When an offense approaches the line of scrimmage, defenses shift, blocking schemes change, the quarterback might call an entirely new play.
Those who can't adapt to last-minute changes usually don't fare well in football ... or in life. Alan Partin, a 6-foot-3, 240-pound offensive tackle at the University of Mississippi from 1979-1983 succeeded in both.
Partin played football, basketball and track at Grenada High School in Grenada, Mississippi and was the class valedictorian. At Ole Miss, he was an Academic All-American with a degree in chemistry and graduated at the top of his class.
Now a surgeon and chairman of the Department of Urology at Johns Hopkins Medical Institution in Baltimore, Maryland, the former offensive lineman credits football for training him to accept change and think fast on his feet - something that pays dividends in the operating room.
"You think you are running right, the defense changes and now you are going left,'' Partin said. "Everything can change in a split second and everyone has to change their plans very quickly. As a surgeon, you have to do that non-stop. No surgery is the same.''
Partin earned an M.D. and a Ph.D in Pharmacology and Molecular Sciences while at Hopkins. By the time he graduated from medical school in 1989, he had already published 50 manuscripts in peer-reviewed publications, written seven book chapters and was establishing a reputation as a leader in the field of prostate cancer.
He performs about 200 prostate surgeries a year, while conducting research on ways to predict the aggressiveness of prostate cancers, so doctors and patients can make better decisions about treatment.
Partin's department is routinely ranked among the top three Urology departments in the nation by U.S. News and World Report, along with the Cleveland Clinic and Mayo Clinic, in Rochester, Minnesota.
In 1993, he developed what became known as the "PartinTables,'' a computer model using mathematical formulas to help prostate cancer patients get an accurate prediction of their likelihood of being cured.
Instead of copyrighting the tables and cashing in, Partin made the information available to everyone. The tables, which are updated every three years, have allowed millions of men to make more informed decisions about their health.
No one has this level of success without being able to adapt to unexpected circumstances and make the right adjustments.
Partin says he plans each operation in great detail, but knows the procedure is almost certain to change in small ways once he makes that first incision.
"Everybody has anatomical variations,'' Partin said. "I remove men's prostates when they have cancer. There are literally 387 well-defined, distinct maneuvers to that operation. Then you get inside a patient and notice an artery that isn't supposed to be there is running across the area where you are operating. You have to change what you are doing. You have to adapt in the moment.''
Partin remembers one operation where the patient had poor circulation in his lower limbs and a previous surgeon had created a vascular graft - where a vein or piece of tubing reroutes blood from one part of the body to another - to improve blood flow.
The surgical notes said the graft ran down the patient's leg. Instead, it ran right through the middle of his abdomen and was in Partin's way during the operation.
Everything stopped. Partin looked over the patient, explained the necessary adjustments to his students and nurses, and began the operation.
"That's like coming up to the line and expecting to see one defense and they've shifted into another one,'' Partin said. "You still want to move the ball forward, so you have to think quickly, change up what you were doing and run the play.''
Surprises in life are inevitable. No big deal, Partin says. Football showed him that.
Don't panic. Just pause for a moment and think. Make your adjustments. Then go like Hell.