Dr. Robin West is arguably the most important figure in Washington sports that isn't (yet) a household name.
She became the director of sports medicine and lead orthopedic surgeon for the Washington Redskins this June. She also has worked as the head team physician for the Washington Nationals since October of 2015. In those capacities, she's the first female head physician in the NFL and the only one currently in the MLB.
To give you an idea of that level of responsibility, consider that the Redskins and Nationals have a combined player payroll of $310,065,963 for 2016 alone, according to Sportrac.com. Now extrapolate that number out over the multi-year contracts on their books and you can appreciate the money at stake.
Away from the professional sports world, West also runs her own practice and serves as the medical director of Inova Sports Medicine in Northern Virginia. She has a lot of hats to wear in a field that has fascinated her since childhood.
In a piece for espnW, ESPN Injury Analyst Stephania Bell suggested that West could be the most influential figure in professional sports medicine today. The profile opened with West asking for the Gray's Anatomy textbook for Christmas when she was five years old.
Bell, herself a physical therapist and orthopedic specialist, reports on athlete injuries. In some sense, these two women are counterparts on opposite sides of the process. One treats the injured athletes and the other reports those injuries and explains what fans can expect.
My conversation with West tried to give Redskins and Nationals fans a glimpse of what she does on a daily basis and how she responds in an injury emergency.
Though she has only worked with the Redskins for a few months, her job feels familiar.
"I was in football for so long. I was with the Steelers for 11 years. I’m used to taking care of NFL players," she explained. "Obviously the teams are different in the sense of how teams are structured and how they’re run, but the players are the same."
But unlike her time in Pittsburgh, West has to balance her work with the Nationals, too. While the NFL season is in its infancy, the MLB season and its injuries are entering the home stretch before the playoffs.
The 89-63 Nationals are well positioned for the postseason, but have several medical question marks hovering: Will Stephen Strasburg be healthy enough to return to pitch this season? Is Bryce Harper’s slump related to some underlying health issue?
It’s a lot to deal with on top of the NFL grind. So the top doc relies on her medical staffs on both teams, including other physicians, athletic trainers and physical therapists.
“Things I take from one team, I’ll bring to the other team, so that’s very helpful,” West said. “It works really well. You know [the players] certainly root for each other.”
So what’s a typical day like for her?
Most don’t start in professional sports stadiums. West has her own orthopedic surgery practice, so she treats regular patients most days of the week. She’s in surgery one or two of those days.
Her game day schedule is the outlier.
She has to report to Nationals Park about an hour before the first pitch in order to meet with players, then during play she either works in the training room or watches the game. She’ll stay for another hour or so after the game ends.
Game days with the Redskins are much more regimented. West gets to FedEx Field about three hours early to see players in the training room. Then it’s time go out on the field, where she watches the players in the game. She’s also around for about an hour after the final whistle.
How West responds to injury emergencies – say Strasburg feels a pull or DeSean Jackson stays down after a hit – also depends on which team she’s treating at the time.
Baseball gives the head physician more time to react and evaluate an injury than football does. It’s the athletic trainer who goes out onto the field with the player, then brings them into the dugout or training room for West to evaluate.
“I have a little bit of time in baseball to look at the injury, look at the replay, look at the player. I have a few minutes there,” she said. “In football you’re running out [on the field], the injury just happened. You may or may not have seen the play because there are a lot of things going on down there.”
Baseball players and football players often get hurt in different ways, too.
“Major League Baseball is more of a year-round season, so they’re playing longer term. We’re seeing a lot of chronic overuse injuries,” West explained.
“In football, you see a lot of acute injuries. More traumatic and acute injuries, versus baseball where it’s a lot of overuse, repetitive type injuries.”
When it comes to diagnosing the problem, West’s knowledge of her patient as an individual is her secret weapon.
“Patients can mislead you because some patients are tougher than others or complain differently.
“It’s important to know the players so when you get out there on the field, or in the training room or dugout, you know the players and how they’re going to respond to pain because you have to do a quick assessment. Are they safe to return to play?”
If the hurt player does need some kind of orthopedic surgery, it’ll usually be West that performs the operation. Sometimes she’ll think another doctor is a better choice for the procedure and refer her patient to them.
A good rapport with players is equally critical to treating as diagnosing them because there’s a mental element to recovery and rehabilitation.
“As an orthopedic surgeon, we can fix [a player] surgically, but we have to also think about everything else,” West said. “On the mental side, a lot of teams have sports psychologists. So we can work on the mental side and visualizing the recovery, visualizing the return to play and high level of play.
“I think it’s really important, the initial response to the injury by the orthopedic surgeon, that it's a positive experience.
“You want to say, 'Hey, you have a great chance of recovering. You’re a high level athlete, you’re going to have great care around you and we’re going to get you back.'”
West also noted that she doesn’t think being a woman has negatively impacted her ability to gain the confidence of players in a male-dominated environment. Her gender might even help.
“I don’t think I’m treated any differently. And maybe some players seek me out because I am a woman. Maybe they think I’ll have a softer side or something,” she said.
That softer side is important when comforting players with very serious injuries. I asked West what she considers the most difficult injury she’s treated and why.
Knee dislocations with damage to multiple ligaments was her answer. And not just because it’s tough for patients – it’s hard on their doctors, too.
“When somebody dislocates their knee and they have a year to year-and-a-half of recovery, nerve injury, those are hard cases because most of these guys want to get back as soon as possible.
“And if you have a long-term injury that you’re dealing with and trying to rehabilitate, those can be trying for the athlete as well as for the medical staff.”
When I spoke with Bell the same day, she also named knee dislocations as one of the worst injuries she's seen.
“Knee dislocations are one of the most brutal injuries, not only visually. When you see them it’s very disturbing because it looks grotesque. Frankly, it’s something your brain’s not used to seeing.
“And then there’s all the risk that’s involved with the potential injury, not knowing what the future of the player is going to be,” Bell said. “There are a lot of blood vessels involved and nerves involved and you’re talking about the health of a player’s leg for the rest of their life, not just for their ability to return to sports.”
She said covering South Carolina running back Marcus Lattimore's comeback from a knee dislocation, in which he suffered multiple ligament damage, was one of the most compelling stories of her career.
My conversation with West wrapped up with her sports allegiances and whether she considers herself a fan of the Redskins and Nationals.
West noted that while she cheers for the players because she wants to see her patients do well, she isn’t actually employed by the teams. She’s independent so that she can keep the best interests of the players as her top priority.
You might be wondering why I didn't ask West for updates on Strasburg’s recovery or what’s really going on with Harper. Because of the nature of her work, she can't answer questions about specific players, but the interview gave me a good idea of how in-demand she is.
Our 20-minute conversation was interrupted twice by phone calls. One was urgent, something about an MRI. She had to take it. The other she seemed comfortable to let go for a moment.
West politely explained why working in professional sports means constantly checking the phone.
"When you have players on the road, they get injured and I have to be in communication."
RELATED: ANOTHER TOUGH WEEK FOR HARPER