Living on the Edge--CarefullyTHE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 10 - OCTOBER 96
Navy pilots who land on aircraft carriers have a dangerous job--it's like landing on a postage stamp that is bobbing around in the sea. The saying among flight surgeons is that "There are old pilots and there are bold pilots. But there are no old, bold pilots." In other words, it's how you do it that counts.
Increasingly, people--some of them you or your patients--are taking up "thrill sports." These activities are certainly thrilling, but are they worth the risk? What do you say to patients who announce they're trying one? I'd like to discuss a few adrenaline-pumpers I've attempted.
Scuba diving lets you visit a new world and meet new creatures (some of which you never wanted to meet). And you do it weightlessly, gliding like an airborne albatross. It is also a good way to get killed if you don't know what you're doing. You need complete training and careful technique, or the water wins.
Hang gliding can be dangerous for novices because they tend to crash into things. I quit after I sprained an ankle on a hard landing, then tried something safer: sky diving. Enthusiasts love the free fall, dropping through the air like a stone with the wind whipping past your face at 120 miles an hour and the ground rushing up at you. Personally, I've had nightmares that were more fun.
So, when your patient tells you she is taking up rock climbing--by which she means she'll be hanging by her fingertips over a chasm hundreds of feet deep--you might feel like talking her out of it. But I'd be more likely to remind her that her ropes and her partner are her lifeline: She needs to learn technique gradually and thoroughly, staying with challenges at her own level. She should play it safe because she's smart, not because she's scared.
Taking my own advice, a month ago I took a well-tutored ride in a glider--a plane with no engine. A real airplane towed us up to 3,500 feet and released us. The trick was to find rising columns of air called thermals to keep us aloft as long as possible. I was in the front seat, and behind me was the instructor. He was 83 years old. I figured I had found the right thrill sport.
P.S. Look for practical advice on helping patients who do end up in trouble in "Detecting and Treating Common Fractures of the Foot and Ankle: Part 2: The Midfoot and Forefoot," by David B. Thordarson, MD. And find help with another issue of day-to-day practice in "Pitted Keratolysis: A Common Infection of Active Feet" by Michael L. Ramsey, MD.
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