Realizing Readiness

Being prepared is more than a motto for Tim Neal. It is a central philosophy that literally has proven itself to be a lifesaver.

By Jim Catalano

Jim Catalano is an Associate Editor at Training & Conditioning.

Training & Conditioning, 12.4, May/June 2002,

A hush fell over the Carrier Dome crowd midway through the fourth quarter of the Syracuse-East Carolina football game on Sept. 29, 2001. Referee Gerry Bram had collapsed on the field and the Syracuse University sports medicine staff was springing into action.

Syracuse Head Athletic Trainer Tim Neal, MS, ATC, and Team Physician Irving Raphael, MD, along with East Carolina Head Athletic Trainer Mike Hanley, ATC-L, and ECU Team Physician John Siegel, MD, rushed to Bram’s side. The referee had stopped breathing and required immediate intervention. Before any instructions had to be given, the SU staff members quickly filled their roles.

The graduate assistants grabbed the automatic external defibrillator (AED), Associate Athletic Trainer Bradley Pike, MS, ATC, PT, placed the pads on Bram’s chest, and Neal cleared the area for the first shock with the AED. Assistant Athletic Trainer Paul Schmidt assisted Raphael with the emergency crash kit. The Carrier Dome’s emergency medical staff soon arrived and took over. Once stabilized, Bram was transported to a local hospital where he underwent surgery to repair a blocked artery.

“Everything happened really fast, but in all honesty it was like a drill for us,” Pike says. “Our graduate assistants were so well trained they knew exactly what to do. Dr. Raphael, Tim, Paul, and I knew what to do, and it was kind of like clockwork. We rolled Mr. Bram over, established the airway, and the grad assistant immediately had the AED out there. We applied the pads, and shocked him once. It was something you always prepare for, and you don’t want it to happen, but it was great that we were ready for it.”

Today, many people credit Bram’s recovery to Neal’s insistence that the Syracuse athletic department purchase several AEDs. If he hadn’t, Bram might not have survived.

“I’ve been interviewed by several local media outlets,” Neal says, “and they all ask, ‘Did you ever think you were going to need the AED? My answer to all of them was, ‘Hell, yes! That’s why we got them.’”

In recognition of the proactive thinking that enabled the SU staff to help save Bram’s life, Neal receives Training & Conditioning’s Above the Call Award for May/June 2002.

According to Pike, Neal put a lot of time into making the case for purchasing the AEDs to SU Athletic Director Jake Crouthamel. “Tim and I both have some colleagues around the country who had them,” Pike says. “Tim put in a lot of legwork in analyzing the research on the AEDs, and he wrote a really nice proposal to the athletic department. Jake was so kind to get us three AEDs, and they’ve been a great benefit for us, and to Mr. Bram as well.”

Neal credits Crouthamel and Associate Athletic Director Rob Edson for being receptive to his suggestions. “They are first and foremost concerned with the health and safety of the student-athletes, and they work very collaboratively with us,” Neal says.

“I went to them, showed them a need, and they met that need,” Neal continues. “They know I try to take an overall look at how we operate, not only from an efficiency standpoint, but also a risk-management standpoint. They value my input and they act on it.”

Adopting a proactive approach to potential emergency medical situations was bred in Neal from his early days as an athletic trainer. “A lot of the attitude of being prepared started during my undergrad work at Ohio University,” Neal says. “Head Athletic Trainer Skip Vossler felt that approach was important to the undergrad student athletic trainers who were covering teams on their own. Assistant Athletic Trainer Ken Wright, who’s now the curriculum director at University of Alabama, also stressed preparedness.”

Neal arrived at Syracuse in 1979 to pursue graduate work under then-Head Athletic Trainer Don Lowe. “The most important thing he instilled in young athletic trainers was being prepared for different kinds of eventualities, especially emergencies,” Neal says. “That’s always with me. We deal with 3,000 injuries per year here at SU—knees, wrists, fingers—and thankfully few of them are very serious. But you need to be prepared for them. I carry that attitude every time I come to work.”

Since becoming Head Athletic Trainer two years ago, Neal has mentored his graduate assistants in much the same way. “This philosophy of proactivity is practiced and taught by Tim Neal and his staff, not only to the 11 graduate assistants they mentor, but to the local medical and athletic communities as well,” says Assistant Athletic Trainer Kelli LaPage, MS, ATC.

“What makes the Bram case stand out is that all of these components were in place with all sideline medical personnel trained, not only to have these items available, but to be prepared to assist in any necessary procedure to save Gerry Bram’s life,” LaPage says. “This is a direct testament to the value of Tim’s philosophy of always being prepared, and ensuring that everyone around is prepared as well.”

For Neal, preparation not only means readiness. It also means that he sets the highest standards for himself and his staff.

“Tim holds everyone to a high standard, and that’s why he’s been so successful,” Pike explains. “He has that high standard, holds us all to it, and we all strive to attain it. That’s why we work great as a group. It’s his role as head athletic trainer to set the tone of our department, and he sets it without fail.

“He’s instilled quite a work ethic in our full-time staff as well as our graduate assistants, in terms of teaching people how to prepare for the emergency crises,” Pike continues. “That really came out when we helped save that referee’s life—the preparation was the key.”

Having AEDs on hand is just one example of how Neal is always trying to learn about new equipment that can help his department do its job better and be ready to address any emergencies. “I like to be ahead of the curve,” he says. “There is a new LMA (laryngeal mask airway) out on the market that doesn’t need a laryngoscope to use. It’s relatively new, but we looked at our needs and got them for all crash kits and for all the facilities. They’re something you can insert easily and quickly and it works very well. Hopefully we’ll never use them, but they’re handy to have around.”

Neal takes his “be prepared” philosophy beyond campus borders, frequently talking to local groups about safety-related and preparedness issues. “Since the incident with the referee, Tim has been asked to do a lot more speaking engagements,” LaPage says. “He visited a local hospital to talk about the necessity of the AED and the quick response that resulted from having the entire medical team prepared. He’ll also be speaking at this year’s NATA convention on this incident and the importance of AEDs.”

Neal and members of his staff teach an annual class on first-aid preparedness and emergency response during athletic events. “We try to get the message out there to coaches and parents about prevention and awareness,” he says. “For example, I’m doing another head-injury talk at the SUNY (State University of New York) Human Performance Laboratory. I did one last fall, and it went over so well, they had more people asking for another session.

“I find that I can’t say no to people,” Neal continues. “And I probably speak once every two to four weeks to groups because I think getting that message out is very important. I think athletic trainers are very knowledgeable, experienced, and for the most part, articulate enough to get that message out.”

LaPage lauds Neal’s efforts to educate the public and other athletic trainers about the importance of emergency preparedness. “I think the one thing that has always impressed me about Tim is that he wants to better the profession for those of us who are up and coming, and he wants to make us better for the profession itself as well,” she says. “That’s what sticks out, and that’s why he does all these extra things without compensation or expecting added recognition for them.”

That’s a belief that is shared by Neal and other athletic trainers around the country. “We do it because we like people and want to keep them informed,” Neal says. “But we also do it to find out what’s important to those people so I can address those issues.”

When Neal talks about the success of his program at Syracuse University, he gives a lot of credit to his fellow athletic trainers. “I have a great staff here. They are experienced people and I trust them a great deal. My biggest thing is to make sure I’m there as a resource for them and to get out of the way to let them do their jobs, day-in and day-out. I get interviewed a lot, but there are a lot of people helping me behind the scenes doing a lot of different things that contribute to the success of our department.”