October 2004 Bulletin

U.S. orthopaedists happy to be “on call” in Athens

Orthopaedists care for U.S. athletes at the Games of the XXVIIIth Olympiad

By Carolyn Rogers

What could be more thrilling for a sports medicine doc than working as a team physician at the Super Bowl?

Walking onto the field at Athens Olympic Stadium alongside hundreds of U.S. athletes as the crowd of 72,000 erupts into a roar of cheers, for one thing.

Left, members of the U.S. Olympic Medical Staff strike a pose, including orthopaedists Sandra E. Glasson, MD, (second row, far left) and (top row, from left) Jo A. Hannafin, MD, David Weinstein, MD, and Gloria M. Beim, MD.

That experience was “certainly on a par, if not more exciting, than being on the sidelines at the Super Bowl,” says Scott A. Rodeo, MD, team physician for the 2004 Olympic diving and swimming teams, as well as associate team physician for the New York Giants. “It was impossible not to feel immense pride in America when walking into Olympic Stadium for the opening ceremony.”

Gloria M. Beim, MD, agrees.

“It was incredible,” the Gunnison, Colo.-based orthopaedist says. “As we neared the end of the tunnel, the lights were so bright and the noise was amazing. The athletes were really excited and nervous and the whole team started chanting ‘USA! USA!’ Then, as we got into the stadium it was all cheers and all positive energy like I’ve never experienced.”

Drs. Rodeo and Beim weren’t the only U.S. orthopaedic surgeons to live out their Olympic dreams at the Athens Games. Seven of the 11 physicians named to the 47-person U.S. Olympic Committee (USOC) Medical Staff were orthopaedic surgeons. Each of the doctors volunteered a month of their time to help American athletes pursue their sport at the highest level.

Other orthopaedic surgeons who served on the 2004 USOC Medical Staff were:

The U.S. medical staff—comprised of physicians, certified athletic trainers, massage therapists, chiropractors and pharmaceutical experts—provided health care for more than 540 American athletes at the 2004 Games.

“There’s nothing like it”

“The vibe was spectacular,” says Dr. Beim. “There was so much excitement everywhere I went—from the dining hall to the gym, to the streets of Athens… The energy was absolutely contagious.”

Dr. Beim has worked with professional athletes, but Olympic athletes are special, she says. “The Olympians just have a spirit and energy among them that’s unmatched. These people are putting all their passion and energy into being the best at their sport…there’s nothing like it.”

From left, U.S. Olympic cyclists George Hincape, Bobby Julich, Levi Leipheimer and Jason McCartney sit with Gloria Beim, MD, just before the road race.

Dr. Beim covered nine different venues at the 2004 Games—judo, wrestling, tennis, fencing, triathlon, Taekwondo, and three cycling disciplines (mountain, road and track).

Olympic medical team

Like the Olympians, the physicians who earned a coveted spot on the USOC medical team also shared passion, skill and years of dedication to a sport.

“This is the Olympic team of sports medical professionals in this country,” says Ed Ryan, director of sports medicine at the USOC. “These men and women have proven themselves in a variety of top events and have made a difference in our athletes’ performances.”

Selection process

The USOC Sports Medicine Division accepts physician applications year-round, but physicians must have five years experience providing on-site medical care for an athletic team at the high school, collegiate or professional level before they can be considered for a position on the U.S. Olympic medical team.

As the first step in the qualifying process, 30 to 50 applicants each year are invited to serve a two-week unpaid internship at one of the three USOC training centers in San Diego; Lake Placid, N.Y., or Colorado Springs, Colo.

From this pool of volunteers, a handful of physicians are selected to cover a large international competition such as the World University Games or the Pan American Games.

At each stage, volunteers are assessed on their clinical expertise, and their ability to work and perform under stressful conditions, relate to athletes and understand their needs, and effectively communicate with team coaches, administrators and other medical staff.

The USOC Olympic Medical Staff is selected from the pool of volunteers who have covered international competitions.

“I couldn’t believe I was going”

Like many people, Dr. Beim had always dreamed of going to the Olympics. However, “I didn’t think it was something I could even aspire to,” she says.

That changed in 1996 when she became a team physician for the U.S. track cycling team and discovered that she really enjoyed international competition. After five years “on the job” she applied for a spot at the Olympic Training Center.

Her application was accepted, and she completed her two-week internship in June 2001. From there, she was selected to work at the World University Games in Italy where she cared for the U.S. ski team.

