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Outside the Lines: Training Athletes to Death

Here's the transcript from Show 71 of weekly Outside The Lines - Training Athletes to Death

Announcer - August 5, 2001.

Mark Schwarz, host - The devastation began in the NFL, Wednesday in Minnesota.

Unidentified Male - It was like he was here today, gone tomorrow.

Schwarz - Later that day, it happened again at a high school in Indianapolis.

Unidentified Female - (Unintelligible) Clinton Central High School. There's a football player with heat exhaustion.

Schwarz - On Friday, a college player was dead on a practice field in Illinois.

Unidentified Male - As a parent, and someone who loves his children a great deal, it was the hardest thing I've ever had to do in my life.

Schwarz - Coaches talk about football being life and death. For these young men, and dozens more like them, it was both. Who's responsible? We'll examine that, and visit a community that continues to grieve one year later. Doctors say heat related deaths can be avoided.

Unidentified Male - It's even more tragic because it is preventable.

Schwarz - The football community must take a hard look at itself, and answer the painful question - Are we training our athletes to death?

Announcer - Outside The Lines is presented by State Farm Insurance.

Joining us from ESPN Studios, and sitting in for Bob Ley - Mark Schwarz.

Schwarz - When it happens in boxing, there is outrage, impassioned cries to ban the sport. But when a player dies on the football field, it is labeled an isolated incident. It is called a flukish occurrence; no one would dare suggest football be banned. And let's keep in mind, it's not contact that is killing athletes - It's conditioning. But when three young players die in the span of 63 hours, perhaps it's time to hold someone accountable.

Remarkably, Korey Stringer is the first NFL player to die of heat stroke in the league's 80-year history. However, in the last seven years alone, 19 high school and college players succumbed to heat stroke. But some have died for other reasons.

For example, Friday at Northwestern, a program now known for rigorous training, Roschiti Wheeler, a 22-year-old safety, collapsed and died during conditioning drills. Asthma, not heat stroke, appears to have been the cause of death. On Wednesday, Travis Stowers, a 17-year-old offensive lineman for Clinton Central High School in Indianapolis fell to his knees during the second day of the team's non-contact drills. Stower's body temperature reportedly reached 108 degrees. The County Coroner says heat stroke may have been a contributing factor.

Eleven days ago, University of Florida freshman fullback, A. Ross Otan died after being in a coma for six days. He collapsed July 19th after running sprints in a voluntary conditioning session. His body temperature also measured at 108. Last August, Michael King, a sophomore tackle for the University of Indianapolis, died after practice. King complained of exhaustion after finishing drills, later became lethargic. He was taken to the hospital where he died; he had a body temperature of 110. Two days after that, Jeremy Tarleya, a 15-year-old junior lineman from Saline, Michigan died after suffering liver and kidney failure and neurological damage related to heat stroke. Tarleya initially collapsed eight days earlier after a one and a half-mile run in pre-season football camp.

Ed Gall, Athletic Director, Saline High School, Saline, MI - He was a young man that was loved by the community and we're all missing him very much. So, you can't easily describe the hurt and pain that a family goes through in a situation like this.

Schwarz - Two and a half weeks after the tragedy in Michigan, Richmond, Virginia mourned the passing of an All-State offensive tackle. It was an event that made a football coach question his existence and examine his methods. Because a new season begins, it's full speed ahead for the Varina Blue Devils.

The Varina High School locker room, it's where the Blue Devils dress. It's also where they remember. But if you ask about Craig Lobrano, you may be asking too much.

Jessica Meade, Athletic Trainer, Varina High School - No, that's definitely not something that I feel that I want to relive for the cameras, or that I think the Lobrano's would want.

Schwarz - On September 4 last year, Lobrano collapsed during football practice. The weather that day in Richmond, Virginia was 77 degrees, with 85 percent humidity. At the hospital, Lobrano's temperature soared to 108 degrees. He had not been feeling well before practice, but told no one until it was far too late.

Unidentified Male - He was No. 78, it stretched across his chest.

Schwarz - At the next home game, cheerleaders painted No. 78 on their cheeks, fans grieved, and outside the Blue Devils locker room, new artwork, a mural that shadows football coach Gary Chilcoat to this day.

