Writer Carlo Rotella

DATE August 19, 2003 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Sheri Fink discusses her book, "War Hospital: A True
Story of Surgery and Survival," about what medical personnel faced
in the city of Srebrenica in the Bosnian civil war
DAVE DAVIES, host:

This is FRESH AIR. I'm Dave Davies, senior writer for the Philadelphia Daily
News, filling in this week for Terry Gross.

Most of us at some point in our lives get hurt and we have to visit an
emergency room. There, we take it for granted doctors will have the training
and the tools to deal with our problems, and if they don't, a specialist will.
But what happens when a doctor is confronted with a dozen life-threatening
injuries without specialized training, X-ray equipment, antibiotics or even
electric lights? Those are some of the challenges faced by physicians in "War
Hospital," a new book by Dr. Sheri Fink about the struggles of medical
personnel in the city of Srebrenica in the Bosnian civil war.

Besides the medical challenges, physicians frequently had to make
life-or-death calls about who to treat and how to stay neutral in a venomous
and bloody conflict. Sheri Fink has worked on humanitarian and relief efforts
with several international organizations in Africa, the Middle East, the
Balkans and, most recently, Iraq. She says the health situation there was
already bad before the war, but postwar chaos and looting exacerbated the
problem.

Dr. SHERI FINK (Author, "War Hospital"): I still can't quite understand how
people can go in and strip a hospital of its beds, put patients on the floor,
take just everything out of a hospital or a health-care center that is
supposed to serve the population. It's a little bit of a mystery to me still,
but when we came into Iraq, we found hospitals that were just stripped of
everything, and not even just the medical supplies, which might have brought
the people who took those supplies some money, but also the lighting fixtures,
everything. So it's not entirely clear to me what the reasons for this were.
It could be that people who were looking for a source of money looted these
facilities in order to make some money to sell things on the black market, or
it could be that the population was reacting to the health clinics as they
were many other symbols of the government.

And indeed, it's been coming out now, in part through the research of groups
like Physicians for Human Rights, that some doctors were complicit in orders
that were sent down by Saddam Hussein, orders to mutilate army deserters, for
example. It sounds almost unbelievable, but there's evidence that this was
the case.

DAVIES: What kind of mutilation? For what purpose?

Dr. FINK: Well, the example that's been given so far was that all surgeons
were required, if asked, to cut off the ears of army deserters, and they were
threatened to do this under penalty of their own ears being cut off. I did
not speak to many doctors about this, but there was a case where a street had
been named after a doctor who actually refused to participate in a mutilation,
had stood up to the authorities.

DAVIES: What was the reaction of Iraqi civilians? I mean, you're coming in
as Westerners, independent of the military operation that had preceded you,
and yet, you are Westerners and I'm just curious how you were regarded by the
Iraqi population.

Dr. FINK: I've found that the Iraqis reacted to me in a wide range of ways.
There wasn't one way to characterize it. Individuals, different individuals,
reacted differently, and I didn't quite know what their reasons were for that,
why some people were quite cool toward me and toward my organization. Others
were very welcoming. And one of the reasons for that coolness that I found on
the part of quite a number of health authorities became apparent to me in the
days before I left, and that was that one of the health authorities who had
worked very closely with my aid organization, other aid organizations and the
civil affairs teams of the US military had his house bombed. This was the
director of health in one of the governorates where I worked.

And that just really drove home to me the fact that these Iraqis who, in many
cases, were democratically elected by their peers after the war to take
positions in the health system were putting themselves at risk by working with
us. And in the days since then, I understand from my colleagues who are still
in Iraq that this has only intensified. There was an assassination of one of
the top health authorities recently, one of the top Iraqi health authorities.
Hospitals are coming under attack, and there is an increasing wariness of
doctors and health authorities to work openly with non-governmental
organizations and foreigners.

DAVIES: Do you think that independent of a Western organization like
International Medical Corps that these facilities would be coming under
attack? Is it their association with Westerners that are generating these
attacks?

Dr. FINK: Well, that's a very good question, and I neglected to say that the
health authority whose house was bombed, he interpreted that attack to be an
attack on him because he was cooperating so openly with particularly the
American military doctors. But I did have a look at the letter that the
bombers left at his house--and by the way, he and his family were OK, they
survived the attack, but there was a threatening letter left. And it didn't
particularly say anything about Americans or him working with Americans. It
simply warned him to leave his job. So then that brings up a question, who is
it that is behind these attacks? Is it a group that's anti-American,
anti-Western, or could it be the Baathists who were removed from power in the
aftermath of the war? This health director, as I mentioned, had been elected
by his peers, but certainly somebody was out of a job, so that's a possibility
as well.

