doc this week what you told me to tell him, how much he is appreciated and everything. he smiled from ear to ear.

smiles, bee

Heather said...

Tis the Season, indeed!

I miss warm cider and hot dogs. Here in the South, they treat high school football as if it's college level---complete with tailgaiting. It's disturbing on so many levels!

Enjoy the back to school routine! Hope everyone has a fantastic first day!

Anonymous said...

YAY! Doc is back in the saddle!


Have Myelin? said...

As a mom I was secretly thrilled my son had no interest in playing football.

As a spectator, I love my Broncos but think it's too brutal.

I do think the NFL should think about revisiting their "tackling policy" but that's the mom in me. I know all the males in America are rolling their eyes at me but I don't care. =p

Barbara said...

I just found your blog and I like it so much! Your compassion, intelligence and humor imbue your writing. I bookmarked your blog and will come back! Take care, the best to you and yours!

merinz said...

Rugby football is the game of choice here in our country, our national game.I am so pleased that none of our three sons ever wanted to play.

Katie said...

We've missed you from blogger world. I hope you've enjoyed your week off and made some cherishable memories with your kids.

Allyson's been making friends with our local ER staff... she's been the ambulance for our marching band with two trips in three days.

<>< Katie

Anonymous said...

I would also like to add my voice to the chorus of those who are glad to see you posting again. I enjoy your stories so much.

SeaSpray said...

Great post!

Your kids go back to school early.

I admit .. of all the things I have love about being a Mom ..I don't miss school clothes shopping and I had boys. :)

I love football starting up fall and all that stuff. A lot of foot ball players seem to be left with knee damage too.

Once ..when I went to the bedside of an injured high school football player... I empathized with his pain and mentioned that there seemed to be a lot of football injuries and was a tough sport.

If looks could kill the daggers his father ..also at his bed side ..shot at me would've done it.

I'm still not sure what I did/said wrong, but felt real uncomfortable.

I wasn't saying he shouldn't [play ..just acknowleding tough sport.

Anyway ..that boy's Mom was very wise. I have a feeling there would be some parents that would not want to be the opportunity and in short sightedness send their son back in the game for the scouts.

Good for you for standing your ground.

Our boys played soccer and baseball, although a lot of people thought older son built for football.

Karen said...

Hurray for the Mom who quashed football for a few weeks in favor of the health of her son. I'm not into sports, particularly football, and am at a loss really for the craziness that surrounds it. It baffles me why football players are treated like 'stars' or 'heroes'. And while I'm up here (on my soapbox) why don't we pay our teachers the money we pay these football players?? Ok, I'm done now :)

WhiteCoat said...

I'm worrying about letting my son play football now.
Hasn't even had his first game and he already has a pretty bad ankle sprain.
Chess Club and Debate Team are looking better and better.