Guns and Goalposts
THE PHYSICIAN AND SPORTSMEDICINE - VOL 25 - NO. 2 - FEBRUARY 97
Planning to finish his team physician duties and head home from a football game, author Robert G. Hosey, MD, instead found himself helping a gunshot victim in the street outside his team's high school ("A Postgame Nightmare").
What does this have to do with sports medicine? Nowadays, too much—which is why The Physician and Sportsmedicine is publishing the article. Homicide rates have tripled among 15-to-24-year-olds in the past 30 years, and homicide is now the second-leading cause of death in this age-group. What your patients deal with in the streets and backyards of their lives is of a different order than the fisticuffs of a generation ago—and these changes are not confined to urban centers.
Still, what can a doctor do? Trying to do primary violence prevention at a sports physical or when tending to an ankle sprain may seem futile. But Kenneth Ginsburg, MD, from the Department of Pediatrics at the University of Pennsylvania School of Medicine in Philadelphia, who writes and lectures frequently on communicating with adolescents, suggests that any encounter with an adolescent offers a chance to screen for behavior-related causes of morbidity. Two critical concerns among adolescents are depression/suicidal ideation and involvement in a cycle of revenge. Particularly after an incident like the shooting described in Dr. Hosey's article, Ginsburg says, identifying vengeful or fearful patients becomes a top priority. In a commentary next month, Dr. Ginsburg will explain both the rationale and the "how-to" for physicians' approaching such issues. Meanwhile, it can't hurt to encourage kids to be involved in games that reward skill and teamwork and set limits on aggression.
In a more traditional vein, we also offer articles this month on Lyme arthritis, exercise-related headache, resistance training, myofascial pain, ocular foreign bodies, and dizziness in a cardiac rehab patient, along with information for your patients about the currently popular low-carbohydrate weight-loss diets.
All of this will help you maintain high-quality care for your sports medicine—or other—patients.