COULD SHE HAVE BEEN SAVED?

After Ruffian's death came the questions. Could surgery have been delayed? Why can't a horse be tranquilized like a human? Was amputation possible? An account of a great filly's last hours
July 20, 1975

Thoroughbreds are a commodity. Decisions concerning their lives and their deaths are, by and large, a matter of economics. Sentiment is seldom involved. And thus it was with Ruffian, the magnificent filly. She was destroyed after suffering desperate injury in a souped-up $350,000 match race with Foolish Pleasure, watched by 18 million people on CBS-TV. She was considered by some the best filly ever to race. We will never know now. Because the tragedy happened in such a supercharged fishbowl, the death of Ruffian will always rank among the most famous in horse-racing history.

She was worth a million dollars, and a herculean night-long effort was made to save her life. A far less valuable horse with the same injury would have been destroyed in a few minutes. The conditions were chaotic, the pressure was killing and, worse, the luck was consistently bad.

The first medical man to reach Ruffian after she broke down on the back-stretch of Belmont Park was Dr. Manuel Gilman, a calm, sober man, chief veterinarian on the New York racetracks for 31 years. He said, "It was as bad an accident as could happen. She had fractured both sesamoid bones [pyramid-shaped, walnut-sized bones behind the fetlock joint] of her right front leg. She had been going so fast and was so full of herself—she was in the race of her life—that she kept running on the fracture, grinding, grinding, grinding the bones. It was an unbelievable injury. The ligaments were shattered. The bones were like pieces of glass."

Ruffian's momentum had caused her to charge onward for 40 yards or more, each step bringing her 1,125 pounds down again and again on the torn nub of her ankle. The hoof was pointed up like a ski, the wound was stuffed with sand and filth from the track. Dr. Gilman put on an emergency airboot cast to hold the shattered bones and stop the bleeding. Ruffian was slipping into shock from the pain, from the massive effort she had made in the race (the first quarter was run in :22⅕ a terrific pace) and from the horrifying surprise of suddenly having only three legs. Dr. William O. Reed, a veterinary surgeon who operated on Ruffian later that night in his equine hospital outside Belmont, said, "The psychological stress on her was immense with her leg gone. It's a terrifying shock to an animal to be that helpless—on three legs instead of four. She couldn't understand, she panicked."

An ambulance took Ruffian from the track to her stall in Barn 34. She was getting more excited, more panicky. The scene at the stall was pure chaos. Dozens of anxious friends of Owner Stuart Janney and Trainer Frank Whiteley were there, plus a throng of reporters, stable employees, Pinkerton guards. Ruffian, wild-eyed, was dripping sweat from the pain and the fear. She was literally losing gallons of fluid, becoming critically dehydrated. Three more doctors arrived to join Gilman and Reed in the stall. One was Dr. James Prendergast, who was Ruffian's doctor of record during her New York races. Another was Dr. Alex Harthill, a Louisville, Ky. veterinarian who has been in the news through the years in a number of controversial cases—including the dispute after the 1968 Kentucky Derby over medication Harthill allegedly administered to Dancer's Image. Many horsemen consider Dr. Harthill a brilliant practitioner; he was Ruffian's doctor when she wintered in South Carolina. He is not, however, licensed to practice at New York tracks, never having applied. When Dr. Gilman gave his dispassionate, detailed account of the factors that led to Ruffian's destruction, he managed not once to include the name of Alex Harthill. Finally, there was Dr. Edward C. Keefer, an orthopedic surgeon on the staff of New York Hospital, who had been at the race and was invited to the barn by Cynthia Phipps, Mrs. Janney's niece. Dr. Keefer had achieved celebrity among horsemen in 1973 when he fashioned an artificial foot, brace and laced-boot-contraption for Spanish Riddle, who had suffered a compound fracture. Keefer's orthopedic device saved the colt from being destroyed.

Dr. Harthill ordered Ruffian's leg placed in ice water. In a tape recording later distributed at Belmont, he said, "The most paramount thing we had to do was to get her into ice in an attempt to stop this terrible hemorrhage." In retrospect, this was a controversial choice of treatment. The water became polluted with the contaminants of the wound. Dr. Reed said, "If I had had a preference, it would have been to place a sterile dressing on it, under compression, to prevent excessive swelling." Dr. Gilman said, "I had nothing to do with it. I don't want to discuss it."

