Posts Tagged ‘sports’

Derek Boogaard: A Bully and His Demons

Tuesday, June 5th, 2012

Derek Boogaard was a hockey player. Well, sort of. He didn’t score goals (only 3 in 6 years) and he spent a lot of time in the penalty box (589 minutes). He was an enforcer: at 6’8″ he was a ferocious and much-feared brawler.
As we learn in a New York Times article, he was also addicted to pain medications. While still playing hockey in 2008-2009, he received at least 25 prescriptions for opioids from ten doctors, a total of 600+ pills: eight team doctors of the Wild (his team at the time), an oral surgeon in Minneapolis and a doctor from another NHL team.
In 2010, he was signed by the New York Rangers for $6.5 million, despite his by then well-documented drug problems – he was an active participant in the NHL’s substance abuse program. While playing for the Rangers, a team dentist wrote five prescriptions for hydrocodone; another team doctor wrote 10 prescriptions for Ambien.
Occupation-related Pain
There is not much question that Boogaard suffered from pain. Here is just a small segment of his pain-filled saga, from the final few months of his career: In October 2010, a punch from a Toronto player broke a three-tooth bridge in his mouth. A couple of days later, he hurt his hand while punching a Boston player. In November he had his nose broken by an Edmonton player. In December he suffered a concussion in a fight with an Ottowa player. He never played hockey again.
In the months following his retirement, he exhibited erratic behavior and wild mood swings. He acquired numerous prescriptions from current and former doctors. In May of 2011 he signed himself out of a rehab facility, spent a night drinking with friends, and died of an overdose in his Minneapolis apartment. He was 28 years old.
Privilege Has Its Pain
The article quotes Dr. Jane Ballantyne, a pain expert from the University of Washington: “A single course of opiates might be O.K. for normal people who only get injured once in a blue moon, but when injuries are frequent, it can easily turn into chronic treatment instead of just acute treatement. And athletes are at high risk of developing addiction because of their risk-taking personalities.” She adds: “the tendency is to overtreat” because team doctors want to help athletes return to competition.” [At LynchRyan, we are strong proponents of prompt return to work, but only where there is no risk of re-injury. There is no such thing as modified duty on ice.]
Boogaard was a fan favorite wherever he played. In hockey, fighting is “part of the game.” But his sad saga is primarily a story of brain injury and addiction. As a professional athlete, Boogaard had virtually unlimited access to drugs, through doctors who, for the most part, did not bother to document their treatment plans or monitor their patient.
It should come as no surprise that an autopsy revealed that Boogaard had chronic traumatic encephalopathy C.T.E., a brain disease caused by repeated blows to the head.Thus he is linked in death to the growing number of football players who suffered the same fate, the result of frequent concussions.
Official Response Speak
As a lifelong student of language and rhetoric, I cannot miss an opportunity to quote some of the official responses to Boogaard’s death:
The NHL: “Based on what we know, Derek Boogaard at all times received medical treatment, care and counseling that was deemed appropriate for the specifics of his situation.”
The Minnesota Wild: “The Wild treated Derek’s medical status in accordance with the NHL/NHLPA Substance Abuse and Behavioral Health Program as we do with all our players.”
The NY Rangers: “We are confident that the medical professionals who treated Derek acted in a professional and responsible manner and in accordance with their best medical judgment. They took extraordinary steps to coordinate the medication prescribed for him with the professionals in charge of the NHL-NHLPA Substance Abuse and Behavioral Health Program.”
Not exactly heartfelt or compassionate, just the voices of powerful corporations, protecting their interests, their brands and their proverbial asses. As for Derek Boogaard and his misguided career on ice, RIP for the man who knew no peace.

