The Steelers fans were a high spirited and jovial lot, bedecked in black and gold, with names and numbers of their favorite players emblazoned on the backs of their official NFL-certified jerseys. The most popular were #43 (Polamalu) and #83 (Ward). The fans were as big as their heroes on the gridiron, with XXL and XXXL sizes the norm for this crowd. Pittsburgh is no longer a factory town, but whatever these guys were doing, their arms bulged and their bellies swelled, stretching the threads of their jerseys to the breaking point.
When these fans were not out painting the town red, they sat together in a bar near the hotel lobby, filling tables with empty beer bottles along with their nachos and dips. In the shifting glow of the TV fixed on ESPN, the men roared and laughed as they downed round after round and regaled each other with stories of their beloved Steelers and how, on Monday night, the defense would smash, pulverize, and maim New Orleans Saints quarterback Drew Brees.
The bar in the hotel was a tophus waiting to happen and I could imagine that, after days of pre-game festivities, when the fans would go over the Superdome for a little pregame tailgate, the uric acid of these fans would rise like the mercury in a thermometer on a hot summer day. Indeed, at the clip these fellows were eating and drinking, the temperature in the Superdome would likely rise an entire degree from the conflagration as thousands of inflammasomes fired off simultaneously in toes and knees.
What’s a Rheumatologist To Do?
Anticipating an epidemic of crystal-induced arthropathy from all of this high-octane indulgence, I was tempted to set up a stand outside the Superdome with a little hand-painted sign that said, “The rheumatologist is in”—although I have to wonder how many fans would know what a rheumatologist is.
As an advocate of prevention and myself a model of temperance and moderation, I should have gone up to those Steelers fans, warmed them of the dangers of excess beer, red beans, and crawfish (all worthy of a risk evaluation and management strategy, or REMS) and shown them the path to a life of synovial tranquility. They would have laughed at me, and I would have agreed. No physician likes to be a nag or be a spoilsport, but sometimes that is what public health requires. Recommending a flu shot is easy compared with recommending restraint.