Gary Chilcoat, head football coach, Varina HS - I think about Craig and his death every day, and then I also ask, why am I here? What am I supposed to be doing? And hopefully, this may be it. Maybe I can help somebody; maybe somebody will hear this piece and -- I spoke to Ms. Lobrano last night. And her statement to me was, that if you can keep one person, one child, from hitting the ground then do whatever it takes.

Unidentified Female - All right guys, let's get the coolers over, get ready for the mile run.

Schwarz - As much as the Blue Devils miss their fallen teammate, they must prepare for this season. This past Thursday, a grueling test, a timed mile in 85 degree heat.

Chilcoat - All right runners, set and go!

Schwarz - The backs went first. They would have to complete the mile in 6.5 minutes or run it again on Monday.

Jonathan Lewis, defensive lineman, Varina HS - I can't run it like that, so don't put the camera on me. Please don't put the camera on me.

Schwarz - Star defensive lineman Jonathan Lewis would be next. He wears Lobrano's number in tribute.

Lewis - As long as it can hold up, I'll be wearing this 78 shirt under my jersey.

Chilcoat - (Unintelligible) back here, right? You're a track star, son, let's go!

Schwarz - The backs complete their run then head for the water and ice towels.

Chilcoat - Water, water, water, get that water! Get up off the ground!

We've emphasized water more, maybe. To tell somebody that they must take in a lot of water, and then just assume that a 15 to 16 year old is going to do it, that's not going to happen.

Unidentified Female - This isn't a debate.

Unidentified Male - I'll give him some water.

Unidentified Female - I'm not worried about your head hurting because you ran a mile. I'm worried about you getting water in you.

Schwarz - Jonathan Lewis is now out on the track. He says Lobrano's death was a harsh wake-up call.

Lewis - If we ain't careful out there on the field, knowing your body's limitations, what it can take and what it can't take.

Schwarz - But halfway through the mile, Lewis is in trouble.

Lewis - Drop out.

Schwarz - And he's not the only one.

Unidentified Female - Go ahead on to the other side, grab some water.

Lewis - I'm going to get back in...

Unidentified Female - That's fine, you don't have to, you don't have to go for it.

Lewis - ... in a little bit. Here I go.

Schwarz - Coach Chilcoat may be more aware of protecting his athlete's health, but he remains a football coach, pushing his players to push themselves.

Chilcoat - Let's go Jason! Don't let them pass you. Fabian, you ought to be up front side, let's go!

Pass it...

Unidentified Female - Get water, get water.

Schwarz - No coach has all the answers, the trick may be asking the right questions.

Chilcoat - Any pain, Bruce?

Unidentified Male - None whatsoever.

Chilcoat - OK.

Schwarz - The art is to push...

Chilcoat - Heave ho, let's go!

Schwarz - ... and to praise.

Chilcoat - And you didn't walk a single step. Good job buddy. Good job Robert.

Schwarz - Lewis soaks it all in, while his coach reminds the team and himself of the delicate balancing act they must perform in order to both survive and conquer.

Chilcoat - That's what we got to do, guys. You've got to understand, gotta know the difference between pain and injury. You've got to know the difference between being pig-headed and thinking you are invincible, and being smart and knowing what your limitations are as far as this game goes. We want to never forget Craig Lobrano. We want to never forget how hard he worked, and what he meant to us. And we want to never forget how much we learn from Craig's death. Whether we've got to be better people because of it.

Schwarz - Can Craig Lobrano's death help save the lives of others? Are coaches and trainers doing enough to safeguard athletes from excessive heat?

Our guest knows heatstroke first hand, he was a victim of it. Now he's a crusader against it. Dr. Doug Casa is the chair of the National Athletic Trainers Association Position Statement on Fluid Replacement for Athletes. Dr. Casa joins us this morning from Lake George, New York.

Doug, we've seen three heat-related deaths in eight days. Could these deaths have been prevented?