Meanwhile, Ruffian was getting more excited, and a mild dose of tranquilizer was administered. Here the bleakest bad luck entered the picture: the drug worked as a stimulant. Doctors call it a "drug idiosyncrasy," which caused a "paradoxical reaction." Instead of becoming quiet, Ruffian turned even more violent in the stall. "She reared up," said Dr. Gilman, "she tried to lie on her belly, she tried to throw herself over. If the tranquilizer had worked properly, she might have been fine. It didn't. Once the drug was in her, we couldn't take it out. We decided then that the only thing to do was to put her on an operating table and go to work on her. You can't put her to sleep in her stall; once she comes out of it, she'll wreck the place. Besides, it was full of filth and she was already infected."

During the ambulance trip to Dr. Reed's hospital, Ruffian calmed down a bit and seemed to be cooling out a little. Reed gave her 9 ccs. of promazine, another tranquilizer, and this time she began to relax. Nevertheless, she was in deep trouble. Dr. Harthill said, "She took a lot of consoling. The pain and the shock was becoming more intense all the time. She was sedated and anesthetized, and this anesthesia process became quite an issue because her heartbeat was running off; her breathing ceased and we had to use artificial respiration as well as artificial stimulants." Twice, the team of veterinarians had to bring Ruffian back from a point of medical death.

Harthill had told Owner Janney when they left the barn that Ruffian's chance of survival was not better than 10%. Dr. Reed said later, "She was a very poor risk. She had no chance of surviving as she was. If this was a human, we would not have operated. She was deep in shock and I would have liked to settle her down, to stabilize her gradually for some period of time before surgery—perhaps even two days—to allow her to tolerate everything as much as possible. But it was not my case to start with."

Because of her extreme dehydration, Ruffian's blood had become thick, sludgelike, and her heart was pumping fiercely to move it through her system. Her pulse was timed on a Datascope oscilloscope in the hospital at 76 beats a minute; normal is 36. Even after she was asleep under the anesthesia and throughout surgery, it never dropped lower. The anesthetic in her already-tormented system added yet another element of stress. She was in critical condition as the actual surgery began. Would it have been better to wait until she was more stabilized? Dr. Gilman said, "You have to pick a method and stick with it. There are always four or five ways of doing things. Our method was to put her to sleep and clean out the wound. It took half an hour—more—just to clean it, flush out the filth, put in a drain and stitch it up. If the fracture hadn't been compound, we could've put a cast on it in her stall and she would possibly have been O.K. The break itself wasn't so severe that she couldn't survive." Gangrene might have set in if the wound had been left dirty. That would have meant amputation. Even though such a treatment worked for Spanish Riddle, it could not have saved Ruffian. Dr. Gilman said, "Spanish Riddle's case was one in a million. Ruffian would've killed herself flailing about if we had amputated."

The surgery itself was elementary. Besides cleaning the wound and installing the drain, it involved removal of some of the bone chips. During surgery, Dr. Keefer entered the operating room. Though humans are his profession, "horses are my hobby, my love," Keefer said. For years he has dabbled in orthopedic devices for horses, and last spring he repaired a yearling's dislocated ankle with a steel brace attached to a shoe, which was then encased in a plaster cast. Keefer said, "I noticed that Ruffian's shoe size was the same as the yearling's and I told Dr. Harthill in the barn that I had a brace we might use to stabilize her leg. He agreed and I rushed off to my home to get it."

The brace consisted of padded steel supports which would run up both sides of Ruffian's leg, from the shoe to just below the knee, where padded metal clamps would be fitted to her leg. Thus, her weight would be supported at that level, well above the ankle, leaving the shattered bones with no pressure on them. The shoe was nailed to Ruffian's hoof by a blacksmith summoned from his bed to the hospital. It took nearly two hours to complete the cast; a large amount of plaster was required to hold the brace in place. The doctors had considered using fiber glass for the cast. It is both stronger and lighter than plaster, but Dr. Keefer chose plaster because he felt fiber glass could become too tight and shut off circulation; also it was possible to make a "window" in the plaster in order for the wound to drain. Fiber glass would have weighed three or four pounds; the plaster cast weighed from seven to 10 pounds, Dr. Keefer said.

