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I worked in the Olympics lab; this medical technologist got an "up close and personal" view of the world's top amateur athletes.

All of a sudden the medical terminology comes flying in languages other than English. It's Los Angeles, not Timbuktu, but a smear is positive for malaria. You get so excited working with patients you've seen on TV that you can hardly draw blood. You can't wait for the next set of test orders, and you wish you could work 24 hours a day, forever.

These are some of the tell-tale symptoms of an epidemic that swept through Southern California last summer. I developed a classic case of Olympic fever as a medical technologist for the 1984 games in L.A. I met world-class athletes, encountered clinical conditions I'm not likely to see again, worked long hard hours, and thoroughly enjoyed myself.

American Medical International, which manages my hospital and more than 150 others worldwide, was named health care provider for the Olympics. The firm built and ran three polyclinics. When it sought volunteers from its U.S. hospitals, I prompty signed away two weeks of my vacation time. The chance to be directly involved with the most important aspect of the games--the athletes themselves--was more than I could resist. (AMI later decided to pay everyone for this duty. Had I known at the start that I could have gone longer than any two-week vacation, I would gladly have climbed aboard for a full month.)

Clinic staff members needed to pass muster with the Los Angeles Olympic Organizing Committee. After undergoing a lengthy application and security clearance process, including fingerprinting, we received uniforms and a careful orientation. A high level of organization was apparent at every step: There was no doubt the games would be well run.

Identification badges stated our name, country, language, and ID number, and even had a supermarket-type code bar that would enable security officials to track our movements through the village's checkpoints. Uniforms were color-coded--gray and white for the medical staff--so anyone could instantly tell where you belonged and what you did.

I had to work out a schedule with my lab manager at Mission Bay Hospital. Since it's hard to arrange substitute coverage for our biweekly weekend duty, I applied for the first and third weeks of the Olympics. That way, I would be at the Olympic polyclinic when the athletes arrived, work my weekend in San Diego, and then return to Los Angeles for the first week of competition.

A polyclinic was set up at each of the three Olympic villages, on the campuses of USC, UCLA, and UC Santa Barbara. Luckily, I drew assignment to the USC polyclinic. The USC village was the largest, housing almost 7,000 of the 10,000 members of the "Olympic family"--athletes, coaches, trainers, team officials, and diplomats, Most members of the U.S. team stayed at USC.

Best of all, our polyclinic was located in the heart of the village. The swimming and diving area was so close we could hear the splashing of the competition.

The polyclinics provided basic medical care plus ophthalmology, radiology, dentistry, physical therapy, and pharmaceutical services. In serious cases of illness or injury, patients would be transferred to one of the designated Olympic hospitals. Orthopaedic Hospital in Los Angeles served as the backup facility for our polyclinic, while the UCLA Medical Center handled referrals from the UCLA village.

The Olympic villages opened on July 14, two weeks before the games began, and AMI staff members from arcoss the country and Great Britain were on hand to greet the athletes. (AMI employees were housed in a wing of the firm's Westside Community Hospital in Los Angeles.) Setting up the clinic was our first exercise in teamwork at its best. The entire staff pitched in as we finalized schedules, stockpiled supplies overlooked in the planning stage, clarified procedures, and got down to the business at hand--caring for the world'd bet amateur athletes.

Although the teams seemed to be tricling into the villages the first few days, their athletes poured into the clinics. We could always tell when a new group had arrived because six or eight tema members would show up in our reception area. As might be expected, those traveling the farthest had the most complaints, primarily nausea and fatigue.

The number of old injuries and other ailments was surprising. The polyclinic staff concluded that many athletes, particularly from Middle Eastern and Third World nations, had delayed getting treatment, either in anticipation of benefiting from our sports medicine programs or for fear of being removed from the Olympic teams. Among these athletes, competing seemed secondary to just being in Los Angeles as part of the games.

Physicians, nurses, and pharmacists were on duty round the clock in our clinic. Laboratory hours ran from 7 a.m. to 11 p.m. During the day, two medical technologists and a phlebotomist staffed the laboratory, or laboratoire as it was known in French, the other official Olympia language. One MT pulled evening duty (that was my shift) along with a phlebotomist for part of the time, and a technologist stayed on called for early morning test requests. Approximately 30 techs worked at the various polyclinics from mid-July to mid-August.

Despite the occasional frenzy of processing an entire team, I had little or no trouble accommodating all requests for phlebotomy and testing. Our lab was equipped for complete blood counts (a hematology analyzer with hemoglobinometer, spun hermatocrits, and differentials); urinalysis (manual dipstick); serum electrolytes, glucose, and BUN (a dry chemistry analyzer); and misscellaneous serologies and Gram stains.

With the exception of the gender verification testing that the USC polyclinic performed on the women, and the banned-substance testing at the UCLA Medical Center, the athletes were not required to have any laboratory work done at all. It a woman had previously been gender-tested at an international competition, she could present a certificate to that effect. Otherwise, the Barr body buccal smear technique was used for verification.

All I knew about the testing for banned substances is what I was told during orientation. The three medal winners in every event were automatically tested, along with a fourth competitor selected at random. Immediately after an event, a "doping control escort" stuck close to each of these athletes until urine specimens were available. The escorts would stand just our of camera range at the award ceremony and also attend any press conference, waiting for specimens.

