Nearing the 20th anniversary of Hank Gathers's death, it's fashionable to look back. But let's look forward. It's possible to save so many athletes from dying young, but it might not be worth the costs.
Gathers passed away from hypertrophic cardiomyopathy (HCM), a mysterious condition in which a part of the heart muscle is abnormally thickened. It's a genetic disease, but not a predictable one. There's only one way to discover if an athlete is at risk: a simple EKG.
It's law in Italy for young athletes to get screened before taking part in organized sports. Since testing started in the late '70s, sudden cardiac death has fallen 89 percent among athletes there. So why not put mandatory screening into play in this country? A Stanford study, the results of which were released today, found that routine testing would cost only $199 per athlete — chump change.
And yet the American Heart Association opposes routine screening, because of the low incidence of the disease. The Stanford study backs that up: testing would save only 2.6 life years per 1000 athletes. (It's a confusing stat. Saving a 20-year old would mean 45 life years, assuming he was predicted to live to 65.)
It's painful to write "only" 2.6 life years because of the real people who might have been saved. Reggie Lewis, Gaines Adams, Ryan Shay, Alexei Cherepanov, Joe Kennedy. But from a purely statistical point of view, they and the thousands of young athletes, famous and otherwise, are not worth the cost.
It's worth noting that the cost isn't only monetary. An echocardiogram (not the electrocardiogram in the Stanford study) detects HCM with only 80 percent accuracy. That's 1 in 5 athletes with the disease who will be told they are completely healthy, and more importantly, a good number of healthy athletes who will be told they shouldn't play.
It's an exceedingly tricking question, fraught with economic and moral judgments. And complicating matters, a statistical study doesn't deal well with the human factor. Cuttino Mobley retired early because of HCM, though it had never interfered with his 11-year NBA career.
And let's not forget: Mandatory EKG screenings wouldn't have saved Hank Gathers. He had been diagnosed with an irregular heartbeat, but hated how the medication made him feel, and went against doctor's orders when he decided to cut back on his dosage. Months later, he was dead. Gathers knew something was wrong with his heart. He made a choice to play in spite of that.
Study: EKGs for young athletes cost-effective [San Francisco Chronicle]