Gabriele Marcotti: O'Donnell's death sheds light on players' health - Sports Illustrated

Life and death situation

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Gianluca Vialli's words came to mind in the aftermath of the tragic and sudden death of Motherwell midfielder Phil O'Donnell, who collapsed during his club's match against Dundee United. The cause of O'Donnell's death was heart failure, and he joins the likes of Antonio Puerta, Miklos Feher and Marc-Vivien Foé on the sad list of footballers who passed away on the pitch in the prime of their careers.

In the aftermath of O'Donnell's death, the Professional Footballers' Association has asked that clubs do a better job screening players for heart conditions and, generally, do more to safeguard their health. It's a reasonable request to, hopefully, stave off something which is totally unreasonable: very fit and healthy young men dying on the job.

At the professional level, however, the onus should be on players, not clubs, to safeguard the health of footballers. In fact, this applies to pretty much every sport. A few months ago, I sat down with Art Caplan,a professor at the University of Pennsylvania, one of the world's foremost bio-ethicists and a consultant to FIFA. He made a very obvious -- but, sadly, often ignored -- point: When it comes to a player's health, there is a potential conflict of interest between the athlete and his employer.

"The doctors work for the clubs, their duty is to maximize the ability of the player to get the job done," he says. "It's the 'double agent' problem. They're expected to do what's good for the club, not necessarily the player. And that may mean clearing a player to play when he's carrying an injury or telling him to play through the pain."

"A medical doctor should protect the long-term health of the player. But the club is only interested in the player's health as it relates to his playing career. The athletes are often young and stupid and they don't know any better, they don't think about getting their own doctor for a second opinion. And the clubs prey upon the relative ignorance of the athlete. In fact, they milk those images of courage and virtue. As for the public, they don't care what a player's body might be like once they retire."

Anybody who has been around former athletes for any length of time will tell you just how beat up they tend to be: gimpy knees, bad backs, migraines. They look like walking wounded. Yet, these are guys who exercised and ate right for 20-odd years.

The average life expectancy for former NFL players is around 55. I have no idea what it is for footballers, but I doubt it's much more than 65, significantly lower than the average in most first-world countries.

Those two factors -- the quantity of years you have left after you retire and the quality of your life after you hang up your boots -- should provide an incentive to all players to look out for their own health. This means getting their own independent medical advice and not just when it comes to serious long-term injuries. With most players in Europe's top leagues earning well in excess of $1 million a year, you would think this would be an automatic choice. And yet the vast majority simply do what the club doctor says.

This is not to suggest that club doctors are incompetent, but rather that they are responsible for 25 or 30 guys and that they know all too well who pays their salaries. They tend not to err on the side of caution.

And so you get stories of players playing through the pain, guys loading up on painkillers, rushing back from major surgeries and so on. Indeed, playing hurt is a mark of pride.

None of this in any way should suggest that O'Donnell's death could have been avoided or that the club could have done anything more. At this stage, we simply don't know. But the fact that too many professional footballers take their health for granted despite being able to afford the finest medical care in the world is downright tragic.

So Juande Ramos has fixed a price for Dimitar Berbatov. The Tottenham boss reckons that a potential buyer "would have to break the British transfer record" to sign the Bulgarian striker. That means shelling out nearly $60 million. Berbatov is a gifted striker and a superb athlete, but that's a lot of money for a guy who turns 27 this month, has a reputation as a bit of a bad egg and whose scoring in the Premier League -- 20 goals in 53 appearances -- isn't anything to write home about. ...

Hats off to Espanyol: UEFA Cup finalist last season, third in La Liga at the halfway mark. And its success has been a function of good leadership, a few savvy transfers and a well-run club. Credit coach Ernest Valverde and general manager Paco Herrera, the man who, you can bet, Rafa Benítez is missing at Anfield right about now.