Let’s start with the sharks. Bert Mandelbaum was tremendously excited about sharks in his youth, which led him to become a marine biology major at State University of New York (SUNY) in Cortland. He was a young diver then, before he started his medical career. Decades passed while he focused on building a career that has taken him around the world to the pinnacle of many sporting events such as Major League Soccer Finals, the World Cup, and the Olympic Games. Then ten years he ago he started diving again – all over the world chasing sharks. He and his son Jordan dove with them in cages in South Africa, then in and out of cages off Guadalupe Island, 160 miles southwest of Ensenada, Mexico. “Guadalupe Island is an amazing shark habitat,” says Dr. Mandelbaum. “There are 4,000 elephant seals living there and about 200 white sharks patrol that island waiting for them to go into the water every four or five days. Sharks are the ultimate hunters – they’re amazing. I’ll show you my friends.”
Dr. Mandelbaum opens photos on his laptop to share some photos. He calls the biggest of the sharks by name. Zapata is a famous 16’, 4,000 lb. shark with a scar on his face, which makes him easy to identify. Then there’s Atlantic and Nicolas Cage. The divers go down in submersible cages into the shark habitat, but one of the cages goes down deeper to 35 feet. The video shows Dr. Mandelbaum stepping out of the cage. “There’s Zapata. He got a little close to me right there. He swam right above me. He has no interest in me,” he says coolly.
Dr. Mandelbaum’s son Jordan caught the shark fever from his dad and the two continue shark searches each year. The whole family is certified to scuba dive, so each year at Christmas time they rent a boat in warm water (captain included) and dive every day. This year it was in the Grenadines. The Mandelbaums are a family of five: wife Ruth Sorkinson, M.D. is a pediatrician; Rachel is a medical student at UCLA; Jordan attends Brown University; and Ava is in high school.
Bert Mandelbaum grew up on Long Island, N.Y. then his parents moved to Tampa, Florida. Bert went to college at SUNY Cortland and lived in Long Beach, N.Y. during the summers where he worked as a beach lifeguard. “I was brought up on the ocean and competed in the lifeguard Olympics. Everything about the ocean appealed to me. The Atlantic is a simpler ocean; the Pacific is a tougher ocean. Now that I’m here, I have surfed at Topanga and Sunset, and I stand-up paddle at Paradise Cove. I just like to get out there. The beauty of living here is that there are so many different options in the water.”
Bert played lacrosse growing up, so he played at Cortland. The day he graduated, he went to visit friends in Baltimore. Johns Hopkins was the place for medicine and lacrosse, so he aimed at the two things he wanted most.
Bert Mandelbaum on right
The week he arrived, a spot opened in a graduate program at Hopkins that came with a National Institute of Health (NIH) fellowship. At the same time, he fell into a position coaching lacrosse at Hopkins. Next he went to Medical School at Washington University in St. Louis where he skipped a year because of his work at Hopkins. The lure of a Hopkins residency took him back to Baltimore where he said, “Residency was like training as a Navy seal or fighter pilot. Hard work was an understatement! I quickly transformed into the trained officer who is ready for any mission, any time, any place!”
Sports medicine and surgery had become Dr. Mandelbaum’s whole life, and as he went to UCLA for a fellowship, he felt his life was definitely on track. He served on the faculty at UCLA for four years and felt as though he’d gone to the Disneyland of Sports, because he was being exposed to the best athletes in the world there. He came to know and be inspired by UCLA legendary basketball coach John Wooden who won an unprecedented ten NCAA championships.
“One of my biggest mentors was John Wooden, starting in 1985. Every year I would take our fellows and our residents to meet him for dinner. The last time we had dinner about five years ago, he read his children’s book Inches and Miles and poetry to us. It was fantastic. He was such an icon. He had such impact on me and others”
After UCLA, Bert joined the Santa Monica Orthopedic Group (SMOG). He was considered an all-around sports doctor. “I did shoulder and elbow arthroscopies and I developed an interest in gymnastics and wrist pain. I was one of the first on the West Coast to do wrist arthroscopies. I would fix the cartilage and clean out debris and loose bodies like you do in any other joint,” he says.
Although he started off working with all body parts and became known world-wide for his work on wrists, two things happened concurrently as his career developed. The doctors in SMOG expanded and accepted fellows for training. “As we brought them in, one wanted to do the shoulder, one wanted to do the hip, one wanted to do the upper extremities, elbow, and wrist. We’ve been expanding since 1995 and now we have someone as a specialist in every one of those areas. It wasn’t about my career; it was about building the practice. It is a team sport! My research mainly focused on the knee, on articular cartilage repair, transplantation, the mechanics of why people are tearing their ACLs (anterior cruciate ligament), and prevention programs. That created a lot of interest and I was inundated with knee ligaments from all over. So now I’m type cast as a knee doctor, which is not so bad.”