DAVIES: Were Iraqi civilians reluctant to seek treatment at clinics and
hospitals that, you know, were associated with international relief efforts?

Dr. FINK: No. In fact, it was quite the opposite. One of the guiding
principles that guided our work in Iraq was that we didn't want to set up a
parallel system. We didn't go in and set up a hospital, a field hospital or a
clinic, because we found many functioning hospitals, many well-trained Iraqi
doctors. However, still, every morning that I woke up and left the house,
there would be a line of mothers holding their babies or children who they
wanted myself and other physicians and nurses with my organization to examine
and to treat. And so I think that it's very common in many places that aid
organizations work, we're seen as Western, we're seen that we may be bringing
in something better than what the people had before. And again, this also may
have been a result in this case of a certain mistrust of the health system,
which was notoriously corrupt under the time of Saddam and possibly involved
in certain crimes against humanity, so that may have been part of the reason
why people sought us out for care.

DAVIES: Sheri Fink, your book, "War Hospital," focuses on a hospital in this
Bosnian city which was isolated. Why don't you give us a reading which
describes conditions in that hospital.

Dr. FINK: Sure. This reading has to do with the time when aid workers
finally reached Srebrenica Hospital, which was after a year of the hospital
being completely isolated and just run by a small handful of local doctors who
had found themselves stuck in a siege situation, had no experience in
performing surgery and really no tools to do it. And in this incident, which
occurred just after the aid workers arrived, there was a shelling of a school
yard at a time when people started to feel safe because some international aid
workers had come in and some international forces, and dozens and dozens of
civilians, and children in particular, who had been playing in the school
yard, were injured and killed.

`There is no water, no light. The doctors have to climb over patients,
sometimes stepping on them, to reach other patients, shining flashlights in a
useless effort to triage people whose wounds are buried under layers of thick
winter clothes. The already beaten-down hospital staff cannot bear it. In
the corridor outside of the operating theater, people wait, arms out, begging
for operations. There was also a lot of pressure from the family members,
including people with weapons, one of the MSF doctors will remember. "We were
never threatened, but it's always a bit impressive if you see people with guns
insisting that their family members will have to be treated first. So that
also influenced a bit the selection for surgery."

The selection, or triage, system, if not well-implemented at first, is at
least clear in the mind of the Doctors Without Borders surgeon Pete
Willems(ph). He divides the injured into three categories: they shall wait,
they shall die or we shall give salvation. That second category is the most
excruciating. Those injured in the head or chest will die without immediate
intervention, but for each one, surgery would require three to five hours in
the operating room. That is too much precious time. In another place at
another time, they might have been saved.'

DAVIES: And tell us, why was the situation in Srebrenica and at this
hospital so desperate?

Dr. FINK: The situation at Srebrenica Hospital was desperate for a variety of
reasons. One was the fact that this little town in eastern Bosnia had become
surrounded by Serb forces. The Bosnian war took place--in 1992, it began.
And very quickly, I think it was about 75 percent of the territory of Bosnia
was held by Serb forces who then expelled most of the non-Serb population.
And this was particularly true in eastern Bosnia, which, if you look on a map,
borders Serbia. But one particular area, this area, Srebrenica, had a number
of very, well, tough fighters, let's say, who were able to organize a
response, mostly at first with hunting rifles and actions like ambushes of the
Serbian forces. And so they were able to hold onto a territory that was
shrinking ever so slowly or quickly at various times the first year of the
war, but all of the non-Serb population of eastern Bosnia began pouring into
this region. So an area that had originally had a population of about 5,000
had ultimately a population of more than 50,000.

And as I mentioned before, these 50,000 people who were being shelled and
bombed in some cases, who were going out to fight, they were being--behind
them stood only a handful of local doctors and not one of them was a surgeon.
Srebrenica Hospital before the war had been a maternity hospital. There was
really no surgery that had ever gone on there. The only thing the doctors
found at the very start of the war was a little bit of local anesthesia found
in the dental clinic. So not only did the doctors there lack any kind of
experience with war medicine, let alone surgery, but they didn't have the
tools to do their job. Add to that no electricity, no running water, and very
frequent military actions and attacks, and you just had a very, very desperate
situation, one of the most difficult situations, I think, that any doctor or
nurse could imagine being put in.

DAVIES: My guest is Dr. Sheri Fink. She's the author of "War Hospital: A
True Story of Surgery and Survival." We'll talk more after a break. This is
FRESH AIR.

