Jan 29, 2015Q&A with Brian J. Smith
Rancho Buena Vista High School, Calif.
In the five years since graduating from California State University-Chico, Brian J. Smith, MS, ATC, NREMT-B, has rehabbed football athletes at Indiana University, worked with the USA Mogul Ski Team, covered an NCAA Women’s Rowing Championship, treated on-the-job injuries at a shipbuilding factory, and coordinated outreach for 11 high school football teams in and around Chula Vista, Calif. But he’s truly found a home as Head Athletic Trainer and Sports Medicine Teacher at Rancho Buena Vista High School, located about seven miles inland from the Pacific Ocean in Vista, Calif., near San Diego.
After arriving at Rancho in January 2004, Smith encountered and successfully treated his first near-fatality during football two-a-days that summer, quickly earning the respect of athletes, parents, coaches, administrators, and neighboring athletic trainers. Later, he spearheaded a successful campaign to purchase an automated external defibrillator for the athletic department, and helped lead efforts by the Far West Athletic Trainers Association (FWATA) to publicize the lack of athletic training coverage at area high schools.
Working in one of six states that doesn’t register its certified athletic trainers, Smith has consistently advocated for the profession and was named the 2006 FWATA Secondary School Athletic Trainer of the Year. In this interview, he talks about working in the high school setting, acting quickly during an emergency situation, and promoting athletic training to a wider audience.
T&C: When did you know you wanted to become an athletic trainer?
Smith: Like a lot of athletic trainers, I had an injury playing in high school. Sophomore year I tore my ACL during football, junior year, I came back, and halfway through my senior year I tore my meniscus. We didn’t have an athletic trainer, but I spent a lot of time in the physical therapy setting, and began to think it might be worth pursuing as a career.
My first semester in college at Chico State I declared a major in exercise physiology, but I didn’t really know what I wanted to do with it. So my older brother, who was a senior in the athletic training program, took me to see the athletic training room, and everything just clicked right then and there. I realized that by becoming an athletic trainer, even though I couldn’t play football anymore, I could still be part of a team and interact with athletes. It gave me a chance to put my love of sports together with my love of medicine.
How did you wind up at Rancho Buena Vista?
To tell you the truth, the whole time I was studying to be an athletic trainer, I never considered working at the high school level. When I was a graduate assistant at Indiana University, where I worked with the football and women’s rowing teams, I was convinced I wanted to work at the collegiate level. But my first job out of grad school was working at the US Olympic Training Centers in Chula Vista and Lake Placid. After that year, I really wanted to return to the San Diego area, so I took a clinical job at a physical therapy clinic, which is where I met my wife, who’s a physical therapist.
Throughout those years, I kept thinking about what my graduate advisor told me: Plan your professional goals around your personal life. So as my relationship grew more serious, high school started to look like a good fit because I’d be able to go home every night, which would be important if we were going to have kids.
I’ve been at Rancho going on three years now, and it’s turned out to be a great move. My athletic director offers nothing but support and my principal backs me on everything I do. When the administration asked if I would be interested in teaching a sports medicine class, I jumped at the chance. I also have some great kids here, which is very rewarding. And I have a top-notch athletic training room–it’s a lot like the room I worked in when I was an undergrad. I don’t have all the high-tech equipment we had at the Olympic Training Center, but I have everything I need to do my job efficiently and give the kids the best care possible.
What are the challenges of working at the high school level? I miss the camaraderie of being around other athletic trainers. When I was going through school or working at the Olympic Training Center, there were always people I could bounce ideas off. If I needed a second opinion, I could get it immediately. Now, if there’s an injury, everybody turns to me. When I first accepted this job, the athletic director said, “Here’s the key to your athletic training room–it’s all yours.” It was a challenge to come in and hit the ground running, create the program I wanted, and prove myself to all the athletes, parents, coaches, and administrators.
At the college level, athletic trainers are usually dealing with just one team. At the high school level, I’m one person responsible for 2,000 athletes. So the challenge is to prioritize everything I do, communicate clearly with athletes and coaches, and make sure I don’t favor one sport over another. Luckily, coaches here recognize I can’t be everywhere at once, so if the athletic training room is full of athletes and I can’t get to their practices on time, they understand.
What have you learned about working with coaches? The big thing is communication, and to always be up front with them. I don’t sugarcoat anything because at this level coaches are a big part of the sports medicine team. I can’t attend every practice and every game for every team, but if there’s an emergency, they need to know they can call me and trust me to do my best for their athletes.
How about working with athletes’ parents?
I hold a parents’ meeting before the start of every season, where I talk about my approach and emphasize that my highest priority is their children’s safety. If kids get hurt, I’m not going to put them back on the field unless I know they’re ready to return. And every time I say that, I see the parents smile and nod their heads because they know how competitive high school sports can get. I tell them I’m not here for the wins and losses, I’m here for their kids’ safety.
What was your most challenging rehab?