As a leading sports doctor, he became the U.S. national soccer team physician and traveled to 52 countries in 18 years. Along the way, there were many intriguing international stories. Take the time the team was in Moscow during the Soviet coup in August, 1991. “We happened to be in the Kremlin when they took Gorbachev in the Russian coup. It was huge. The military was everywhere. There were probably 100,000 people in Red Square at the time. Officials whisked us off to the airport. We didn’t really know what was happening until we got to Munich. I came home and a few days later, President Reagan was in my office. He was very interested in what had happened over there. He was asking ME! He kicked the secret service out of the room and we talked for hours. Then I asked him how he related to Mikhail Gorbechev. President Reagan told me the whole story. He said he knew they were just two men. Dr. Mandelbaum next imitates Reagan’s voice saying, ‘Well, I looked in his eyes and he looked in my eyes and I knew and he knew that we wanted no part of war.’” To this day Dr. Mandelbaum keeps Ronald Reagan’s autobiography in his study signed: “To my good friend Bert, Ronnie.”
At the 1998 World Cup, the U.S. was playing Iran. No diplomatic relations existed between the two countries, but the athletes broke protocol and exchanged flowers. “There was great camaraderie between the two teams. That really speaks to the beauty of world sport and how sport can bring people together and be the gathering place for human emotions and good will. It is the Life of sport and the Sports of life.”
A story that Dr. Mandelbaum obviously cherishes spans 1986 to the year 2000. It involves Cliff Meidl, a 20-year-old kid who was in Manhattan Beach working with a jack hammer in what was supposed to be a safe area. When he contacted live electrical cables, about 30,000 volts went through him. Fast-responding fire fighters started his heart again. His legs were horribly burned and injured. Dr. Mandelbaum did fourteen surgical procedures on him over many months so that he could walk again. At that same time, Olympic gymnast Tim Daggett broke a tibia and was around the office. The two met there and Meidl took inspiration from the injured Olympian. He began paddling as a kayaker – and paddling and paddling and paddling until he made the U.S. Olympic team in kayaking in 1996 in Atlanta. The part of the story that clearly moves Dr. Mandelbaum takes place in 2000 at the Sydney Olympics. Dr. Mandelbaum is sitting in the sixth row of the opening ceremonies, which are always inspiring and uplifting all by themselves. Then the U.S. team walks in, and YES – that’s Cliff Meidl carrying the American flag at the front of the delegation! This was thirteen years after his accident and Cliff had found a way to express the athlete inside of himself, make the American Olympic team and carry the flag into the stadium.
Cliff Meidl in Sydney
The next Olympic Games were in Athens in 2004. The United States was at war with Iraq. Part of Dr. Mandelbaum’s job at the time while working for FIFA (the international governing body for soccer) was to oversee the Crete venue as Medical Director. Preliminary games were played in Crete and two other Greek cities, then the finals were in Athens. Because Iraqi air space was closed due to the war, the athletes couldn’t fly out of Iraq. They drove to the Syrian border in a bus, crossed into Syria then Jordan and eventually flew from there to Greece.
“They arrive a couple of days late,” recounts Dr. Mandelbaum. “They don’t have equipment, their doctor didn’t travel with them, and I’m the FIFA medical officer who is responsible for them. They don’t have a medical kit so I’m working feverishly to get them equipment and everything they need. I was a little nervous about this whole thing – I was professional but kept my distance. Whenever they needed something, I would leave it for them at the door. So they fly in and they do really well. In fact, one night they’re playing against Australia in a preliminary round. They are the underdog. They not only came and played; they beat the Australians 2-1. By now the doctor and administrator had arrived. So after the game, it was 12:30 at night, we had to drive back to the hotel, which was about 20 miles from the stadium. We’re in one van, five Iraqis and one American, driving the dark roads of Crete and all of a sudden it must have hit them – they WON that night! The players began to sing and clap. The next thing you know, I’m clapping and singing along with them. Here we have two countries at war, five Iraqis and myself, laughing and celebrating life together. What an amazing Olympic experience.”
Dr. Mandelbaum with two Iraqi soccer players at the 2000 Olympics
Then there’s the story Dr. Mandelbaum speaks of as “Bubba and me.” It was the summer of 2010 and the U.S. Soccer team was at the World Cup in South Africa.
