Mario Andretti Roberts carefully gripped the stack of photos in his tight fists and moved slowly into his sparsely decorated living room. He was holding pictures of the last football game he ever played, Oct. 31, 1985, when he was the 16-year-old quarterback for the junior varsity team at Dunbar High.
"These were taken by my grandfather just a little bit before my injury," he says. Action shots of Mario standing behind the center, Mario punting, Mario running in his red and black uniform. There was Mario poised to throw a screen pass -- but he was set up in the opposite way most quarterbacks would be. Mario was left-handed.
These days, there is no way of knowing that. Today, his hands, still locked in their perpetual clutch, sit in his lap, hidden by black cycling gloves. He wears gloves all day long. It's the only way to avoid callouses when he pushes himself around in a wheelchair.
Roberts, now 21, broke his neck and severed his spinal cord when he attempted to tackle an opponent who had intercepted his pass. The other player's helmet hit him under the chin, forcing the top five vertebrae in his neck to crush his sixth vertebra. The injury caused Roberts to be paralyzed from his chest to his feet.
"I remember lying on the field face down and trying to get up," he says. "I kept thinking, 'I can't breathe, I can't breathe.' Then they took me to the hospital and did the stick-and-feel test. 'Can you feel this?' they asked me," prodding his hands and legs with their fingers. "No, I said."
What happened to Roberts is an extreme example of the hazards of one of America's greatest pastimes: kids playing sports. Every fall, as thousands of boys play high school football, and every winter, as thousands of girls and boys play high-school basketball, there are the inevitable sad stories of debilitating injuries, of irreversible internal damage, even of death.
Fortunately, the tragic stories are so few that when they do occur, they are the subject of intense scrutiny. Last August, a 16-year-old football player at McLean High School collapsed during team practice; seconds later he was dead, the victim of an enlarged heart.
Yet injuries are a part of all sports. The National Athletic Trainers' Association reports that 5.8 million high-school students play interscholastic sports and about 1.3 million injuries occur every year in those sports. More than one-fourth of those injuries -- 332,000 -- happen in football. An average of 36 fatal or paralyzing injuries occurs each year.
Sometimes, the injuries are inevitable. At other times, they are easily preventable. In some athletic activities and in some schools, young athletes are put at greater risk than necessary because of improper medical care, lack of funding for adequately trained medical personnel to attend games and practices, inferior coaching or improper equipment. There is also what some call the "Superman Syndrome," the natural tendency for children to believe they are invincible. Poorly trained or opportunistic coaches can play on those feelings. In these win-at-any-cost times, even high school coaches feel the pressure and pass it on to those playing on their teams.
To be sure, sports are a delightful sidelight or passion for a child. Support for school athletics comes right from the White House. "I happen to believe in competitive sports," said President Bush, adding that he "heavily engaged in competitive sports early on." The harshest critics of high school sports say kids should participate. Even Mario Roberts still loves football.
"I don't think football is a bad sport at all," Roberts says. "If by some strange chance I got up and walked, I'd go back and play football tomorrow. That's how much I like football." Contact Sports
Medical experts find more fault with football than with any other high school sport. One-third of the million boys who play football each year are sidelined by injury at least once during a typical season. Dennis Rivenburgh, American University athletic trainer and the former athletic trainer at Sidwell Friends School, says the worst sports in terms of the potential for serious injury are football, wrestling, basketball, gymnastics, hockey and soccer.
The safest sports, Rivenburgh says, are golf, tennis and running -- non-contact sports.
Statistics are not available on all sports, but they do exist for high school basketball and wrestling. Among 380,000 boys who play basketball, there are 119,000 injuries in the sport per year. About 84,000 players are injured at least once. For the 333,000 girls playing basketball, there are 110,000 injuries, and nearly 76,000 players are hurt at least once. In wrestling, there are 278,000 participants, with 124,000 injuries and 73,000 players injured at least once.
The NATA says that about 75 percent of all injuries are minor, meaning a player is sidelined for a week or less.
But Roberts is one of those athletes whose injuries were not minor. After Roberts was paralyzed, he met a few Redskins stars while he was in traction: Sonny Jurgensen, Curtis Jordan and John Riggins.
"I remember the reaction on their faces," he says. "They didn't say it, but I knew what they were thinking: 'God, this guy was playing football. This could have happened to me.' "
In the most recent study conducted by the NATA, high school football injuries declined from 636,000 in 1986 to 503,000 in 1988. But major injuries -- those sidelining a player for three weeks or more -- increased from 54,400 to 65,600.
"The results are a mixed blessing," says John Powell, a researcher from the University of Iowa who directed the study. He says the decline in minor injuries was attributable to better coaching, safer equipment and better awareness of health and health care.
"But it's the major injuries that keep coaches and school administrators awake at night," he says.
