the injury. Today, 90 percent to 95 percent pass the examination. That’s a testament to improved surgical procedures and a greater understanding of the injury. NFL physicians learn from each other as well. Each year, Dr. Connor takes two fellows with him to the Combine, and they consider it the highlight of their fellowship. “They see so much in such short a time,� he says. “It’s like drinking from a fire hydrant.� One year, Tennessee Titans team physician Dr. Burton Elrod presented information about how he and two other surgeons repaired the fractured sternum of former Titans QB Steve McNair. The doctors grafted a football-shaped piece of bone from McNair’s hip onto his sternum to promote bone growth. It was hardly standard stuff, and the assembled physicians – who were hardly greenhorns – were happy to learn about the procedure. “None of us had dealt with a sternal fracture and how that can impact the heart,� Dr. Connor says. Physicians speak with each other during the season, and it’s not unusual for them to consult on different injuries. There is even cross-pollenization. Baseball’s Dr. Ahmad is an expert on throwing injuries of the shoulder and elbow and has spoken to NFL doctors who have to care for players with injured arms. One characteristic many team physicians share, along with their medical skill, is a competitive spirit born of their own athletic experience. Dr. Ahmad was named honorable mention all-Ivy in soccer while at Columbia and helped the Lions to the NCAA tournament. Dr. Connor was an all-America “He was heroic,� Dr. Meyers says. “He chose to play the rest of the season, and it was a contract year.� College athletics do not have contract years, so William N. Levine, M.D., professor of clinical orthopedic surgery, director of sports medicine at P&S, and head team physician for Columbia’s 31 intercollegiate athletic teams, is not worried about his patients’ next paydays. To him, treatment is “always in the student-athlete’s best interest.� He has had to tell a senior who had contracted mononucleosis that she couldn’t run in the final race of her career. He also had to “medically retire� the starting goalie on Columbia’s women’s lacrosse team, because she was unable to recover from concussion symptoms. “Sometimes at the professional level, an athlete will make a decision that’s not in his best [long-term] interests, based on financial or contractual situations,� Dr. Levine says. The best way to advise athletes at any level is to keep gaining knowledge, and physicians who work with teams and schools have ample opportunity to do that. One such avenue is the annual NFL Scouting Combine, which Dr. Willis describes as “100 years of experience in three days.� Every February, more than 300 players travel to Indianapolis to be scrutinized by the NFL’s 32 teams. Included is an exhaustive medical examination designed to reveal every injury a player has ever suffered and whether the treatment and recovery will allow him to be a successful professional player. “You see a broad spectrum of injuries,� Dr. Willis says of the Combine. “Through the sheer volume of examinations, you understand the nuances of the injuries and see what will allow them to compete and what are not compatible with a long career in the NFL.� A repaired anterior cruciate ligament (ACL) 30 years ago was definitely incompatible with long-term pro football success. Dr. Warren estimates that NFL doctors would flunk 80 percent to 85 percent of players with
@ 9OU HAVE TO TAKE INTO ACCOUNT THE PERSONALITY OF THE ATHLETE GOALS OF MANAGEMENT AND THE ATHLETE S NEED TO REMAIN PRODUCTIVE – Andrew Willis’97, New York Jets team physician tennis player at Oklahoma State. Dr. Warren was a member of Columbia’s only Ivy League football championship team (1961), while Dr. Willis played on three Ivy football title winners at Dartmouth (1990-92). “We know about the heat of battle and injury,� Dr. Connor says. “Many of us can fall back on personal experience in this field.� That knowledge also prepares them for the job’s pressure. “It’s the greatest but most stressful job any orthopedic surgeon could hope for,� Dr. Ahmad says. Part of that strain comes from media members who criticize doctors for operating only with teams’ best interests in mind. Dr. Connor says team physicians absolutely do not do that. “We’re not just worried about the player, but the reputation of the organization,� he says. “People have to know the doctors and trainers are doing the right thing by the players.� So, is it worth all of the time and aggravation? Dr. Ahmad says the “most satisfying aspect� of the job is when a player thanks him for his efforts. Dr. Maloney reports how much fun he had during the 2011 season, when the Niners won the NFC West and reached the conference title game. “I’ve always been a fan, and part of what makes this great is that you love to see your team do well,� says Dr. Warren, who has four Super Bowl rings. “I like to see people that I’ve taken care of come back and play at a high level. You don’t see that in private practice.� Fall 2012 ColumbiaMedicine 31