NFL and Dementia: A Changing of the Guard

Wednesday, May 4th, 2011

Last month we blogged the suicide of Dave Duerson, a former NFL star who killed himself at the age of 50. In order to preserve his brain for study, he took the unusual step of shooting himself in the chest. He suspected – and the subsequent autopsy confirmed – that he suffered from chronic traumatic encephalopathy, a degenerative and incurable disease that is linked to memory loss, depression and dementia. A definitive diagnosis is available only through an autopsy.
Among the many ironies surrounding this sad tale is the fact that Duerson sat on the six person NFL committee that reviewed claims for medical benefits submitted by retired players. Duerson was known for his harsh line on these claims, apparently voting to deny benefits in many cases (the votes of individual committee members were not recorded). He even testified before a Senate subcommittee in 2007, supporting the NFL’s position that there was no definitive relationship between repeated concussions and subsequent dementia.
The days of denial appear to be over. Dr. Ira Casson, who represented the “prove it” mentality of the NFL, is no longer actively involved. The medical evidence is accumulating; while some refuse to connect the dots, it’s increasingly clear that repeated brain trauma (concussion) is often directly related to a precipitous decline in brain function in the post-gridiron years.
Old Game, New Order
The NFL is trying to improve the safety of its players. The new rules limiting return to the playing field after a concussion are taking root. Helmet to helmet hits are being penalized with increasing financial severity. But even as the league tries to limit future exposures, the fate of retired players looms large. There will be increasing numbers of claims for disability, including workers comp where applicable, by players who face a substantially diminished burden of proof to connect dementia to playing field (“workplace”) exposures.
It is painful to contemplate the agony of Dave Duerson’s final days. Confronted with the incontrovertible evidence of his own demise, he must have realized how wrong he had been in taking the company line on dementia. He knew what his own autopsy would reveal: a brain damaged by chronic traumatic encephalopathy, caused by repeated trauma. His choosing to shoot himself in the chest was a farewell gesture, not only to his own life, but to the beliefs that had led him to take a hard line with his former colleagues. A loyal member of the “old guard,” he ended his life with the unmistakable and moving embrace of the new order.

Health Wonk Review, CTE, bill review, messing with Texas, and more

Thursday, March 3rd, 2011

Jared Rhoads of The Lucidicus Project hosts this week’s Health Wonk Review, and he dishes up a heaping helping of the blogosphere’s best heath policy posts from the last two weeks. Check it out!
Happy Birthday – to David Williams at Health Business Blog for 6 years of quality healthcare blogging. David is one f the regular Health Wonkers. See his Best of the Blog post for a fine sampling of his work.
More sports-related head trauma tragedy – Earlier this week, my colleague posted about football-related chronic traumatic encephalopathy (CTE). Yesterday, the New York Times featured a story about how hockey brawler Bob Probert also suffered from CTE: “But the legacy of [Bob] Probert, who died last July of heart failure at 45, could soon be rooted as much in his head as his hands.After examining Probert’s brain tissue, researchers at Boston University said this week that they found the same degenerative disease, chronic traumatic encephalopathy, whose presence in more than 20 deceased professional football players has prompted the National Football League to change some rules and policies in an effort to limit dangerous head impacts.”
Bill review – Are you getting what you pay for with medical bill review? At Managed Care Matters, Joe Paduda takes some of the mystery out of the equation in his discussion about what your savings should be from your work comp medical bill review program.
Criminal indictment for Massey mine official – Hughie Elbert Stover, the chief of security for Massey Energy’s Upper Big Branch Mine has been charged with two felonies related to the April 2010 explosion that killed 29 coal miners. He is accused of lying to investigators and destroying records. On his blog, reporter Ken Ward asks if this is just the beginning of indictments.
Don’t mess with Texas – If you ever use the words “workers compensation” and “Texas” in the same sentence, you better think twice. TX law blogger John Gibson has been issued a “cease and desist” order and threatened with further legal action for his TX Workers Comp Law Blog for having the temerity to use the words “workers compensation” and “Texas” in his blog. We can’t get Gibson’s take because his blog appears to be down (www.texasworkerscomplaw.com), but Julius Young posts the scoop on the Texas workers comp language imbroglio at his Oakland Workers Comp Blog. If you don’t see his post – or ours – please blame Texas. Just to be on the safe side, from here on out we may begin referring to Texas as “Exas-Tay.”
Sedgwick acquires SRS – In a major move in the world of third party administrators, Sedgwick completed the purchased of Specialty Risk Services for $278 million. SRS was the claims TPA arm of The Hartford. In his bog on the Hartford Courant, Matthew Sturdevant reports that: “The deal makes Sedgwick CMS the largest independent North American provider of claims administration services. The combined companies will have annualized revenue of about $1 billion as well as almost 8,500 employees.”
Devil’s in the details – Yvonne Guilbert of Complex Care Blog posts two concrete incidents that show how one small detail missed in home care could easily end up costing $50,000 or more.
Safe hiring practices – As the economy ramps up, new hires will increase an employer’s potential for workplace injuries. At MEMIC Safety Blog, Greg LaRochelle says that a new employee is 5x more likely to have a lost-time injury than a more experienced worker, and that 40% of all workers injured on the job have been on the job for less than a year. He posts about hiring practices to help mitigate risk.
Hiring VetsHR Daily Advisor offers a good roundup of tips and advice for hiring returning veterans. The post includes questions to ask and to avoid during the interview.
Short Takes
AIG results and workers comp
Four steps to evaluate absence policies
Insurance Fraud Hall of Shame 2010
Smiling makes the world go round
7 wellness benefits employees want most

