Author: ndermer

The Toxic Culture of Health & Medicine: The Calvin Ridley Story

Photo from The Players’ Tribune, “A Letter to the Game” by Calvin Ridley

Calving Ridley is an All-Pro wide receiver in the NFL. However, his prosperous young career was disrupted this past season when he was banned from the NFL for gambling on his own team, the Atlanta Falcons, to win. He made a mistake and he owns up to it. However, just recently he shared his personal story which provides a lot more insight into what he was going through at the time. In diving deeper into his career and experiences, he highlights a handful of ways in which the culture of health and medicine within the NFL had failed him and led him down an extremely dark path. A team trainer contested and ignored Ridley’s broken foot. Then, Ridley reflects on his personal experience surrounding the passive medicalization of painkillers in the NFL. Finally, we see a more complete picture as Ridley expands upon the social impacts and stigmas around mental health as an athlete.

“Nah, bro, this is different. My shit broke.”

Calvin Ridley on pain in his foot to teammate Julio Jones5

Contesting Broken Bones

Ridley begins his story talking about his early career in the NFL. During his first two years, he played through bone spurs with the help of painkillers. He was performing at an extremely high level despite the pain. Then came the 2020 season, and after a Week 8 game against Carolina, Ridley’s pain level was at an all-time high. Feeling that there was something seriously wrong, he went to the team trainer and got an MRI. The trainer said it was just a bone bruise. Feeling that this was an injury and pain that he could manage, Ridley finished out the season posting career high numbers in receiving yards and touchdowns. However, his team was not performing as well and finished the season 4-12 resulting in a complete staff overhaul. When the new trainer came in, Ridley was sent to a specialist who within the first hour of the examination admitted to Ridley, “Your foot is definitely broken.”5

Broken bones are usually not a contested illness or condition, but in this case it was. While each scenario exemplifies key differences, Calvin Ridley’s injury reflects a lot of similarities to others who deal with contested illnesses. One example of such a condition includes Chronic Fatigue Syndrome. Patients experience incapacitating physical and mental fatigue, but due to the abstract nature and complexity of symptoms and indicators, this condition has historically been highly contested.6 Just like Ridley, these patients know there is something more serious going on even though doctors assure them that they are fine. This often leads to false diagnoses along with excessive, unnecessary, and often ineffective treatments. 

“I’m a football player. I know what we get paid for, you feel me?”

Calvin Ridley on taking Toreador shots every Sunday5

Passive Medicalization of Toradol in the NFL

In Ridley’s case, he was experiencing a ton of pain but persisted on playing through his “bone bruise.” In order to accomplish this goal, he took Toradol every Sunday to ensure that he could play with minimal pain and continue to perform at a high level. Now, Toradol is a drug, often injected, used for quick-acting pain relief. However, it is not supposed to be taken frequently due to high risk of side effects.3 Nevertheless, it was allowed and normalized because of the culture of the NFL and the expectations of its athletes. 

There are several parallels between the use of Toradol and the passive medicalization of Viagra. Similar to the societal expectations we place on athletes, the culture norms of masculinity contribute to the negative feelings that emanate from erectile dysfunction.1 Social factors such as insecurity stigmas around men’s health explain the high demand of Viagra. Men will often opt to take the pill for the quick fix rather than feeling the embarrassment of actually addressing the root causes of their ED. Thus, Viagra users eliminate the possibility of seeking counseling or any other solutions that would more effectively help and potentially solve their condition long term.

“My daughter don’t care. She’s two years old, and she’s running straight up to me, “Dadddyyyyyy!!!” She’s wanting to bake some cookies in the Fisher-Price oven, you know? But I’m coming home broken. I can’t even do anything but lie around in a dark room.”

Calvin Ridley on mental health issues off the field5

Social Impacts and Stigma around Mental Health as an Athlete

As Arthur Kleinman highlights, it is often not until detailed context of a lengthy case is revealed that we can come to fully understand and experience the social meaning and impact of illness.2 As Ridley continued with his struggles with injury, he explains that “after practice, once that painkiller wears off, you still have to come home and be a husband and a father.”5 The social structure of a patient’s life is an integral part of their inner experience and is an aspect of healthcare that is important and necessary but is often ignored. In Ridley’s case, he had a daughter, a wife, teammates, coaches, and even a whole city that were counting on him in one way or another, and the last thing he wanted to do was let anybody down. 

