|(Deborah Stalford photo)|
For Cal's team doctor, the student-athlete is No. 1
Dr. Cindy Chang is in charge of providing health care for 900 competitors on 27 varsity squads
| 09 November 2005
As a 14-year-old in Columbus, Ohio, Cindy Chang listened with rapt attention to recordings of canine heart sounds brought home by her older sister, who was studying to be a veterinarian. After earning her bachelor's at Ohio State, she went on to med school there with the goal of becoming a family practitioner.
Chang stuck to her game plan, but with one slight variation. Instead of a conventional practice, she wound up ministering to a single, ever-changing, uniquely injury- prone extended family - the more than 900 student-athletes who play for Cal's 27 varsity teams, not to mention their parents and coaches, some of whom complicate the business of doctoring in ways Marcus Welby could never have imagined.
The stodgy, bromide-dispensing Welby, of course, likely couldn't have imagined Chang herself, a spirited, sports-savvy child of Chinese immigrants who recently completed training in acupuncture and who landed the job as Berkeley's head team physician while still in her early 30s. In contrast to the relative simplicity of a typical family practice, Chang has spent the past decade answering to both Hippocrates and Pappy Waldorf, constantly seeking to strike that delicate balance between the health of her patients and the desire to win.
Her judgment calls have not always endeared her to coaches, some of whom may be more focused on tomorrow's game than on their charges' long-term welfare.
"Some coaches consistently challenge my medical decisions," she says. "It's a little bit frustrating, because I'm the one who's gone to medical school, and I'm the one who's been doing this for years. But you know, the coaches rely on their anecdotal experiences," often asserting that they've had athletes with similar injuries who were cleared to play, "so why can't this athlete come back?"
But as Chang knows from painful personal experience, when it comes to taking care of their health, athletes can be their own worst enemies.
"I was playing in this all-Ohio med-school basketball tournament, and damn it, we had to win," she recounts. "I'd hurt my knee, but I didn't seek care because our next game was a big game. So I had my boyfriend tape it up, and every time I took a jump shot and landed my knee would shift, and I'd pop it back into place and run back down the court.
"Now, at 42, I've got a bum knee," she says, laughing at her younger self's eagerness to jettison common sense for the "here and now." Unwilling to give up "cutting sports" like basketball and volleyball in favor of straight-ahead activities like biking and running - "I'm a cutting-sports person," she insists - she's undergone five surgeries stemming from the injury.
Beyond that internal drive to compete, however, are other, external demands on athletes to play through illness or injury. "To the coaches, the most important thing is their team's performance on the field, and I can understand that," Chang says. "I'm not the athlete who's going to be given the cold shoulder by the coach when they can't play, or given the negative look, like, 'You're not strong enough,' or, 'Why'd you have to tell her you have a headache?' Unfortunately, that sometimes happens."
To better assess their condition, she makes a point of first seeing athletes alone, away from coaches and parents who, she says, "sometimes don't understand the power differential they have" over student-athletes.
"It gives them the opportunity to say, I feel pressured, I don't think I'm ready," explains Chang, who bristles that she's been accused of being "too maternal" for what coaches have viewed as the babying of athletes.
"My business is to get them healthy as quickly as possible and keep them playing," she reflects. "I could go someplace else and do what I do and have less angst and a much calmer lifestyle. The reason I stay on is I want to make sure that our student-athletes are getting the best possible medical care, and keeping their health and safety first and foremost."
It's all about the team
Remarkably, Chang is the Berkeley athletic department's only full-time M.D. She's supported by associate team physician (and Cal grad) Jeff Nelson, a University Health Services staffer who devotes a day a week to intercollegiate athletics, and 14 "overworked and underpaid" certified athletic trainers. But she's a team doctor in more ways than one.
Since taking on the job in 1995, Chang has assembled a stellar roster of specialists who volunteer their services - many of them Berkeley alums, former athletes, or doctors who bring experience with Olympic or professional teams. Hand orthopedist Monty Cardon, for example, played Cal football from 1984 to 1986, while Will Workman, another ortho consultant, pitched for the baseball Bears and played professionally in the California Angels system. Bob Eppley, the department's lead orthopedic team doctor, was on his college basketball team. Podiatrist Tim Dutra played tennis. Clem Jones, an orthopedic spinal surgeon, played football at both the college and semi-pro levels.
The list goes on . . .
Josh Hatch, an orthopedist with Kaiser, played football at Princeton. Christy Allen was on Duke's soccer team, and serves as an orthopedic national team physician for U.S. Soccer. Derric DesMarteau is the team dentist for the Golden State Warriors and the Oakland Raiders. And Cal grad Marc Safran has written three books on sports medicine.
"We find the resources we need," Chang says. "It's all about nurturing relationships so we can get things done when we need to for our student-athletes." In addition to consulting services, volunteer doctors donate several hours a month to help with physicals, clinics, and event coverage.
As for Chang herself, she's been a volunteer doctor at the U.S. Olympic Training Center, and served on the U.S. medical staff for the Winter Paralympic Games in Nagano, Japan, in 1998 and in Salt Lake City in 2002. The first woman to serve as head team physician for an NCAA Division I school, she loves sports, both as a participant and a spectator. ("I could watch bowling," she says.) But she never meant to specialize in sports medicine, and very nearly didn't apply for work at Berkeley.
"I didn't go into family medicine to be a team physician or a sports-med doc. I went into it because I enjoy the holistic viewpoint of taking care of the whole family," she explains. "I only decided to pursue a sports-medicine fellowship when, during the course of my training as a family physician, I saw a lot of musculo-skeletal injuries - the weekend gardener who'd come in with a sore elbow, for example - things I wanted to know more about."
She was just finishing her residency at UCLA when she learned of an opening for head team physician at Cal. "My boyfriend at the time - now my husband - said, 'Apply! Apply! Apply! Shoot for the stars!'" she recalls. She was reluctant, saying in her cover letter that "I'm sure there are much more qualified people," but that she expected to do a fellowship in sports medicine, and "perhaps in the future there'll be a need for me."
Back at Ohio State as team physician in 1994, to her great surprise she received a call from Berkeley, inviting her to interview for an opening as lead physician of urgent care. She got the job, and took over as head team physician the following year.
Before hiring on at Cal, though, she also interviewed for a position at Stanford, a prospect that prompted a warning from her Cal-grad husband. "He said, 'You know, I don't have any problem with accepting a paycheck from Stanford," Chang recalls. "'But if you expect me to go to any Stanford games and not wear my Cal stuff, you're mistaken.'"