A Bullet to the Heart

Tuesday, March 1st, 2011

Dave Duerson was a star safety in the NFL. He used his head in the way that aggressive defensive backs often do – as a battering ram to bring an opponent down, maybe even jar the ball loose. He was articulate, generous and in his post-football life, successful. So it saddened many of his friends and colleagues to learn that he had committed suicide last month. But even in this last, desperate act there was a method to the madness: he shot himself in the chest, so that his brain would be left intact. He was convinced that the downward spiral of his life over the past few years was due to football-related brain damage – chronic traumatic encephalopathy. He texted his ex-wife just before he shot himself, requesting that his brain be given to the NFL brain bank. Just in case she did not get the message, he left a written note with the same instructions.
We have blogged the issue of concussions in the NFL and their potential for long-term brain damage. As this prior blog pointed out, a changing of the NFL’s medical guard indicates that the league finally appears willing to confront the issue head on (so to speak). They no longer systematically deny a connection between concussions on the field and severe cognitive problems after football careers come to an end.
Over the past few years, Duerson was in a downward spiral. He lost his business to bankruptcy. He (uncharacteristically) assaulted his wife, who soon felt compelled to end their marriage. While his friends did not see major changes in his behavior, he talked openly of his fears of dementia. He suffered short-term memory loss, blurred vision and pain on the left side of his brain. He looked into the future and despaired at what he saw coming. At the time of his death, Duerson was only 50.
Suicide as Political Act
Duerson’s last gesture was an explicitly political act. He was convinced that his life problems – and the rapidly diminishing quality of that life – were directly connected to his years as a football player. So he not only decided to end his life, he made sure that suicide would leave his brain intact for research. The NFL has been (belatedly) collecting the brains of deceased players willing to donate them, to try and determine the impact of repeated violent collisions on aging. At this point, there is not much doubt of the causal connection – not in every individual who played the game, but surely in a significant percentage who suffered from multiple concussions.
With this connection medically proven, the burden falls on the NFL to improve player safety. That will not be easy. This past season, a number of players – most notably the Steelers linebacker James Harrison– complained about the newly implemented fines for helmut to helmut hits, defined as:

“using any part of a players helmet (including the top/crown and forehead/hairline parts) or facemask to butt, spear, or ram an opponent violently or unnecessarily; although such violent or unnecessary use of the helmet is impermissible against any opponent, game officials will give special attention in administering this rule to protect those players who are in virtually defenseless postures…”

Duerson the player would have agreed with Harrison about the rule. Duerson the retiree would have supported it. Experience is an exacting and often cruel teacher. As Duerson’s sad demise demonstrates, what we choose to ignore in the prime of life may give birth to demons that haunt us as we age.

