"Too hot, too hot!," is spoken at the beginning of Shakespeare's The Winter's Tale by Leontes, who comes to the (false) conclusion that the courtly flirting, acceptable at the time, between his wife and his old friend Polixenes, had gone too far. This is a classical example of figurative heat; in this little article, we will discuss two examples of the real thing, excess body heat, occurrences of which killed one man and almost killed another. The two incidents of heat stroke occurred nearly four decades apart; the most recent event resulted in the tragic death of a young athlete. If the second event had had a similar outcome, there would not have been subsequent decades of shared love and shared struggle experienced by a man named Thomas and by a woman named Nirmala. In other words, there would be no words here, words written by a person who considers himself lucky to be alive.
Let us begin with the tragic death of a young football player.
1. The Case of Jordan McNair
Young Jordan had been an excellent student at McDonough High School, a prestigious private school in the Baltimore area. He began his first year at the University of Maryland in 2017. Not only gifted academically, he was athletically gifted as well. Standing at six foot four and weighing about 300 pounds, you can guess the sport at which he excelled.
During football practice on a hot day at the end of May, McNair was noted to be having difficulties at around 5 p.m.. At 4:15, the team members performed about fifteen minutes of aerobic exercise, followed by a period of conditioning, which consisted of several 110 yard sprints. After completion of these tasks, around 5 p.m., McNair was in trouble. He was taken into a team room to recover. At around 6 p.m. an ambulance was called; the young man was having a seizure. His temperature at his arrival at a local hospital was 106. After a crucial lapse of an hour during which little had been done to help him, his temperature was brought down by cold water immersion, the standard treatment for heat stroke. He was subsequently airlifted to Maryland's prestigious Shock Trauma Center, but it was apparently too late. Brain damage had already occurred; after struggling for two weeks, he died.
This death should not have happened. There was a so-called strength coach on duty at the football practice, who quite possibly pushed the players hard, too hard. This harshness, which sometimes might cross the border from harshness to abuse, is apparently a frequent aspect of the macho world of football.
The well-known football coach Vince Lombardi was fond of repeating Red Sanders famous dictum, "Winning isn't everything; it's the only thing." Winning brings prestige--and a lot of money--to colleges whose teams are victorious. Not only coaches, therefore, but many college and university presidents tacitly support this dictum as well, although they might be hesitant to admit it in public.
I imagine that McNair, fearing to appear wimply, did not complain until it was too late--that is, after indications of impending collapse appeared.
During the eighties, I was the Director of School Health for the Baltimore City Health Department. Our team made sure that coaches understood that athletes must be allowed, without shaming, to take liquids whenever they felt it was needed. We also identified the dangers of practice during hot days. This was apparently not the policy the "strength coach" followed on that fatal day in May.
Treatment for heatstroke is well established: rapid cooling by immersion in cold water. This would have saved Mr McNair, and should have been available, if not immediately, then after only a brief delay.
The University of Maryland is responsible for the gross negligence of delaying necessary treatment for a crucial hour. The institution will have to pay the family millions in damages, no doubt about that.
How could the staff have been so ignorant, so indifferent in their handling of a true medical emergency? I should talk!
2. The Case of Thomas Dorsett
In the summer of 1978--hardly the coolest time to be in India--my wife, Nirmala, and I traveled to Calcutta. We were exploring the possibility of adopting a child from India; we also planned to meet my brother-in-law, the late and great Lieutenant Colonel Vijayan Gopalan, who was stationed near Calcutta at the time. We met him on the morning of a hot day. We visited Mother Teresa's orphanage, and saw a child we wanted to adopt--she was about six months old. It didn't work out, since neither of us are Catholic. We also visited the famed Loreto School in Calcutta.
Toward the end of the day, we toured the Calcutta Botanical Gardens. We were walking along a long path in the gardens, which stretched straight ahead of us for almost a mile. Nirmala and Vij were lost in an animated discussion. Unnoticed, I began to drop behind. I just couldn't keep up; I began to feel quite ill.
By the time they noticed that I hadn't kept up with them, I had fallen quite a distance behind, maybe a half kilometer. They turned around and waited. They thought I had been busy smelling jasmines, or something like that.
