The following is an article I was recently asked to write for the MDA National Magazine on the topic: "What do I love about my specialty?"
What do I love about Sport and Exercise Medicine (SEM)? I’m sure most people assume it is the front-row and behind-the-scenes access to sporting events. It’s not.
Recently I had my first experience interviewing prospective registrars for the Australasian College of Sport and Exercise Physicians. Perhaps unsurprisingly, many candidates described being drawn to the field by their love of sport. There is no doubt that a healthy love of sport goes a long way to enjoying a career as a SEM physician but it doesn’t take long for your all-access sports-event pass to lose its novelty.
Don’t get me wrong. A front-row seat to some diverse and amazing experiences is a major job perk. In my first 2 years as a registrar I was pitch-side for victories in: a WAFL grand final, an NBL championship, a South East Asian Soccer Cup, an under-18 div 2 AFL championship and a Men’s Hockey Champion’s Trophy. I’d flown on a private jet with the Australian Boomers. I’d been backstage with acrobats of the Circ Du Soleil. I’d even been medical consultant for an arctic adventurer.
But not all those experiences were as glamorous as they might sound. The above list neglects to detail the mundane bus trips, the difficult interactions with coaching staff and some of the unrealistic expectations and external pressures. A low point was watching a player I’d cleared to play just days earlier suffer a high grade achilles tear in front of a massive live audience in the first game of an NBL grand final series.
Inspired and Challenged by My Own Patients
The thing I love most about SEM can be summed up by this quote: “The key is to keep company only with people who uplift you, whose presence calls for your best” (Epictetus c80AD)
The company that you keep, over time, subtly influences the person you become. In my life, I’ve encountered no other field, personal or professional, that has led to more interactions with people who inspire me. I’m not necessarily talking about elite athletes here either. On a daily basis I get to meet ‘dream-chasers’. I see people with personal goals and private battles as diverse as the diabetic trying to run their first marathon, the 60-year-old cyclist embarking on a masters world record attempt, the middle-aged father-of-three challenging himself with ultramarathons.
Not only am I inspired by my patients but I also find they regularly raise the bar on what I expect of myself. I won’t be making any world record attempts anytime soon but I do love being challenged by the concept of what it is possible to achieve, how much can be squeezed into a life and what amount of difficulty and setback can be overcome.
A deeper appreciation of sport
Sports media is understandably biased towards the success stories. It is hard to be a follower of sports and develop a true appreciation of how many athletes train, strive and sacrifice but still fall short of their goals. For every winner, there are hundreds, if not thousands, of also-rans. There are stories of injury and misfortune. There are stories of modest, more personal goals and quite achievements. There are those that eventually do triumph with their backstories of hardship-overcome never told. SEM physicians are uniquely privy to the unpolished warts-and-all side of elite sport uncensored by the news media. It is a side of sport I feel privileged to be a part of and affords a deeper appreciation for sport on all levels.
Most physicians know the frustration of care compromised by poor patient compliance. SEM patients are generally very motivated and engaged with their treatment. They are usually happy to follow advice even when it may be difficult, unpalatable or onerous. Often sports people are process-driven which is a mindset that can be very useful when dealing with pain and injury. Lingering within the sick role for secondary gain and pain that is escalated by emotional responses or a sense of helplessness are not common in SEM. It’s true that occasionally the pendulum swings too far and SEM patients can sometimes be over-zealous in their injury management but that tends to be much easier to address.
Since becoming a sports physician I’ve learnt, through my patients, about the worlds of dance-sport, underwater rugby and roller-derby just to name a few. I’ve treated musicians, dancers, acrobats and archers who have all shared interesting insights into their professions. I’ve seen trekkers, climbers and adventurers who have shared stories about their adventures and travels. Every day I learn something interesting that may be completely unrelated to medicine.
A diverse experience at the elite level of sport is actually quite a rare thing. Athletes and coaches who reach the highest levels of their sport are obviously highly specialised. The SEM physician however is an exception and can experience multiple elite sporting environments and cultures. Often the team doctor is a fly-on-the-wall observer during team meetings and has the unique opportunity to view differences in coaching styles and methods and team culture across dozens of sports.
As doctors, we all love to help people. Helping people who inspire you and value (and comply with) your advice is a bonus. Being able to help people overcome setbacks and achieve their goals brings added reward. Engaging with people doing interesting things across diverse fields of physical activity enhances job satisfaction. And, in the end, in SEM you generally get to help facilitate aspirations more often than you have to advise against them.