Ding, ding, ding!

16 Nov

I recently read a story in the Globe and Mail, “Stampeders backpedal on concussion talk” about Calgary QB Drew Tate who was hit in a head-to-head collision in the 2nd quarter of play on Sunday, November 11. At halftime, Tate said that he had his “bell rung” and couldn’t remember the first half of play, generating this comment from Eric Francis of the Calgary Sun, “All the questions Monday will and should revolve around the apparent silliness of letting Tate play after his halftime admission to TSN.” (emphasis added) Not to worry though, according to Tate all that really happened is that he was “dinged” and “felt some fuzziness”, besides, as Tate says, “As far as talk about a concussion, I didn’t get what the fuss was because I felt fine and just wanted to play.” The Stampeders administered concussion tests during the game, after the game, and Monday morning. Tate was ruled to be symptom free.

It seems fairly clear that Tate was concussed. However, not according to Dave Dickenson, Calgary’s offensive coordinator and a former QB, whose diagnosis was that  he “can tell when I look into someone’s eyes if they are concussed or not,” and he didn’t see any symptoms. Nevertheless, Chris Nowinski knows a thing or two about concussions, concussion management, and the long term effects. Nowinski, of the Sports Legacy Institute and Boston University Center for the Study of Traumatic Encephalopathy and the man whose research and work really instigated the discourse on concussions in the NFL, disagreed and said that the best concussion diagnosis comes directly from the player. In this case, Tate himself said he was “dinged” (he also said he couldn’t remember the first half of play) and  Nowinski noted, “It doesn’t matter if he passed the sideline test. To put ‘dinged’ in the statement, you can be certain he had a concussion.”

The CFL ‘Concussion Card’ reads like it was written for kids being rough in the school yard, not grown men, colliding repeatedly with power and intent (to knock the other guy down), wearing, essentially, full body armor.

I like scientific, research based evidence, it makes sense to me, and when it comes to human health, it has proven to be extremely effective, and consistently reliable. I trust empirical evidence. Football (especially) has been one big scientific experiment, taking Newton’s laws of motion, notably 2 and 3, and applying them to bigger and bigger humans bodies. I’ve written several times about the apparent inevitability of concussions in contact sports such as football and hockey, and no matter how much the  ’protecting the brain’ mantra or concussion management policies are preached, the obviousness of concussions is never seen by everyone. Not everyone who’s hit in the head is knocked unconscious, but some are, and not everyone who’s been hit in a head-to-head collision on a football field or hockey rink has symptoms of a head injury, but many do. Nobody knows who those people are. Concussion tests are administered immediately and their results are taken as concrete evidence – even though many brain injury symptoms may not show up until much later. Of course athletes are going to say they feel ok! They want to play! Besides, the symptoms may not show up right away. Then again, is it fair if player x is forced to sit out even though they feel fine and don’t have any symptoms? Yes! Emphatically yes!  ’Fair’ is often applied to the lone athlete. Fair doesn’t have to be re-defined, it has to be understood. If player x is hit in the head, passes all the concussion tests, so is then ushered back in the game and has no further symptoms, then what about player y who also receives a blow to the head, passes his/her concussion test and is then ushered back into the game, is hit again and ends up with devastating symptoms of a brain injury, such that the rest of their life is severely affected. Is that fair to player y?

Players in these hard-hitting sports know what they’re getting themselves into. They may not appreciate the real dangers, but they know there are risks. They don’t want to sit out any time, ever. However, if they know that by sacrificing one game, or one week, will help ensure that more players can play for longer, and that life after the game won’t be fraught with trips to the doctor, then you’ll see a change in attitude.

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2 Responses to “Ding, ding, ding!”

  1. Joana Valek November 17, 2012 at 01:05 #

    “Concussion tests are administered immediately and their results are taken as concrete evidence – even though many brain injury symptoms may not show up until much later. Of course athletes are going to say they feel ok! They want to play! Besides, the symptoms may not show up right away. ”

    So true ! – IA woman fell on a ski slope onto here forehead – in a fairly hard (man made East Coast snow). She received a bandage from the First Aid at the ski area, and was asked if she felt she had a concussion. She asked “How would that feel ?” and was met with “You would know !”.

    She then went on to teach a demanding 90 minute ski class lifting little children over and over in order to send them down a short ski run. Parents of these children later said “The woman with a bandage on her forehead was just amazingly dynamic and energetic, and gave a great lesson to many kids that afternoon…”.

    Yet 30 minutes after the lesson ended – and her adrenaline wore off – that same woman was CONFUSED, her EYES unable to focus in order to find her car in fast falling snow in the parking lot – that was quickly getting dark…all doors and shops were locked already …and she felt scared and alone, without ability to think about the situation in her normal logical and resourceful manner. ..A man with a snow plow found her crying and wondering around …he helped her find her car driving her aroudn..Two hours later she was vomiting every 20 minutes in her hotel room…Next morning she could not realize that she could easily dial “0” for operator and get a cup of tea brought to her room.

    And her injury velocity was nowhere near to the average football blow ! – I know how it felt, because that woman was me.

    So thinking that someone looking normal right after the impact is very shallow state of professional knowledge applied to athletes when we now should know better.

    • Joana,

      1- The reported, insightful and descriptive brain injury experience of yours deserves a response.

      2- Your unfortunate initial injury event and the subsequent secondary effects experiences reveals and spotlights significant flaws in the erroneous and “rush to judgment” approach utilized to quickly ” screen for a concussion / brain injury”.

      3- Sideline ” tests ” (or perhaps illusionary screenings) are merely “smoke and mirror” illusionary activities…
      these so- called screenings are not designed to evaluate ALL possible brain injury symptoms…

      To me these screenings are equivalent to participating in a yearly physical exam….only having your knee
      evaluated…and conclusions being made about ALL aspects of your body’s health.

      4- The Suspected injured person should be closely medically followed by knowledgeable brain injury health care professionals.

      Furthermore, multiple disciplines are needed to fully evaluate the athlete’s health / injury status…due to the multiple array of possible adverse cognitive, physical and emotional effects of the brain injury.

      5- If any athlete / person is SUSPECTED of suffering a concussion then

      this individual should be requested to reduce taxing activities and to corresponding rest when possible.

      …BECAUSE the effects of a concussion / brain injury may not manifest itself for a period of days…

      and activities that overload the brain may cause further brain damage…

      6- Medical ethics / Hippocratic Oath (Corpus) emphasizes … “First, Do No Harm” …

      Returning an individual to “normal” play / employment / school:

      a) without close medical monitoring;

      b) without reducing brain taxing activities; and

      c) without correspondingly allowing time for secondary injuries of a concussion to manifest themselves..and be comprehensively evaluated by a multidisciplinary team

      … serve only as ” rush to judgment ” … and thus violates the concept of “First, Do No Harm”

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