We had become tortoises and a debilitated Achilles, characters from the ancient anecdote which supposedly proves that no motion is possible. Zeno, the author of the anecdote which since has been known as Zeno's paradox, asserted that for Achilles to reach a tortoise, he must first reach half the distance between them, then half of that, etc--There would always be a divisible portion left--Therefore the hapless god will never reach the tortoise.
In my case, I, a debilitated Achilles who had weaknesses beyond those of his heels, could only proceed at a tortoise's pace.
When I finally reached my wife and brother-in-law, they gave me an annoyed what's-the-matter with-you look. Annoyance quickly turned to concern when they noticed that something indeed was the matter with me. I could hardly talk; I could barely walk.
We thereupon entered the Botanical Gardens canteen, where they had been waiting for me. They bought me a cold drink, but I could only take a few sips, lest I vomit. My head lay on a table; I couldn't sit up.
They realized I was quite ill. Vij called for the army jeep to take us to Barrackpore, about 30 kilometers north, where Vij was stationed.
The jeep came; I sat in the front. I don't know how long the journey took, maybe about an hour. The roads were unpaved and the ride was bumpy.
I asked a few times, with a weak voice, are we almost there? Yes, Vij replied. I remember this jeep ride as the worst time I felt in my entire life. I was barely conscious.
When we arrived, Vij and Nirmala still assumed that I could walk to the barracks, but I couldn't. (This was my fault--I never told them how sick I felt, and by this time, I couldn't talk at all). I exited the jeep and collapsed. I was helped to the barracks. Upon arrival, my oral temperature was over 106 degrees Fahrenheit.
I don't think I seized, but I writhed about on the bed. Clothes were removed down to my undershorts. Nirmala brought wet sheets and wrapped them around me. Boy did that feel cold! This had to be done several times, as I defervesced.
I survived. and was damn lucky that I did. No one at the time realized that the heat stroke I suffered could easily have been fatal. In fact, my aha moment came forty years later when I read about what happened to Jordan McNair.
There are eerie similarities between the two cases. We both had temperatures of 106. Fever doesn't get much higher than that; at this temperature, brain damage is a distinct possibility--in McNair's case it became a tragic reality. We both remained untreated for at least an hour after severe symptoms first appeared.
Regarding the young football player, there had been an egregious error. In my case there was an error as well: After all, I was a doctor and should have recognized my symptoms as that of impending heat stroke. But I didn't--I thought I merely needed fluids and some rest, until, quite suddenly, I had become too ill to talk.
What brought about the death of a promising young athlete? Negligence. Inexcusable negligence. What brought about the survival of an older man, thus enabling him, as it turned out, to write on into old age?
Plain, simple, and inexplicable luck!
Let us begin with the tragic death of a young football player.
1. The Case of Jordan McNair
Young Jordan had been an excellent student at McDonough High School, a prestigious private school in the Baltimore area. He began his first year at the University of Maryland in 2017. Not only gifted academically, he was athletically gifted as well. Standing at six foot four and weighing about 300 pounds, you can guess the sport at which he excelled.
During football practice on a hot day at the end of May, McNair was noted to be having difficulties at around 5 p.m.. At 4:15, the team members performed about fifteen minutes of aerobic exercise, followed by a period of conditioning, which consisted of several 110 yard sprints. After completion of these tasks, around 5 p.m., McNair was in trouble. He was taken into a team room to recover. At around 6 p.m. an ambulance was called; the young man was having a seizure. His temperature at his arrival at a local hospital was 106. After a crucial lapse of an hour during which little had been done to help him, his temperature was brought down by cold water immersion, the standard treatment for heat stroke. He was subsequently airlifted to Maryland's prestigious Shock Trauma Center, but it was apparently too late. Brain damage had already occurred; after struggling for two weeks, he died.
This death should not have happened. There was a so-called strength coach on duty at the football practice, who quite possibly pushed the players hard, too hard. This harshness, which sometimes might cross the border from harshness to abuse, is apparently a frequent aspect of the macho world of football.
The well-known football coach Vince Lombardi was fond of repeating Red Sanders famous dictum, "Winning isn't everything; it's the only thing." Winning brings prestige--and a lot of money--to colleges whose teams are victorious. Not only coaches, therefore, but many college and university presidents tacitly support this dictum as well, although they might be hesitant to admit it in public.
I imagine that McNair, fearing to appear wimply, did not complain until it was too late--that is, after indications of impending collapse appeared.
