As far back as 1979 Pappas was accused of allowing a player to play when he should have been healing, simply because the Red Sox needed the player in their lineup. This was the charge at the heart of Barrett's lawsuit, and it is the most common allegation leveled at team doctors. In '79 the player was catcher Carlton Fisk, who played the last six weeks of the '78 season with broken ribs. He was in terrible pain, but the Red Sox were in the middle of a pennant fight, and neither Pappas nor manager Don Zimmer (nor Fisk, for that matter) suggested that Fisk do anything but play. The following spring, when Fisk found himself on the disabled list—as the result of an elbow problem—he placed at least part of the blame for his sore elbow on the fact that Pappas had allowed him to play with the broken ribs.
"When I broke my ribs I should have had two weeks off," Fisk says, "but [Pappas] said, 'Well, you can't hurt yourself anymore than what's already been done.' The reason I hurt my elbow is, I was favoring my ribs when I threw.... I think he should have indicated the problems that could arise." According to Fisk, Pappas never did.
The first professional athlete known to have successfully sued a team doctor was Dick Butkus, the Hall of Fame linebacker of the Chicago Bears. He did so in 1974, the year after he retired from football with knees that would never be right again after having been repeatedly shot up with cortisone and other drugs during the last two years of his career. The purpose of the drugs was to deaden the pain in his knees, making it possible for him to play. What Butkus was alleging was that the team doctor, Theodore Fox, had put the short-term needs of the team over Butkus's long-term health. He asked for $1.6 million and settled for $600,000.
Four years later, in a lawsuit against orthopedist Robert Cook, the Portland Trail Blazers' team physician, former Blazer center Bill Walton charged that he had never been told about the lasting damage being done to his fragile feet while they were numbed by painkillers injected into them before every game. Although Walton, now an NBC basketball analyst, is no longer willing to be interviewed about his lawsuit, he was outspoken at the time, even after the suit was settled out of court, about his belief that he had been wronged by Cook.
In the two decades since those groundbreaking lawsuits much has changed, most of it for the better. Today, some of the most prominent orthopedic surgeons in the country serve as team doctors—for example, Stephen O'Brien, an orthopedic surgeon at the Hospital for Special Surgery in New York, is the orthopedic specialist for the New York Giants, and Michael Dillingham, the associate director of Stanford University's Sports Medicine department, handles the San Francisco 49ers. These are doctors whose very prominence as surgeons gives them clout with team officials. According to Leigh Steinberg, the agent who counts Niner quarterback Steve Young and 23 other NFL quarterbacks among his clients, Dillingham actually called him after Young's recent shoulder injury to warn him that Young would probably want to come back before he was ready.
Another improvement has been the gradual establishment over the past 15 years of the right to a second opinion—paid for by the team—if an athlete is dissatisfied with the team doctor's diagnosis. This second-opinion clause, part of the standard player contract in all four of the major professional team sports, is very much a by-product of disputes like Butkus's and Walton's.
Finally, there is no question that team doctors have become more cautious about administering steroids, painkillers and other drugs to athletes. Of course, as Kevin Harrington, a San Francisco orthopedic surgeon who advises the NFL Players Association (NFLPA)—and operates on many athletes—points out, the reason for this is not necessarily a heightened attention to the Hippocratic oath. "Nowadays there are so damn many lawsuits," he says, "that the doctors have to be a lot more careful than they used to be."
Yet team doctors are still placed in the position of having to answer to two different masters: player and team. And too many times, they wind up putting the needs of the team ahead of the needs of the player.
The most obvious, and most shameful, example of this divided loyalty takes place in pro football after a player retires. Hundreds of players over the past 15 years, having suffered debilitating injuries during their playing days, file for workman's compensation. According to Richard Berthelsen, the general counsel for the NFLPA, team doctors almost invariably side against players in arbitration hearings—claiming that players' injuries are not related to their having played football.
In late 1993 when a reporter for The Washington Post asked Lon Castle, a respected cardiologist who now works at the North Ohio Heart Center in Elyria, Ohio—and was the team doctor for the Cleveland Browns until he left the Cleveland Clinic, which provides medical care for the Browns—about the workman's compensation issue, he offered this chilling response: "You know, this is like the Mafia. You know: 'We're going to shoot you. It's nothing personal. It's business.' "