Canada's Olympic doctors: A behind-the-scenes look

While the top Canadian athletes compete at the Beijing Olympics this month, a small but important contingent of Canadian doctors are responsible for keeping the team and the staff in tip-top shape.

“I think it’s going to be fantastic,” said Dr Connie Lebrun, the Canadian Olympic Committee (COC) assistant chief medical officer and a former Olympian herself, before heading to China in early August. “We are privileged to be there.”

The COC’s core medical team consists of 10 physicians as well as a host of other health professionals, from massage therapists to sport psychologists. Along with other Canadian physicians accompanying individual sports teams, they are responsible for the care of the 600-odd Canadian athletes and support staff for the duration of the Olympics. With challenges running the gamut from smog and traffic to brutal schedules, no sleep and little to no pay, the job of an Olympic doctor isn’t all fun and games.

To read our profiles of some of Canada’s Olympic physicians, click here.

OLYMPIC MEDICINE
A day in the life of an Olympic doctor begins in the early morning; some doctors head directly to the Canadian team clinic, and others fan out to the various venues where Canadian athletes are competing.

“They’re long days,” says Dr Bob McCormack, the New Westminster, BC, orthopedic surgeon who has been named the COC’s chief medical officer for the Beijing Olympics and the 2010 Vancouver games. “It’s not heavy physical work, but it’s long hours. We typically open the clinic at 7:00am and close at 11:00 or 11:30 at night -- and then there’s more work to do, administrative work and emails and such.

Each doctor follows several Canadian teams. Dr McCormack, for instance, is responsible for baseball, women’s softball, men’s and women’s wrestling and the equestrian squad. The schedule can be grueling, shuttling between the Canadian clinic and the venues. “You get breaks at supper and lunch, and most days I try to get out for a half-hour exercise break.”

Making that schedule additionally challenging are the inevitable problems with access to the venues. Security, not surprisingly, is incredibly tight at every Olympics.

“As the games get bigger, if an athlete is in distress it’s not always easy to figure out how to be there,” says Dr Alan Vernec, the medical director of Athletics Canada and an Olympic veteran. “At their time of need you might get blocked by a security agent, which is ironic because you’ve come across the whole world to be there with the athlete.

Beijing is unlikely to prove an exception to the doctors’ struggles with security guards, but Dr Vernec is prepared. He’ll show up at a venue ahead of time and do a test run of the security barriers to figure out the best strategy to get in; in Athens, the RCMP had to intervene with the 18-year-old Greek soldiers who had blocked Dr Vernec’s entrance to a stadium. “Sometimes,” he admits cagily, “we have to use other means to get in.”

ASIAN RENDEZ-VOUS
The Olympics are about more than just sports, of coure; the weeks-long games are a social event too.

“One of the pleasures is getting to know people from other countries’ medical crews over the years, and helping each other out,” says Dr Vernec. “I’ve received some emails already from people saying they’re going to Beijing -- ‘Looking forward to seeing you.’”

“That’s a fantastic highlight,” Dr Lebrun agrees. Her friends from past Olympics and international sporting events hail from Great Britain, Australia, New Zealand, Norway and the United States. “Quite often we have a mixer with other medical staff in the evening, to get to know them better.”

Just being a part of the Olympics tradition is a thrill for many of the physicians, several of whom were Olympians themselves.

In 1976, in Montreal, Dr Lebrun was a member of Canada’s Olympic volleyball team. “We finished eighth out of eight,” she recalls. “But it was great walking into the stadium. It gave me chills.”

Four years later, Canada’s decision to boycott the Soviet-hosted games in Moscow meant that Dr Bob McCormack, then a medical student, missed his chance to run track and field in the Olympics. “When I think back to the boycott in 1980, the Canadians traded more wheat with Russia that year than in previous years,” he says. “I think the athletes were used as pawns.

“I personally wish there was greater separation between politics and sport. The Canadian Olympic Committee never considered boycotting this year. We told the athletes the Olympics is not the place for that.”

He never have had the chance to compete in the Olympics, but Dr McCormack now has the opportunity to do the next best thing. “I work with a lot of teams now and I live vicariously through them.”

“IT’S NOT A VACATION”
Living in the Olympic Village in the heart of Beijing, being a part of one of the largest Olympics ever held, meeting top athletes and medical staff from around the world -- for many, it sounds like a dream job.

But being a doctor at the Olympics isn’t as glamorous as it sounds: 12-hour days, at a minimum; over a month away from home; no pay for most physicians; and endless bickering with the host nation’s security guards about access to the venues.

“It’s frenetic,” says Dr Vernec. “There is a sense it is once in a lifetime for the athlete. The anxiety level goes up, from the athletes to the coaches and support staff, to make sure everything is right, that the athlete is healthy and ready to go.”

That’s as much pressure as it sounds -- and then some.

