A GAME FOR ALL SEASONS

- Neal Flomenbaum, MD, FACP, FACEP,?March 2017 (updated February 12, 2024)?

Super Bowl 58 yesterday, between the Kansas City Chiefs and the San Francisco 49ers, is only the second Super Bowl ever to go into overtime. The article below is excerpted from an editorial I wrote?for?Emergency Medicine?after?the first overtime Super Bowl in 2017.

Sports and sport figures can provide both welcome relief from the stress of dealing with life and death in the emergency department (ED) and memorable ways of characterizing serious health care issues. The landmark 2006 Institute of Medicine report,?Hospital-Based Emergency Care: At the Breaking Point,?clearly documented the severe ED overcrowding and ambulance diversion that continues to hinder attempts to provide timely emergency care for all in need. But the great New York Yankees catcher Yogi Berra may have more memorably summed up the ED overcrowding situation in describing a popular restaurant: “nobody goes there anymore—it’s too crowded.”?

On this past Super Bowl 58 weekend, with severe ED overcrowding?nationwide, it is worth noting why Super Bowls 51 and 58?serve as paradigms for the dedication and hard work of our emergency physicians, nurses, physician assistants, nurse practitioners, EMTs, and paramedics who provide emergency care 24/7.

Before Super Bowl 51, the New England Patriots were slight favorites to win over the Atlanta Falcons. Though the first quarter ended scorelessly, by half-time Atlanta was leading 21-3. In more than fifty years of NFL Super Bowls, no team had ever overcome more than a 10-point deficit to win the game, and with a little over 8 minutes left in the third quarter, the deficit had widened even further to 28-3. But then the Patriots began to turn things around. Though the Patriots never led during regulation play and no Super Bowl had ever previously gone into overtime, the game ended in a 28-28 tie, and the Patriots went on to win 34-28 in overtime.

Coming out of the locker room to play the second half of that game 18 points behind and in front of over 111 million viewers, the Patriots had a daunting challenge, but no more so than the experience captured in EP/cinematographer Ryan McGarry’s award-winning?documentary?“Code Black”. In the movie, young, idealistic emergency medicine residents are seen walking through a packed waiting room to begin their shift with the realization that they could not treat all of the ill patients needing treatment in the next 12 hours. But once inside, the residents proceeded to treat one patient after another without stopping or giving up. In the end, the patients?were?seen and, like the New England Patriots in Super Bowl 51, the residents too, had won their game against all odds.

Many patients arrive in EDs so ill that there is no reasonable expectation that any intervention can save them, but we nevertheless try and often succeed in doing the seemingly impossible. The physicians and health care providers who have devoted their lives to emergency medicine are frequently no less heroes than were the Patriots in February, 2017. When physicians and health care providers go out to “play ball” in the nation’s overcrowded EDs, they can probably recall another famous Yogi Berra quote: “It ain’t over till it’s over.”?