(Soundbite of music)

DAVIES: My guest is physician Sheri Fink. She's participated in several
international relief and human rights efforts and is the author of "War
Hospital," a book about medical personnel isolated in the town of Srebrenica
in the Bosnian civil war.

Physicians in Srebrenica were faced with the barest of circumstances, often
having to operate without anesthesia, for example. Concretely, how do you do
that?

Dr. FINK: Oh, boy. Well, it's not pretty. You just do what you have to do.
And the doctors would constantly have to talk their patients through the
procedure, and they would just say, `Hold on, hold on,' and the patients were,
from what I've heard, just incredibly stoic. And I think just knowing that
the procedure that they were undergoing, although it would be tremendously
painful in the short term, might help save their lives, got them through it.
But it was horrible, and I think if more people know about how horrible the
situation was, hopefully maybe more of us will be motivated to make sure that
something like this doesn't happen in the future.

DAVIES: A lot of the kinds of surgery that you would need on a battlefield is
pretty specialized--I mean, heart surgery or neurosurgery. And as you
mentioned, these medical personnel didn't have that kind of training. There
was a particular story where Dr. Ilias(ph) was confronted--I don't know if you
recall this, where somebody--I guess he had kind of a brain hemorrhage and
he'd literally never done neurosurgery. Do you recall this particular
anecdote?

Dr. FINK: Yes. Yes.

DAVIES: I mean, tell us that story.

Dr. FINK: This is an amazing story. So Dr. Ilias, who was sort of a country
bumpkin, let's say, first guy in his family to go to college, really the first
person from this rural part of eastern Bosnia to go to medical school and
become a doctor, had never had any ambitions to become a surgeon, was, in some
ways, kind of thrust into the position of becoming the surgeon for this
population. And over the years, he did receive some assistance from Doctors
Without Borders, once they were able to get into Srebrenica. But at one
point, he had gone finally for his first vacation of--during the war, he was
given a few days off to travel to another village and just take a few days
off, and this was after more than two years of practicing under these
difficult conditions.

But as fate would have it, when he got to this village, there was a helicopter
that had been ferrying in supplies, a Bosnian helicopter that was furtively
doing this, and it was shot down, and there were quite a number of survivors
of this helicopter crash, but they had terrible injuries. And one of the
young men who was injured had a brain injury. It was clear to Ilias, when he
examined the man, that he was going to die shortly, but the man's father came
and just pleaded with Dr. Ilias. He said, `Just do whatever you can. Try
something, anything. Just relieve us of this feeling that we didn't do
something.'

And so against his better judgment, against the medical tenet, first do no
harm, Ilias took him to the operating room and tried to remember back from
medical school what it was that he should do, and he was able to relieve the
pressure by opening the skull, making a little opening, and sewing up a blood
vessel that had been the cause of this man's bleeding in his brain, and he
saved the guy's life. And I really love this story because--a few months
later, Srebrenica fell. The town was overtaken by Serbian forces, and the
entire population either took to the woods in a desperate bid to reach another
Bosnian government-held territory or turn themselves over to some UN soldiers
who were nearby and hope for protection. And as many people know, this ended
up being the biggest massacre in European soil in 50 years. Up to 8,000
mostly men and boys were killed. But this young man who Ilias saved just a
few months earlier is credited with saving about 20 lives. During that
journey through the woods, he went back. He'd made it to safety and went back
and led another group of 20 men and boys to safety. So that one life that Dr.
Ilias saved ended up saving 21 lives.

DAVIES: One of the dilemmas that you confront in this situation is whether to
treat soldiers, because if you treat soldiers, then you can be seen by the
other side as assisting, you know, in restoring the combat capability of one
side. How do international relief workers deal with that issue?

Dr. FINK: I think that international aid workers tend to want to keep away
from treating military, treating soldiers, and in some cases, that's fine
because the soldiers may have their own doctors treating them. But in a case
where there is nobody else to treat an injured soldier, then a doctor has an
ethical duty to provide that care. And that just goes to the concept of the
neutrality of medical practice in war. That's why people aren't supposed to
shoot at doctors and hospitals, because they treat all patients equally, and
any injured soldier becomes protected under international law.

DAVIES: You write in the book that medicine was a weapon in this war. What
did you mean by that?

