The Super Bowl

“When people are playing in the Super Bowl, they know they are playing in the Super Bowl.”

Multiple times I have heard my wife utter some version of this quote. It all stems from a kind of verbal contest that she used to have with one of her best friends in high school. It was a game kind of like Tic-Tac-Toe (or Global Thermonuclear War) in that no one ever wins. Apparently, one day Susie made a mistake and her best friend actually won the game. Immediately upon this happening, he apparently declared himself “World Champion”. Rightfully so, Susie objected to this because it was not established ahead of time what the stakes were, leading to the quote that started this post.

When you enter in to a competition, you know what the stakes are. I think this is part of why people like to watch, as well as to play, sports. It is all very neat and tidy. The rules are established, the stakes are clear and the competition is under way until a resolution occurs. There are no season ending cliffhangers that do not get resolved until the next week or the next season. There are no surprises about what was at stake. A nice, compact experience all wrapped up in 2-3 hours with a bow.

Life, however, is not nearly as neat and tidy. Very rarely do we truly know what is at stake that day when we wake up in the morning. So often we think we know how our day is going to unfold only to find that Life clearly had a different plan. There are also many decisions that get made that seem big at the time that turn out to be insignificant over time. And as Joe Paterno has found out, there are some decisions that only with hindsight are discovered to be the decision that frames your entire life’s work.

As of this moment, Coach Paterno is not in any legal trouble. Rather, he has become vilified for doing precisely what he was known to rail against, doing the bare minimum. Paterno himself acknowledges this when in his statement earlier this week he says that he “wished he would have done more.” Whether he truly believes this or whether this is just lip service, only he knows.

His entire legacy up until about a week ago had been about standing up for what is right no matter the cost and living a life of integrity. And now his legacy is rightfully up for debate. For some people, this seems to be unfair. The argument goes that he has done so much good in his life that it doesn’t seem right to just throw it all away because of one bad decision. And to some degree, they are right. It is not fair. But then again, life is not fair. By most accounts, Joe Paterno is on the whole a good man and a fine human being. A man who has mentored, taught and developed scores of young men and probably helped many of them be the person they are today. He knows something about making good, solid decisions. However, in the biggest moment of his life, Coach Paterno swung and missed.

When Coach Paterno woke up that day he had no idea that he was going to make a decision that was going to define his life. He probably didn’t know it at the moment of the decision nor the days and weeks immediately following. Most likely, he didn’t know until law enforcement started to tighten up its grasp around his former defensive coordinator who is now alleged to be a child predator. And then, I am guessing it hit him like a ton of bricks. He seems to be a smart guy, so I would think he had an idea about how this would start to unfold for him personally. Maybe he didn’t know exactly what would happen by the time an indictment was handed down this week, but I would think he knew that things would look bad, very bad. As he talked with lawyers, investigators and finally a grand jury, I would guess the writing on the wall for him was pretty clear.

I have been thinking about Coach Paterno’s “bare minimum” effort a lot this week. As a pediatrician, I am well aware of so called “Mandatory Reporting Laws”. If I have suspicion or knowledge that a child is being endangered, I am bound to report that to the authorities. To be honest, I find these laws to be a godsend. Because they take away any opportunity for judgement and stereotyping. There is no room to think “Well, they ‘look’ like a good family” or “That guy totally looks like an abuser” or any other biased thinking. You discover something amiss during your history taking or during a physical exam and you report. And there are times that I have reported things that have turned out in the end to be non-hamrful situations. You might think that this experience totally fractures the doctor-patient/family relationship, but invariably I have found that it does not.

Because it is the law and there is no judging or prejudice, the families by and large end up being cordial and understanding about it. They understand that I am only doing what I am supposed to be doing, protecting children, even if there is a part of them that is angry or insulted.  In my limited experience, it is usually the people who have something to hide that get the most irate.

I staff resident continuity clinics, so I do not have my own set of patients. I often see a patient and family once, only to not see them again for a year or more, even though they have come to the clinic more frequently than that. So there are times when I have had to report something from clinic and then I never see or hear anything about it again. I have no idea what the end result is or how that decision was reached. But I do know that I have done my job and reported it. Is that just the bare minimum? That has been on my mind often this week. Am I just like Joe Paterno? Sliding by on the bare minimum? Or maybe what Coach Paterno did was not nearly as bad as it has been made out to be? I have been grappling with this.

At first blush, I thought that maybe I should be doing more. But as I thought about it more, I realized that was not the case. For one thing, I know that I have reported to the proper authorities and the next stage is truly out of my hands. I am a trained physician and not a trained investigator. Also, I have the utmost trust in the people that I am working with to help me interface with the authorities.Plus, I began to realize that I do a lot more follow up than I thought I do. None of my experiences have been even close to the level of egregiousness as in the Penn State case, and yet I call and follow up on outcomes with some of the doctors and investigators to whom I have referred the child.

From that I came to the conclusion that if I were thrust into a situation even close to that magnitude, I would be doing some significant follow up if I knew I was not going to be directly involved with further care of the patient. Surely, Coach Paterno could have done the same when he met with the athletic director for various meetings or bumped into him in the hallway at some point. It sure doesn’t seem like that happened. And so I have settled into the thought that Coach Paterno really should have done more and it is not out of bounds for him to be receiving some heat for his lack of action this week. I have also personally redoubled my efforts to make sure that things are followed up on to some degree, whether they are big or small, consequential or not. Because as we have seen, the magnitude is not always able to be judged in the moment.

None of us know when the most important decision of our life is going to be. It may be when we are 18 or 45 or 105. When we are greener than green or at the height of all of our experience and intelligence. We need to be on the look out for that moment and be prepared for it at a moment’s notice. No one wants to lose the Super Bowl. Especially if they didn’t know that they were playing in it.


About ironsalsa

I'm just a man who likes to hear himself talk, yet pretends he can't stand himself.
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