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doi: 10.1097/01.HEARTI.0000373310.99438.57
Features: Cover Story

Bobby Brown's Been “Berry, Berry Good” For Baseball


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How The Ballplaying Cardiologist Changed Baseball Culture

Robert (Bobby) Brown, M.D., did something no other cardiologist has ever done — play Major League baseball, and play it well.

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During his lifetime, Brown has touched ‘em all: Professional athlete, World Series champion, cardiologist, baseball executive. As a New York Yankee, Brown played in four World Series, mostly as a third baseman, and still holds the record for the highest batting average among players with at least 40 post-season at bats (.439). He practiced cardiology in the Dallas/Ft. Worth area for more than 25 years. And from 1984 to 1994 he served as president of Major League Baseball's American League (AL).

Brown was the first Major Leaguer in baseball history to play while simultaneously attending medical school. Pitcher George (“Doc”) Medich followed in his footsteps when he signed with the Yankees in 1972.

Nicknamed “The Golden Boy” because of his (then) blond hair and a (then) enviable $52,000 signing bonus, Brown took pre-medical classes at Stanford University and UCLA, then entered Tulane School of Medicine in December of 1944. He played baseball at all three schools, and attracted the attention of several professional teams. In 1946 he played down on the farm with the Yankees' minor league affiliate in Newark, NJ, and was called up to the Bronx Bombers at the House That Ruth Built that September.

But Brown usually missed spring training because of his medical school schedule. “I knew my timing would be off if I got out of shape, so I fit an hour workout in between my studies. I'd also swing a bat in the hallway,” he recalls.

From the last half of the 1952 season to the beginning of the 1954 season Brown traded his pinstripes for the olive drab of an Army medic during the Korean War. He patched up wounded soldiers as a battalion surgeon at the 160th Field Artillery Battalion Aid Station in Korea, and also served in a MASH hospital 15 miles behind the demilitarized zone.

A brief comeback attempt in 1954 persuaded Brown to quit professional baseball and practice medicine. After a three-year residency in internal medicine, Brown began a cardiology fellowship at Tulane. “In those days, cardiology wasn't a specialty, but I liked cardiology. We would listen to the heart, look at X-rays and read electrocardiograms.” He enjoyed figuring out what was causing a patient's symptoms.

Brown and medical school classmate Albert Goggans opened a cardiology practice in Fort Worth in 1958. For more than 25 years, the two cardiologists “dealt with things we could hear and see — heart attacks, high blood pressure and strokes,” he says. In 1983 as he approached his 60th birthday, Texas Rangers owner Eddie Childs asked Brown if he was interested in replacing Bowie Kuhn, who was stepping down as the commissioner of Major League Baseball. “I did two interviews, but the board wanted a businessman, which I wasn't.” But the board thought highly enough of Brown to tip him off that AL President Lee MacPhail — son of Larry MacPhail, who had signed Brown to the Yankees when he was one of the team's co-owners — was retiring. “I spoke to Lee, and the league offered me the job in 1984. It was a baseball job. I hired umpires, did the schedule for the teams.”

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Figure. Top right: B...
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Chewing (aka spit/smokeless) tobacco had been part of American baseball since the 1900s, when players stuck wads of it in their cheeks to keep their mouths from getting dry in the dusty parks. “In my day, chewing tobacco was rampant — at least half of the players did it,” says Brown, who has never used any form of tobacco.

As a cardiologist, Brown knew that tobacco increased the risk of heart attack, as well as high blood pressure and abnormal heart rhythms — both of which could cause stroke. A 1985 meeting with Roy Sessions, M.D., chief of head and neck surgery at New York's Memorial Sloan-Kettering Cancer Center, and Jerome Goldstein, M.D., who headed the American Academy of Otolaryngology, convinced him that he was in a unique position to deter smokeless tobacco use among baseball players.

“Since I was a doctor and the AL president, they hoped I could do something from the inside,” says Brown.

Brown struck out when he broached the idea of banning smokeless tobacco in the Majors, because it would have required altering the collective bargaining agreement between the players and owners, and the players union wanted no part of it.

His next stop was Jimmie Lee Solomon, Major League Baseball's director of Minor League Operations. Solomon was more receptive to Brown's message that, “Smokeless tobacco is not only bad for the players themselves, but also sends the wrong message to young boys who look up to players as role models.”

In 1991 Minor League baseball banned use of smokeless tobacco at the rookie level. Just two years later, a ban on the use of all tobacco products — including cigarettes and smokeless tobacco — throughout the Minor League went into effect.

The National Collegiate Athletic Association also decided to swing for the heels and banned the use of all tobacco products, including smokeless tobacco, in 1994; all youth baseball leagues followed in 2000.