Dr. FINK: Medicine, just like troops and munitions and guns, is one of, you
could even say, the fuels that keep the engine of war running. It's a fact.
When soldiers have doctors behind them, they can fight more effectively. They
know that they'll have the peace of mind to know that they'll be treated. And
so when a particular side has more doctors and better medical facilities and
better amount of supplies, they can go out and fight more effectively. So one
of the negative consequences of aid might be that it enables a military to
fight better. It doesn't just help civilians, which is what it's usually
intended to do, but it might strengthen a military, it might actually be
stolen by a military. In certain cases in the book, there were times where
medical aid that was brought in by Doctors Without Borders was taken out of
hospitals and used in the military. And a couple of times after Srebrenica
finally got some aid, the Serb side argued that they went out and fought more
after that. So there's that.

There's also the negative consequence of aid when it was used, as many aid
workers in Bosnia felt, as a cover for inaction among the international
community, a way of saying that `We're doing something' without really
addressing what was keeping this war going. The war lasted for more than
three years. So does that mean, though, that aid should not be delivered,
that we should give up the enterprise of aid? Well, no, I don't think so.
However, I do think that aid workers need to look very closely at what those
negative consequences might be or what the unintended consequences might be
and plan for them, and certainly in some cases not deliver aid, and these are
some of the most excruciating decisions that aid workers have to make.

DAVIES: Well, Sheri Fink, thanks so much for being with us.

Dr. FINK: Thank you very much for having me.

DAVIES: Dr. Sheri Fink. She just returned from a medical aid mission to
Iraq. Her new book about doctors treating patients during the war in Bosnia
is called "War Hospital."

I'm Dave Davies, and this is FRESH AIR.

(Soundbite of music)

(Credits)

DAVIES: Coming up, as the US Open approaches, athletic trainer Doug Spreen
tells us about treating the world's top tennis players in high-stake matches.
Also, Maureen Corrigan reviews the new novel "Breaking Her Fall." And Geoff
Nunberg considers the battle between Fox News and Al Franken over the use of
the term `fair and balanced.'

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: Novel "Breaking Her Fall" by Stephen Goodwin
DAVE DAVIES, host:

This is FRESH AIR. I'm Dave Davies sitting in for Terry Gross.

Novelist Stephen Goodwin is a professor of creative writing at George Mason
University, and past president of the PEN/Faulkner Foundation. He's also
adept, says book critic Maureen Corrigan, at churning out a good,
old-fashioned page-turner. Here's her review of Goodwin's latest novel
"Breaking Her Fall."

MAUREEN CORRIGAN reporting:

The enchanted phrase `summer reading' for me means lots of mysteries, maybe a
biography, and at least one melodramatic novel who's plot revolves around a
decent man or woman who stumbles into moral quicksand. The harder that
character squirms, the more he or she gets sucked in. Even as we readers
sweat along with the hapless hero or heroine, we're also reassured by the
knowledge of how these stories usually end. That is, at the 11th hour, fate
will toss our victim a rope, and he or she will emerge muddied but unbowed on
the firm ground of deliverance.

The moral melodrama of last summer was Ann Packer's engrossing novel "The Dive
From Clausen's Pier," which has just come out in paperback. This summer's
exquisitely rendered migraine is Stephen Goodwin's novel "Breaking Her Fall."
It's an intelligent story full of vivid characters and narrative digressions
and a great neo-Dickensian ending that just about falls into the safety zone
of credibility.

Here's the originating mess. On a summer evening back in 1998 an amiable
divorced dad named Tucker Jones drops his 14-year-old daughter Katherine,
nicknamed Kat, off at a busy street in Washington, DC. She's going to a movie
with her best girlfriend. The novel is narrated by Tucker in retrospect, and
at this point in the story he ironically recalls that `there wasn't a speck of
makeup on Kat's face, but she painted her toenails. And I thought that if
this was how she was going to fix herself up--her feet, not her face--she was
still a girl, still a long way from trouble.'

But the two girls run into friends, and one of the boys in the group invites
everybody back to his house. His parents are away, he has a pool and access
to the liquor cabinet. A few hours later, Tucker gets a phone call. Not, as
he expects, from Kat checking in, but from another father who's daughter has
fled the wild party. This guy tells Tucker that Kat is at the party drunk,
and that when last seen she was about to perform oral sex on a parade of boys.

Frantic, Tucker drives off to the house and finds only a few boys talking
around a patio table. He picks up a stray garden spade as he approaches them.
Looking back, he says he doesn't know why he did that. Maybe it was because
he's a professional landscaper and compulsive about tools lying around. Or
maybe he thought he'd need protection. Jed Vandenburg(ph), the arrogant boy
who lives in the house, won't tell him where Kat is. Tucker gets into a
shoving match with Jed. Jed falls, strikes his head against an iron table
edge, and ultimately loses an eye. Assault charges, and a long period of
estrangement from Kat, the beloved daughter Tucker was trying to rescue,
follow.

