Fans shun EDs to cheer on winning teams

For more than eight decades the Boston Red Sox broke the hearts of faithful fans, always coming up short of a World Series title and finding new ways to muff a chance at being baseball's champion. Just mention the Babe Ruth trade or the ball that got through Bill Buckner's legs, and a Red Sox fan's blood pressure may start to rise.

After all those years of pain and suffering, there's no way some fans would let a little illness interfere last year when the Red Sox won their first World Series championship in 86 years.

A new study in the October Annals of Emergency Medicine found that when the Sox were winning pivotal games in their post-season run, visits to emergency departments in Boston dipped as much as 15%. Fans apparently thought it was more important to watch their team on TV than worry about charging off to the hospital.

"The conclusion is that Red Sox fans are diehard," said John S. Brownstein, PhD, an epidemiologist at Children's Hospital Boston and co-author of the study, which ran as a letter in Annals.

Anecdotally, physicians have long noticed that emergency visits drop during major sporting events such as the Super Bowl. But Dr. Brownstein and two other Boston researchers (all Red Sox fans) wanted to see if they could use data to directly link a decrease to a sporting event.

They used an emergency department surveillance system to track hourly visits at six Boston-area hospitals and then compared the figures with TV ratings during Red Sox games in the 2004 American League Championship Series and World Series.

During the lowest-viewed games when the Sox were losing, emergency visits rose about 15% above normal. But after the Red Sox won Game 4 of the ALCS against the New York Yankees, emergency visits dropped 5% for Game 5. Coincidently, or not so coincidently, that drop occurred as TV ratings jumped.

In the highest-viewed games (the deciding Game 7 of the ALCS and Game 4 of the World Series), emergency visits dropped 15%. Researchers said fans likely put up with smaller afflictions, but emergency departments still saw serious cases, such as heart attacks.

"The higher the Nielsen ratings, the less people were in the emergency department," said co-study author Kenneth Mandl, MD, MPH, an attending physician at Children's Hospital Boston.

The Red Sox were pleased with the findings and added some good-humored thoughts.

"This study clearly indicates that the Red Sox winning is good for the health of Western civilization," Red Sox President/CEO Larry Lucchino said in a statement.

Red Sox Executive Vice President of Public Affairs Charles Steinberg, DDS, believes Red Sox fans have a toughness, a sturdiness that may make them tolerate minor illnesses when the team is playing well.

"To find that there is a therapeutic benefit to our victories makes us feel a little bit better about our contributions to the community," he said.

Maurizio Miglietta, DO, chief of trauma surgery at NYU Medical Center in New York City, said Yankees fans probably wouldn't defer care in large numbers as Red Sox fans did. That's because Yankees fans are used to winning championships.

"If you haven't been there much, when it does happen, you're going to do everything you can to stay away from the hospital," Dr. Miglietta said of rival Boston. "Being New Yorkers, we've been there and done that."

Physicians nationwide agree that EDs tend to quiet down during big games in their towns.

When the Seattle Mariners were in the playoffs in 1995, physicians noticed anecdotally that traffic slowed in the emergency department at the University of Washington Medical Center in Seattle.

"And patients who were in the waiting area waiting to be seen didn't want to come back to the emergency room because they wanted to watch the game" on waiting room televisions, said Kathleen Jobe, MD, medical director of the center's ED.

But not all sporting events clean out an emergency department.

"I haven't noticed it much with the [NBA] basketball playoffs and hockey games," said Sheldon Jacobson, MD, chair of emergency medicine at Mount Sinai School of Medicine in New York.

Along with major sports events, emergency visits often dip when the weather is beautiful and during major holidays, such as Christmas and July 4th. There's even been a dip seen during some TV programs.

"During the "American Idol" finale, it was relatively quiet," Dr. Miglietta said.

But when the Chicago Bulls played for the National Basketball Assn. championship, Mount Sinai Hospital in Chicago added extra staff in the emergency department. After the Bulls won the title, the department was swamped with serious cases, such as gunshot wounds, amid wild celebrations in Chicago.

"Every time we won the championship, we'd see an upsurge in traumas," said Leslie Zun, MD, chair of Mount Sinai Hospital's department of emergency medicine.

It's hard to predict what would happen if the Chicago Cubs ever win the World Series, a feat they haven't accomplished since 1908. But Dr. Zun doubts he'll have to worry about it.

"Not in my lifetime."