Medicare and Physician Pay: Jim Bunning’s Bean Ball

Wednesday, March 3rd, 2010

There are four things that are memorable about Jim Bunning’s professional baseball career: First, tossing a perfect game for the Philadelphia Phillies against Trace Stallard and the New York Mets on the afternoon of 21 June 1964, lowering his ERA to 2.07 in the process (Phillies: 6 runs, 8 hits and no errors; Mets: Zip, Nada and Zilch); second, finishing second in the Cy Young voting in 1967 (Mike McCormick of the Giants won with 18 first place votes; Bunning got one, but, hey, it was good enough for the silver medal); third, from 1955 to 1963 while pitching for the Tigers, striking out Ted Williams more than any other pitcher Williams faced (and, as Jim Bouton’s Memoir, Ball Four, tells it, Teddy Ballgame did not like it one bit); and fourth, entering the Hall of Fame compliments of the Veterans Committee in 1996.
About this time in Washington, DC, there are many Republican Senators, baseball fans all, who are wishing that the 6’3″, 190 pound righthander had called it quits right there and retired to the backwoods of Kentucky. But, of course, he didn’t. He had to go ruining it all by running for and winning a Senate seat from the blue grass state in 1998; and then he did it again in 2004! The political version of the Peter Principle.
Republicans politely call him “cantankerous” – at least that’s what they say in public. Behind the scenes, they’re not so nice about it. Senator Bunning marches to his own drummer, and always has.
One Pitch, Three Strikes
He’s retiring this year, but not before throwing one more hard-breaking slider (his best pitch back in the day). On Monday he managed something he never could in the Big Leagues – he threw three strikes with one pitch. By preventing a vote on an emergency spending bill, Senator Bunning: first, at least temporarily, killed an extension of unemployment and COBRA subsidy benefits for more than a million long-term unemployed Americans; second, shot down a short-term extension of the Highway Trust Fund, which is a federal fund set up to pay for transportation projects nationwide, after which Transportation Secretary Ray LaHood said that up to 2,000 employees at the Transportation Department will be furloughed without pay as a result; and third, insured that Medicare would immediately reduce fees to physicians by 21.3% via the Medicare Sustainable Growth Rate Factor (SGR). Wow, a “threefor!”
Strike 3 is what concerns us here. We’ve written often about the steep and steadily rising costs of Medicare, and now along comes Senator Bunning saying we have to lower costs and let’s do it on the backs of hard-working primary care physicians. He certainly has a point that we need to lower Medicare costs, although he expressed it in a wild pitch sort of way. Here’s a chart from the Centers for Medicare and Medicaid Services (CMS) that shows what will happen to Medicare costs in the future if nothing changes. The vertical axis is percentage of GDP:
medicare-in-the-future.jpg
And here’s a summary from a Congressional Budget Office (CBO) Issue Brief on the Medicare Sustainable Growth Rate Mechanism (PDF). It’s from September, 2006, but is still appropriate: The Supplemental Medical Insurance program (Part B of Medicare), which will cost about $158 billion in 2006, pays for physicians’ services, outpatient hospital services, durable medical equipment, physical therapy, and certain other outpatient services. About 38 percent of those expenditures are payments for services provided by physicians, which are based on a schedule of fees that specifies the amount to be paid for each type of service. Most of Medicare’s payment rates are simply adjusted each year for inflation–but not those for physicians’ services (emphasis added). Those rates are governed by a complex formula — the Sustainable Growth Rate (SGR) mechanism.
The SGR is pegged against a target originally established in the 1997 Deficit Reduction Act. Its aim is to hold down Medicare costs. It’s calculated every year, and every year since 2004 this complex and nearly Byzantine calculation has called for an annual reduction of physician reimbursement rates by an average of 3% to 4%.
Nonetheless, every year since 2004 Congress, yielding to the medical lobby, has voted to override it by delaying the triggering of it. The trouble is, the law is cumulative. So, what Congress has done in a typically heroic display of moral courage, is to dig itself into an ever-deepening hole by not facing up to yet another looming catastrophe. Sound familiar?
Docs Rush the Mound
The AMA is nearly apoplectic about the SGR and the prospect of Senator Bunning causing it to be finally triggered. Monday, the organization was out in force in DC making its views known. The current President, Dr. James Rohack, went on Bloomberg and, later, CNN with Larry King. President-Elect Dr. Cecil Wilson even did an hour on Washington Journal C-Span answering questions from Democrats, Republicans and Independents, and, generally making his case.
And his case was that for a while now, physicians have been abandoning the Medicare ship, because, even though their Medicare fees have remained steady due to the congressional overrides, they claim they’re losing money with Medicare patients because their costs have been inexorably rising. Moreover, it’s no secret that there is an ever-increasing shortage of primary care physicians, and CMS reports that, while 92% of primary care physicians participate in Medicare, only 73% are accepting new patients. If nothing changes, that will surely drop precipitously.
Case in point – the Mayo Clinic, President Obama’s iconic national model of high-quality health care efficiency, lost $840 million on Medicare in 2008, and, as of January 1, 2010, stopped seeing Medicare patients at its Glendale, AZ, clinic. The Mayo claims Medicare covers only 50% of its costs every time it sees a Medicare Patient.
So, we’re left with another one of those rock and hard place things. Medicare could bankrupt the nation, but physicians don’t get paid enough from it.
Yesterday, Congress stole second base on Bunning by extending unemployment and COBRA benefits for another month and by delaying the 21.3% Medicare physician pay cut until the end of March, at which time we’ll probably have to go through this whole thing all over again. (Yogi Berra’s “déjà vu?)
Perhaps Senator Bunning’s out of left field move will actually cause Congress to do something it has thus far been absolutely incapable of doing regarding our nation’s health care. That is, fix it.
Right. And tomorrow 78 year old Jim Bunning will quit the Senate and to great expectations accept a $100 million free-agent contract to rejoin the Phillies as their Pitching Ace.

