The Baltimore Ravens trailed the visiting team by 4 points, the third quarter was ticking down, and as Joe Flacco lobbed a pass to the end zone, 71,220 anxious fans followed its flight through the sky.
For the moment, Leigh Ann Curl was one of them. From the sideline, she saw the ball on the fingertips of a streaking Ravens receiver, giving Baltimore the lead in the late October game against Buffalo.
Then something else caught her eye: One of her prize patients, Todd Heap, lay prone on the M&T Bank Stadium turf.
"He was moving a little, but he didn't get up," says Curl, the Ravens' head orthopedic surgeon and the first and only female to hold that title in the NFL. "I thought about the previous week [and Heap's much-publicized near- concussion against New England], so I went on the field."
Heap had a shoulder stinger — a painful jolt to the nerves linking shoulder and head — and not an aggravation to the damage done Oct. 17, when a Patriots player had felled him with a vicious helmet-to-helmet hit.
In other words, it was just another blow in the trench warfare that is daily life in the NFL — and another bit of business in the life of a woman utterly at ease in a world run almost exclusively by men.
"A football field is a dangerous place," Curl says. "They're all at risk to get catastrophically hurt every practice, every snap, every play. [We] keep them as healthy as we can. When they do get hurt, we try to get them back as quickly and as safely as possible."
In Heap's case, that was quickly indeed. Sideline tests by Curl and the head trainer showed no damage to the spine, no loss of motion, no greater risk of crippling injury than all players face. Though smarting, he was back on the field in 15 minutes.
Curl returned to the sideline, where she was the only woman among the 60 or so people between the 30-yard lines. Clad in purple and black, she watched through aviator shades, relishing the action as her patients took the Bills into overtime.
If her career has been groundbreaking, it's not because Curl set out to make a statement. Her role as team head orthopedic surgeon — and thus as chief monitor of everything from Ray Rice's ankles to Ed Reed's neck — unfolded gradually, an inevitable result of who she is.
Curl, 47, was born in Pittsburgh, the second of six kids in a working-class family. A self-described tomboy, she took up softball and basketball early on.
She was also nuts about the 1970s-era Steelers team that won four Super Bowls. "Yep, Terry Bradshaw, Franco Harris, all those guys," she says a bit sheepishly. "I had to get over my Pittsburgh allegiance pretty quickly" after coming to Baltimore.
Sports provided a sanctuary when times were tough — such as when her mother died at a young age — and helped jump-start a new life. She earned a basketball scholarship to the University of Connecticut. A 6-foot-2 power forward, she set a batch of school scoring records and was twice named a GTE Academic All-American.
She also finished first in a class of more than 4,000.
"A No. 1 scorer and valedictorian, are you kidding me?" says Dr. Claude "Tee" Moorman, a former Ravens head team physician who now directs the sports medicine program at Duke. "She's off the charts in intelligence, and with her background in sports, she has an empathy for athletes and what they go through unlike anyone I've ever met."
Strange, then, that Curl never imagined becoming a doctor — at least not until a professor urged her to apply to a place she'd barely heard of: the Johns Hopkins School of Medicine. She got in, fell for the hands-on practicality of orthopedics, and finished at the top of her class in 1988.
She was the only woman in her graduating class to pursue one of its subspecialties, sports medicine. While applying for residency programs, she did get a few questions that verged on discriminatory. One interviewer asked if she wouldn't rather get married and have kids.
To Curl, though, following her passion felt less like blazing a trail than, say, tuning out crowd noise while lining up a free throw. "I decided to become good enough that [gender] wouldn't matter," she says.
Framed jerseys, including those of ex-Ravens Jonathan Ogden and Samari Rolle, line the walls of Curl's Cockeysville office. She has a full practice in addition to her football-related work — a combination that demands workdays of 12 hours or more.
After finishing with a spate of patients, she springs into the lobby in a white coat, hand extended to greet a visitor, and falls into patter about her favorite sport.
