Baltimore Colts to Neurosurgery

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“Make each day your masterpiece.” – John Wooden

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For as long as I can remember, I have loved sports! As far back as I can remember, I spent fall Sundays with my dad watching the Baltimore Colts. During that era, they were the ultimate “working man’s team” with unlikely heroes like Johnny Unitas (cut from the Steelers and working construction before getting the chance to launch his record-breaking career) and Gino Marchetti (fought in the Battle of the Bulge before being labeled “the best all-around player”). Even my start in medicine can be linked to my involvement with the Colt’s athletic trainer (Ed Block), who was the epitome of old school, having gained most of his amazing skill and knowledge on the job.

Throughout my youth, I actively participated in three or four sports, ranging from competitive swimming (I also taught and lifeguarded) to field hockey (State champions 1976) to volleyball and softball. I served as the athletic trainer of the boys’ basketball team, becoming the first female in my region to receive a “letter” for participation on a boys’ team. As others effectively discuss throughout this issue, these experiences taught me about the importance of teamwork, dedication to honing a skill and the value of physical activity. As an adult, I have not achieved the monumental hiking feats of my mentor, Dr. Neville Knuckey, nor biked the length of Baja California, like my colleague Dr. William Couldwell, but I have conquered the seven-day Inca Trail to Machu Picchu and recently traversed 100 miles over the spectacular terrain of southern Patagonia. As my body has (gracefully?) aged, I increasingly appreciate the necessity of remaining physically active with particular attention to flexibility and upper body strengthening to remain effective in the demanding world of the operating room.

Art by Dr. Kathryn Ko

Given all this, I was thrilled when the concept of devoting an issue of the AANS Neurosurgeon to sports and the neurosurgeon was proffered. The spectrum of athletic achievements and motivations of so many neurosurgeons who contributed is remarkable and their stories are often poignant and moving. For many individuals, it is clear that involvement in sports (teams) is a metaphor for life and a predictor for success (in neurosurgery and beyond). To this I feel compelled to raise two serious concerns to sufficiently rain on an otherwise beautiful parade.  The first is that there is incredible potential for evil lurking in the world of youth sports. In addition, the practice of using success in team sports as a gauge for resident selection is inherently biased and flawed.

One might ask, how can sports possibly be evil? There are so many ways that I have witnessed personally and many more I am sure are beyond my ken. I will only relate some of the most egregious I know:

  • Overzealous sports parents: a classmate was forced to play varsity football with a ruptured appendix and as a consequence a routine surgical intervention morphed into a life-threatening event
  • Poorly trained coaches: there are many stories of concussions and broken bones ignored, or athletes punished for letting classroom requirements take precedent over team activities
  • Unreasonable physical stress on young bodies
  • Team bonding/pressure run amok: every year I was in high school, one top athlete died from a drunk driving accident after a big athletic event, while many other examples of foolish and dangerous behavior routinely results from such intense peer pressure
  • Mental and sexual abuse by adults of their athletes: too many examples of this, but the US women’s gymnastics team is perhaps one of the most horrifying

Why, you might also ask, would using sports team involvement as a component of assessing resident applicants be problematic? Several critical concepts must be considered:

  • Is there any evidence that this is a reproducible and reliable tool for predicting success?
  • Are any of the laudable qualities attributed to being a successful athlete (dedication, hard work, grit, sacrifice, etc.) unique to sports and not equally true of those who excel in art, music, chess, literature or other endeavors?
  • Could those with less access to sports teams (such as women), those from smaller communities or individuals with fewer resources be unfairly excluded?

In America today, obesity is the greatest health issue. Leading an active life can help keep one healthy and there is clear evidence that promoting these habits early in life is key. As we all age, exercise provides nearly unlimited benefits to health and well-being. For many neurosurgeons, these endeavors have been formative and rewarding – I count myself among that cohort. But let us not allow our love of these pursuits blind us to perils and pitfalls while looking at this through glasses with too rosy a tint.

“Wisdom is always an overmatch for strength.”

 Phil Jackson

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