With the help of Thomas James, M.D., head of the University of Texas (Galveston) Medical School, Brown spearheaded the production of a film starring Houston Astros star pitcher Nolan Ryan that graphically explained and depicted the harmful effects of smokeless tobacco. The film was distributed to 22,000 high school baseball teams across the country in 1988. “This was one of the first major efforts to counteract the prevalent use of smokeless tobacco among high school students,” says Brown. The film is still shown to high school teams today.

Since he couldn't attack smokeless tobacco use among Major League players head-on, Brown took an indirect approach. In 1990 Major League Baseball joined forces with the Professional Baseball Athletic Trainers Society (PBATS), the National Cancer Institute, and the Fox Chase Cancer Center to launch a full-scale educational campaign teaching professional baseball players and team personnel about the long-term hazards of using smokeless tobacco. They worked together to publish Beat the Smokeless Habit, a guide tailored to help baseball players break the habit, as well as clubhouse posters.

Major League Baseball issued a report on the hazards of smokeless tobacco later that year. Treatment and education programs were introduced to help current players beat the habit and to prevent the next generation of players from using it. Spring training surveys of Pittsburgh Pirates players' smokeless tobacco use from 1991–2000 showed a drop in usage from 41 percent in year one of the study to 25 percent in year 10. Smokeless tobacco has yet to be banned in the Major Leagues, but as a result of Brown's efforts many players have switched to chewing big wads of gum, a much healthier alternative.

In April, House Energy and Commerce Committee chairman Rep. Henry Waxman (D-CA) and Health Subcommittee chairman Frank Pallone (D-NJ) held a hearing on chewing tobacco use by young people and the bad example set by professional baseball players who use the stuff. In a promising development, a Major League Baseball official and the chief labor counsel of the Players' Association agreed to put the issue on the table when the players' labor contract expires in December 2011. Whether the players agree to a ban during collective bargaining remains to be seen, notes Brown, adding, “anything they do to stop the use of smokeless tobacco is a step in the right direction.”

In any case, the message seems to have filtered down to younger players and fans as well. A report to the Surgeon General in 1986 on the health consequences of smokeless tobacco found that that 16 percent of males between age 12 and 25 had used some form of smokeless tobacco within the past year. In 2007, only 6 percent did.

Brown really knocked the cover off the ball with his campaign to change hearts and minds about a habit as entrenched as smokeless tobacco — and then behavior.

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A Whole ‘Nother Ball Game

During Brown's days as a ballplayer, cigarette smoking was common — some players even lit up in the middle of games. And his Yankee teammates were notorious for their drinking and carousing. (Brown himself has always been a teetotaler.) “We used spring training to get into shape. Most players didn't exercise in the winter because they had to work full-time jobs,” he says. “We didn't have any performance-enhancing drugs. We only had aspirin.”

Today's players stay fit year-round with healthy diets and weight training. Nutrition coaches personalize an eating regimen for a player based on, say, his need to lower his body fat content, and trainers tailor exercise programs to the position he plays. For instance, a third baseman like Brown would do agility drills and arm strengthening exercises, in addition to fielding thousands of ground balls.

Unfortunately, the pressure to perform at peak levels 100 percent of the time — in other words, to “earn” the multi-million dollar salaries that were unheard of in Brown's day — led some players to use anabolic steroids in the late 1990s and early 2000s. Perhaps because steroid use wasn't as rampant as smokeless tobacco had been, “No one was talking about the risk of using steroids then,” notes Brown. Steroid abuse can elevate blood pressure, alter sugar metabolism to increase the risk of type 2 diabetes, raise blood cholesterol levels, promote plaque buildup in the arteries and is associated with a dangerous thickening of heart muscle called hypertrophy — the same kind of heart-muscle enlargement seen in some patients with congestive heart failure.

Figure. Bobby Brown ...
Figure. Bobby Brown ...
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To stamp out steroid use, Major League Baseball instituted routine testing and harsh penalties in 2005. A positive test will result in a suspension of up to 10 days; the second positive test will get a player suspended for 30 days; a player is looking at a 60 day suspension with a third positive test; and will be suspended a full year with the fourth positive test. Players are now randomly tested at least once a year, and several players can be tested numerous times per year. Strong disapproval by fans and sports journalists has also proved an effective deterrent, says Brown.

The 86-year-old donned his Yankees uniform again for the first Old Timer's Day at the new Yankee Stadium last July, and walked on to the field without using any mobility aids to join his Hall of Fame teammates Yogi Berra and Whitey Ford.

Speaking as a cardiologist, Brown is more than happy to share the secret to his vim and vigor: Don't smoke, stay active, control your cholesterol levels, eat the right foods, maintain your blood pressure, stay at a healthy weight and control your blood sugar levels.

Follow his advice, and you'll be batting a 1.000 in terms of cardiovascular health. HI

© 2010 American Heart Association, Inc.