Learning ABIM Exam Review Concepts from the News: Pat Summerall
As you prepare for the ABIM exam, its helpful to read news articles to see how they apply to what you’re studying. This is a good practice in general and you will certainly remember concepts faster when you can apply them to real life.
Pat Summerall, the NFL kicker who would later leave his mark on the sport with his inimitable style of succinct commentating, passed away last week at the age of 82. He was recovering from surgery to repair a broken hip.
A little known fact about Summerall is that he was born with his right leg twisted backward. The doctor attending to him performed a novel procedure by intentionally fracturing his leg, turning it, and resetting it during his infancy. His mother was told that he would likely be walking with a limp for his entire life. Instead, Summerall competed in high school, college, and a decade of professional football despite his shorter right leg.
While most football fans today remember Summerall for his on-screen relationship with the animated John Madden, his pairing with Tom Brookshier laid down the foundation for arguably the most successful career by a NFL commentator.
Unfortunately, it was also with Brookshier that Summerall would pick up the habit that would later destroy his liver, health and family relationships. The two were known to party hard and drink heavily on road trips before and/or after calling the broadcasts.
In textbook fashion, Summerall displayed the effects of alcoholism. In his 2006 memoir, he noted that alcohol turned him into a “practiced liar” (denial) and led him to spend increasing amounts of time at parties (preoccupation with alcohol). He admitted that he abandoned his marriage and three children (impaired social relationships). “I became more erratic in my judgment and less patient as I drank more frequently and recovered more slowly,” he wrote.
In 1990, Summerall nearly lost his life when he developed one of the common gastrointestinal complications of alcoholic cirrhosis—a ruptured gastric ulcer—while having drinks on a flight back to Florida. Although his doctor in Jacksonville admonished him that “If you drink, you die,” his addiction continued.
In 1992, at the insistence of his family, he entered alcohol abuse treatment at the famous Betty Ford Drug and Alcohol Abuse Treatment Center. He remained sober for twelve years thereafter before receiving a transplant for his cirrhotic liver. Adron Shelby, a 13-year-old boy who lost his life suddenly from a brain aneurysm, was the deceased organ donor.
The Dallas Morning News first reported Summerall’s passing in Dallas’ Zale Lipshy Hospital, part of the University of Texas Southwestern medical system. Sudden cardiac arrest was listed as the cause of death. Summerall, along with his wife Cheri, spent the later years of his life spreading the message of the evils of alcoholism.
A screening tool with excellent sensitivity and specificity for detecting alcoholism is the CAGE questionnaire, first published in JAMA in 1984.
Cut down: Have you attempted to cut down on alcohol use?
Annoyance: Do you become annoyed when others criticize your drinking?
Guilt: Do you feel guilty about your drinking?
Eye-opener: Have you taken an eye-opener?
A score of 2 to 3 correlates with a high index of suspicion and a score of 4 is essentially diagnostic of alcoholism.