Roberts sued the District of Columbia after his injury, charging he was not properly trained to tackle. Roberts's attorney, Milton Heller, says Roberts received two days of training in proper tackling procedures; one week of training is suggested by most national high school athletic associations. Heller says the District was negligent because Dunbar did not have an adequate number of coaches and equipment to support well-trained varsity and junior varsity teams.
In June 1987, the District government agreed to pay Roberts $1.45 million, believed to be one of the largest out-of-court settlements ever paid by the city to an individual.
Still, Roberts isn't against school sports. "I'm just against sports that aren't monitored well. I'd tell parents, 'Go out with your kids. See what's going on. See how they're monitored.' I wouldn't say, 'Don't play football.' I'd just make sure it's safe." Medical Monitoring
The NATA has compiled a list of 18 recommendations to make sports safer for high school students, including medical exams before participating in a sport, training with weights and conditioning during the off-season, required breaks at least every 45 minutes to drink fluids; mandatory mouth guards in all contact sports, parental knowledge of who is responsible for injury care at the school and certification of coaches in first aid and CPR -- cardiopulmonary resuscitation.
The presence of medical personnel, in particular, has been a continuing controversy in the District. Last winter, the city was ordered by a D.C. Superior Court judge to comply with the law requiring that a doctor, nurse or certified athletic trainer be present at every athletic event at a public school in the District. The ruling forced postponement of many high school and junior high basketball games at the start of the 1989-90 season.
Sam Jones, the former Boston Celtics star and a member of the National Basketball Association Hall of Fame, is the new athletic director of the Interhigh League in the District.
"We've solved that problem, and we're going beyond it," he says. "My hope is all coaches should be certified to be athletic trainers. Right now, we have no athletic trainers on staff in the District. I don't think we had any orthopedic surgeons on the football sidelines last year. I'm not sure some of the people who were working on the sidelines knew what to do when people got injured."
What Jones lamented is hardly unique to the District. Around the country, boys and girls are practicing and playing sports without proper medical supervision, according to the NATA. Of the approximately 20,000 public and private high schools in the United States, only 1,619 employ certified athletic trainers, says Hal Hilmer, a suburban Chicago high school athletic trainer and chairman of the NATA's secondary school athletic trainers' committee.
In college, there is one trainer for every 55 athletes. In high school, there is one trainer for every 2,500 athletes, Hilmer says. Who is left in charge of administering medical attention to young athletes? The coaches.
"In Illinois, coaches don't have to know CPR," Hilmer says. "Scary, isn't it?
"Parents are out there thinking that the coaches know it all and are taking care of their kids," he continued. "They're not doctors, they're not emergency medical personnel, they're not trainers, they're coaches. The last time most of these people did first aid was in college, and for some of them, that's 15 to 20 years ago."
Bruce Patrick is coordinator of athletic student activities in Fairfax County, where each of the 23 high schools has a certified athletic trainer.
"I don't think there is any question this is a problem nationwide," says Patrick, who was the head football coach at Mount Vernon High School from 1979-88. "People are really running a risk not hiring a trainer for the school or school district. We don't know how many injuries they actually prevent."
Patrick gives an example: When he was coaching in the early 1980s, one of his top players, a defensive lineman, had his neck bent back during a play. The boy came off the field and the trainer looked him over.
The player said he felt fine and wanted to go back into the game.
"No way is he going back," the trainer said.
"He looks pretty good," Patrick said.
"No way," she said.
As a precaution, the boy went to the hospital. Soon, the boy's whole left side was paralyzed. Fortunately, he recovered and -- although he could never play contact sports again -- he is leading a normal life, Patrick says.
"If it hadn't been for the trainer, he might have gone back in. And who knows what would have happened?" Patrick says.
When parents and other interested observers focus on the threat of injury to high school athletes, they tend to look at games, not practices. They should change their focus, Hilmer says. Seventy percent of injuries in high school sports occur during practices; only 30 percent occur during games.
"School boards like to say they've got a doctor on the sideline during a game," Hilmer says. "You've got the best players out there then, the players in the best shape. Practices are the problem. That's where the little kids are getting hurt, where the worst players are playing, those most prone to injury." Superman Syndrome
At times, bones break and ligaments are torn because of faulty equipment and bad facilities. It may not be the coach's fault or the player's fault. Sometimes, schools are scrambling to make ends meet and doing the best they can to put a team on the field.
As school sports budgets decrease, other avoidable risks increase, such as the hazards of playing on poorly tended fields filled with potholes or broken glass.
Then there are the pressures coaches constantly feel to win. It's no secret that children play hurt. Trainers and coaches relate the dialogue this way:
Coach to limping player: "How do you feel?"
Player: "I feel great."
Coach: "Go back in."