Duplicate specimens were placed in two sealed containers, identified by number only, and then turned over to a "doping control station" for blind testing in the lab. The banned-substance list includes anything officials believe might enhance an athlete's performance. For example, certain types of cough syrup might be prohibited because they contain a particular additive.

In order to fill presecriptions for banned substances, where a medical need had been established, the polyclinic pharmacies required signatures of both a team physician and a clinic physician. In any case, the pharmacies could only dispense drugs approved for use in the United States.

For the most part, the complaints of patients visiting the clinic during the first week either were so simple that no testing was indicated or else required testing beyond our capabilities. For example, we saw a lot of sore throats but had decided not to perform any bacteriology in-house. A local AMI hospital laboratory did reference testing for the USC and UCLA polyclinics.

That first week we performed a few CBCs and urinalyses each shift and prepared some send-out speciments, including throat smears for culturing and thick and thin blood smears for malaria examinations. Two cases of malaria were confirmed--oen a recurrence, the other previously undiagnosed. Both patients came from central African nations. We also ordered thyroid levels for a diplomat under treatment for hypothyroidism and ova and parasite exams for several patients who complained of constipation or diarrhea.

The polyclinic's relative light workload gave me time to socialize with our visitors. Thanks to the gender verification requirement, I met the entire U.S. women's gymnastics team, along with their competitors from Romania, Canada, and Australia, in one exciting half-hour.

The week flew by. Back in the eal world, I had to watch the opening ceremonia on television just like everyone else. But my brief encournter with the participants lent a personal touch to the pageantry.

In my second tour of duty, I found the village hat changed markedly. The atmosphere was laden with the mounting tension of competition. Clinci workload had muliplied several times, and as the only medical technologist on the evening shift, I was constantly busy. Instead of the minor ailments and discomforts that characterized the earlier patient load, we were now seeing serious illness and injuries that, in some cases, would alter the outcome of the games.

Mostly, the polyclinic staff helped ease aches and pains suffered in training and preliminary competition and kept the athletes medically fit for their events. Sometimes our efforts made all the difference. When a member of the U.S. men's handball squad complained of nausea, dissiness, and frequent urination, we found a previously undiagnosed case of diabetes. Although he required round-the-clock glucose testing, he was able to compete.

Some of the cases were buffling. Despite a battery of tests, including ANA and RIA procedures, the physicians never were able to pinpoint the cause of recurrent dizzines, nausea, and muscle fatigue in a track athlete from Ghana.

A boxer from Thailand was diagnosed as having hepatitis just hours before his opening fight. He claimed to feel well, and the jaundice wasnht apparent at first. The discoloration in this eyes was detected during a routine physical the day before the match. A urine specimen showed nothing but bile. We took a blood specimen and sent it to the reference lab for Stat liver enzyme testing. That night, the Thai team physician joined me in the polyclinic to wait for the phoned results. By fight time, the boxer was in the hospital instead of in the ring. It's a wonder he came so far in his condition. I was touched when the Thai physician later brought me a beautiful pin to thank me for letting him share the vigil.

One polychlinic physician had to tell a woman track athlete that a pituitary carcinoma had reappeared. Although she had undergone surgery, chemotherapy, and radiation therapy just six months earlier, this woman had still managed to qualify for the Olympic team. When the dizziness and loss of coordination returned, she came to the polyclinic for testing. The diagnosis certainly must have overshadowed the disappointment of not being able to compete. I still find it hard to think about that case.

Most of our patients did go on to participate, and polyclinic staff members rooted for old favorites as well as new friends. As the games progressed, athletes often stopped by the clinic to say goodbye. There were many lighter moments, such as the evenign a doctor decided it was time to take a break and whisked me into the village disco for a whirl around the floor. I talked shop with physicians who didn't speak English via interpreters who didn't understand the first thing about microbiology.

The biggest test of my creativity came when a Spanish doctor wanted to aspirate a wrestler's elbow. A simple enough task, except that there wasn't a single needle in the entire lab--the phlebotomists used vacuum tubes. I scared up a syringe and finally found an I.V. needle in one of the kits from the trauma room. The doctor performed the procedure, placed the aspirate in a urine tube--we didn't have a more suitable sterile transport medium--and ultimately found a staphylococcal infection.

Meeting Edwin Moses, the gold medalist U.S. hurdler, ranks as my top Olympic thrill. This gracious athlete took the time to talk to every single staff member during his visit to the clinic.

I collected more than two dozen national and corporate Olympic pins. My most prized souvenir is the U.S. team pin. One day at the clinic, I mentioned how badly I wanted that extremely popular emblem. Ruby Fox, a member of the pistol team, reached into her pocket without a word and gave me hers. I was very pleased when she went on to win a silver medal.

I took home many wonderful memories, along with a seven-piece Olympic wardrobe. I wear the jacket all the time, and the cap, which displays my pin collection, has a place of honor in my living room.

I may never recover from Olympic fever.
COPYRIGHT 1985 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1985 Gale, Cengage Learning. All rights reserved.

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Author:Crabb, Elizabeth
Publication:Medical Laboratory Observer
Date:Mar 1, 1985
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