Doctor Adrian McGoldrick all too aware of Cheltenham's dangerous side

The first fall of Cheltenham 2018, when it comes (not if), will be steep and fast and final. If history is a judge, it probably won't be in the Supreme, where there's been just one unseat in the past five runnings. But if it isn't in the Arkle – two falls, two unseats in five years – then it will almost certainly be in the third race on Tuesday, the handicap chase that has put 16 jockeys on the deck since 2013.

When it comes it will be gone in a blink. The camera won’t linger. The jockeys won’t give it a thought. The commentator will scramble to catch the colours, but his eye will turn back to the rest of the field before horse or rider get up. Cheltenham will convoy ever on, trucking away as if nothing remarkable has happened.

For Adrian McGoldrick the festival will simplify itself very quickly at this point. When it happens the Turf Club’s senior medical officer won’t take his eyes off the jockey. Whether he is trackside for that race or waiting back in the weigh room, his will be one of the first faces the jockey will see. Unless there’s another faller before the winning post comes, the remainder of race won’t register with him in the slightest.

“I wouldn’t know the form at all,” he says. “I wouldn’t even know what was running on any given day. I go through the card at the briefing before racing and count the number of runners, check for helmets and safety vests and everything else.

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No idea what won

“But the racing itself, I would go home most days not having the faintest idea what won. I might, if I had multiple fallers, I would have an idea what came back in and what did well or didn’t. My job is to get the jockeys out of there safely. But you’d often go home with no idea what won.”

McGoldrick retires this year having been the “senior” since January 2008. He has been the racecourse doctor at the Curragh since 1986. In 32 years, he has never asked a jockey for a tip, never looked for a steer to pass on to a friend. He couldn’t be less interested.

“I never mention a horse to a jockey, and they never mention one to me. I just wouldn’t do it. It would compromise the relationship, it would undermine it. I presume any of them would be happy to give me one if I asked, but I would never do it.

“The most important thing was getting their trust early on. Once you have their trust, then it’s a two-way thing. There’s nothing I would conceal for them but they know that I will try to get them back as quickly as possible and as quickly as is safe. So they hide nothing from me either.”

Ask an Irish jockey who the most important person in racing is to them, and whatever wisecrack variation they give on Mullins/Elliott/O’Leary/McManus, the actual answer is Adrian McGoldrick. He is there when they get hurt, he is there until they get better, he is there long after that as well. They love him, they depend on him, they never want to see him again.

Racing goes ahead

"People get on with their lives when a jockey gets hurt," says jockey Davy Russell. "Racing isn't going to stop for Davy Russell or Ruby Walsh or Sean Flanagan. There's always someone there to take your place. There's always someone to ride the horses when you're out. Racing goes ahead, and you get left behind very, very fast.

“It’s not a team sport. You’re alone in it. It’s a solitary pursuit. In a team sport you have an organisation who has a vested interest in getting you back to full health as quick as possible. In racing you’re on your own.

“The only person we have on our side is Adrian McGoldrick. To have someone like Adrian there to relate to, someone who has your best interests at heart and no other considerations, that’s a massive thing for us. I couldn’t speak highly enough of the man.”

The feeling is mutual. McGoldrick has a GP practice in Newbridge and uses his holidays to go racing. They call it the only sport in which you compete with two ambulances following you – he is the man in the ambulance. He has their back when nobody else has. Their back, their legs, their wrist, their neck, their fingers. Their everything.

“The jockeys are my priority,” he says. “I always refer to them as ‘my jockeys’. They come first above everything else. These guys, for them it’s an addiction. They are genuinely a different breed. I absolutely adore them. I am amazed by them constantly.

Humdinger

"I was in Thurles last week and I picked up poor Rachael Blackmore from an absolute humdinger of a fall, I nearly had to peel her off the ground. Then three days later I was in Naas on the Sunday and she had another one. And she just said to me, 'Adrian, I have to stop having these falls.' But she dusted herself down and just kept on at it.

“It’s more than bravery. It’s a different personality. She had a hell of a fall and she just shrugged it off. You just have to be in awe of them. When you pick them up, you can’t but be in awe of them. She’s just amazing. She’s the most petite young woman, an amazing jockey. They just have this most incredible will. They’re remarkable. I just find them unique.”