"The coach may just turn to him and not even look him over," Rivenburgh says. "High school kids tend to be a little macho. They see a John Riggins play the whole game and it's a little ego there, a little role model thing."
Alan Levy, team physician for the New York Giants and Mets, says he never allows an athlete back on the field until he says he is ready to play. But the system breaks down at the high school level because prep athletes suffer from the "Superman Syndrome," he says. They believe they can't get hurt.
"The biggest problem at the high school level is that someone gets hurt a little, says he can go back in the game, then goes back and gets hurt a lot," Levy says.
Hilmer had to tell a 15-year-old gymnast she had to give up the sport. She didn't want to hear it.
The girl, a gymnast of average ability, had a badly dislocated shoulder but still wanted to keep on performing. She also was a cheerleader.
"She always said, 'I'm fine, I'm fine,' " Hilmer says. "So I told her, 'Let's look at the other people you're affecting.' The team aspect. The fancier tricks, where she had to hold people. 'You're a danger to other people,' I said. She finally agreed to give up not only gymnastics but cheerleading, too. She has found other outlets in fine arts and choir. She's redirected her energies. Kids are extremely versatile. They bounce back." Heart Risks
When college basketball star Hank Gathers dropped dead on the court of heart problems last March, athletes at every level began to wonder about the cardiac-related risks of playing sports. That concern was heightened in August with the death of the McLean High School football player.
Barry J. Maron, a cardiologist at the National Heart, Lung and Blood Institute in Bethesda, is an advocate of increased heart testing of all athletes, especially the young.
He would like to see athletes take an exam called an echocardiogram, an ultrasound test that permits high-resolution imaging of the internal cardiac anatomy to detect several diseases, including Marfan's syndrome. Marfan's syndrome, a connective tissue disorder associated with rupture of major arterial vessels, killed U.S. Olympic volleyball star Flo Hyman in 1986 and Maryland basketball player Chris Patton in 1976. An echocardiogram can also reveal abnormalities such as an enlarged heart, which led to the death of McLean player David Robinson.
But the test costs as much as $800, a sum beyond the means of all but affluent -- or well-insured -- families.
Maron says both the Georgetown and Maryland basketball teams screen their players for heart troubles, but that's very unusual.
"Most coaches don't want to know," he says. "All you do is find out something bad. You've spent all this time recruiting a kid and then you find out he can't play. Who wants that?"
Maron has two sons who are swimmers.
"I like the idea of individual sports," Maron says. "The kids can always play. You don't have to worry about the coach putting them in the game."
Everyone has a story about a child injured playing sports. About eight years ago at Hilmer's school in Arlington Heights, Ill., an assistant football coach watched as his son took himself out of a high school game. The father couldn't believe his son was coming out until the boy blurted out, "I can't get my eyes uncrossed."
The boy fell down on the sideline and was rushed to the hospital, where he was paralyzed on his left side. A blood clot was found on his brain, he slipped into a coma two days later and died five days after the game.
The father coached football a few more years, then became the girls' track coach at the school. He recently coached his daughter at the state track championships. And the younger brother of the boy who died is a freshman running back at the high school.
"Their life has gone on, and sports are still a part of it," Hilmer says.
"Sometimes, there is no cause, it just happens," he says. "People like to blame football or other contact sports. But sometimes, things just happen."
They happened to Mario Andretti Roberts, named for the race-car driver his father admired. Perhaps with the right coaching, Roberts wouldn't be in a wheelchair now. Perhaps his injury had nothing to do with coaching. Nowadays, Roberts has to rely on friends for everything, to help him pull his pants on, to help him buy food, to help him get around.
"The only difference between me and the next guy is that he walks through the door, and I roll through it," he says. Before, he was 175 pounds. Today, he weighs about 135. "I wish I could be big," he says. "I wish I could be in the weight room right now. I wish I could be like I was.
"It used to bother me that I always had to have someone around," he says. "Now I say, 'I'm paralyzed. I don't want sympathy. I'm okay. I'm doing fine. If I need help, I'll ask for it."
Christine Brennan, a sportswriter for The Washington Post, covers football and the Olympics.
Wrestling: Bone fractures, strained and torn ligaments, dislocated joints.
Basketball: Bruises from falling and colliding; sprains in shoulders, elbows, knees and ankles.
Diving: Occasional head or neck injuries, usually in unsupervised setting.
Gymnastics: Injuries from falling; torn cartilage, fractures.
Hockey: Bruises and lacerations from collisions; sprained knees, ankles.
Soccer: Most injuries below the waist; sprains, torn ligaments and contusions.
Golf: Occasional muscle strain, stretched tendons
Tennis: Wrist and shoulder problems, mostly from repetitive movement.
Running: Musculoskeletal pains and injuries due mainly to improper warm-up and overexertion.