“It’s not a vacation, even in the slightest,” Dr Vernec says. “It’s hard work. I don’t relax until the games are over.”

In fact, some doctors take a vacation after the Olympics end, just to recover from the whirlwind of work and travel.

According to Dr Julia Alleyne, another COC physician at this year’s Olympics, medical and support staff burnout is a major concern. “They have long hours and feel they are on duty constantly,” she says. To help keep the doctors, coaches, athletes and employees healthy, this year Dr Alleyne will be launching the first-ever Canadian Olympic Committee wellness centre.

CHALLENGES APLENTY
Canada’s Olympic physicians have all been granted temporary medical licences in China so they can order tests and prescriptions while they are there; the logistics of simply ensuring patients get appropriate medical care can be difficult. None of the Canadian physicians have been given hospital privileges. That means that although Beijing has hospitals and medical staff ready to help out in emergencies, if a serious medical problem arises the patient will likely be flown back to Canada. “We like to be self-sufficient,” says Dr McCormack.

That hasn’t always been the case. At the 2006 Winter Olympics, in Torino, Italy, Dr McCormack arrived at a local hospital to visit a patient and was surprised to find an Italian surgeon repairing a Canadian athlete’s broken ankle. After some negotiating, Dr McCormack, an orthopedic surgeon, scrubbed in and joined the surgical team.

Beijing’s infamous smog, although certainly not an ideal environment for high-performance athletics, doesn’t appear to disturb Canada’s medical staff as much as it has the international press, who have been breathlessly reporting particulate-matter readings and futuristic (but mostly ineffectual) Chinese efforts to bend the weather to their will. “We are preparing for the worst but I am optimistic it will not be that bad,” says Dr McCormack. “Even if the air is compromised, it’s not really a health issue. It may be uncomfortable and some people can get exacerbations of asthma, though I personally feel when we get to the games it will not be as bad as past times we’ve been to Beijing. I’ve been there when you could see the building across the street but nothing behind it. This is a very important event for the Chinese and they have spent an enormous amount of money to clean up the air, and have made great strides.”

For the Canadian Olympic team, whose own embarrassing doping incident is now 20 years past, performance-enhancing drugs remain a concern -- as they do for every other team. “It is the same as any field of human endeavour,” says Dr McCormack. “There are people who are not honest on their taxes every year. There will always be people who cheat, and it’s the same with doping. A small percentage will always be cheating.” The COC takes a hard line on doping: whereas there are rumours that other countries have received positive doping tests from their athletes and used them as “educational tools,” Canada has all its testing done independently and externally. “We don’t need another Ben Johnson fiasco,” he says.

Although significant strides have been made in developing effective testing standards, new and more advanced forms of cheating are being developed. Gene doping, which the Montreal-based World Anti-Doping Association has warned about, is “on the horizon,” Dr McCormack says. “It’s a game of cat and mouse.”

AMATEUR PROFESSIONALS
One aspect of the Canadian doctors’ Olympics experience that typically goes unmentioned is the matter of pay -- or rather, the lack of pay.

The COC doesn’t pay its physicians at all. Other Canadian Olympic physicians, however, and even some of the COC core medical team, have financial agreements with the various national sports federations, independent of the COC. (For instance, Dr Alleyne is paid by the figure skating team during the Winter Olympics.) What that means is that some of the Canadian physicians at the Olympics are being paid while others draw no salary whatsoever. That discrepancy has created a degree of frustration and tension, several doctors confirmed in interviews.

“It does create a little bit of a thought at the back of your mind,” says Dr Lebrun of the discrepancy in pay. “But nobody would say I won’t go because I won’t be paid. It’s not a problem for us in our day-to-day work.”

“It is a concern,” Dr Alleyne says. “[The absence of a COC salary] is a limiting factor on how many times you can volunteer, and who can volunteer. Basically, you are taking vacation time to do work elsewhere and you can only do that so much in a year.”

The Canadian Academy of Sport Medicine has published guidelines for physician remuneration, but they stop short of explicitly demanding that all physicians are paid for their work at amateur sporting events like the Olympics.

The topic of the pay discrepancy is somewhat uncomfortable for some of the physicians to discuss (one would only discuss it off the record) but it hasn’t soured the physicians on the Olympic experience.

Dr Lebrun says, “We are privileged to be there. Our transport and everything is paid for -- and we get the uniform.” For her, the matter of money is outweighed by the value of the experience. “It’s not something you can buy.”

“Regardless of pay there have been good people involved, because it is satisfying experience, you are treated well and you gain skills,” says Dr Alleyne. “You come home and your patients know you were an Olympic doctor. That goes pretty far in promoting your practice. There are so many benefits learning from this that I can rationalize in my mind this is a beneficial experience for me.”

Photo: Beijing's Olympic Stadium, known as the Bird's Nest

Check out our website: www.nationalreviewofmedicine.com