However, the pressure of these expectations compounded with his injury struggles is where the anxiety began. Ridley knew something was off but could not let anybody down, so he just stuck to pills, shots, and gritting it out. This really speaks to the stigma around men’s health, specifically the male athlete.4 There is often a feeling of expectation that men should deal with their problems on their own, and athletes especially are taught to just tough it out. Eventually, Ridley realized that his mental health issues were getting to be too much, and he decided to step away from football to seek help. Even then, there were people in the building that were supportive, Ridley recalls other people looking at him like, “You good, bro.”

Official Statement by the Atlanta Falcons after Calvin Ridley’s suspension4

Depression, Shame, and Recovery

Ridley recalls his time away from the game as major low in his life. He was extremely depressed, did not know what to do or where to go, and was just trying to get through each day. He hit rock bottom when the gambling scandal became public.

“Whenever people ask, ‘What were you thinking?’ The only answer I can give is, ‘I wasn’t.'” 

Calvin Ridley on responding to criticism relating to his gambling scandal5

Ridley eventually sought real help and contacted a therapist. He finally was able to learn more about what he was going through as well as how to cope with the emotions he was feeling. Throughout his story he recognizes and owns his mistakes but also reveals more of the background on what led him to that moment. It is not all his fault and much of what occurred can be attributed to a broken system that has much room to grow in how physical and mental health is handled. 

References

1Carpiano, Richard M. “Passive Medicalization: The Case of Viagra and Erectile Dysfunction.” Sociological Spectrum, vol. 21, no. 3, 2001, pp. 441–450., https://doi.org/10.1080/027321701300202082. 

2Kleinman, Arthur. “The Illness Narratives: Suffering, Healing, and the Human Condition.” Academic Medicine, vol. 92, no. 10, 2017, p. 1406., https://doi.org/10.1097/acm.0000000000001864. 

3Murdock, Joshua. “Toradol (Ketorolac): Pros and Cons of This NSAID Pain Reliever – Goodrx.” GoodRx Health, 7 Oct. 2021, https://www.goodrx.com/ketorolac/what-is-toradol-ketorolac-nsaid-pain-reliever. 

4“Official Website of the Atlanta Falcons Football Club.” Falcons Home, https://www.atlantafalcons.com/. 

5Ridley, Calvin. “A Letter to the Game: By Calvin Ridley.” The Players’ Tribune, The Players’ Tribune, 8 Mar. 2023, https://www.theplayerstribune.com/posts/calvin-ridley-nfl-football-jacksonville-jaguars. 

6Walker, Jacob. “Researching Contested Illnesses: The Case of Chronic Fatigue Syndrome (CFS).” In-Training, 28 Feb. 2016, https://in-training.org/researching-contested-illnesses-the-case-of-chronic-fatigue-syndrome-cfs-90. 

Brick by Brick

America is the land of the free and home of the brave. It is the land of opportunity where so many have come to try to live their own American dream and make it big. However, this country is in no way perfect and has a handful of glaring flaws, one of the biggest and most significant being the healthcare system. Still, throughout the nation’s history, we have shown the ability to recognize our flaws, address them, and turn out better in the end. The healthcare system is broken, but not beyond repair. The key is finding exactly where and why it is broken and then repairing it piece by piece, brick by brick.

Trials and Failures

America is the world’s largest economy by nominal GDP and spends more on health care than any other country. Despite this fact, the US scores surprisingly poorly on a variety of key health measures, such as life expectancy, preventable hospitable admissions, suicide, maternal mortality, and obesity rate4. In this country, it is mostly pay to win, but many are still paying a lot just to continue to get the short end of the stick. 

Certain efforts are geared towards improving the current system, but many of them do not address any of the root causes of these current issues. In fact, the majority of the investments in the healthcare system simply perpetuate and intensify the system’s flaws. For one, there is an extreme overemphasis on procedures and drugs4. While these options should generally be seen as secondary, tertiary, or last resort alternatives, they make up a sizable chunk of primary treatment decisions. These options can be helpful and beneficial, but they are often burdensome on the body and usually come with a collection of side effects making them less than ideal.  Focusing on drugs and procedures has also led to a high emphasis on technology and specialty care4. Innovation in these fields can be very exciting and life changing for many people, but it also diminishes the attention towards promoting basic health practices such as nutrition, exercise, mental health, and primary care in general. This is extremely problematic as ignoring these components of people’s lives is often what leads to the more serious health issues. 

