Rope 'em, ride 'em, mend 'em: When rodeo cowboys get hurt, volunteer physicians are there to help

R. Pepper Murray, MD, knows the ropes of rodeo. He competed in roping contests as a teenager and was on his college rodeo team until his horse bucked him, causing a knee injury that ended his shot at turning pro.

These days, he watches the action from the other side of the fence -- as a physician to cowboys who risk life and limb for their sport. He is among the dedicated physicians who volunteer at rodeo arenas across the country, tending to injuries and other health needs of professional rodeo athletes.

It's a relatively new calling for physicians.

Back in the 1970s, "there was really no medical interest in rodeos. There was an ambulance at the rodeo back then, but that was it," said Dr. Murray, an orthopedic surgeon in Bountiful, Utah, north of Salt Lake City.

That changed in the winter of 1980, when Dallas physician J. Pat Evans, MD, saw a need and began offering medical care to rodeo cowboys.

"The doctors did not know anything about the rodeo. They said, 'If you broke your arm riding a bull, then don't ride a bull.' That didn't go over well," he said.

In 1981, the Justin Boot Co. began sponsoring the medical program, with Dr. Evans and athletic trainer Don Andrews leading the effort. Now, more than two decades later, the Justin Sportsmedicine Team, which includes Dr. Murray, treats about 6,000 cases annually at more than 125 rodeos sanctioned by the Professional Rodeo Cowboys Assn.

"They say, 'Yes, ma'am,' and 'Yes, sir.' They're very grateful to you," Dr. Murray said.

If an athlete gets injured and can't ride, he or she doesn't make money. And injury is a definite job hazard if you're riding a 2,000-pound bull.

"You either get smashed, mashed or twisted," said Dr. Evans, a semi-retired orthopedic surgeon.

About 150 to 200 physicians offer their medical skills for free through the Justin program at rodeos nationwide, Andrews said. Doctors typically work with athletic trainers, paramedics and other health professionals. Some arenas use training rooms as clinics while others get visits from mobile trailers.

Some doctors travel to rodeos several times a year, typically letting partners handle their regular practices while they're away. Most are as down-to-earth as the cowboys they treat. They look the part, too.

Orthopedic surgeon Tom Weeks, MD, of Pendleton, Ore., usually heads to the rodeo in what he wears to his office: cowboy hat, cowboy boots and jeans. "I do have a suit, but I don't see it very often," said Dr. Weeks, who has tended to rodeo athletes for more than 20 years.

Bull riding most dangerous for cowboys

At the San Antonio Stock Show & Rodeo, orthopedic surgeon Keith Markey, MD, heads the medical committee of about 160 volunteers. They care for cowboys and spectators at four first aid stations and one training room. Dr. Markey and his wife, otolaryngologist Donna Gibbons-Markey, MD, often watch the action near the chutes.

"That's where the most visible and immediate need is," Dr. Markey said.

But sometimes, getting close has its risks. Doctors often have to scramble into the arena to care for a downed rider. One time a bull jumped a six-foot fence, giving Dr. Markey a closer-than-wanted look.

"Everybody had to run for cover. I was high and dry very fast," he said.

Volunteer physicians said they don't view rodeo events as cruel to animals. They say the horses and bulls are pampered by cowboys.

"They are better cared for than the family dog," Dr. Evans said. "[Rodeo athletes] have an investment and want to take care of them."

Nationally, the Justin team examined the types of injuries it treated from 1981 to 2000. Bull riding caused the most injuries, followed by bareback riding. Spine and knee injuries used to top the list, but were replaced in the last decade by head and face injuries.

From 1996 to 2000, concussions rose dramatically to be 56% of all major injuries. Shoulder fractures and dislocations were the second most frequent major injury. Of all rodeo athletes, bull riders were more likely to be injured in the head or face, usually from colliding with the bull's head or horns.

Dr. Evans has seen two athletes killed. Both were in their 20s and both died of kicks to the head. He knew one of the men well.

He has had some close encounters, entering rodeo rings to treat fallen cowboys. He has been bumped and stepped on, but has learned to keep a distance from the animals. "You just have to respect them," he said.

The 1989 death of bull riding champion Lane Frost prompted many rodeo cowboys to start wearing protective vests, which often are made of plastic and foam covered in leather. Helmets have been debated as another safety measure, but some say helmets limit visibility and don't look Western.

"If we could get one with a brim on it, that would be good," Dr. Evans said.

The doctors see no ethical dilemma in treating athletes in a dangerous sport.

"These kids are going to do it anyway, so we should be out there to take care of them," Dr. Weeks said.

Some hurt cowboys later become office patients, but doctors say they don't volunteer in hopes of recruiting patients. They say they provide free cowboy care because they love the sport, the atmosphere, the satisfaction of healing wounds and the charm of the people who ride.

"These guys are a special lot," said Tandy Freeman, MD, a Dallas orthopedic surgeon who attends more than 120 rodeo and bull riding performances a year. "In a lot of ways, I'm like the small-town doc for that community."