"Breaking Her Fall" is a rich story that shoots off in multiple directions.
It tackles, among other subjects, Kat's confusion about her own sexuality, the
class politics of the landscaping business, the sweetly pathetic courage of
middle-aged garage bands, the elusive lore of faith and the social gradations
of Washington geography. Goodwin is especially adept at conjuring up the
halting, hurtful quality of a certain type of conversation between
middle-class parents and their adolescent children. He also addresses the
Catch-22 terrors of contemporary enlightened fatherhood.

Early in the story Tucker confesses, `I suppose we all regarded ourselves as
too highly evolved to admit how frightening it was to watch our daughters come
of age. To develop hips and breasts and turn into young women at a time when
the juggernaut of popular culture seemed to bear down on them with the
relentless message that they could fulfill themselves as dopey sex-kittens.'

Because there's even the specter of a trial here, "Breaking Her Fall" evokes
like comparisons to "To Kill a Mockingbird," that granddaddy of all `good man
in a sticky situation' tales. But Tucker is a New Age shadow of Atticus
Finch. Soft on certitude and guided less by the Bible than by Eric Clapton.

DAVIES: Maureen Corrigan teaches literature at Georgetown University. She
reviewed "Breaking Her Fall" by Stephen Goodwin.

Coming up, treating the injuries of the world's top tennis players during
competition. We meet athletic trainer Doug Spreen.

This is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Doug Spreen discusses what goes on behind the scenes as
an athletic trainer for professional tennis players
DAVE DAVIES, host:

The US Open tennis tournaments begin next week at Forest Hills in New York.
And while fans will focus on the competition, my guest, Doug Spreen, will be
worrying about blisters, cramps and other injuries of the players who launch
120-mile-an-hour serves and run full speed for three hours in the August heat
and humidity. The exertion alone has, on occasion, left well-conditioned
athletes delirious with heat exhaustion.

Spreen is an athletic trainer for the ATP, the professional tennis tour. For
nine years he's been on the court in high-stakes matches, responsible for
treating the aches and pains of the world's best male tennis players, often
with a three-minute clock ticking. Doug Spreen was an assistant trainer for
the Cincinnati Reds before joining the pro-tennis tour. He was also the head
trainer for tennis players at the Olympics both in 1996 and 2000.

Now players will be playing the US Open in a hot part of the year. And heat
and humidity can certainly take a toll on players. And I wonder if the death
of Korey Stringer, the Minnesota Vikings player who died at training camp two
years ago, has affected the thinking on the part of tennis pros and trainers
about the dangers of that.

Mr. DOUG SPREEN (Association of Tennis Professionals): Well, it has always
been a concern for us, because for a decent part of the year--we kind of chase
the sun and we chase the heat ourselves and it's tough. I mean, it's not like
uncommon for our guys to be playing in 90-degree-plus weather when it's humid,
and court temperatures can reach 130, 140 on the hard courts. And, you know,
these guys can be out there for three or four hours, so heat illness and, you
know, heat exhaustion, are definitely part of our game.

The fortunate thing we have in tennis is our guys are able to wear shorts and
short-sleeved shirts. And they don't have to pile all that equipment on 'em.
We don't really deal so much with the court temperatures, we just deal with a
lot of dehydration. It's amazing how much fluid somebody can lose in two,
three hours on a tennis court.

DAVIES: How much can they lose?

Mr. SPREEN: We've actually had guys test it. Guys who have had problems
with cramping and with the heat in the past, we've actually sent them to some
labs and had them tested. And it is not uncommon under exercise conditions
for these guys to test at losing two-and-a-half, three--we even had an athlete
test out at losing over four liters of fluid an hour. And that's a tremendous
amount of fluid. And it really physiologically is only possible to put about
two liters at the most back into your system an hour. And so two, three hours
on a tennis court you can quickly become several liters behind in your fluid.

DAVIES: So what do you do?

Mr. SPREEN: Well, if it's during a match, it's a matter of trying to manage
the situation as best you can. Getting as much fluid as you can in on
changeovers, trying to keep yourself cool. And then after a match, it's
really important for a player to work on hydration almost immediately after a
match. One of the things we find is that both with the hydration and with
nutrition--with food--is that the body uses a greater percentage of what you
put in it in the first two hours after activity--after exercise. And so one
of the things that you really have to avoid in hot weather is the cumulative
effects.

