Working a shift in the emergency department (ED) or attending a Super Bowl party — or the actual Super Bowl — this Sunday? Be prepared for health crises.
Read on for doctors’ most memorable stories of treating football fans who let their excitement about a big game get out of hand.
Leap’s Law of Emergency Medicine
Many years ago, I was working in our ED, which was near Clemson University in South Carolina. There was a home football game, but I cannot recall exactly which team was playing Clemson. At any rate, a well put-together man in his 40s, who was very intoxicated, came to the ED after falling backwards and striking his head on the concrete. He had been knocked unconscious but was awake.
Now, I saw many people like that in the 20 years that I worked at that facility. Usually we ordered the CT scan, it was fine, we watched them a bit and sent them home.
Not this time.
His CT showed that he had a skull fracture, which crossed the transverse sinus, a low-pressure venous system in the back of the skull. Neurosurgeons are pretty stoic folks, who rarely seem worried — but his neurosurgeon was.
“Those go bad really fast. You need to get him to me.”
So, the patient was transferred to the referral center and, fortunately, out of my ED before something unpleasant could happen.
In the process I acted upon what I call, “Leap’s Law of Emergency Medicine,” which goes as such: “Make everything someone else’s problem as soon as possible.”
And I did. As usual, I never heard more about it from anyone. So, I assume he did well.
Edwin Leap, MD, is a board-certified emergency physician in Princeton, West Virginia.
Keep Rivals Far Apart
Almost 20 years ago, as a resident at Jefferson Health in Philadelphia, I had the unique opportunity to work as the on-site doctor during Eagles football games. It was a coveted assignment among senior residents. I felt so lucky. Standing on the sidelines. Up close at an NFL game? Absolutely.
But let me tell you: this was not an easy gig. Fans watching at home don’t see what can be real chaos off the fields in the parking lot and in the stands. I vividly remember being the sole doctor in the triage room off-field, tasked with caring for fans who found themselves in medical emergencies. While I had access to the field, most of my time was spent in the depths of the stadium, far away from star players. Picture a hospital ward from the early 1900s, with stretchers lined up side by side. I was constantly bouncing between fans who were too drunk to walk or talk, vomiting and needing IV fluids, and others who had gotten into fistfights.
The key to keeping the peace? Keeping fans from rival teams far apart.
Since then, I’ve also manned EDs on game days, including Super Bowl game days. It’s far different. When action is happening on the field, the ED is eerily quiet. Most people are home, glued to their TVs. I chose these shifts because of the relative calm and because, I’ll admit, I’m not an avid football fan. (Talk to me about Tar Heels basketball, though — different story!) It was a light workload with only the sickest patients showing up.
The calm never lasted, though. The floodgates opened as soon as the game ended, and the post-Super Bowl overnight shift was as chaotic as the stands during the game.
N. Adam Brown, MD, MBA, is a practicing emergency physician, founder of ABIG Health, and a professor at the University of North Carolina’s Kenan-Flagler Business School in Chapel Hill.
Naked and Unstoppable
Football games can bless the ED with that rare quiet shift — or send in the fans. After a big game, we usually get two types: the celebrating drunks and the devastated drunks. One night, this guy was the “celebrating drunk,” dropped off solo as usual, and too blitzed to know if he needed medical care. After we confirmed he was just impressively intoxicated, we let him know he would need to sober up in the ED — but he decided he was leaving. An argument ensued.
After a few minutes, the nurses were done arguing and left, so I stepped in, suggesting he wait for his ride. He asked what would happen if he didn’t. I foolishly answered: “We won’t stop you, but protocol means we call the police.” His response? “Tell them I’ll be the naked guy.” Before I could try a new communication technique, his clothes hit the floor. Fully nude, he strode to the nurses’ station, hopped up onto a desk, and informed them that I’d just told him he “couldn’t be stopped.” The nurses turned to me, their faces asking the obvious: Why is there now a naked man standing on the desk out front?
Brad Walker, MD, is an emergency medicine physician in Georgetown, Texas, and advisor to ABIG Health.
What Do You Get When You Cross a Football Fan, 11 Beers, and Four Shots of Whiskey?
My patient came into the ED during the overnight shift, directly from attending a football game, escorted by a group of five of his buddies, still singing the chant of his favorite team. At first, we thought he only had alcohol poisoning. However, as the attending noticed, every so often, one of his friends would thump him on the arm, and he would stop singing, scream out in pain…and then go back to singing. To make matters worse, when we tried to get him to X-ray, it was impossible to get him to stay still long enough to get the images.
It was exceptionally busy that night, so it took a long time for his results to come back. All through the night, he had a circulating band of friends come in, all decked out in his team’s colors. Finally, his girlfriend showed up around 4 a.m. and made everyone leave.
Hours later, although he and his friends had failed to mention any sort of trauma to his arm, we found that he’d fractured his ulna during an electric-scooter collision in the parking lot. Don’t assume your drunk patients don’t have something else going on!
Nidhi Bhaskar is a third-year medical student at the Warren Alpert School of Medicine of Brown University in Providence, Rhode Island.
Stadiums Aren’t Designed to Protect People
Stadiums aren’t known for their accessible stairs or soft materials, and some of the worst sports-fan injuries I’ve seen in the ED have been from people falling over ledges, slipping on stairs, and otherwise getting seriously hurt by those surroundings. This is all the more likely when people are drinking, as spectators often are at football games, like the Super Bowl. (And bad weather can make it a lot worse.)
The worst injuries I’ve seen came from fans falling over balconies and ledges, resulting in bleeding into the brain, fractured skulls, and even injured spinal cords — not unlike some of the worst injuries that athletes can sustain on the field. Even a fully sober person is going to get hurt by falling on concrete and metal edges. I remember one patient who was jostled over a ledge by their own family jumping up and cheering around them, resulting in a severe traumatic brain injury.
My advice to spectators? Football stadiums are not designed to protect you, so it is even more important to try to drink in moderation and to have someone sober with you who can look out for you. When in doubt, just go slow and do not lean over anything.
Ryan Marino, MD, is a medical toxicologist, emergency physician, and addiction medicine specialist, and an associate professor in the Departments of Emergency Medicine and Psychiatry at Case Western Reserve University School of Medicine in Cleveland.
Have your own football-fan patient story? Share it in the comments below!
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