'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.