It was a senior starter on the boys’ basketball team, who had a meniscus tear. The doctor was adamant he’d be able to play in a couple of weeks, the coach wanted him back as quickly as possible, and his teammates were all pushing to get him on the court again. It was a relatively simple surgery, so the hard part wasn’t getting him back, it was getting everyone to keep the injury in perspective. I made it a point to keep reminding everyone, “If we can get him back safely in those two weeks, then we will. If we can’t, we won’t. He’s got his whole life ahead of him, and we’re not going to rush this.” If needed, I was prepared to be the bad guy. But in two weeks he was back on the court to finish the season and everybody was happy.
During your first football preseason at Rancho, you helped save an athlete’s life. How did you respond to that situation? If people think I saved his life, that’s fine, but I don’t really look at it that way. I recognized we were in an emergency situation and I took the necessary steps to get the help he needed. It was mid-August, we’d just started two-a-days in our new football stadium, and this was the first real emergency situation I was thrown into at Rancho.
This particular athlete, who was a fairly hefty fullback, was walking back from a huddle when he collapsed on the field. I ran out and when I got to him his eyes were rolled back in his head, his breathing was labored, and he was going in and out of consciousness. I immediately threw my cell phone to the head coach and said, “Call 911.” While we waited for the ambulance to arrive, I monitored his vital signs to make sure he wasn’t getting any worse and kept his airway clear.
His heart rate was going through the roof. I was trying to take his pulse and couldn’t keep up with it, that’s how fast it was. Once the paramedics got there, they gave him an EKG on the field and saw his heart rate was over 200 beats a minute. They got him to the hospital, stabilized him, and after some tests they diagnosed it as superventricular tachycardia, a pre-existing condition we hadn’t known about and was probably exacerbated by the heat. When it was reported in the newspaper, they made it seem like I’d diagnosed this pre-existing condition, which I hadn’t. But I knew it was an emergency and got the ambulance rolling as quickly as I could. The situation had a happy ending and the athlete made it back to play three or four games that season.
What did that experience teach you?
I learned to always be prepared, because in this profession you never know what’s going to happen next. I was thrown into a situation where I needed to act quickly, and it made me really evaluate my program: Did I have everything I needed to save someone’s life? It took another two and a half years before I convinced the athletic department to get an AED, but I pushed hard, raising funds through my physicals until we were able to purchase one. That incident opened my eyes to see that anything can happen, and we need to have the right equipment on hand, even if we never have to use it.
What was your reaction to winning the FWATA’s Secondary School Athletic Trainer of the Year award? When I first got the news, I thought someone was playing a joke on me. I like to be involved and get my voice out there, so I’m on the secondary school committee, and I think it’s important to promote the profession. But I really feel I do what any other athletic trainer does.
What are some things you’ve done to promote athletic training?
I did a survey where I called all the schools in the San Diego area and asked the athletic directors, “Do you have an athletic trainer on staff? Why or why not?” I found that of 90 schools, only 21 have a full-time athletic trainer and 41 have no athletic trainer of any kind. The most common reason for not having an athletic trainer was money–the school felt it couldn’t afford one. It’s unfortunate that too often it takes a catastrophic injury before people realize they can’t afford not to have one.
I don’t believe in promoting the profession by standing on a pedestal and saying, “Athletic training is the best career out there and every high school needs to have an athletic trainer.” Instead, I try to set an example. When I travel with the football team to a school that doesn’t have an athletic trainer, or when one of those 41 schools comes to play us, I make sure to take care of the athletes on the opposing team as well as our own. I do all I can in the hope that some parent or coach will say, “Why don’t we have an athletic trainer at our school?” I try to act professionally in everything I do, and I always tell my students that whatever career they’re planning to pursue, whether it’s athletic training or anything else, they need to be proactive: “Don’t just punch a time clock–get involved.”
Do you ever think about working at the college level?
I do. My brother is on the athletic training faculty at James Madison University, and sometimes when I hear him talk about it, I miss my days as a graduate assistant at Indiana. But at the same time, I have to pinch myself because my job here at Rancho is great. Being able to influence young athletes is a huge advantage to this setting, plus I get to go home every night and spend time with my wife. I can live the life of an athletic trainer and still have time to try to be a good husband.
Brian J. Smith
Head Athletic Trainer Sports Medicine Teacher Rancho Buena Vista High School, Vista, Calif.
BS, California State University-Chico, 2001 MS, Indiana University, 2002
One-Year Fellowship Athletic Trainer, US Olympic Training Center, Chula Vista, Calif., and Lake Placid, N.Y., August 2002-June 2003
Sports Medicine Director, Sweetwater Union High School Outreach Program/Lead Physical Training Aide, Edward Ayub Physical Therapy Clinic, Chula Vista, Calif., June-December 2003
Athletic Trainer, National Steel and Shipbuilding Company, San Diego, Calif., August-December 2003
2006 Far West Athletic Trainers Association Secondary School Athletic Trainer of the Year