“I spent hours with President Clinton in the locker room after a game, sewing up players. He got a kick out of it. A player might need sutures on the head, and he was sitting there helping me out. We talked about everything. He wanted to talk about soccer, the team, Africa, and his new diet. He had lost 20 pounds and was talking a lot about that.”
All these remarkable stories won’t be lost. All through Dr. Mandelbaum’s career, he has made slides and taken notes in his little book. In effect, he’s become basically a medical journalist. I remember being impressed with the slides he showed in October, 1994, when he and I presented the first-ever aquatic therapy symposium in Italy. In those days, we used slides made of film rather than Powerpoint presentations.
Dr. Bert Mandelbaum on left, Lynda Huey in green
Today he has dozens of Powerpoints on his laptop that he moves easily between when wanting to make a point. That’s his raw material that has become part of his book The Win Within: Eleven Life Principles to Help You Get Off the Sidelines and Back in the Game. It will be published soon highlighting the inherent athlete in each of us.
His book came from being asked to give a graduation speech at his alma mater, the State University of New York. At the same time, he was awarded an Honorary Doctorate of Humane Letters. (The other recipient of the award was the first female four-star Army general.)
“I had to give a graduation speech to 10,000 people. I’ve spoken a lot all over the world to people and doctors, but I’d never given a graduation speech before. I started putting it together and I started writing not from the scientific part of my brain, the left brain, but from my right brain. Writing the speech motivated me so much that I started writing and writing and I just couldn’t stop writing. It was like turning on a faucet. That’s what ultimately led to my writing an inspirational, motivational book using these stories to get my eleven principles across, that life is always a great journey.”
When asked what’s the latest in research and cartilage repair, he opens another Powerpoint about Adjuvant Therapy, the concept of dealing with a complex problem in multiple layers. He explains.
“We have to think of regenerative therapies as a triad:
- you need cells (dedicated cartilage cells or stem cells)
- you need scaffolding (collagen-based or a composite of polylactic acid and polyglycolic acid)
- you need growth factors (platelet-rich plasma, bone marrow aspirate concentrate (BMAC) or fat-derived stem cells or a combination).
Then you need to turn on the rejuvenation and at the same time turn off the degeneration. This is orthobiologics. We’re developing studies, we’re comparing, and we’re changing each of the variables looking for the best possible treatment.”
He shows a slide of a knee with a cartilage defect. “This is an example of a patient of ours having this big osteochondral (bone/cartilage) defect, and filling it with a bone graft and BMAC stem cells.” He brings up another slide. “And this is the BMAC stem cells all in a clot filling that hole. It actually clots, because you put clotting material in it and into the rest of the cartilage. There is special MRI technology to look at the repair and here you see if filling up beautifully.
“We can learn the most interesting thing about this kind of work from other fields. There have been sixteen controlled, randomized studies on patients who have had heart attacks. They injected BMAC in and around the myocardium (the muscular tissue of the heart). Six months later, the BMAC group has a better ejection fraction (how well the heart pumps each beat). The damaged tissue has been reduced significantly. But here is the most dramatic part of the study: 3 months, 6 months, and 12 months after they’ve had the heart attack and the BMAC treatment, there are these cells CD 34 and 45 that are surveillance cells. They float around the body and they say ‘we’ve had a heart attack. Send some more stem cells from the pelvis. Send some more over there. We haven’t healed enough.’ When you compare the control group that didn’t get the BMAC with the group that received it, the ones who got the BMAC have a lot more of the surveillance cells. So what’s happening is that not only is the tissue being healed locally, but enhanced healing over time is happening as well.
“That’s why when people ask if the key is this one thing or that one thing, I tell them it’s much more complicated than that. We’re interested in CD 34 being out there healing a degenerative knee, that muscle, or that tendon when you’re sleeping four months from now. The frontier is all about molecular biology and how we can utilize these techniques. Our present understanding of stem cells and maximizing their desired effect is in its infancy. It’s a good step so far.
“So even though I do mostly knees, I still have a lot of variety, because I’m always on a frontier. It never gets boring because there’s always a new concept and a new challenge to look at through clinical trials.”
Lynda Huey, M.S., founder of CompletePT Pool & Land Physical Therapy and Huey’s Athletic Network, is a former athlete and coach whose own injuries led her into the water to find fitness and healing. She was educated at San Jose State University where she starred on the track and field team during its golden years. Lynda is the author of four books on water exercise and water rehabilitation. Lynda is happy to answer the questions of any of her followers on Twitter.com/lyndahuey.