"Did you see the end of the Steelers' game?" she says of a Pittsburgh win that was sealed by a controversial end-zone fumble recovery. "Those guys always seem to get the close calls."
Ravens linebacker Brendon Ayanbadejo says Curl can talk football with the best of them. But when she talks shop, she sees football as physics-meets-anatomy.
"You can't appreciate the speed of the game when you're watching on TV or even from the upper deck," she says. "Down on the sideline, you can hear the force of the collisions; you hear the wind getting knocked out of [the players] when they get hit. It's impressive more of them don't get hurt more often."
That's partly because of training; veterans like Ray Lewis survive because they take good care of themselves, she says. It's also luck; other players seem to have a gift for avoiding injury. (Ogden comes to mind, she says, except for the toe injury that ended his 12-year career.)
The rest of the time, keeping 70 or so players up and running takes collaboration and skill.
The medical team includes the primary care-trained head team physician, Andrew Tucker; Curl, who oversees musculoskeletal matters; and head trainer Bill Tessendorf and his team of four. The doctors run numerous physicals a year on every player, oversee all courses of treatment and apprise each other — often by text message — of every sprain, ache and knock on the head that occurs.
Tucker and Curl spend an afternoon each week at the Owings Mills training complex; the trainers are there daily, serving as the docs' "eyes and ears," Tessendorf says, and conducting rehabilitation programs. The doctors perform tests, do surgical consults and help arrange for second opinions as needed. (Players needing orthopedic attention go to Cockeysville or to Curl's office at Harbor Hospital, where she's on staff.)
When surgery is needed, players often seek an outside specialist through their agents, though Curl performs many operations herself. (Privacy laws prevent her naming any.)
It all makes for a demanding year, from training camp in August through four preseason and 16 regular season games and any playoffs. In February, she hits the NFL scouting showcase in Indianapolis, where she evaluates about 300 potential draftees, providing Ravens officials with a risk analysis on each.
The players visit her by position, a regimen that has proved an education. Certain injuries, it seems, occur disproportionately at given positions: contusions abound for running backs, medial collateral ligament issues for linemen, catastrophic stuff like ACL tears for wideouts and defensive backs.
Why? It's how the game is played. "Every player is at risk, but the highest-speed collisions are in the open field," Curl says.
There are many ways to measure a team doctor's reputation, most somewhat subjective.
Robin West, the Steelers' assistant team orthopedist and the only other female physician in the NFL, says more players than the norm ask Curl to perform their surgeries, and that when Ravens are hurt, they often head straight to her. "That's a major sign of trust," West says.
"When you're hurt, you're kind of reeling, and you need someone solid to stabilize things," defensive tackle Kelly Gregg says. "Dr. Curl has operated on both my knees, the left one twice. Once I was back on the field in 10 days with no pain. She's just good."
Ayanbadejo appreciates Curl's knowledge of sports. "When she's testing me, she gets me into the most awkward positions and then says, 'How does this feel? How does that feel?' We end up talking about staying low, how to create drive, where power comes from."
In the M&T Bank Stadium locker room, Curl moves casually among bandaged stars and limping special teamers. "What makes a good team physician applies to a lot of things in medicine," says Tucker, the team's physician. "You look for the 'three A's': ability, availability and affability. Leigh Ann is a highly regarded clinician, she has always been the sort of person who does far more than she has to, and she gets along great with others."
Small wonder that working in a male-dominated field (even now, only 8 percent of orthopedists are women, according to one study) has never held Curl back. "Once in a while, I can't find a place to change, but that's about it," she says.
It doesn't hurt that she ends up with winners. After medical school, Curl won one of the top fellowships in the business, at the Hospital for Special Surgery in New York, where she trained in shoulder reconstruction and knee surgery, spending off hours working with the Mets and Giants. Hopkins made her a faculty member, but in 1997, the University of Maryland hired her away, naming Curl head team physician for Terps athletics.