Injured Jocks and Medical Costs

Monday, July 20th, 2009

College athletics is big business. While athletes are not paid for their efforts (well, some are), they can reap substantial benefits while pursuing glory on the playing fields of their Alma Maters. But athletes, like workers, are prone to injuries. And once injured, they may find themselves liable for the cost of medical treatment. There is no workers comp for injured athletes, but perhaps there ought to be.
Kristina Peterson writes in the New York Times that athletes are often stuck with the medical bills for sport injuries. Students may have coverage through their parents’s insurance policies, but these often exclude varsity sports, limit out-of-state treatment or do not cover much of the bill. Schools may offer supplemental plans, but these vary greatly. Athletes who play for major Division I schools often benefit from robust coverage. Big Ten athletes rarely have to pay for medical treatment. The NCAA offers catastrophic insurance for all athletes, but coverage begins at $90,000. An athlete would run through an awful lot of treatment to reach that level of medical billing.
Even in the Big Ten, where insurance coverage is robust, stuff happens. Jason Whitehead played football at The Ohio State University. He was badly injured during a practice and was airlifted to a hospital.
“The next day, when I woke up, the doctor came in and informed me that surgery went well, but this was a career-ending injury…It took a while to sink in.”
Whitehead lost his scholorship one year after the injury. He also ended up with $1,800 in medical bills not covered by his father’s insurance or by the school’s. The school valued Jason as an athlete; as an ordinary student, well, he ended up pretty much on his own.
Rowing to Oblivion
As in workers comp, medical coverage for student athletes is complicated by factors that may or may not be directly related to the injury. Erin Knauer went out for the crew team as a freshman walk-on at Colgate University. She had a cold when she took a five kilometer workout test on rowing machines. On pace for the fastest time, she suddenly felt a shooting pain beginning in her back and reaching her toes.
She eventually was diagnosed with postviral myositis, a muscular inflammation that causes weakness and pain. Colgate officials determined that this was an illness, not an injury, so financial responsibility fell to Knauer. She tapped out her student health policy at $25,000, leaving her $55,000 in debt. She is currently working two jobs and paying down the bills at the rate of $250 a month.
There is little doubt that Knauer’s illness was exacerbated, if not caused, by the strenuous workout. If this had been a work-related situation, comp would likely have picked up the entire tab (plus indemnity). But as a student athlete, Knauer has no guarantee of coverage. She wanted to row for the glory of Colgate. She ended up in serious pain and serious debt. Glorious it was not.
College athletics often involve a fundamental trade off: in return for playing sports, athletes benefit from a low-cost or virtually free education. That might be a pretty good deal, except when the sport results in a life-changing injury. As David Dranove, a professor at Northwestern’s Kellogg School of Management, puts it: “It makes no more sense to tell the athletes, “You go buy your own health insurance,” than it does to say, “You go buy your own plane tickets and uniform.'”
The rationale for mandatory insurance for athletes is similar to the rationale for workers comp. The schools benefit from the labors of their athletes. The least they can do is pay for any and all medical treatment required to make these athletes whole.

