The bubble was holding. Through the first two months of the NBA’s astonishingly complex and expensive restart to the 2019–20 season at Disney World in Orlando, Fla., the league’s unprecedented social, sports and epidemiological experiment seemed to be working. The strict quarantines, the daily tests and health checks, the electronic checkpoints, the endless cleaning and sterilization, the mask wearing and hand washing—all the procedures that NBA vice president and events medical director Leroy Sims, ’01, MS ’02, MD ’07, and his colleagues had labored over for months and that hundreds of players, coaches, reporters, staff and resort workers complied with daily—had kept COVID-19 at bay. As the regular season ended and playoffs began, no player or other resident of the NBA campus had tested positive for the coronavirus, even as the pandemic raged across the state.
But as the end of August approached, a new and potentially troublesome variable loomed: little kids. The NBA had agreed to allow player guests—four per player, restricted largely to family—inside the bubble after the first round of playoffs. How well would the bio-fortress hold then? “It’s one thing to ask adults to get tested every day, wear masks and follow strict social distancing guidelines for the common good,” says Sims. “But a 5-year-old?”
DISEMBARKING: Sims approaches the arena for the first time, on July 19. (Photo: Leroy Sims)
The grade-school set’s tolerance for nasal swabs was just one of scores of questions keeping Sims up at night—that is, when he wasn’t already pulling an overnight shift as an emergency medicine doctor at Mills-Peninsula Medical Center in Burlingame, Calif. A Chicago native who loved the field of medicine as a kid and ran track at Stanford, Sims found himself juggling two high-adrenaline jobs, including the orchestration of a novel medical endeavor that his boss at the NBA, Jeannette Neyses, likens to “running a bunch of sprints, every day.”
“Work in this bubble is harder than working in the ER because I’m so prepared for the ER,” said Sims in early September. He spent six weeks in the bubble early in the summer, flew back to California to his wife and two young daughters for three weeks—and six ER shifts—and then returned to Orlando to finish out the season. “There is no playbook for the bubble.”
Before COVID, Sims oversaw the operations of all things medical at NBA events worldwide, from the annual All-Star Game to a Global Game in Paris to an NBA Africa Game in Johannesburg. The bubble was a hybrid beast—both an event and the end of a season that was put on pause for four months due to the pandemic. In effect, it was an event of such long duration—from the restart in early July to the crowning of the Lakers as champions in mid-October—that, in addition to sourcing MRI machines and sussing out which local hospitals could provide private entry, Sims had to think about all the off-court medical needs people would normally handle themselves. What if one of the 1,500 or so bubble residents suddenly needed an ophthalmologist? Or had chest pains?
Then there was the matter of a global pandemic to repel. Before players arrived for the restart, Sims and his NBA colleagues spent months consulting with specialists in everything from mathematics to infectious disease to industrial hygiene. They talked with the NFL, the NHL, Major League Soccer, Major League Baseball, various European soccer leagues, the Fédération Internationale de Basketball and the Australian Football League. They wrestled with questions such as: What type of test should we do and how often? How do we do that without taking resources from the local community? (The NBA, in conjunction with BioReference Labs, provided free testing in the Orlando area.) How do we most reasonably limit the biggest COVID risk factor—exposure to other people—while playing basketball? “I know a lot of people give us kudos: The NBA is showing people how to do it in the bubble,” says Sims. “But the NBA didn’t sit in the room and come up with this de novo. We really did our homework and consulted folks.”
The resulting 113-page medical protocol spells out what would have happened if someone had tested positive (isolation housing and further testing) and is rife with rules and restrictions: no visits to teammates’ rooms, no caddies in golf, no doubles in table tennis. No reusing a deck of cards. No interaction with the outside world. (In July, Richaun Holmes of the Sacramento Kings inadvertently crossed the bubble border to grab a delivery of chicken wings and paid for his indiscretion with 10 extra days in quarantine.) COVID tests—three shallow swabs of the throat and one swab of each nostril—were mandatory daily, as were temperature and oxygen saturation readings and symptom checks that were uploaded into wearable devices that tracked bubble denizens’ health and accordingly granted or denied them access to entrances around the campus.
WE GOT THIS: Sims at the orientation and walk-through for the medical and health teams. (Photo: Courtesy Leroy Sims)
Unforeseen scenarios kept popping up. In one nine-day stretch, nine people had dental emergencies; six required root canals. Recognizing that the dental resources he had lined up were insufficient for the demand, Sims engaged a mobile dental unit to move into the bubble for the duration. “Leroy is really good at dealing with uncertainty,” says his wife, Melissa Enriquez Sims, MD ’07. “You know how people play chess and they think seven moves ahead? Leroy has to think seven moves ahead with multiple branches of scenarios. Say his team is making a policy and then the CDC changes something completely. Or the players association says that they want this or corporate says that they need that. He never lets that completely throw him off balance.”
‘You know how people play chess and they think seven moves ahead? Leroy has to think seven moves ahead with multiple branches of scenarios.’
Colleagues appreciate that equilibrium, as well as Sims’s diplomacy, flexibility, humility, empathy, tireless availability—he has two phones with him at all times, sometimes occupying both ears at once—and ever-present smile, no matter how little sleep he got between an ER shift and his 5 a.m. Zoom. “It’s a running joke around here: ‘What cup of coffee are you on now, Leroy?’” says Neyses, the NBA’s senior vice president and deputy chief security officer.
