Here in the Midwest we have finally made it through the doldrums of winter, which also indicates the season that basketball fans eagerly anticipate all year: March Madness.
The annual National Collegiate Athletic Association (NCAA) single-elimination basketball tournament inspires millions of folks to fill out brackets predicting the winners, myself included. I love sports for a multitude of reasons, and witnessing these young adults experiencing some of the best—and hardest—moments of their lives in real time is something special. People all over the country root for strangers for the sake of sport and the love of the game.
A charming quirk of March Madness is that success in one’s bracket can depend wholly on luck and not at all on athletic ability or knowledge. For example, each year without fail, my brilliant co-fellow, who has never played an organized sport in her life, fares better than I, a former college athlete. Creating basketball brackets allows for friendly competition among colleagues and loved ones and reminds us how sports manage to unite us.
I recently learned that March Madness can even assist with the mental status exam. My colleague was consulted on an elderly patient, hospitalized with a potent combination of dementia and delirium, who was oriented only to himself. He did not have any understanding of day, time, or situation—until he accurately lamented that his bracket was “busted” when Wisconsin lost in the second round. While this detail did not affect management, it did offer us a genuine glimpse into some small part of him still rooted in reality. Alert and oriented x2—self, and basketball.
March Madness may even help to establish rapport. Last month, I was asked to see a young man who was admitted to the hospital after swallowing a number of objects, including a razor and a metal wire, in a self-harm attempt. On my way to his hospital room I could hear him shouting and swearing while nursing staff clamored to call security. The patient came from jail, so he was handcuffed to the bed rail with a uniformed officer hovering nearby.
While frustrated, he was agreeable to speak with me and emphatically described that he perceived an interaction with nursing staff to have been punitive. He felt that he was being withheld pain medication because he kept his bed higher than nursing staff requested, but with his bed too low, he was unable to see the television.
I asked what he was hoping to watch on TV, half-joking as I suggested, “Any March Madness?”
“Yes,” he immediately replied, “but only the women.”
“Did you hear about Juju Watkins?” I asked. He had not; he was devastated to hear that she was out with a knee injury, as he had selected Watkins and the USC Trojans to go to the finals. He respected my choice of UConn winning, hoping for Paige Bueckers to finally get her championship.
By the time hospital security arrived a few minutes later, he was happily listing the names of his favorite women’s basketball players (including but not limited to Flau’jae Johnson, Angel Reese, Sabrina Ionescu, and Caitlin Clark). He also agreed to resume antidepressants and consented to the recommended surgical procedures to remove the foreign bodies from his intestines. He participated in safety planning and thanked me for treating him with respect.
Basketball may not provide common ground for everybody, but I am grateful it did for us in that moment. Medicine, like basketball, is most successful when we are able to work as a team. Whether we are assessing bracket winners, mental status, or a frustrated patient, March Madness reminds us of the reason many of us went into medicine in the first place: The innate human capacity for connection.
Caitlin J. McCarthy is a consultation-liaison psychiatry fellow.
