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AANS Neurosurgeon | Volume 28, Number 1, 2019

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The Football and Neurosurgery Connection

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I come from a football family. My father was the founder of the Caribbean American Football League in my home in the Bahamas. My cousins Samari and Antrel Rolle played several seasons with All-Pro and Superbowl accolades earned during their National Football League careers. This family momentum and their tutelage helped me become ESPN’s #1 rated high school football prospect in 2006, then an All-American at Florida State University, which eventually led to being an NFL draft pick with the Tennessee Titans. But at the same time I was competing on the field as a young man, interest in neurosurgery came to me through a book called Gifted Hands by Dr. Ben Carson, pediatric neurosurgeon and current Secretary of Housing and Urban Development. This interest was furthered when I had the opportunity to shadow and observe neurosurgical operations and excellent outpatient care by Chris Rumana, MD, FAANS(L), John Robinson, MD, FAANS and Phillip B. Storm, MD, FAANS. Now, I am a neurosurgery resident.  

Are Football and Neurosurgery World’s Apart?

To some onlookers, these competing athletic and academic interests could not be farther apart. On one hand, I intentionally tried to de-cleat wide receivers as they attempted to catch passes over the middle of the field. On the other, I desired to one day diligently take care of patients with traumatic brain injuries and other neurosurgical conditions. I recognize the apparent dichotomy here, but, frankly, football and neurosurgery have more commonalities than one may expect and I hope to outline those here.

Preparation

My teammates and I:

  • Watched quarterback Peyton Manning and his Colts teammates compete on film;
  • Studied formations, personnel groupings, tendencies in certain game situations; and
  • Noted Manning’s hand signals and audibles at-the-line of scrimmage.

We did all this to secure a better position to win come Sunday. When a new patient comes through the Emergency Room with weeks of headaches, new onset emesis and an MRI brain demonstrating a large heterogeneously enhancing insular lesion, this becomes a new opponent. As neurosurgeons, we:

  • Study the images;
  • Identify a safe and effective approach to the mass;
  • Ensure the proper equipment and staff members are available; and
  • Certify that labs and anti-coagulation/anti-platelet statuses are optimized.

We do all this to put us in a better position to maximize care come OR time.

Communication

As a safety, I often had to identify the strength of the opponent’s formation and call out any adjustments that were needed. Dynamic play-calling and awareness of the down and distance were used to predict the plays our opponents could run. We did all this to make sure we were on the same path towards our collective goal. As a neurosurgery resident, we have open dialogue with the anesthesia team during the entire operative experience. We speak to faculty about operative plans, what we see in real-time during the case and receive any helpful advice that could aid in perfecting our craft. We ask questions of device representatives and speak freely with circulating nurses as well as scrub technicians. We do all this to make sure we are on the same path towards our collective goal.

Handling Pressure

When we’re holding on to a small margin lead in the last minute of the fourth quarter and quarterback Tim Tebow and his Florida Gators are in our red zone preparing to score, it gets tense. In these clutch seconds, we are coached to take a breath, take one heartbeat and focus on fundamentals and the training that brought us to this moment. We do this to have the best chance of success. When we come to a very critical part of a neurosurgical case, the atmosphere in the room certainly changes. We understand that complications can occur in this high-risk setting. But faculty coach us to remain calm, steady our hands and focus on our fundamentals and training. We do this to have the best chance at helping the patient.

Through discipline and work-ethic as well as the aforementioned preparedness, communication and pressure-mitigating skills, football and neurosurgical practice are two worlds closer than anticipated. And that’s a good thing for me.

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