Thoughts on the Rhabdo crisis, from Cool Hand Luke

Thoughts on the Rhabdo crisis, or "What we have here is a failure to communicate."

Rhabdomyolysis is not common. I'd wager 90+% of the American public has never heard of it. I'd heard of it, but only because it was a part of my job to have heard about it, at one time. Here's one example: college student, gets done with finals, drinks about a fifth of Jack. Passes out, roommates leave him sleeping on his bed and they pack and go home for break. Day and a half later, he wakes up, sore as hell. Confused. Ends up on dialysis and a ventilator with no memory even of taking his tests. Rhabdomyolysis+Alcohol poisoning=Big Problems.

Prisoner, bored in the weight room. Bets a guy he can do 300 squats. Does 300 squats. Next day, is exhausted, peeing brown, sore as hell. Next thing you know, he's on dialysis. Still, he won the bet, right?

Football team. Comes back from Winter Break. Big work-out coming--legendary big, according to past players who remember it well almost as a rite of passage. When you do it--big-time squats, then blocking-sled work--you will feel it. Not for days, but for weeks. Some guys puke. Others can hardly walk. But fuck, man, we DID IT! When you got done, you were as high as a cloud. WE DID IT!

Uh oh. Guy pees brown. 'Nother guy does, too. I can imagine the texts and tweets and Facebook posts flying fast: "Hey, my pee is brown, is yours?" "FUCK man, heard his was, too!" "What, that makes four guys, now!" The hospital is filling up fast with Hawkeyes all peeing brown. The docs have got to be thinking: what were they DOING in that bubble? Twelve, no--THIRTEEN guys all peeing brown.

The docs hear about the workout. Yep, I remember that prisoner with the squats, one might have said. Hey, weren't there a bunch of kids out in Oregon this happened to? remembers another. None of that matters now. Labs are drawn, urines sent. Thirteen players are admitted. The renal consult service has just doubled its census in one big gulp.

Here's where I run out of things to say. I don't know what those labs showed. But if players are still receiving inpatient treatment (specially-formulated IV fluids, mainly; possibly dialysis), then these are significant episodes, not blips. They'll all get better, I'm sure. They're young and healthy, they got diagnosed quickly, they're at a great hospital bursting with experts. Those who are the sickest, with falling kidney functions, can be supported by temporary dialysis. It's a big deal, since catheters have to be inserted into big veins and that's no small thing when you're 20 and have never been sick, but I think they'll all do fine.

But the medicine is the easy part. Even that college student walked out of the hospital under his own power, with the loss of only about a week of memory. But some problems remain.

Iowa is squandering its one great resource: the image of its football coach, Kirk Ferentz. A lot of people can coach football, but few command the respect of parents and fans like Kirk. He cries for his players when they win. He donates money to the very hospital they are in. He truly cares about their welfare. But someone did him a great disservice when they did not have him fly back home and be at the side of his players in their time of need. I don't know who "someone" is, whether it's Sally Mason or Gary Barta or Kirk himself. But I know this: as a father, if one of my kids was about to go on dialysis, I'd be there. I'd be at the press conference, too, (carefully) expressing my regret with what happened, most of all expressing my concern with the health of my players. I might even break down and cry.

Why this didn't happen is what, to my mind, truly needs investigation! The Rhabdo thing will sort itself out. They'll find that some players were on a supplement of some sort, or had been on a drinking binge a day or two before, or hadn't practiced the right hydration practices. But who will find out why Kirk didn't come home? He might have lost one or two recruits leaving abruptly (which I doubt--any recruit that would hold the fact the Kirk left to see ill players isn't someone we want anyway), but how many might we lose in the future from the PR shit-storm that seems to be occurring? Worse, there was a "Press Conference" (note facetious use of quotes) where basically no one anybody had hardly ever heard of said nothing at all except one guy: a father of a player. Well, we needed to hear from the father of ALL the players. We needed to hear from the coach.

Yeah, there's HIPAA to worry about. I know all about HIPAA. You can't even tell a husband what his wife's lab results are, unless he's signed a form ahead of time. You can't release info about sick Iowa football players, either. But you CAN speak in generalities: "I'm sick with worry about my boys. We've never had this happen before, but we won't rest until we find out what happened, so it never happens again. They're in great hands, and I know they'll get better. Those crazy lugs, some of 'em even want to get right back to practice! Hell, some of 'em are even trying to exercise on the wards when no one is lookin', and they're pissin' off the nurses! Most of all, I just want everyone to know that we're in this together. The whole team is praying that these thirteen guys are back together with 'em as soon as possible. Thanks for coming. Your prayers are appreciated."

Instead, what we had here, indeed, was "a failure to communicate."



I am not a strength coach, nor an ex-Division 1 athlete. But I am concerned by any work-out that is so severe that former players state that they were sore for "two weeks" afterwards. I am concerned with any special work-out that is referred to basically as some "rite of passage", for such rites lend themselves by their very nature to youthful exuberance and then all-to-often to folly if not actual indiscretion (remember the military's initiation scandals of last decade?) I am certain these sorts of things happen far more often than anyone suspects, and at many institutions (the list of prior Rhabdo episodes at other institutions grows by the hour). But these things should NOT happen. Unfortunately, it happened at little ol' Iowa, and now we're the ones who will bear the brunt of the criticism. I do not know if anyone needs to be fired over it. I do not know if it will have lasting detrimental effects on the program. I do not know if some weirdo cause will become apparent and make Iowa look a lot better (I'm not holding my breath on this one, frankly).

But we CAN do one thing: we can now be at the forefront of a movement to rid athletics of such workouts, if they pose a danger to the athletes. We screwed-up our initial response. We cannot afford to screw up the chance to fix the problem. We will have to eat incredible amounts of shit for some time, and it's going to be awful, but when it's all over we can do this: we can lead. Until then, let's hope our PR gets better, because to my mind, so far, it couldn't be much worse.

Unless otherwise expressly indicated by BHGP editors, this FanPost is strictly the viewpoint of the author and is not endorsed by BHGP in any way.

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