Building From the Ground Up

Since there are so many problems that can be prevented, addressed, and treated on the primary care level, there needs to be more emphasis on its importance. Due to social media and pop culture, people often get lost in the alure and flare of the operating room, dramatic technological innovation, and breakthroughs in medical research. Shows like Grey’s Anatomy or ER demonstrate the adrenaline, excitement, and miraculous effects of surgery and medical innovation, and these values and perspectives seep into the viewers mind, distorting the image of the real healthcare system in its entirety. Each of these components holds intrinsic value but can overshadow the power and impact of incremental primary care2. 

“Governments everywhere tend to drastically undervalue incrementalism and overvalue heroism.”

Atul Gawande from the New Yorker2

I have seen this firsthand when my own little sister’s life was saved because of the attention, care, and intuition of her primary care physician, Dr. Nicholas Kyriazi. My older sister, myself, and my younger brother all had the same doctor, so our family had a good, long-standing relationship with him. One day, during a routine check-up, he was listening to my little sister’s heart and noticed the rhythm was slightly off. He notified my mom that he had identified a heart arrythmia and advised that she follow up with a cardiologist to confirm and seek proper treatment. Through a variety of tests and scans, the cardiologist confirmed what Dr. Kyriazi had detected with his stethoscope. The cardiologist found a small hole in my sister’s heart which was the source of the arrythmia. However, since it had been caught so early on, there was plenty of time to address the issue and ensure the best treatment be put in place. At 5 years old, my little sister had successful open-heart surgery to repair the hole in her heart, and she is now a fully healthy and happy 15-year-old having no issues since. The surgeon directly resolved the issue in the end, but Dr. Kyriazi identified the problem and gave our family plenty of time to find the best solution. He is a hero.

Giving Care to Those Who Need It Most

“Until today, I didn’t know what a leaf looked like.”

4 year old child after receiving glasses for the first time at RAM3

My sister needed a hero, and there are plenty more out there who need a hero just as much if not more than she did. A multitude of those in need are suffering from more than just medical issues. One of these groups includes middle-aged, non-Hispanic white people, especially those without a college degree. Throughout the past few decades, this group in particular has experienced a spike in mortality, identified by a Princeton University study1. These so-called “deaths of despair” include “white, working-class people ages 45 to 54 were drinking themselves to death with alcohol, accidentally overdosing on opioids and other drugs, and killing themselves, often by shooting or hanging1.” These source from four main indicators which include feelings of hopelessness, having low self-esteem, feeling unloved, and worrying frequently. Both the deaths and the associated indicators are evidence of the social determinants of health. 

Source: Science News

There have been efforts to address these issues and kickstart some reparations to this broken system. Organizations such as Remote Area Medical have made an incredible impact in these rural communities of Appalachia. They travel and set up large medical clinics in rural areas where they provide free medical, vision, and dental treatment to people who generally do not have financial or geographical access to healthcare3. They provide relatively simple care, but the effects of what they do change the lives of so many underserved individuals. Organizations like RAM and individuals like Dr. Kyriazi represent the small yet powerful solutions to our broken system. Recognize them, celebrate them, and emphasize their power and importance. 

References

1Bower, Bruce. “’Deaths of Despair’ Are Rising. It’s Time to Define Despair.” Science News, 2 Nov. 2020, https://www.sciencenews.org/article/deaths-of-despair-depression-mental-health-covid-19-pandemic. 

2Gawande, Atul. “The Heroism of Incremental Care.” The New Yorker, 16 Jan. 2017, https://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care. 

3Reichart, Jeff and Farihah Zaman, directors. Remote Area Medical. Candescent Films, 2013. 

4Robert H. Shmerling, MD. “Is Our Healthcare System Broken?” Harvard Health, 13 July 2021, https://www.health.harvard.edu/blog/is-our-healthcare-system-broken-202107132542. 

5Tikkanen, Roosa, and Melinda K Abrams. “U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?” U.S. Health Care from a Global Perspective, 2019 | Commonwealth Fund, 30 Jan. 2020, https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019?gclid=Cj0KCQjw7pKFBhDUARIsAFUoMDbVZBN2PrzOlYBZvEe8qGs1PvCiAAxHemHZb_FjjCnAbSdQ0LSPChYaAmLYEALw_wcB.