And this is something that may have happened with Korey Stringer, it may
happen with other people, is that they're fine for a day or two exercising in
the heat. But what they do is they don't replace the fluids that they've lost
on a day-to-day basis, and so after one day they're a half liter behind.
Another day they're two liters behind and all of a sudden the third day of
exercise now they're putting themselves in danger.

So we really stress with our players that immediately when they get off court,
they've really got to focus on drinking and eating something and trying to get
themselves prepared for the next match. If that's a day or two later, the
preparation for that match starts as soon as they get off the court.

DAVIES: Do tennis players use steroids or other performance-enhancing drugs?

Mr. SPREEN: I would think that the usage is very, very minimal, if any. We
have an extremely good drug-testing program in the ATP. These guys are
tested--I was just talking to some guy, he told me the other day he'd been
tested 14 times so far this year. And I don't get the sense of--I've been in
the game now for nine years, and we've had so few guys test positive that that
really is not a big issue in our sport.

Tennis is a sport that really goes to the issue of repetitive activity. And
if you watch guys hit forehands and backhands, it's not about muscling a ball,
it's not about all the power being delivered on one shot. And the motion in
tennis--the serve, backhand, forehand--it's a fluid motion. And you will see
an enormous amount of range and motion.

You take a guy like an Andy Roddick and before he hits a serve, how far back
his shoulder gets, his hand gets in cocking to hit that serve, is amazing.
And that's really--not only is he strong but he also developed it because he's
got such great range of motion that he can develop that power over a pretty
good distance. And so for an athlete--especially in tennis where flexibility
is so important--to become muscle-bound is really counterproductive.

DAVIES: You said that tennis is a real endurance sport. Is that why tennis
players are younger than other athletes? Why they don't last into their late
20s and 30s?

Mr. SPREEN: Andre Agassi right now seems to be the guy that is going against
that trend. He's 33, he's held himself together, he's been relatively injury
free and the guy's still, you know, ranked in the top three or four in the
world right now. Won the Australian Open and at the US Open he'll be one of
the favorites.

But it seems like when our guys reach the age of 30 that seems to be a time
when they seem to be retiring. Tennis is a young person's sport. And it's a
sport that the guys are so close in their competition right now, there's so
little that separates anybody in the top 100, that just the fact of getting to
a certain age and losing half a step, or losing a little bit of pop on that
serve or that forehand can make a huge difference. There's not many matches
that we have anymore that are blowouts. And so just losing 1 or 2 percent off
your game makes a huge difference. And so you don't see many guys reach their
mid-30s and they're still out here playing.

DAVIES: Now in other pro sports, athletes have their own trainers and coaches
right there. Tennis is different, right?

Mr. SPREEN: Yeah, tennis is different. You know, it's different working in
an individual sport because I'm responsible for all the guys. And so I'm in a
unique position as an athletic trainer that when I send two guys on court I've
maybe prepared both those guys often. You know, two guys that are going out
on court before a match are sitting on two treatment tables right next to each
other getting ready out on court and I have to be ready to help both guys.

DAVIES: Why doesn't tennis permit each player to bring their own trainer or
medical staff on to the court?

Mr. SPREEN: Well, they do permit them to bring their own trainer, their own
massage therapist, their own conditioning coach, their own coaches to a
tournament, credential. They can work with those people before and after
matches. But one of the reasons that they don't allow it during matches is
because there are rules, first of all, of what we can treat and for how long
we can treat people. And the other thing is, is that it's a duration sport.
It's a sport that physical condition is definitely a part of it. And so it's
very important to have somebody neutral to make that decision when it's
appropriate for somebody to receive some medical care, to receive some medical
treatment, to, in essence, cause a short break in the match. And we want to
have as little break as we can in the match.

One of the things that I always think about when I go on court, is if I go on
court to treat a player, I've got to realize that the other player on the
other side of the net is also being affected by the potential delay, the
potential just--sometimes mentally it can wear on you. `Is the guy I'm
playing really hurt or not hurt? Is he playing games with me?' And I've got
to remember that it affects the other guy on the other side of the court, and
so I've got to try and treat those guys fairly. And that's part of my job,
and that's part of hopefully letting the guy's tennis do the talking on the
court.

DAVIES: What are the rules that govern an injury time-out, if a player has a
cramp or a problem?