Preservation of that uniqueness is his mission. McGoldrick’s time in the job has been one of relentless improvement and innovation on any number of fronts. He fishes his phone from his pocket and pulls up a clip of Blackmore’s fall in Thurles. The anatomy of what happens in that situation is a walk-through of how far standards have improved.

McGoldrick was in the ambulance behind her that day. In front of him was an iPad with the live TV footage of the race giving him a head-on view. As common-sense as that sounds, it’s only something that has been made possible in the past four months – up to now his only view of any fall was of the backside of the horse disappearing over the jump and nothing re-emerging the other side.

Horrible fall

“With Rachael’s fall here, straight away I’m looking for her neck. She flipped over so it’s her neck that I’m immediately concerned with. That was a horrible fall. But again, we’re very lucky – Liam Healy the photographer was at that fence and he was able to tell me what it looked like from his angle as well. He would have been taking multiple photos so he was able to show me the sequence on his camera. The more information, the better.

“Because for the jockey what happens is that they get an adrenaline rush so they actually feel okay pretty quickly. So it has to be more than just them saying they’re fine. Rachael was shaking her head and that’s something I never like to see in a jockey who has just had a fall. It means they’re more sore than they anticipated.

“So after a fall like that, we get the footage from IRIS, we get the footage from the stipendiary steward, I look after the jockey and devise a course of action for them. Also, on top of that we send the helmet off to UCD. There’s great research going on into helmets in UCD – every time a jockey falls and breaks their helmet we send it to UCD along with a clip of the fall.”

The falls are only one part of it. A pretty big part – they have in the region of 1,600 falls a year – but still only a part of it. It is, he says, a highly dangerous sport and all he can do is try to make it safer along the way.

“You can’t stop them doing it. If you banned it, it wouldn’t stop them. They’re born into it, they’re addicted.”

Concussion

Top of his list when he took over in 2008 was to do something about concussion. The days of jockeys learning off the name of their horse in the next race so as to pass the doctor had to end. Now every jockey who falls – even if they land on their feet – has to pass a protocol to ride the next race. McGoldrick asks them a standard six questions, makes them do a balance test, and they have to hand over their helmet as well. He sees an average of 20 to 22 concussions a year from those 1,600 falls so it’s relatively rare but he still says education needs to be better.

An increasingly bigger issue in the weigh room is mental health. McGoldrick commissioned a study two years ago that found the prevalence of depression symptoms to be twice as high among jockeys as in the general populace. His next job is to find out why, although he can posit some fairly concrete theories.

“Long hours definitely is one of the underlying reasons. Jockeys work exceptionally long hours, and the pay fluctuates hugely depending on where you’re attached to. The top 5-10 per cent of jockeys make a decent living, the rest are barely making ends meet.

“There is a lot of uncertainty because racing now is very polarised towards the larger trainers. A lot of jockeys are just about getting by. Add in diet and trying to make weight, it all takes a toll.”

Quiet week

For the biggest week of the year, he links up with the Cheltenham medical team under Sue Smith. His hope, always, is for a quiet week. One where he isn’t crouched too often over a prone jockey or ushering a worried family member into a quiet room while they wait for news.

It’s five years since JT McNamara had the fall that left him paralysed and from which he ultimately died in 2016. McGoldrick has seen a lot of trauma in 38 years of medicine and he doesn’t shock easily, but he remembers that as a day of pure grief, carried on the wind from the prone figure of McNamara and infecting everyone who was there. The festival is manic, dizzying and euphoric for almost everyone almost all of the time, but it can get dark in a hurry.

“With JT, it was the anaesthetist who was with him immediately, Rob Simpson is his name, lovely guy. Rob was on the spot and actually intubated him straight away. But it was terrible, you knew almost immediately that it was serious. And it just cast a total shadow over the whole place. The atmosphere that evening and the following day was just almost funereal. It was unbelievable.

Serious injury

“I would say that one out of every two years I will end up in Cheltenham General down in Gloucester or even Frenchay Hospital in Bristol, which is where JT went. Every so often there’s a serious injury. It’s such a competitive meeting.

“My week over there is semi-work, semi-social, but until Friday evening comes and everyone is fit and well, you don’t relax.”