Concussion Talk

Benjamin Gray , 18, was a defenceman for the J.L. Ilsley Judges – a high school hockey team from West Pennant, Nova Scotia (about 20 km from Halifax). By grade 12, he had sustained three concussions from playing high school hockey and, after taking time away from school and after his rage boiled over one day in August, his family took him to a specialist who told him not to play contact sports again. “I never felt healthy. There was just to much anxiety, depression and definitely anger problems.” The full story, written by Monty Mosher, is here: ‘A ticking time bomb’ 

Benjamin, hoping to help others in similar situations, wrote a letter discussing his experiences. Unfortunately, it is a story to which too many can relate. I urge young athletes, parents, educators, coaches and league administrators to read this letter and know that it was written by someone who is only 18:

I started playing hockey when I was 6 years old. I was dedicated, motivated and passionate about this sport and I trained hard at being the best player I could be. I never imagined that I would one day be told by a neurosurgeon that I could never play hockey again. At the age of 18, I was diagnosed with Post-Concussion Syndrome as a result of three concussions I had sustained while playing high school hockey. To say that this news was devastating and that it has impacted my life would be an understatement. My story, as I am learning, is like that of so many others.

By the time I had my third concussion, I was not allowed to play hockey for 6 weeks. I knew the only way to get my family doctor to sign the permission slip to allow me back on the ice was to lie about my symptoms. A doctor’s diagnosis/prognosis is only as effective as the concussed person’s ability to verbally express their symptoms. Therefore, I was in control of my fate — not anyone else.

That decision would end up being an irrational one. The symptoms I was trying to hide were headaches, dizziness and extreme fits of rage. The pressure of not wanting to let myself and others down was overwhelming. My grades, my personality, my angry outbursts, mood swings, lack of focus, indecisiveness, depression, frustration and anxiety were all too much to manage. It finally got to the point where I could no longer hide my symptoms and on Aug. 20, 2012, my mom called 911. My condition was having a profound effect on the people who care about me.

My symptoms have been exacerbated not only by the diagnosis, but by the trauma of the news that I will never play the sport I love again. How do you heal? How do you move on? My path to wellness has included counselling, researching, diet (green tea to help with anxiety; food rich in anti-oxidants to help my brain heal), rest, patience, a new black lab puppy (a gift from my parents) and a new car (a new focus and sense of accomplishment for me).

I do not know what my future holds, let alone how each day will unfold, but I do know that my story may help shed some light on the constant array of emotions a concussed 18-year-old person feels. As my mother tries to relay to me, as rotten a deal as this has been, “it could be so much worse “ — I could be in a hospital bed. She says my life is meant to have a different purpose. I just have to try and figure out what that purpose may be. I have to make sure that this experience and diagnosis do not define me or my potential.

Benjamin B. B. Gray

West Pennant, N.S.

The media in Halifax have done a good job covering Benjamin Gray’s story.

Another letter from Halifax’s Chronicle Herald about Benjamin Gray and education about brain injury.

A news story (video) on Global News Halifax about Benjamin Gray.

While I didn’t intend to write a post about brain injury in sport, I was inspired to write it based on some events in the NHL playoffs.  Since it’s not my point to dissect the danger of the two hits, I won’t spend much time on them. In fact, I’ll just let share the links to the Gryba hit on Eller and the Abdelkader hit on Lydman. Seriously, whether I think either of those hits was clean or delivered with malicious intent is not, in any way, the basis or inspiration for this post. What is, is the idea that we – the North American contact sports-loving public – have all but abdicated our right to a free conscience. Whether either hitter was deserving of the suspension they have subsequently received, depends not on the hit they delivered, but on which team you cheer for (or against), or whether or not you like seeing big hits in hockey. It has nothing to do with what happened.

