Competitive Eating: A New Niche for Radiologists?

A bit over a week ago, I finally attended the annual hot dog eating contest at Nathan’s in Coney Island, New York. My lady attended for the past few years. First going on a whim, she found it surprisingly entertaining, the sort of fun that just doesn’t get captured on a TV broadcast.

I wasn’t motivated to join her for the next couple of go-rounds. It takes a couple of hours via train and subway to get there from where we live, and if you want a good spot, you will get up extra early. On a day off, I am more about sleeping in. On a hot summer day, I would much rather be poolside or at a quiet beach than in the concrete jungle.

Repetition is a strong persuader, however, and hearing about her enjoyable escapades enough times had me dragging myself out the door at around the time I am usually waking on a workday. The struggle didn’t end there. The sun was particularly powerful that day. While a merciful breeze occasionally took pity on us, most of the hours we spent standing in front of the stage, surrounded by other overheated individuals, were in stagnant air.

Still, it was worth the hype. They don’t just have the two rounds of hot dog eaters to watch, but a series of warm-up acts and other entertaining bits of tomfoolery. One was a “chug” contest in which the reigning champion downed a gallon of lemonade without seeming at all challenged.

The men’s champion retained his title for the umpteenth time, downing 66 dogs (including buns as is the rule). It was a relatively slow year for him. His record there is 76 (83 elsewhere). The heat, it seemed, wilted him as it did the female champ who also retained her title.

One might wonder how the heck a human can do such things and why. The latter might be easier to understand when you think about things like fame and fortune. Joey Chestnut, the men’s champ, travels all over, has a pretty ardent fan base, and rakes in more than lots of radiologists (AI tells me he gets over $500k per year, between prizes and sponsorships). Not everyone agrees, but “competitive eating” is widely considered to be a sport.

Make something rewarding and competitive enough, and a whole supportive world grows around it. It is not just sponsors. The bigger a deal the sport is, the more its rising tide lifts its flotilla. That includes the physicians employed by sports leagues or individual teams/competitors within. A lot of docs gravitate towards the idea of getting out of the “rat race” of hospitals, CMS, etc., especially if they are fans of the sport in question.

Competitive eating has not quite risen to the level of, say, the NFL in this regard, and I haven’t found any mention of an official physician in Nathan’s ranks. They did have a “medic tent” off to one side of the festivities, and a couple of folks in the crowd who succumbed to the heat were taken care of there. However, I found myself thinking that Chestnut and his ilk might have use for a doc in their professional entourage.

I am not talking about physicians for clinical purposes. They surely see GI specialists in addition to whatever else their actual health care requires. I am thinking more along the likes of assessment and enhancement of professional performance.

If you think competitive eating is just about who is gifted with the most expansile proximal tract, you haven’t looked into it enough (and, really, who would blame you?). I had occasion to watch a documentary or two over the years, and a lot more goes into it. Successful competitors have training regimens and practiced techniques that give them huge advantages over those who do not.

I would assume, thus far, that they have just developed these routines themselves, or learned them from retired champs willing to pass on their secrets. One figures out, often through trial and error, what works well and what doesn’t.

I could picture someone getting more scientific about it though and this is where a friendly radiologist might enter the picture. Suppose, for instance, a would-be champion has himself imaged via fluoroscopy or even scintigraphy during his training sessions. Now, instead of just going based on what feels right/wrong, it can actually be watched.

Some competitive eaters, for instance, hop up and down or wiggle their torsos in certain ways that they have found helpful in moving their ingested material to make room for new stuff (and to avoid potentially catastrophic reversals). One might have a sense that “When I do this, it helps,” or “When I do that, it’s bad.” Getting a bunch of video-fluoro footage of what you are accomplishing will give you a lot more objective data, especially if you have an experienced rad going over it.

In addition to helping competitive eaters pursue their goals, a radiologist on the team would be valuable in identifying obstacles and outright threats. There have been a couple of fatalities from choking during competitions. Someone accustomed to viewing video swallowing studies might proactively advise the competitor “Hey, you have come close to disaster (micro-aspiration) while I have been watching. Let’s figure out if you can adjust your technique.”

That could also be useful for identifying structural abnormalities before they present in sudden career- or life-ending ways. Suppose Chestnut has an esophageal or gastric diverticulum that causes no symptoms but gradually expands and gets thinner walled with each stressful event. One day, in the middle of a training session or contest, it ruptures. Wouldn’t it be better if a rad on his team proactively saw it? He would then be able to pursue surgical correction or an early retirement.