12/13/2006 12:00AM

One of racing's true miracle men


INGLEWOOD, Calif. - Joe Steiner was introduced to Dr. David Seftel in the usual manner. That is to say, Steiner was flat on his back, on the clubhouse turn of the Bay Meadows turf course, dazed and gasping for breath.

"I was there to ride the stake, and I picked one up in the last race," Steiner said not long ago. "The horse fell after the wire. Next thing I know, I'm lying on the ground, the wind knocked out of me, and there he is, standing over me. I asked him how he got there. He said, 'I ran.' "

Steiner is retired now, but while he rode, such mundane tumbles were par for the course. In Seftel's experience, though, as medical director of the two major northern California racetracks, there is a certain amount of urgency attached to even the most innocent looking fall.

"You've got about 90 seconds to get someone breathing again to have a chance to avoid major brain damage," Seftel said. "And after three minutes they're brain dead. There is no luxury of time."

In the harsh economic reality of the racing world, there is really no room for a luxury like David Seftel. His presence in the medical mix of the Thoroughbred world is nothing short of amazing. When Bay Meadows management was looking for someone as a temporary replacement for a retiring track physician during the 2000 San Mateo County Fair, their specifications did not read like this:

Wanted - Board-certified internist, currently on staff as pulmonologist at San Mateo Medical Center, preferably trained at Harvard's Beth Israel Hospital and Loyola University, also with a master's degree in business administration from Harvard. Other interests should include research directorships in areas of macular degeneration and disease surveillance technology, as well as the application of NASA tele-medicine technologies in making prenatal ultrasound screening available to the impoverished, AIDS-riddled rural female population of South Africa.

But that's what they got.

"I was fascinated," said Seftel, 38, of his first reaction to the racetrack. "It was like walking into a totally different world. There was so much about horse racing that I did not know. But it was very familiar in that it was family. No matter what their petty conflicts might be, the objective every single day was to put forth their best performance.

"It was also an environment in which people wanted to be well," Seftel said. "This is different from a lot of clinical practice, particularly in hospitals these days, in which you have a category of people which I term the institutionally sick, the people who wallow in the sick role, who keep coming back to the hospital and actually become comfortable with that role. At the racetrack, people get ill, but they want to get better, because they're passionate about what they do."

Seftel's mandate is to care primarily for the jockeys in his practice, but that has not stopped him from treating the ills of the backstretch community and even the occasional fan. Pete Tunney, president of Golden Gate Fields, marvels at Seftel's generosity.

"The running joke has been, someone with a cold will want to go see Seftel, but they can't, because he's doing open heart surgery," Tunney said. "He's a real humanitarian, who also happens to be a genius."

A more or less typical week in Seftel's very atypical work life recently included a trip to his native South Africa for hands-on administration of the prenatal ultrasound project, then a presentation at the Jockeys' Guild meeting in Las Vegas on the riders' health survey, and then back to his clinic at Bay Meadows, where he attended to a pair of riders who went down last Sunday in the mud. Both of them got up.

"I've always been drawn to unusual challenges," Seftel said. "But I pale in comparison to my parents. They always say I'm bone idle and lazy."

Seftel is a son of doctors, both professors of medicine. His father, Dr. Harry Seftel, puts in 14-hour work days that include being radio host of one of South Africa's most popular call-in health shows.

Harry's son, on the other hand, makes headlines only when he is called on to comment about serious injuries to jockeys - injuries that might have been worse without the rapid response provided by Bay Meadows and Golden Gate through Seftel's clinic.

"There is very inconsistent medical and emergency care at racetracks throughout the country," Seftel said. "I was taken by the fact that there are very few racetracks that actually have a doctor on site and have trained paramedics. Most tracks have basic life support ambulance crews - young kids just out of college with a few weeks of training in CPR, but absolutely no experience in the extreme kind of trauma that we see at the racetrack.

"Sometimes, when I look at my records, the repertoire of cases and conditions is more bizarre than the most extraordinary fiction," he said. "I remember a day at Golden Gate when we had five riders down. One with a punctured lung, one with a fractured spine - literally a classic triage situation. That's a scenario that all racetracks have to plan for and be ready for, but unfortunately very few are."

If Seftel has anything to say about it, that will eventually change.