IT’S A BALMY AFTERNOON IN OCTOBER, and while Dallas Mavericks team physician Tarek Souryal would prefer to keep fuming about the just-rendered O. J. Simpson verdict, he has another famous-but-troubled athlete to worry about: the Mavs’ terrifically talented center, Roy Tarpley, who was supposed to have shown up for a preseason physical but got sick and had to cancel at the last minute.
Ordinarily, this wouldn’t cause Souryal much consternation. But Tarpley…well, for starters, the seven-footer has been a repeat violator of the National Basketball Association’s substance-abuse policy. He also has a pair of gimpy knees that needed to be checked out for off-season conditioning. And the word around Dallas is that he has suffered intermittent bouts of stomach cramps so severe that he has had to be hospitalized. The problem, perhaps, is pancreatitis—a condition that is no day at the beach for anyone, especially for someone with a history of alcohol abuse. Still, Souryal isn’t disturbed that Tarpley had to cancel his appointment. “We’ll have to see,” he says with a shrug. “It could be something serious.”
Souryal does not make such pronouncements lightly. As the Mavericks’ top doctor since 1992, he is painfully aware that every judgment he makes involves not only the patient’s health but the team’s nightly performance and millions of dollars in salary and bonus money—in Tarpley’s case, around $24 million over six years. Each stroke of Souryal’s pen has legal ramifications and practical complications; careers are saved or ended, playoff berths clinched or lost, crucial players acquired or rejected. It can be a difficult balance to strike—the player’s well-being versus the team’s need for the player on the court—and, in fact, sports doctors like Souryal have come under fire in recent years for being either too solicitous of their employers’ wishes at the peril of injured players or too coddling of spoiled athletes who just want an extra day off to play golf. “Really, it’s not all that uncomfortable,” insists the handsome 39-year-old native of Cairo, his bushy eyebrows dancing with intensity. “The player’s interest, the club’s interest—it’s always the same. I try to leave it to the player, just like any doctor with any patient. For me the critical thing is, if the guy is limping, he really shouldn’t be playing. Who’s going to disagree with that?”
Fortunately, other than Tarpley, none of the Mavs’ top players were limping during the week of preseason physicals. Mavs guard Jim Jackson, potentially an All Star this season, bounced back swimmingly from a savage ankle sprain that ended his season just after the midway point last year. Reserve forward-center Terry Davis, another pricey reclamation project, progressed far beyond what Souryal had expected after a total reconstruction of his elbow two seasons ago.
Then there was the matter of a player who can’t be identified for privacy reasons but whom the Mavericks had considered for their first-round draft pick this year. As far as Souryal was concerned, the player was a nine on a scale of zero (no medical risk to the club) to ten (a high medical risk). Because of the player’s prior knee surgeries, Souryal had decided he was a high medical risk. But the kid had had a spectacular college career, and the Mavericks’ coaches couldn’t help wondering, almost daily, “Are you sure he’s a nine?” Souryal stuck by his assessment. “I just felt that if this was a player that the team was going to sign to a one-year deal, then fine. But for a first-round choice who’s going to command multiple years for multiple millions—all guaranteed money? I mean, this young man, age twenty-one or so, already had arthritis beginning in one knee!”
Team officials got the message and opted instead for six-foot-eleven-inch Cherokee Parks of Duke University, another player they had liked all along. Mavericks fans who watched the draft at Dallas’ Reunion Arena hooted at the choice derisively, but Souryal got the last hoot: As of mid-October the player not taken by the Mavs, who was eventually drafted by another team, was on the injured list after—you guessed it—knee surgery. Parks, meanwhile, was in great shape and was already contributing to the Mavericks’ front-line rotation.
As Souryal could tell you himself, sports medicine hasn’t always been so glamorous or high-stakes. As recently as the early seventies, when he first entertained the notion of becoming a sports injury specialist as an undergraduate at Sam Houston State University in Huntsville, sports doctoring was the weekend specialty of orthopedists who happened to be (a) fans of the local college or pro team or (b) friends of the coach. They nursed bumps and bruises and declared players fit or unfit to play, but their impact on the success or failure of a team—on the court or on the bottom line—was negligible.
Yet during the past two decades, professional sports has exploded into an international multibillion-dollar entertainment industry that is every bit as cutthroat as the film business. A player’s health can mean millions, not only in any given season but for years, even decades. Because of the amount of money at risk, team owners and players unions have become increasingly adversarial, and often the bone of contention is a player’s medical condition—past, present, or future. “No question about it,” says Keith Grant, the Mavs’ director of player personnel. “Money in pro sports made the need for quality medical advice at the conference table absolutely necessary.” At the same time, the science of orthopedics has made enormous technological breakthroughs in the treatment of musculoskeletal injuries. Chief among them, of course, was the development of arthroscopic surgery, which overnight revolutionized the treatment of the athlete’s most frequent medical nemesis: damage to the cartilage or ligaments in the knee. By allowing minimal invasion of the joint during surgery, the arthroscopic procedure transformed what had always been considered a career-ending injury into one that was merely career-interrupting, sometimes for less than a season.
The arthroscope—or “scope,” as it is known—turned sports doctors into celebrities, putative miracle workers