Some people don’t like where the NHL or NFL are heading; the frequency with which penalties are called when a player hits anywhere near an opposing player’s head. I don’t think that either of these two leagues, NHL and NFL, understand the concept of risk and reward. Hard hitting contact sports are so popular because they exhibit risk in a raw form. That’s probably why some/many of the athletes who make it to the highest levels get into the types of trouble they do. We watch news about multi-millionaire athletes who crash Porsches or who get arrested, and we may think “why would someone with so much to lose risk so much?” However, the athletes actually made logical (that doesn’t necessarily mean good) decisions. They do what all of us do before making most decisions. They, however briefly, look at their risk/reward histories plus their confidence (which is unvaryingly high), and make the relatively clear choice that they should take the risk. Their risk/reward histories include their risky decisions to go all in into their sport, play with injuries, among others, and their rewards include playing a sport professionally, their lifestyles, the money, among others. You sometimes hear people who aren’t professional athletes say that they wonder if they could’ve made it if they went all in. These pro athletes took the risk when it was presented. For every athlete who took a big risk and made it big, there are many, many more, who took the big risks and it didn’t work out and had bad consequences. If taking a big risk always meant good things happened, it wouldn’t be a ‘risk’ at all. Hindsight takes away risks, or puts risks in perspective, and it’s why people pay to watch pro athletes.

However, it’s also why the NHL and NFL are not perpetual money machines. These leagues, like their players, have a risk/reward ratio. Their reward has been to make millions, billions of dollars off the risk accepted by young men, who as we’ve seen, are predisposed to take it. Still, their is one major risk I haven’t mentioned; an brief career – for the athletes – or a brief existence – for contact sports leagues. It’s obvious why pro contact sports are played primarily by men in their 20s, and the leagues should take note. The athletes stop when their bodies can’t take any more strain, and when they can no longer convince themselves that the risk/reward ratio looks good. Likewise, these leagues will have to make similar decisions about the brand of sport they choose to exhibit. I’m not going to say that these leagues should just shut down now, but in act of decency to players and fans, how about they not pretend the sport they’re promoting is risk-free, good, clean fun? Both sports are brutal. That doesn’t mean they’re not fun to watch or that I don’t like watching them, but, instead of providing an excellent product/service in many markets, they’re providing a poorer product/service in too many markets. This product/service is poorer because it’s delivered by only the best. Not the elite. For sports with such high risks, the highest levels of player talent, strength, endurance and intelligent play should be pursued. Unfortunately, this won’t happen. There’s too much money to be made.

In the end, the only choice facing these two leagues is that of the type of sport they’ll show; a highly regulated game in which contact is not necessarily banned, but is discouraged, or a game in which careers are generally shorter, contact is celebrated and serious injuries are par for the course. Obviously, these games will attract different fan bases, and the second option comes with onerous legal and insurance costs. That’s why I think the leagues are headed to option one. In geometry, an asymptote of a curve is a line such that the distance between the curve and the line approaches zero, but never touches. Contact in he NHL and NFL are on that curve. Right now they’re relatively high on the curve, such that contact is nowhere near zero, but as time passes, injuries build and memories fade, I think contact will approach zero and these leagues will have to deal with the repercussions; a smaller fan base, reduced revenue, and ultimately, their sustainability. Or maybe, people will watch in the same numbers, with the same enthusiasm because the contact we see today and in recent years, will no longer be important or necessary to the fans and players.

Whether or not fans want to admit it, we’re seeing the beginning of that whole process now. The debate over the two hits mentioned above, or any other hits for that matter, is divided relatively strictly between supporters of the respective teams, and less by whether or not the hits broke NHL rules or a some moral standard about hitting, or the reality of wrong place, wrong time. It’s not the hit or the consequences to the player who was hit that really inspires debate or anger (on both sides). It’s the punishment – penalty and/or suspension – or lack thereof, and the effect that has on a team, that really fuels discussion.