Mr. SPREEN: Well, a player can receive a three-minute, what we call, medical
time-out on court for an injury. When I get called on to court, I have
evaluation time. I get a chance to evaluate the problem or the injury with
the player. And that evaluation time is unlimited. Meaning, if we felt it
was serious enough that a player had a heart condition, just something that
was potentially dangerous, we can call for a doctor to come on court. That
happens less than .1 percent of the time. Usually we try and do our
evaluation very quickly, 30 seconds. A lot of times we can. The guy says,
`Hey, I have a blister on my foot,' that takes about two seconds to evaluate
the fact that his foot's bleeding.

But we try to do an evaluation for whatever the problem is as quickly as we
can. Get it done in 30 seconds and then once I start doing anything for the
player--if it's taping, if it's massaging, if it's doing some exercises, just
some stretching--I have a total of three minutes to do whatever I can with the
player to help him. And after that, we're then allowed to treat the player
for two changeovers. So the 90 seconds that they have between every second
game, we can then can go back on court some time during the match and treat
them for 90 seconds.

DAVIES: Now what's the controversy at the US Open two years ago, at a match
between Justin Gimelstob and Michal Tabara? After the match Tabara thought
that Gimelstob had been faking an injury during the match in order to gain
time because he wasn't in as good a condition. And, in fact, he said that he
actually spit at him after the match. And this came up in the post-game press
conference with Gimelstob.

Do you recall being in that one? Do you recall the injury time-outs?

Mr. SPREEN: You know, I recall the spitting, or the alleged spitting. And,
you know, I think that was more of a case--you get that sometimes after
matches. Guys aren't happy with the fact that a guy called for the trainer
and had an injury. And sometimes guys just aren't happy with the way a guy
carries himself on the court. But, you know, I do remember that situation.
And Justin Gimelstob is a guy who's had problems with the heat and heat
exhaustion and cramping in the past, probably as much as anybody.

And one of the things that, once I explained it to players, is that Justin's
problem and his issues is not the fact that he doesn't work hard enough and
it's not the fact that he's not in good condition. Justin is one of those
guys that has an enormous sweat rate. This guy literally can cause a pool of
sweat around him. He is losing liters and liters and liters of fluid during
each match. And so he literally is a guy that his physiologic makeup causes
him to lose more fluids than he can possibly put into his system. And so he
does have problems with cramping.

And, you know, one of the things that's difficult for like a Michal Tabara in
that situation and for tennis players is sometimes there's guys out there that
no matter what they never have cramped. And so they don't understand how
other guys can have cramping.

DAVIES: Gimelstob said in his post-match press conference that if any of the
reporters doubted him they could talk to Doug Spreen. Did anybody come to you
and ask you what happened?

Mr. SPREEN: Yeah. A couple of reporters did come and talk to me. And in
that case I was able to say with 100 percent conviction that Justin was
suffering from muscle cramps and that he had played by the rules.

DAVIES: You mentioned earlier that before matches players are often
side-by-side on training tables or in locker rooms. Do they ever pick up
information about little problems, injuries, or vulnerabilities and then try
to exploit them in the match?

Mr. SPREEN: That only makes sense that they do that. And I think one of the
thing is there aren't that many secrets. If a guy's getting his shoulder
treated two or three times a day, people can pretty much pick up on that he's
at least got some soreness in that shoulder. There are a lot of times,
though, when guys go on court and their opponent knows nothing of what's going
on. And when it is appropriate, we will make sure that a player has his
privacy, that we communicate with that player in private, even find a way to
treat that guy privately so that whatever he's got going can be a secret.

But, you know, in a game where the guys live and exist so closely together and
there aren't many secrets, and also players can pick up on another guy's
weakness and another guy's problem pretty quickly out on court. They know
each other so well, they've played against each other, they've probably
scouted the other player and they can tell when all of a sudden, `Hey, this
guy's not serving like he normally does.' They'll be able to pick up on it,
that something may be amiss with their opponent.

DAVIES: Doug Spreen, thanks very much for speaking with us.

Mr. SPREEN: Yeah, my pleasure.

DAVIES: Doug Spreen is athletic trainer for the professional tennis tour.
Next week he'll be at Forest Hills in New York for the US Open.

Coming up, Geoff Nunberg on the Fox News' lawsuit against Al Franken.

This is FRESH AIR.

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Commentary: Fox News' lawsuit against Al Franken
DAVE DAVIES, host:

The Fox News' lawsuit against Al Franken for using Fox's trademark slogan
`fair and balanced' in the title of his new book has a lot of people wondering
how someone can own a common phrase. Our linguist Geoff Nunberg has testified
in a number of trademark cases, and weighs in here.