The ACC's first female team orthopedist, she oversaw Ralph Friedgen's 2001 conference champion football team and both Gary Williams basketball squads that made the NCAA Final Four.
When Moorman, the Ravens' first team physician, moved on, he recommended Curl as his replacement. A year later, the team won the Super Bowl — and she got a commemorative ring.
She rarely puts it on. "For a surgeon, it's a bit on the bulky side," Curl says.
A clear head
On balance, the Ravens have done well this year — a 6-3 record, Reed back in action, few catastrophic setbacks — but close calls always abound. The Heap incidents come to mind.
About 85 percent of Curl's work, she says, deals with players in a state of recovery from something. An injured player usually wants to know one thing: "Am I recovered enough to play?"
Curl, a single resident of Owings Mills, says it's a blessing to work for a club that never pressures its medical staff to cut corners. (If that happened, she adds, she'd quit.) If an injury doesn't disqualify a player outright, her role is to give him all the information needed to make a decision about whether to choose a particular treatment — or to play.
"I get injections before every game, and she's cut on me quite a bit," Gregg says. "She always takes the time to lay out the best- and worst-case scenarios ahead of time."
Given a choice, players usually opt to play; in New England, Heap had no such option. As he returned to earth after an attempted catch, the Pats' Brandon Meriweather drove his helmet into Heap's so violently it cost the safety $50,000 in fines — and helped re-ignite a nationwide debate over head safety in the NFL.
Curl determined on the field that Heap had no concussion — he was breathing and conscious and remembered the play — or neck injury before allowing him to be moved. She later monitored his neck and shoulders with imaging tests. "He basically had to recover from the whiplash effect, if you will — just soreness," she says.
Still, she adds, it's always wise to take a closer look at concussions. Now that players are bigger and faster, and advanced helmet design has made head collisions all but pain-free, so called "head shots" are more dangerous than ever.
"We don't want to talk to these guys years from now and hear them say, 'You know those 10 concussions I laughed off when I was playing? They're not so funny now,' " Curl says.
After the Ravens outlast Buffalo, 37-34, Curl moves through the locker room, nearly as upbeat as the players.
Gregg bruised a thigh but returned to action. Reed, in his first game back, collapsed after returning an interception 40 yards, but it proved to be simple soreness.
"Some guys will feel pain tomorrow that they don't even have right now, but nothing happened that should cost anybody significant playing time," she says, smiling.
She'll be in the training room for a couple of hours — players may come in for any treatment they want — before one more long Sunday will be over.
Tonight, she won't be able to indulge in the sort of relaxation she enjoys on her rare vacations; last year, she biked the toughest mountain stretch of the Tour de France. But that doesn't mean Curl can't reward herself before returning to the grind.
"I'm going to watch 'Sunday Night Football,'" she says.
Leigh Ann Curl
Position: Ravens' head orthopedic surgeon — the first and only woman to hold that title in the National Football League. Also has private practice in Cockeysville and is on staff at Harbor Hospital
Education: University of Connecticut; medical degree and residency, Johns Hopkins
Specialties: Knee and shoulder injuries
Worked with: New York Mets, New York Giants and Baltimore Orioles; various teams at St. John's University, Johns Hopkins University; University of Maryland; USA Basketball; USA Rugby
Basketball trivia: Scored 1,388 career points (23rd all-time) at UConn., averaging 14 points a game (10th); named to GTE Academic All-America Hall of Fame in 1998; last played for fun in 2001
Off-hours: Attends Terps football games as a season ticketholder; conquered L'Alpe d'Huez and Mont Venteux in the French Alps on her Trek 1500 bicycle; takes care of her 12-year-old golden retriever and two cats
On concussions: "It's a Catch-22. Everyone wants to see that wicked hit [in football], see that guy get hit so hard he doesn't want to get up. But while you may think it's cool to watch that happen to someone, maybe we shouldn't be promoting those sorts of hits anymore. They come with a serious price."