Staff photo by Robin Rudd / A trainer attends to an injured Brainerd football player during a game at Howard on Aug. 17, 2018. is seen to by the trainer as the player's head rest on a penalty flag. Erlanger Sports and Health Institute supplies licensed athletic trainers to 14 public high schools in Hamilton County, as well as three in Georgia.

In late July of 2018, a Tyner Academy football player approached athletic trainer Hunter Amos complaining of a fever and severe stomach pain. Fearing appendicitis, she made a quick call to Erlanger Sports and Health Institute's medical director, Dr. Bill Moore Smith, who swiftly sent for an ambulance to take the young man to the hospital.

The appendix, highly infected and on the verge of rupture, was soon removed and "the patient made a full recovery," Amos said.

But what if no trainer had been there that day? What if — as had often been the case before Erlanger agreed to largely fund a program that would place a full-time trainer in each of Hamilton County's 14 sports-playing high schools, as well as nearby Georgia programs Lafayette, Ridgeland and Ringgold — it had been left to longtime Rams coach Wayne Turner to take care of the young man?

What then?

Said Turner on Friday night as he recalled that event: "If Hunter hadn't been there, I'm pretty sure we would have just sent him home. There's almost no way we would have thought it was a ruptured appendix. And if we'd sent him home, he probably wouldn't be here today."

Then there's the routine physical Dr. Smith was giving an Ooltewah baseball player last year that led to the discovery of a severe heart problem.

"The dad said, 'That's fine, but he's got a game in an hour,'" Smith recalled. "I said, 'Not anymore,' and we got the kid on a heart transplant list. He's been treated at Vanderbilt and he's doing fine."

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Contributed photo / Dr. Bill Moore Smith of Erlanger

Incidents such as these were why Smith first began pushing Erlanger close to five years ago to consider assigning a licensed athletic trainer to every Hamilton County public high school for both practices and games, and largely free of charge save a yearly $35 fee per athlete.

"I never felt comfortable having a trainer at some schools that could afford one, but not at others which couldn't," Smith said of his reasons for first approaching the Erlanger board about his plan. "Every kid everywhere deserves the best medical care they can get. The only way we could do that was to cover every school."

Because Erlanger is a public hospital and would be serving public high schools, both the hospital and the school system believed the concept needed to be thrown open to bids.

Erlanger won that bidding process, and in summer 2018 Smith's dream became a reality, which meant Arts & Sciences, Brainerd, Central, East Hamilton, East Ridge, Hixson, Howard, Lookout Valley, Ooltewah, Red Bank, Sale Creek, Signal Mountain, Soddy-Daisy and Tyner, plus the aforementioned trio of Georgia schools would now all have full-time trainers on campus, much as private schools Baylor, Chattanooga Christian and McCallie long have.

The Erlanger program also counts Bryan College in Dayton, Covenant College on Lookout Mountain and the University of Tennessee at Chattanooga among its clients.

"One trainer is assigned to each school," said Tessa Black, who manages the hospital's sports medicine program. "They work at that school only. They're there by 2 p.m. each day, and they stay until after practices or games end that night. It's a lot of hours."

It briefly appeared early this summer as if it would be no hours. When the COVID-19 pandemic shut down spring sports in March, Erlanger suddenly had a whole lot of trainers with a whole lot of time on their hands, some 26 in all, Smith said.

Forced to furlough all of them, there was much concern by both the trainers and the high schools that they would not be able to return, even if high school sports did, because of Erlanger's mounting financial losses.

"It would have been an easy decision," Smith said of a program that's estimated to cost the hospital more than $1.5 million a year. "It was low-hanging fruit. It's a loss financially, and Erlanger's had to make a lot of tough financial decisions during this pandemic."

In the end, Erlanger decided to keep the trainers program, with Smith explaining that the hospital's board "believes that our mission is to take care of everyone, regardless of their ability to pay."

No one was more relieved than Tyner's Amos.

"It was devastating," she said of the furlough. "It's tough to lose any job, but this is not just a job, it's my passion."

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Staff photo / Tyner football coach Wayne Turner watches his players warm up before a game at East Hamilton on Sept. 21, 2018.

How passionate is Amos? During her first year working with the Rams, one of the football players blew out a knee early in the season during a game at Bledsoe County.

"It happened three feet from me," the trainer said. "I knew immediately what had happened. So much of these kids' self-identity comes with being an athlete. I felt so bad for him. I remember crying all the way home."

Should COVID-19 force another cancellation of high school sports this fall as it initially did last spring, the trainers know they could be furloughed again.

"I do think about it," Amos said. "It's in the back of my mind every day."

But for now, they're all out there, doing what they can to take care of the vast majority of this area's high school athletes, regardless of their ability to pay.

"I'm tickled to death they're back," Turner said of the trainers. "Especially with all the COVID-19 protocols, we need them more than ever."

Howard football coach John Starr, known for looking after his players even off the field, sees them as essential.

"I just prayed that Erlanger would bring them back," he said. "At some point, you've got to do what's right for these kids, and having a trainer is what's right for them. Those trainers are a godsend. I don't want to think about where we'd be without them."

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Mark Wiedmer

Contact Mark Wiedmer at Follow him on Twitter @TFPWeeds.