The operation had been performed with Ruffian lying on her left side on a hydraulic table that rises out of the concrete floor of Dr. Reed's operating room. The doctors were gowned in surgical green and masked. Ruffian was covered with sterile green sheeting. An oxygen tube had been thrust down Ruffian's throat. The anesthetic vaporizer filled and emptied slowly with her breathing. There was the constant ping of the oscilloscope monitoring her heartbeat. The plaster cast in place at last, it was 12:30 a.m., more than six hours since she had broken down.

Now she was ready for the recovery stall. A steel door, hinged at the bottom, is set in the wall of the operating room. It can be dropped so the top rests flush with the edge of the operating table, forming a ramp. The other side of the table was raised and Ruffian's great weight slid down the tilted door into the recovery stall. It is about 15 feet square, with grey Ensolite padding on the cement-block walls; the floor is covered with straw. Dr. Harthill said in his taped recollection, "Well, she lay there for about an hour and 15 or 20 minutes. At this point she started a mild struggling period, which is to be expected. This happens to all horses after anesthesia. In between these sessions her body was rubbed with alcohol, in an effort to increase circulation and to rejuvenate the muscles which had to become toxic from laying for so long and from the accumulation of waste products.... The struggle became more violent. We had several men trying to hold her, and she threw us around as if we were rag dolls. We could not hold her down." Dr. Keefer said, "We were trying to keep her on one side or the other. But she was all around the recovery stall, hitting the walls with her feet. She thought she was still galloping in the race, she kept trying to run."

Ruffian flailed and rolled and threw herself about, a raging dumb animal crazed with the trauma and pain of an awful injury. Finally, more than an hour after she revived, she became so violent that the cast began to jerk slowly down her leg. Incredibly, the nails in the shoe began to loosen from the ferocity of her actions. The cast dropped an inch, two inches, six inches—and finally it came off. There was nothing more to be done. Another operation—four or five hours more of anesthesia—was out of the question; she could not tolerate it. Harthill said, "The idea of trying to keep her sedated for a long period of time wouldn't be the answer because where in human beings you can keep them in bed a long time, in the case of a horse you have to get them up. You have no alternative. They lay on that one side and develop radial paralysis, and we have to work very feverishly to keep this from happening." Radial paralysis comes from pressure on the shoulder nerve; it can develop in a matter of minutes.

Why hadn't they used a sling to immobilize her? Dr. Reed said, "You cannot put a sling on a hyperactive animal like Ruffian. She'd have torn down every wall in the hospital."

They sedated Ruffian quickly to prevent her from hurting herself even more. She had already done damage to her other legs, the cast was off, she was in worse shape than ever. Dr. Keefer said, "People have wondered if the cast was too heavy, if it flew off from centrifugal force and its own weight. I stick up for my cast, I would use it again. Ruffian was a very high-strung horse. She would not tolerate any cast. Last year she did not tolerate a very light fiber-glass cast on her hind leg for a hairline fracture. She fought the air cast after she was injured. I've been lying awake nights thinking about it. The only regret I have is that we couldn't anchor the shoe to the hoof better, but I don't know how we could."

It was now after 2 a.m. and Dr. Harthill phoned Stuart Janney. "We apprised Mr. Janney of the prospect," said Harthill. "He said, 'Doctor, she is too great to go through what you say is going to be the eventuality of necrosis and gangrene. I'm a realistic man and I have been in the horse business long enough to know you can do so much and that's as far as you can go.' He thanked us very much."

At 2:20 a.m. on July 7, 1975, Ruffian was given a massive dose of phenobarbital. She was dead in five seconds. When the news became known, tens of thousands who had never been closer to Ruffian—or any other horse—than their TV tube, wept.

TWO ILLUSTRATIONSALLAN MARDON

HOLE YARDS PAR R1 R2 R3 R4
OUT
HOLE YARDS PAR R1 R2 R3 R4
IN
Eagle (-2)
Birdie (-1)
Bogey (+1)
Double Bogey (+2)