Douglas Casa, Ph. D., UConn Director of Athletic Training Education - Mark, yeah, the deaths can be prevented. And the tragedy, even if heat stroke leads to death or not, all cases of exhertional heat stroke that occur in athletics whether it be during two a day practices or at any time, are completely preventable. So any time they do occur, you have to take a serious look at either the prevention, identification, or treatment.

At some point within that process, something went wrong. And oftentimes there was problems within the organizational structure at all three parts of that process. So, we have to take a close look at why they are occurring. Anytime they occur, something went wrong in terms of what the structure, the policies and procedures, what the people who are involved in the process are doing.

Schwarz - What about the players themselves, when they are feeling ill. Don't they share some of the responsibility?

Casa - The players, you always want to create an environment where with the athletic trainers. There's no question about that. But, it is absolutely critical, when we're dealing with cases of heat stroke, is that the medical professionals have to be able to be the ones to make the final decision regarding continued participation.

Schwarz - Well I want you to hear what NFL Union Chief Gene Upshaw, the man charged with protecting NFL players had to say, this week on ESPN radio about player responsibility. Then we'll get your reaction.

Casa - OK.

Gene Upshaw, President, NFL Players' Association - A player always wants to go back on the field. And he should go back on the field if he feels like it. Now obviously, he's the only one that can control this. You just, if you don't feel well, don't go out there. And there are a lot of guys that don't. So, there are ways to deal with it, but it is still really up to the player to police his own action.

Schwarz - Can the players police themselves Doug? Is Upshaw right?

Casa - Mark, It's extremely tragic when a person in a position of power shows such shear ignorance to such a serious condition. We know in exertional heat stroke, before the condition reaches the point of collapse, athletes often show things like confusion, irrational behavior, agitation. Common signs and symptoms before the onset of this, that they are in no position to decide if their continued participation would be safe or not.

That's why high schools, colleges, and professional teams employ athletic trainers, and why they should be the ones that make the ultimate decision to keep them out of continued participation, if they feel that there is a potential risk of exertional heat stroke.

Schwarz - OK Doug, when we return, a man who won three Super Bowl rings is among the high school coaches we'll put on the spot. How much of the responsibility is theirs? But first, do you remember the days when water wasn't allowed on the practice field? Joe Paterno does.

Joe Paterno, Penn State head coach - When I played football, even in high school, you weren't allowed to drink water. I mean, my coach used to put a bucket of water on, and he put a sack of oatmeal in it, so you wouldn't drink it. You could wipe the sweat off you. And the first ten years I coached in college, we never let water on the field.

John Mackovic, Arizona head coach - We weigh out players every day, weigh out, weigh in. Then our trainers keep track. Does somebody lose 10 or 12 or 15 pounds, they are right on him immediately.

Dr. Robert Cantum, Medical Director, National Center for Catastrophic Sports Injury Research - Weigh themselves before practice, weight themselves after practice, and make sure that they are not losing more than two percent of body weight without dehydrating back that weight with fluid.

Schwarz - This weekend that is Hall of Fame in Canton, Ohio, the NFL saluted high school football. And we sat down with some of the nation's most prominent coaches, and an NFL veteran for a round table discussion. Joining us, ex-49er Riki Ellison, who won three Super Bowl rings, and begins his high school coaching career this fall at the Virginia school portrayed in the movie, "Remember the Titans." Tommy Reamon who coached Heisman winner Michael Vick and Saints quarterback Aaron Brooks at Warwick High in Newport News, Virginia.

Chris Gedney, who played in triple-digit heat in Arizona, and whose failing health due to intestinal problem a few years back, helps him relate to Korey Stringer, even more than he would like. And finally Sonny Detmer, father of two NFL quarterbacks, and a high school coach for 30 years, now an athletic director. I asked him if it ever gets so hot in Texas that he won't practice his players in full pads.

Sonny Detmer, Athletic Director, Somerset High School, Somerset, Tex. - No, because it's -- maybe you adjust practicing, things like that. But you still go out and do your work. And it's awful hard to neglect that part of it, because you might get a period of time in there where three or four days, five days in a row. Just the fact that it is hot -- see our kids live in a hot climate.

