Rugby Surgery

The smash of bodies grinding on the wet ground, grass and earth giving way to arms and legs and heads and torsos – the slap as two bodies collide at full speed, sweat and blood dripping down the skin… this is rugby.

I love rugby. I played for 11 years from college to club teams. At the strong flanker position my job was to have the first hit out of the scrum if we didn’t get the ball and to support our wings if we did. The satisfaction of making a hard tackle – just drilling the guy across from me the second he got the ball – is unparalleled. Walking off the field a bit battered, maybe broken, but knowing that I had put it all out there – left it all on the field – was exhilarating.

I’ve given concussions, and I’ve gotten stitches. Every game I ever played in, we had to use the ambulance at least once. I even broke a girl’s ankle once so badly that she had no blood flow to her foot, and even though I broke it, I had to set it right there where I had tackled her. I saw her four weeks later at a tournament hobbling around on crutches, and she thanked me for saving her foot. After 7 hours of surgery that day, her orthopedist told her she would’ve had an amputation without my intervention. That’s how rugby is – we maul each other sometimes nearly to death on the field and then go hang out afterwards like old best friends.

I love rugby. 

Then I broke my hand. I was a 2nd year surgery resident at Johns Hopkins, and I broke my hand. I reluctantly got my removable cast – removable because at Hopkins you were still gonna work even with a broken hand. As I continued to work and even to take that cast off when I went into the operating room, I ached with every dissection and endured searing pain when tying knots. Still, that game was worth it – that tackle was so worth it.

Rugby and surgery are quite similar actually – particularly trauma surgery where the patient comes in critically wounded with a gunshot wound to the chest, a knife wound to the gut or massive internal injury from a gnarly car crash. With a loose ball in rugby, both teams fling themselves towards the ball scraping and kicking and piling higher and thicker into a massive ruck or mall. When a critical trauma comes in, the team descends on the patient all at once: stripping off clothes, placing IV lines, taking x-rays, intubating the unconscious, and possibly even cracking the chest immediately for the lifesaving cross-clamping of the aorta and internal defibrillation. This, too, appears like a massive pile of people clamoring for space and action. Eventually, the ball is controlled and hurled out of the crowd to an awaiting scrumhalf or wing who races off with it toward the goal. The patient, now stabilizing, emerges from the huddle of health care practitioners and is raced off to the operating room where definitive surgery is performed.

Both rugby and surgery are fueled with adrenaline. Both require team work and forge deep, long-lasting friendships as those teams grow, learn and improve together. The actual playing of a rugby game and running of a trauma often appear as utter chaos to the uninitiated observer. In the end, however, it’s quite clear that there’s a method to the madness. What seems like swarming confusion is actually – if done properly – a kind of dance with every member understanding what his or her role is in each particular situation. The results will yield a goal or a win in the case of rugby, and hopefully, a life saved – body and mind mended – in the case of trauma surgery.

I don’t play rugby anymore. I haven’t since I broke the hands that I required to heal others. I watch it, though, and occasionally read books about great rugby teams and their strategies. And even still, sometimes in the midst of a crashing, bleeding patient, for a brief moment I see striped jerseys and cleats, smell mud and sweat, and push everyone around me – self included – to work together, to move faster, to reach the goal.