Indoor Football: Piling On the Sanctions

Tuesday, April 28th, 2009

The Sioux Fall Storm are members of the Indoor Football league (not to be confused with the Arena Football League, although, truth be told, I am confused). They have won the league championship four years in a row (bet you did not know that) and were well on their way to a 5th title, having won their first six games in 2009. Then they made a big mistake. They neglected to purchase workers comp insurance for the team.
The league owners, all of whom have had hopes of a championship crushed by the relentless Storm, came up with a set of sanctions unique in the history of workers comp. The owners forced the Storm to forfeit the first six games of the season (6 and 0 instantly becomes 0 and 6). In addition, the Storm is only allowed to dress 20 players for future games (other teams can have 21). Finally, if the Storm should overcome the formidable obstacle of six losses and reach the playoffs, they are not allowed to host the initial playoff game. That sounds like roughing the franchise to me!
League owners have converted one team’s failure to buy insurance into leverage to ensure that someone else – anyone else – wins the title this year. I have no idea which teams are any good, so I have handicapped my preferences based solely upon the intriguing names:
Billings Outlaws
Bloomington Extremes
Maryland Maniacs (I am not making this stuff up!)
Omaha Beef
RiverCity Rage
Everett (WA) Destroyers
And then there is the Kent*. No, not the Kent Asterisks. This is either an expansion team or inactive franchise, currently lacking a name. Given that they represent Seattle, I think something nerdy might be in order: The Kent Keyboards? Or given the need to project a violent image, how about the Kent (Hard Drive) Crashers?
Comp in Professional Sports
We have blogged the uneasy fit between workers comp and professional athletes. There really is no class that reflects the risks of being a football player. Given that the estimated premium for covering the Storm is about $200,000, it appears that insurance coverage per player runs in the range of $8,000 to $10,000.
Storm team President Colin Steen is not happy with the penalty:
“Clearly, these outrageously harsh punitive measures, imposed by a majority vote of IFL team owners, are intended to place the Sioux Falls Storm and its players at a competitive disadvantage against the other teams in the League for the remainder of the season and into the playoffs for a mistake that was totally unrelated to competition on the field.”
Steen is correct, but unfortunately his only recourse puts the issue right back into the hands of the same resentful owners who dreamed up the sanctions. In other words, it may be roughing the franchise, but the call stands.
This situation reeks of conflict of interest. It’s admirable and necessary to enforce insurance requirements on all teams, but in this case, the penalty is totally out of alignment with the infraction. It’s piling on – a fairness problem in most endeavors, but perhaps appropriate for indoor football.