Riki Ellison, Head Coach, T.C. Williams High School, Alexandria, Vir. - You've got to be able to judge your team, and you've got to be able to judge the condition of your team. And cut it off, if they are fatigued. We all play in different conditions, but as a head coach, you've got to understand how your players perform, and their fatigue level during practice. And back them off if it is ...

Schwarz - Tommy, you mentioned that you had at least one kid on your team that you would consider obese. Now that what happened to Korey Stringer happened, a kid that was 335 pounds, will you look at that kid differently than you ever have before?

Tomy Reamon, Head Coach, Warwick High School, Newport News, Vir. - We will watch a heavy kid that's out there, a kid that's not been participating, that we think may be out of shape, I may tell them to back off a little bit on agility drills, or something. And be cautious of water breaks more.

Schwarz - If a kid vomits three times, the way Stringer did on a Monday, do you practice them on Tuesday?

Detmer - Most kids, even high school kids, will come back that next day. And if they are feeling fine, yeah, you go ahead and put them out there. You just, you know, you kind of watch them a little bit more.

Ellison - The problem I perceive is that you're going to have two groups of kids. You're going to have kids that go through a conditioning program over the summer that are in shape. Then you have a separate group of kids that didn't go through a conditioning program, for whatever reason, that are going to have problems. And you've got to be able, either to mess them -- and a lot of tendency would be to mess them and have everybody do the same drills. Or you're going to have to, either separate them, and work more conditioning on the guys that are out of condition. And still have them as a ...

Detmer - Don't you think a pro player can hide it from his teammates and coaches a little better than a high school kid would? I would think that, because a high school kid, if he's really feeling bad, you know, you can really see that. And a pro player sometimes can force himself through a situation where maybe nobody notices as easily.

Chris Gedney, Bears tight end (1993-'96), Cardinals tight end ('97-'98, '00) - I agree with Riki, that I think, if you leave it up to the player, he's probably going to mask everything. And you're not going to be able to tell. And it is up to the teammate. Really, I've been in the huddles like that, where you're bent over, bent over barely able to breathe. And the guy next to you will just pull your jersey back, and say, come on man, let's get somebody else in here. It's not worth it. But, I think, ultimately if you leave it up to the player, more of these things will probably happen.

Schwarz - About six years ago, you were in training camp with the Bears in Platteville, Wisconsin, 100 degrees, and you weren't healthy. Tell me about what you were experiencing, as you were trying to get through those practices, but not feeling well.

Gedney - Probably something very similar to what Korey Stringer went through. I had, I became sick, which a couple months later was diagnosed as ulcerative colitis, but for those couple months at the end of training camp and the beginning of the season, I'm trying to fight through this. And I think it's just in my mind. And I remember Mike Shuler, my tight ends coach at the time pulled me aside. And said, Chris, you've got to get your act together. You know, you're a third-round draft pick for us. We expect more out of this from you. You're getting beat on one on one drills by some, you know, rookie linebacker.

Schwarz - Why couldn't you tell your coach, Mike Shuler, that you weren't feeling well?

Gedney - Well, you know, I think as a player you don't want to be labeled as somebody who doesn't feel well, or that's prone to injury. And the year before, I had, you know, several things come up that sidelined me. You know, different nicks here and there. And it -- I was still relatively young in my career, and I don't want to be stigmatized that way.

Schwarz - Sonny, who is responsible at the high school level when a kid doesn't feel well. Is the kid responsible for telling the coaches that he doesn't feel well? Or are the coaches responsible for seeing it before it gets out of hand?

Detmer - Well, we expect the kid to tell us if he's not feeling well. We also ask the other kids on the team, if you're notice a teammate is not feeling well, please tell a coach. And then the coaches themselves, if they can notice that, then we have certified trainers at most of our schools down there now.

Schwarz - How many trainers do you have supervising how many kids?

Detmer - Well, we've got one trainer. We've got 120 kids, probably in high school. And he's with the high school group most of the time. The junior high, our fields are in close proximity, and then the trainer can be called for those kids, for the junior high kids.

Ellison - At the high school level, there is one, one trainer for hundred, two hundred kids. There's no medical history on them. And this was shocking to me. This is important, because I don't really want to get close to having any type of serious injuries, especially a death.