While updating job descriptions recently, Neyses was struck by how much Sims’s role has evolved during the pandemic. “We’ve created a unicorn,” she says. “Those are job descriptions that are sometimes viewed as standards no one could meet. But, boy, has he met them—and then some. Wrong sport analogy here, but he keeps stepping up to the plate and hitting it out of the park.”
‘I wanted to be in it’
Sims was primed for the world of high-stakes medicine. Growing up in East Garfield Park, a west Chicago neighborhood where gun violence was common, he spent a lot of time wandering the halls of Northwestern Memorial Hospital, one of the places his mother, Claudia, worked as a nursing aide. He loved everything about the hospital scene, especially the rush he got watching reruns of Emergency! “I loved the ambulances tearing down streets, running red lights,” he says. “I wasn’t one of those people to shy away from blood. I was the rubbernecker. I wanted to be in it.”
In his Head Start class, he declared his career goal: EMT. Then, when he was 8, he became riveted by a news report about Ben Carson, the young Black neurosurgeon who led the first successful separation of twins conjoined at the back of the head. Sims had found his role model. He, too, would be a young Black neurosurgeon.
After his ninth-grade year, Sims had a chance to attend summer school at Phillips Exeter Academy in New Hampshire, where he was introduced to air travel, the music of John Coltrane, World Cup fútbol and the concept of jet lag (his roommate was from Taiwan). “I realized how narrow my world was,” he says. He liked the Exeter experience so much that he spent his last two years of high school there. While many of his classmates were aiming for Harvard, he had a different plan. As a 9-year-old, he had flipped through the 1988 “best colleges” issue of U.S. News & World Report and discovered pictures of palm trees and students with their chests painted red at a Stanford football game. “I thought, that looks like a place I want to be,” says Sims, who still has the magazine.
Turning down opportunities to play basketball at the University of Chicago, Emory and Washington University in St. Louis, Sims said yes to Stanford, where he walked on to the track team that would win the NCAA title in 2000, his junior year. (He still owns the school record in the 55-meter dash—an event that’s no longer contested.) His ambition to be a neurosurgeon was fueled when, as a sophomore, he asked to shadow Gary Heit, MD ’91, a Black neurosurgeon then working at Stanford Hospital, as Heit implanted a deep brain stimulator into a Parkinson’s patient.
Photo: Stanford Medicine
While doing a neurosurgery research project midway through med school, Sims got a taste of how all-consuming the specialty could be. He took a mentor’s advice and made a spreadsheet with the specialties he was interested in on one axis and the things that were important to him—marriage, kids, travel—on the other. “Neurosurgery hit all my professional goals and none of my personal ones,” says Sims.
Sports medicine was next on his list. He knew he could get there through a residency in emergency medicine, his early passion. “I always wanted to be that guy who could take care of anyone, anytime,” he says. After three years treating gunshot and stab wounds, heart attacks and car-accident injuries at Harbor-UCLA Medical Center—the exterior of which was, incidentally, in the opening shot of his beloved Emergency! series—Sims returned to Stanford in 2010 as a fellow in its sports medicine program.
As a fellow and for three years as a junior faculty member in orthopedic surgery, Sims served as the team physician for Stanford football, women’s soccer, women’s tennis, wrestling, rowing, and track and field. His work for the Cardinal led to gigs as a team physician for the Golden State Warriors and for USA Track and Field, and, ultimately, to his current job with the NBA. “Stanford has always given me opportunities and connected me with the right people,” says Sims. “It has always been
a tailwind behind anything I am doing.”
From mentored to mentor
Overlaying the NBA bubble enterprise was the Black Lives Matter movement, the league’s embrace and promotion of which was fundamental to the players agreeing to restart the season in July—and to return to the court in August after a three-day strike to protest the shooting of a Black man, Jacob Blake, by a white police officer in Kenosha, Wis. The BLM movement is deeply personal for Sims. “When I walk down the street people don’t see Stanford, they don’t see NBA, they don’t see doctor,” he says. “They see just another Black guy, and that puts me at the same level of risk as Jacob Blake. So I have this same level of stress and anxiety about being in society. I see a cop in the rearview, my palms get sweaty.”
Sims can’t control how police or people on the street perceive him. But he’s determined that certain people do see Stanford and NBA and doctor when they look at him: all the Black kids at the Dr. Martin Luther King, Jr. Boys and Girls Club he frequented in his youth. “Coming out of the West Side of Chicago and having the successes that I’ve had, it’s mandatory that I reach back and encourage those kids,” he says.
To that end, he joined the board for the Boys and Girls Club of America as a Midwest trustee in 2017, and visits the old club when work duties take him to Chicago. He hopes some kids there will draw inspiration from his journey, and from his presence. “There’s power in seeing someone who looks like you doing something that excites you,” says Sims. Especially, perhaps, when that person is doing something that has never been done before.
One week into September, players’ guests had arrived in the bubble—bringing the welcome sound of children’s laughter—but COVID had not. The NBA’s successful experiment came at such an enormous cost—the league spent around $180 million, according to a New York Times article—that it would be difficult to replicate elsewhere. Indeed, the league itself is unlikely to bubble next season. As it discusses returning games to teams’ home courts, Sims is helping develop arena and health and safety protocols. And there is now data that didn’t exist before. Says professor of medicine Dean Winslow, an infectious-disease specialist who served as an NBA consultant, “What Leroy and his NBA colleagues have done proves that, if you do take appropriate precautions, we can defeat this virus. Not flatten the curve, but basically bring the curve to zero, which is really what they did.”
Says Sims: “Now we have a playbook.”
Kelli Anderson, ’84, is a writer in Sonoma, Calif. Email her at stanford.magazine@stanford.edu.