When she learned in April that she’d been named to the 2004 U.S. Olympic medical team, she says, “I just couldn’t believe I was going!”

Anti-Doping Code

The U.S. Olympic team physicians arrived in Athens on Aug. 1, 2004—about two weeks before the start of the games. After checking in to the Olympic Village, “team processing” was first on the agenda. For the physicians, this meant reviewing each athlete’s medical history as well as any supplements or drugs the athlete was taking to make sure they’re not banned.

Knowing the new, nine-page World Anti-Doping Code in detail and keeping athletes from accidentally violating it is one of the trickiest aspects of the job.

“A number of medications require special permission for athletes to use during the Olympic Games, such as insulin for diabetics, asthma inhalers, topical creams or ear drops that contain glucocorticoids,” says Dr. Rodeo.

Scott A. Rodeo, MD, (left) and 2000 gold medallist wrestler Rulon Gardner meet at the Olympic opening ceremonies.

“Several athletes had taken over-the-counter medications that could have gotten them into trouble, so we had to complete the proper ‘Therapeutic Use Exemption’ forms and get those into the International Olympic Committee,” Dr. Beim explains. “It was our job to make sure everybody was okay.”

All Olympic athletes are also subject to no-advance-notice drug testing, and the physicians accompany the athletes during this process, as well.

More advanced testing procedures meant that a record number of athletes were caught for doping offenses in Athens. For one of Dr. Beim’s athletes, those test results translated into a bronze medal.

“One of our track cyclists, Erin Mirabella, came in fourth in her event,” explains Dr. Beim. “She’d never medalled and she was so close to a bronze, but she was still very happy with her performance. Then at the closing ceremonies she found out that the Columbian cyclist who placed third had tested positive [for a stimulant], so she got the bronze after all.”

State-of-the art medical clinics

Team physicians also provided medical coverage at a large, well-equipped Sports Medicine Clinic that was established for all U.S. athletes in the Olympic Village.

“We had an amazing, state-of-the-art medical clinic,” Dr. Beim says. “There was a training room, a tremendous pharmacy…all the equipment we could need—and did need.”

The village was also home to a “Polyclinic”—available to credentialed athletes from all countries—that had facilities for laboratory tests, X-rays, CT scans and MRIs, as well as a pharmacy, an anesthesia room and more.

The physicians also had to be able to provide on-site medical care at the different venues all over Athens. This meant team physicians had to stock supplies for “on the field” care at each venue.

“One of the U.S. swimmers has a cardiac condition that required us to have a portable defibrillator available at all times,” Dr. Rodeo says. “So I had to verify that I could be on the pool deck with the defibrillator during the competitions. At the diving venues, I had to confirm that a spine board and cervical collars were available because significant cervical spinal and head injuries can occur during the platform events.”

To the athletes, you’re just ‘doc’

Although the AAOS members were chosen in part for their orthopaedic knowledge, the majority of their time was spent treating general medical conditions.

“The athletes come to you with everything—to them you’re just ‘Doc,’” says Dr. Rodeo. “That’s the fun part of it, too, getting back to being a general doc for a little bit.”

The medical staff treated coughs, colds, sore throats, earaches, rashes, traveler’s diarrhea, heatstroke, and other general ailments.

Dr. Rodeo (right) poses with tennis star Martina Navratilova at the Aug. 13, 2004, opening ceremonies.

“I even had to take an insect out of somebody’s ear!” Dr. Beim says. “You also have to play the role of psychiatrist sometimes, to help calm the athletes down…There are a lot of nerves, as you can imagine.”

“Let the Games begin”

With just one afternoon ‘off’ the entire month they were in Athens, the doctors savored events such as Friday night’s thrilling Opening Ceremony. Members of the U.S. delegation gathered in the gymnastics hall prior to marching into the stadium, so the doctors had the opportunity to meet many of the U.S. athletes competing at the games—including tennis legend Martina Navratilova, 2000 gold medallist wrestler Rulon Gardner, members of the U.S. men’s basketball team and even a few Iraqi Olympians.

It was right back to work the next day, with competition kicking off in the morning.

“Michael Phelps started off the competition with a gold medal in the very first event, with a World Record in the 400 Individual Medley,” says Dr. Rodeo. Then the United States won the Men’s 4x200 freestyle relay, just edging the Australians in an amazing race.