Schwarz - So, you feel responsible for 200 kids, but you don't feel, maybe, you have the resources to be responsible.

Ellison - Well, I am responsible for 200 kids. I've got to deal with what we've got to deal with, in terms of resources. I can't -- where is it going to come from? I've got to be able to deal with it. So I've got to be more in tune with my players.

Schwarz - Is the kind of heat-related death that we've seen this year, not only with Korey Stringer but at Florida, is it preventable?

Reamon - We could do everything perfect, right in supervision and management and still no guarantee that something like this will not happen.

Schwarz - Joining us again, Dr. Doug Casa. And Doug, if I am the father of a high school football player. And at my school there is one trainer overseeing 200 football players, should I feel secure?

Casa - Well there are a couple of things to consider. We also have to consider that more than half of the high school in America still don't have certified athletic trainers. So that alone, in those situations, you have two or three hundred athletes doing two a day practices, not just football. You might have men and women soccer, freshman, JV and varsity teams. Also field hockey and cross-country teams, so you got schools that have no certified athletic trainers, looking out for the medical care of the athletes.

And you also have some schools that only have one. So there are a lot of solutions to the problem, but just for bare minimum, every single high school in America should at least have one certified athletic trainer. So at least there is someone responsible for the medical care of those kids every single day while they are doing their two-a-days and then throughout the rest of the year. And right now it is not like that, unfortunately.

Schwarz - Yeah, well you have some critical do's and don'ts that any football program should follow. Why don't you go through those with us.

Casa - Not a problem. There are a lot of things that you can do if you do feel there is a risk of heat stroke. Now we have to remember it doesn't have to be extreme heat. Some of the things you could do would be - decrease intensity, move practice times to earlier or later in the day. So have them early in the morning or late at night. Increase staffing during high-risk times, would be another critical factor. Decrease the amount of clothing, so if you have them in full pads, consider taking the pads off. Have them just wearing T-shirts and shorts.

Increase amount and length of rest breaks, this is absolutely critical. And do this in the shade, this gives our body a time to cool down. Dehydrate them properly, and this can be done properly during the rest breaks. Dehydration is an absolute, critical factor if you want to prevent the onset of a heat illness. That's going to limit the rise of core temperature. Consider only one practice during extreme heat, when it's very bad conditions, this is one simple way to solve the problem. Just have one practice early in the morning. And also, if possible, move intense portions of practice to air-conditioned facilities.

Schwarz - Dr. Casa thank you very much for those suggestions. Hopefully, coaches, trainers, players standing by with all ears, attending to this very important information. Thanks for joining us today from Lake George.

Casa - Mark, thanks for giving me a chance to share with this.

Schwarz - In a moment, your thoughts about last week's show on Fred McGriff's dilemma.

Schwarz - Last week, we looked at how some athletes would rather stay close to home with a losing team, then leave town to play for a winner. They were greeted by applause and with a smattering of boos.

From Tampa, Florida - "At a time when sports fans are being bombarded with the embarrassments of the Gold Club scandal, it's nice to know that for every Patrick Ewing and Andruw Jones, there's a Fred McGriff and B.J. Surhoff. These players should be commended for their desire to balance family needs with the demands of being a professional athlete."

And from Phoenix, Arizona - "It is very hard for me to feel sorry for Major League Baseball players who get paid millions of dollars a year to leave their families for seven, mostly summer months when there are thousands of U.S. military members who have to leave their families for a year or longer; and some don't make in a year what some baseball players make in a day.

Remember the address for the online Outside The Lines is Get more on today's topics there and our library of streaming video. Our e-mail address is

Schwarz - Thanks for watching our program. You can catch us 10:30 Eastern Sunday mornings on ESPN, 1:00 p.m. here on ESPN2, where the Cubs and Dodgers tango at 8:00. Mariners-Indians on ESPN. Highlights from the Great Outdoor Games next on ESPN2.

Right now Rece Davis and Betsy Ross with "SportsCenter."

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 Mark Schwarz examines the uncomfortable, but all too real dilemma that athletes face when teammates pass on.
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