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| As on-site radiologic technologist at Dolphins Stadium, Tom Waters, RT, has every sports fan’s dream job. |
To the casual observer, Tom Waters, RT, has every sports lover’s dream job. He has season passes to the Florida Marlins baseball and Miami Dolphins football games. He is on a first-name basis with many of professional sports’ premier players. He even is required to attend the annual Orange Bowl Classic and the National Football League’s Super Bowl when it comes to town.
What’s not to love? Well, for one thing, even though Waters is on-site for every contest?day or night?throughout both the baseball and football seasons, he never sees a touchdown being scored; never experiences the thrill of a game-ending twin killing; and never rises to his feet with 74,916 Dolphins faithful to scream “Defense” at the top of his lungs.
“My job is not nearly as glamorous as people think,” admits Waters, on-site radiologic technologist
for two of Miami’s three sports franchises. “It’s one thing to sit up in the stands, have a beer, enjoy
the game, and root for the home team. It’s another thing to have to work and always ask, ?Who’s winning?’ “
On most football game days, Waters notes, the only score that matters is the number of injured players who limp, are helped, or are wheeled into his examination room off the West end zone at Dolphins Stadium. Since 1993, Waters has been the head radiologic technologist for both the Dolphins and the Marlins. Nearly 3 hours before each home game, Waters already is at work taking X-rays of players’ injuries to help evaluate whether they’re fit to compete.
Football Versus Baseball: Injury Roll Call
Waters’ responsibilities don’t stop with images for pregame evaluations. In fact, it’s not uncommon for Waters to still be working long after the final gun has sounded and the parking lot has emptied.
“Football is much more demanding because it’s a contact sport,” notes Waters, who joined the team at the urging of Dolphins team physician Dan Kanell, MD. “We see more fractures, dislocations, and, naturally, the most important thing is spinal cord injuries. I would say that it has been very beneficial to have worked in a trauma center, because it makes it so much easier to provide the images we need and to be confident in what we’re doing when interacting with the trainers, a physician, or neurosurgeons accompanying visiting teams.”
Because baseball is predominantly a noncontact sport, the majority of the injuries are benign in nature. Waters more likely will have to deal with pulled muscles suffered when players run the bases, twisted or dislocated ankles from improper sliding, small breaks from batters being hit by pitches, or broken bones suffered when fielders run into outfield walls.
“Baseball has its moments,” Waters says, “but it doesn’t provide nearly the volume of cases as football does. Many times, I’ll spend the entire day X-raying players from both teams and never know what the score is or who’s winning.”
Huddle Up: Recognizing the Problems
With as many as 16 players visiting his 14- x 16-foot examination room every game day, with trainers and team physicians insisting on “immediate” player status, and with postgame complaints stacked up like 747s at Miami International Airport, Waters knew the time was right to upgrade his radiology equipment. And when the National Football League (NFL) reduced its halftime from 15 to 12 minutes, Waters realized he needed a faster, more efficient way of handling cases and disseminating the information as quickly as possible.
“I would say we had pretty decent equipment,” Waters recalls. “It was ideal for a doctor’s office. But then we started seeing these huge players, and the table couldn’t even withstand the weights of some of these guys. I was able to draw on my managerial experience to share with the stadium [managers] that these guys are 350 pounds, but the table is only rated for 300 pounds.”
In the mid-1970s, taking a simple X-ray took several minutes just to place a player on the table and make an exposure. The real problem came in the processing, when it took nearly 4 minutes to get an image. A much more efficient 90-second processor was installed in the mid-1990s, and that was sufficient for most team physicians.
“The team physicians were tolerant [of the processing time],” Waters says. “They had worked in hospitals or offices, so they knew how long it took.”
Go Team: Making It Happen
Four years after presenting his initial proposal to the stadium’s managers for a new processor, Waters was finally given the go-ahead to turn his examination room into a state-of-the-art NFL facility. Waters received CR vendors’ suggestions from several orthopedic surgeons, but he wasn’t satisfied with the time restrictions. “I needed this to process quickly; I needed an image fast,” he maintains. “This was a paramount issue for me.”
That’s when Waters, a former supervisor of radiology at a local hospital, drew upon his relationship with Eastman Kodak Co (Rochester, NY), which had provided the hospital’s imaging equipment. He met with Kodak representatives and explained his needs and constraints. Then he asked the pivotal question: “Has this improved?” When Kodak representatives answered in the affirmative, a plan was presented to the stadium’s managers.
Last year, Waters oversaw the purchase and installation of Kodak’s DirectView CR 825 system with a DryView 8150 laser imager. The system provides team trainers and physicians with a complete read of a player’s physical condition in less than 2 minutes.
Dolphins Stadium officials were elated with the addition. “It’s important that our stadium have state-of-the-art imaging equipment so that our team physicians can determine the seriousness of players’ injuries and their ability to return to the game,” says G. Eric Knowles, senior director of stadium operations and community relations for Dolphins Stadium. “Physicians for the Dolphins and visiting football teams have been extremely pleased with the increase in image quality and speed provided by our new digital medical-imaging system.”
Waters weighed the options and says he found that every vendor but Kodak was lacking in the essential qualities needed to make his imaging operation more efficient. “I wasn’t satisfied with what I was seeing [from other vendors], and I was dealing with way too many salesmen who were not able to answer the technical questions,” he explains. “Then they’d give me to an engineer at the home office who was the same as the field engineer.”
Kodak, however, provided the perfect combination of speed, efficiency, image quality, and service. In fact, one of the deciding factors was Kodak’s ability to produce a large 14- x 17-inch image in the same amount of time as an 8 x 10. Many competing vendors, Waters relates, had different time ranges for different sizes of film, which doesn’t bode well when players as large as 400 pounds enter the examination room.
“Today, doctors come in, see the digital, and say, ?That fast?’ I say, ?Sit right there, count to 14, and see if you don’t have an image.’ The orthopedic specialists are extremely impressed with the image quality produced by the CR 825 system. The specialized medical-imaging software provides both the fine detail and high contrast required to detect soft-tissue injuries and subtle fractures,” Waters says. “The image quality of the radiographic film output is also outstanding.”
The process has become so streamlined that it’s almost as artistic as the game being played a few hundred feet away. When a player is injured, the severity of the injury is assessed on the field. Waters knows that if a trainer accompanies a player, the injury usually is bone-related. An appearance by the team physician is an immediate signal of a more severe injury.
“They’ll come in and tell me just the body part,” Water notes, “because I have enough experience with orthopedics that I know what they want and what to give them. One of the things I’d like to convey is that some of the people who cover other games?and I’m hearing this from [visiting team physicians]?are not trained enough in trauma to handle the views they need.”
That will never be the case at Dolphins Stadium. The ease and clarity of the image surprises even veterans in the field of radiology.
“In less than two minutes, I can get a player on the table, take a picture, and put it in the machine,” Waters says. “And then in about 14 seconds, I can get a 14 x 17?same for 10 x 12?and hand it to them. They’re really elated with the speed and the image quality of digital.”
Tom Waters might not get to see a professional game firsthand, but he’s as much a part of the outcome as if he was on the sideline or in the dugout delivering signals.
P-A-C-S! WHAT DOES IT SPELL?
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Dave Cater is a contributing writer for Medical Imaging.