“Relays are tremendously exciting—I used to love competing on relays during my competitive swimming days,” he says.

Dr. Rodeo swam breaststroke at Stanford University for two years in the 1980s, earning a trip to the NCAA National Championships. He became involved with U.S. swimming out of a desire to give back to the sport that had ignited his interest in sports medicine.

Another former competitive athlete turned Olympic team physician is Jo Hannafin, MD, who is also Dr. Rodeo’s colleague at the Hospital for Special Surgery in New York.

In the 1980s, Dr. Hannafin was a three-time gold medallist at the U.S. National Rowing Championships, and a member of the silver medallist lightweight double at the 1984 World Rowing Championships. Dr. Hannafin traveled with the rowing, kayaking and canoeing teams, and was always stationed shore-side to take care of any medical issues.

Playing through injuries

Throughout the games, Dr. Rodeo took care of several swimmers and divers with significant shoulder injuries. He also managed one diver’s chronic low back injury, and an ongoing spine injury in one another diver—a stress fracture that became exacerbated during the Games.

Caring for an athlete on the Olympic stage is unique, he says, in that physicians may sometimes allow athletes to compete with an injury that would normally preclude them from competition.

From his position on the pool deck, Dr. Rodeo snapped this photo of Olympian Michael Phelps (third swimmer from left) prior to another gold medal swim.

“The Olympics are the culmination of years of training, so athletes are often willing to take some risks,” he explains. “Our role as physicians is to carefully explain the risks of making an injury worse, and to identify when an athlete truly cannot compete.”

One of the U.S. cyclists—Bobby Julich—injured his wrist during the Tour de France a few weeks prior to the Olympics.

“At the time, the X-rays were negative, so he went on racing.” Dr. Beim says. “When I arrived at the [Olympic] village, he said it was bothering him so I took another X-ray and, sure enough, it was fractured.”

Dr. Beim taped Julich up a bit, and the cyclist went on to compete, winning a bronze medal. As soon as the competition was over, they put a cast on his wrist.

“He was so tough and strong to win a bronze medal against such a phenomenal field of athletes,” she says. “To beat all those guys with a broken bone was just amazing.”

The world-class cyclists she worked with are “just the greatest,” she says. “They were good sportsmen and friendly to everybody. I just loved being around these people.”

Olympic Village - “a perfect world”

At the Olympic Village, the doctors roomed with other physicians and trainers from all over the United States. Athens Olympic Village was the largest one ever built; the U.S. team alone took up two to three square blocks.

Dr. Beim lived in a house with six other women, all of whom shared one bathroom after the second one flooded. “We lived like a family,” she says.

The village was home to a health club, post office, bank, Internet café, flower shop, gift shop and more—and all were “off limits” to everyone but athletes. The dining hall served food 24 hours a day and seated between 12,000 and 14,000 people.

“I made a point to sit with athletes from different country every chance I got— Iraqis, Chinese, Australians,” says Dr. Beim. “It was a perfect world. There were no politics in that village.”

She says she didn’t encounter any animosity among the other athletes toward the U.S. athletes. “We worked out with them, ate with them… Among the athletes there was harmony. It was a wonderful experience, especially with what’s going on in the world.”

Winning medals

One of many highlights for Dr. Beim was being involved with athletes who won Olympic medals.

“To stand five feet from the medal stand and watch an athlete you’ve been taking care of receive an Olympic medal was just amazing,” she says. “On the road cycling team, Tyler Hamilton won the gold and Bobby Julich won the bronze. Both had bad crashes last year at the Tour de France, and they both came back brilliantly.”

Dr. Rodeo came away from his Olympic experience with a deeper appreciation for how important the Olympic Games are for athletes of all sports. “For most sports, the level of intensity, anxiety and emotion is higher here than for any other competition,” he says. “It represents the culmination of many years of training and a lifetime of focus on sport for the athlete. It has just been a privilege and an honor to work with these athletes.”

Grateful for training

Throughout her Olympic experience, Dr. Beim’s thoughts often wandered back to her years of training.

“I kept thinking back to my grassroots—to my training at Columbia’s New York Orthopaedic Hospital and my sports fellowship at University of Pittsburgh,” she says. “I was so fortunate to get such great training, and I thought so much about the attendings and senior residents who taught me everything I know, wishing I could thank all of them for getting me to this place. Being a member of the Olympic medical team really was the ultimate goal for me as a sports medicine doctor.”

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