During the eighties, I was the Director of School Health for the Baltimore City Health Department. Our team made sure that coaches understood that athletes must be allowed, without shaming, to take liquids whenever they felt it was needed. We also identified the dangers of practice during hot days. This was apparently not the policy the "strength coach" followed on that fatal day in May.
Treatment for heatstroke is well established: rapid cooling by immersion in cold water. This would have saved Mr McNair, and should have been available, if not immediately, then after only a brief delay.
The University of Maryland is responsible for the gross negligence of delaying necessary treatment for a crucial hour. The institution will have to pay the family millions in damages, no doubt about that.
How could the staff have been so ignorant, so indifferent in their handling of a true medical emergency? I should talk!
2. The Case of Thomas Dorsett
In the summer of 1978--hardly the coolest time to be in India--my wife, Nirmala, and I traveled to Calcutta. We were exploring the possibility of adopting a child from India; we also planned to meet my brother-in-law, the late and great Lieutenant Colonel Vijayan Gopalan, who was stationed near Calcutta at the time. We met him on the morning of a hot day. We visited Mother Teresa's orphanage, and saw a child we wanted to adopt--she was about six months old. It didn't work out, since neither of us are Catholic. We also visited the famed Loreto School in Calcutta.
Toward the end of the day, we toured the Calcutta Botanical Gardens. We were walking along a long path in the gardens, which stretched straight ahead of us for almost a mile. Nirmala and Vij were lost in an animated discussion. Unnoticed, I began to drop behind. I just couldn't keep up; I began to feel quite ill.
By the time they noticed that I hadn't kept up with them, I had fallen quite a distance behind, maybe a half kilometer. They turned around and waited. They thought I had been busy smelling jasmines, or something like that.
We had become tortoises and a debilitated Achilles, characters from the ancient anecdote which supposedly proves that no motion is possible. Zeno, the author of the anecdote which since has been known as Zeno's paradox, asserted that for Achilles to reach a tortoise, he must first reach half the distance between them, then half of that, etc--There would always be a divisible portion left--Therefore the hapless god will never reach the tortoise.
In my case, I, a debilitated Achilles who had weaknesses beyond those of his heels, could only proceed at a tortoise's pace.
When I finally reached my wife and brother-in-law, they gave me an annoyed what's-the-matter with-you look. Annoyance quickly turned to concern when they noticed that something indeed was the matter with me. I could hardly talk; I could barely walk.
We thereupon entered the Botanical Gardens canteen, where they had been waiting for me. They bought me a cold drink, but I could only take a few sips, lest I vomit. My head lay on a table; I couldn't sit up.
They realized I was quite ill. Vij called for the army jeep to take us to Barrackpore, about 30 kilometers north, where Vij was stationed.
The jeep came; I sat in the front. I don't know how long the journey took, maybe about an hour. The roads were unpaved and the ride was bumpy.
I asked a few times, with a weak voice, are we almost there? Yes, Vij replied. I remember this jeep ride as the worst time I felt in my entire life. I was barely conscious.
When we arrived, Vij and Nirmala still assumed that I could walk to the barracks, but I couldn't. (This was my fault--I never told them how sick I felt, and by this time, I couldn't talk at all). I exited the jeep and collapsed. I was helped to the barracks. Upon arrival, my oral temperature was over 106 degrees Fahrenheit.
I don't think I seized, but I writhed about on the bed. Clothes were removed down to my undershorts. Nirmala brought wet sheets and wrapped them around me. Boy did that feel cold! This had to be done several times, as I defervesced.
I survived. and was damn lucky that I did. No one at the time realized that the heat stroke I suffered could easily have been fatal. In fact, my aha moment came forty years later when I read about what happened to Jordan McNair.
There are eerie similarities between the two cases. We both had temperatures of 106. Fever doesn't get much higher than that; at this temperature, brain damage is a distinct possibility--in McNair's case it became a tragic reality. We both remained untreated for at least an hour after severe symptoms first appeared.
Regarding the young football player, there had been an egregious error. In my case there was an error as well: After all, I was a doctor and should have recognized my symptoms as that of impending heat stroke. But I didn't--I thought I merely needed fluids and some rest, until, quite suddenly, I had become too ill to talk.
What brought about the death of a promising young athlete? Negligence. Inexcusable negligence. What brought about the survival of an older man, thus enabling him, as it turned out, to write on into old age?
Plain, simple, and inexplicable luck!
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