The news that 13-time Grand Slam singles champion Serena Williams has suffered a serious medical crisis is sobering. On Wednesday it was revealed that Williams, a force of nature on the tennis court who overwhelms her opponents with her strength and vigor, was treated last month for a pulmonary embolism, and then subsequently developed a hematoma. She required emergency treatment on Monday.
I asked Dr. Mark Neuman, an assistant professor of anesthesiology and critical care at the University of Pennsylvania, for a primer on this kind of condition. He explained that a pulmonary embolism is a deep vein thrombosis (DVT), or blood clot, which travels from where it developed — typically in a leg, where blood vessels are relatively big — to the lungs. The fact that Williams is one of the finest athletes in the world does not protect her from this kind of scary episode. DVTs are fairly common in people who have been immobilized during long flights, or those who have just had orthopedic surgery, which can stir up inflammation or interrupt normal venous flow.
Though for me the term “DVT” conjures the tragic case of NBC journalist David Bloom, “most of these pulmonary emboli aren’t fatal,” Neuman said. Someone with a pulmonary embolism might experience shortness of breath or have low blood-oxygen levels; a CT scan can confirm diagnosis. Then the patient is placed on blood-thinning medication to prevent the development of further clots, and the original clot dissolves on its own.
But Williams’ development of a hematoma — “a collection of blood outside a vessel, where it’s not supposed to be,” as Neuman explained it to me — is an additional complication on a rehabilitation road that has already been riddled with setbacks. Williams hasn’t played an official tour match since she trounced Vera Zvonareva to claim her fourth Wimbledon title last July. In a freak accident a few days after that victory, she stepped on broken glass while leaving a Munich restaurant and sliced a tendon in her right foot. Eight months and two surgeries later, Williams is still unsure when she will return to competition, though she said in a statement Wednesday that she hopes to be playing by early summer.
Being on anti-coagulants wouldn’t necessarily preclude someone from playing tennis, said Neuman, who has not treated Williams. “But just taking a certain amount of pounding could increase the likelihood of hematomas in your joints, like in your knees,” he said. “Obviously, that’s not optimal.”
The good news is that Williams’ medical status is apparently stable. But as long as Serena is out of the game, the prognosis for women’s tennis is grim. Seven of the players in the current Top 10, including top-ranked Caroline Wozniacki of Denmark, have never won a Grand Slam singles title. Belgium’s Justine Henin, with whom Williams waged several compelling on-court battles (most recently in the final of the 2010 Australian Open, which Williams won in three sets), recently retired from the game, again. Neither Wozniacki, nor Zvonareva, nor Victoria Azarenka of Belarus, nor former No. 1 Jelena Jankovic of Serbia has yet been able to convert her considerable talent into a major title.
Williams has more power, and more star power, than any woman currently in the game. Even a shameless Kim Clijsters-phile like me knows that women’s tennis is an infinitely better product when Serena is part of it. The longer her absence stretches, the more difficult it will be for her to come back, particularly considering that she’s operating in a body that’s 29, not 21. But Serena is by far the best female player on the planet. She’s a formidable competitor, and a fighter. Let’s hope for her sake, and for the sake of the game, that this health scare doesn’t permanently derail her career.