Genetic Testing, Part Two: The Heart of an Athlete

Wednesday, October 12th, 2005

Yesterday’s blog concerning genetic testing has prompted some thoughtful responses from our readers. It has also led to further research into the current and rather compelling story of Eddie Curry, a highly touted young center for the Chicago Bulls. Curry missed the last 13 games of the season and the playoffs due to a heart problem. The Bulls wanted him to submit to a genetic test, to determine whether he’s susceptible to cardiomyopathy, the ailment that killed former Boston Celtics guard Reggie Lewis and Loyola Marymount star Hank Gathers. Curry, citing his right to privacy, refused. He was subsequently traded to the New York Knicks, who say they have no intention of requiring the genetic test “because of New York’s privacy and employment laws.” Instead, the Knicks will rely on their team doctors.
John Hollinger at ESPN Insider was at the Knick’s press conference: “Isiah Thomas, [the Knicks general manager] must have said ‘I have tremendous confidence in our medical team’ about 12 times in a 20-minute [period].”
Wow. This is a loaded and truly fascinating situation. Were the Bulls being prudent in requiring the DNA test, or were they violating the ADA? Were they concerned for Curry’s well being or the team’s bottom line? Are the Knicks and their team doctors opening themselves to lawsuits (from Curry’s family, no less) for allowing him to play without knowing the details of his condition? Is the life of a 22 year old worth the risk, if he can pull down the boards and put up some points?
Hollinger has a rather scathing analysis of the risks the Knicks are taking: not the health risks per se, but the impact on the team’s future performance. He’s not impressed with their risk management skills.
The Death of Reggie Lewis
This situation brings to mind the saga of Reggie Lewis, the former Boston Celtics captain whose death from a heart ailment in 1993 is still wending its way through the courts. (A thorough and lucid summary of the story can be found here.) Lewis passed out briefly during a playoff game. He was sent to New England Baptist hospital where he underwent a number of tests supervised by a team of 12 of the most respected cardiologists in the Boston area. This team was called “The Dream Team” based on a similar phrase to describe the superior talent of the gold medal winning USA basketball of 1992. After thorough testing, the Dream Team diagnosed Lewis to be suffering from ventricular tachycardia, the most dangerous form of arrhythmia. The cause of this was believed to be focal cardiomyopathy, a disease of heart muscle. Of the various forms of arrhythmia, some are harmless and others are potentially life-threatening, such as this diagnosed one. Dr. Stanley Lewis, director of clinical cardiology at New England Deaconess Hospital and member of the Dream Team, said, “When you talk about arrhythmia’s that result in loss of consciousness’ you’re dealing with a deadly arrhythmia.”
Lewis found the dream team’s diagnosis — and its resulting immediate end of his basketball career — to be a nightmare, so he sought a second opinion. He consulted with Gilbert Mudge, a well known cardiologist who ran his own tests and declared that Lewis was not suffering from any sort of cardiomyopathy but merely from a curable neurocardiogenic fainting disorder.
Approximately two months after receiving Mudge’s favorable diagnosis, Reggie Lewis collapsed and died shooting baskets at a Boston gym. An autopsy revealed that his heart was abnormal, enlarged and extensively scarred. The state medical examiner was vague about the description of the scarring and the how it was likely caused.
Hidden Truth
Overarching this entire sad saga is the distinct possibility that Lewis abused cocaine. If this is true (his widow denies it vehemently), his failure to disclose the drug use directly impacted Mudge’s findings and those of the dream team as well. The author of this study finds plenty of blame to distribute among the blazing egos of the dream team docs, Gilbert Mudge and Reggie Lewis himself.
It is a cautionary tale, but the lessons are probably beyond the reach of the ambitious New York Knicks and their new center. In the best of worlds, people would look at all the available information and make informed judgments concerning Eddie Curry’s future. The world of professional sport is far from ideal — there is simply too much at stake. So here’s wishing Mr. Curry the best of luck as he throws up his jump shots and fights for his rebounds. Every time he loses his balance and falls to the floor, we’ll all just hold our collective breaths — to see if he is able to get up off the floor and go on with the game.

A (Tired) Fan’s Notes

Friday, October 29th, 2004

In these rare days of the first Red Sox championship since 1918, we take a few moments to extract some of the lessons in this dramatic triumph for managers in all types of businesses. This is not meant to be an exhaustive list (and is written, frankly, by an exhausted fan).
Hire people who are really motivated to do the work.
Have fun (but of course, work safely).
Conversely, don’t hold onto people who (apparently) don’t want to be there, even if they have performed well in the past.
Build a core crew of experienced and knowledgeable players. These players should welcome newcomers and make them feel part of the team.
Pay good wages (well, not that good!)
Have patience — as long as your trust is placed in people who really can do the work.
Accommodate injured workers. Highly motivated employees want to work. Team up with them and their doctors to make it happen.
Don’t let individual egos get in the way of the team.
Never give up. Even in the darkest hour, with defeat looming, you might be able to steal a base and turn the situation around.
If you’re lucky enough to win, start planning for the next big season.
Our apologies for those who do not follow baseball. For all the others, your comments and additions to this list are welcome.