GEOFF NUNBERG:

A lot of people were surprised to realize that Fox News could own the slogan
`fair and balanced' in the first place. Much less that they could get after
Al Franken for using the phrase in the title of his new book, "Lies and the
Lying Liars Who Tell Them: A Fair and Balanced Look at the Right." But it's
no different from Nike trademarking `Just Do It.' Nike can stop me from using
that as a slogan for my products, but not from using the phrase when I'm
telling my daughter to clean up her room.

That will certainly be part of Franken's defense. That he's just using the
phrase in a descriptive way, not trying to delude people into thinking he's
associated with the network. In fact, if there was ever any possibility of
confusion here, it's been pretty much eliminated by all the coverage of the
lawsuit, which has sent Franken's book to the top of the Amazon.com
best-sellers list.

And, in any event, the law gives a lot of latitude for fair use. Particularly
in the case of satire. But if Franken wants to make mischief for Fox, some
lawyers have suggested that he could make a counterclaim and ask the court to
cancel Fox's trademark on the grounds that it's what's called `deceptively
misdescriptive.' That is, it induces people to buy the product by
misrepresenting its properties. That could mean that the court would have to
decide whether the slogan `fair and balanced' is an accurate description of
Fox News, with the prospect Bill O'Reilly and Neil Cavuto having to take the
stand to defend their balance in the case of hostile questioning. Now that's
a trial that would drop Kobe Bryant to the bottom of the hour.

But it's hard to believe any judge would want to take that question on. And
actually, Fox's best defense against the charge of deception would be to argue
that the slogan `fair and balanced' is just vague puffery that nobody's likely
to take as a verifiable claim. That's the principle that allows car rental
companies to get away with registering trademarks like `Thrifty' and `Budget'
without having to demonstrate that their rates are really cheaper than others.

Of course, that would put Fox in the awkward position of having to argue that
their slogan is merely transparent hype. But it would be a pretty solid
defense. There may be lots of consumers who would assume that a car seat
cover called Lovey Lamb was made of real lambskin. But it's hard to believe
that the average television viewer is going to assume that a network's news
offerings are fair and balanced just because the network says they are. That
would be like trusting a used car dealer because he calls himself `Honest
Angus.'

In fact, that's what made the `fair and balanced' slogan so striking when Fox
came up with it seven years ago. When people make a point of advertising
their credibility or reliability, it's usually because there's a widespread
assumption that the field is full of untrustworthy characters, like the used
car business. You don't often see banks depicting themselves as honest, that
would raise all the wrong questions. And the fact that Schwab is out there
touting the integrity of their stock recommendations suggests what's happened
to the reputation of brokerage firms over the past few years.

And of course, Fox's `fair and balance' line was an obvious reference to all
the mentions of media bias that we've been seeing in the press over the past
15 years, more than 95 percent of them referring to liberal or left-wing bias.
In fact, if you looked only at how disproportionately the press talks about
liberal bias, you'd have a hard time understanding how anybody could imagine
that it has one.

In recent decades, in fact, both balanced and bias have become partisan words.
Anybody who advertises himself as balanced or unbiased nowadays is a pretty
good bet to have a right-wing point of view. The `fair and balance' slogan
drives liberals crazy, of course, given that Fox News doesn't exactly hide its
point of view under a bushel. But then the point of the slogan isn't to sell
liberals on the network's evenhandedness. It's about the pleasure that
conservatives take in knowing how much the slogan annoys the other side. It's
like Ozzy Osbourne biting off a bat's head on stage. Kids get a kick out of
imagining how their parents will react.

What's significant is that Fox didn't use the word `objective' in its slogan.
That word implies a neutral dispassionate presentation, what the philosopher
Thomas Nagel described as the `view from nowhere.' It's true that objectivity
has always been a hotly debated value. As the historian Michael Schudson
said, `It's a notion that seems to disintegrate as soon as it's formulated.'
But until now most broadcast journalists have taken objectivity as an ideal
even if it's ultimately an unattainable one.

Of course Fox's problem with objectivity is only that it sounds like a
turnoff. It's more lively to let the partisans square off on camera and let
the viewers decide. And if the network itself has an obvious point of view,
that's just a question of balancing the surreptitious bias behind all the
ostensible objectivity on the other channels.

Still, it's a sign of the times that Fox has become the champion of
epistemological relativism. After all, who's to say they're not balanced? As
that eminent postmodernist Rupert Murdoch might put it, `You pays your money
and you takes your choice.'

DAVIES: Geoff Nunberg is a linguist at Stanford University's Center for the
Study of Language and Information and author of "The Way We Talk Now."

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DAVIES: For Terry Gross, I'm Dave Davies.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.