Even the current focus on brain injuries everywhere in society hasn’t increased awareness and understanding of the issue to a sizeable majority of the public. If I hadn’t been brain injured, I don’t know how much I would know about it either. For the most part, brain injuries are viewed as either, a bodily injury like any another, or one that is rare and obvious. This lack of wide spread understanding is why hits causing brain injuries are so easily politicized by fans to advocate for ‘the rules’ or for  some moral high ground. For now, brain injuries are considered the simple price of playing contact sports and as such, are just another point to show the injustice done to ‘my team’ by some unfair interpretation of the rules. That’s how any debate about the seriousness of brain injuries ends, allowing fans on both sides to feel vindicated. Yet, no progress on the real issue is made.

To know anything about brain injury, fans, players and the general public must genuinely want to know. Otherwise, one of the most important issues that sports has ever faced is simply reduced to sound bites.

I wrote this post on Sunday, but since I didn’t post it right away, I was going to wait until the weekend or so. Then I saw that Chris Nowinski tweeted this, study by researchers at the University of Buffalo about the benefits of exercise for people who’ve had a concussion, and I thought I’d post now. I was constantly told that my recovery from a severe brain injury (even though, by no means am I back to the way I was pre-injury) was due to my pre- and post- injury fitness. This is an issue I am passionate about and it seemed obvious to me throughout my immediate rehabilitation and continuing recovery/life after my brain injury that exercise and fitness are extremely important. It hasn’t solved my problems or made them go away, but it’s incredibly beneficial and allows me to deal with the effects/issues confidently.

I should know better than to write those four title words when we’re hardly clear of winter. So, first I will apologize in advance to the people of St. John’s. For all intents and purposes, I’ve just guaranteed another dumping of snow. In fairness to me, the title sounds good and I’m looking at a beautiful sunset out my window, so I couldn’t help but write with a tauntingly cheery attitude. Nevertheless, sorry, my bad.

It’s Sunday and the wind was really kicking up a fuss this morning. I, however, stayed safely inside and, although it was sunny and marginally warmer than it has been in a while, I had no need or intention of going outside for very long. Plus, I was lazy today. That said, if I had to go outside for a while, the wind wouldn’t have been an issue. My balance has steadily improved (pun intended) since my brain injury and I’ve felt solid against the wind for some time, but ever since I’ve taken a keener interest in Pilates and working out with more of a concentration on my core, I’ve really felt confident and stronger on my legs.

I started doing Pilates a year ago and, appropriately enough, my instructor’s husband is a trainer who makes core strength a dominant part of his programs. I’ve always tried to keep in good shape, but since my brain injury almost 10 years ago, it’s been more difficult to actually ‘get to the gym’ or pool since I can’t drive, but walking,family, friends, and the odd taxi have made it happen for me. This way I’ve been able to stay active, get stronger, and, although it’s cliché, it’s made me feel better; about myself and about a lot else as well. Since my brain injury, swimming and working out have been important ways for me to keep some level of fitness, and now Pilates and my new workout regime have provided another challenge, which itself has obvious obstacles, but more importantly, the eventual and consequent results are clear and invaluable.

As you can probably tell, I’m keen on this. The reason I wanted to write about this is not an excuse to compliment myself, I’ve actually got at least three good reasons: 1) To thank and show my support to Sarah and Mike at Pony Locale on Lemarchant Road in St, John’s. Sarah’s the awesome Pilates instructor I mentioned, and Mike is the incredible trainer. Thanks! 2) The physically toughest things I’ve had to deal with since my brain injury have been my walking, balance, and efficient movement. Staying fit and challenging myself have been extremely important for me. From my experience living after a serious brain injury, keeping fit has been one of, if not the best thing I’ve been able to do. Not only does it help me meet physical challenges, it makes me feel good because it allows me to enjoy the other great parts of life. And 3) My mom suggested I write about it. The first two reasons were good, but 3) sealed it.

In the end, what I’m saying is, check out Pony Locale. Being brain injured is tough and it’s more of a challenge for some, it’s relative. Don’t base your perception of how hard you’ve worked on someone else. What does that matter? It’s not easy, but doing nothing is even harder.

The thing about expectations is that they presume a certain course of events. In July 2003, I assumed that I would start my co-op job in Ottawa in September and I based my expectations for the coming years on that presumption – my previous post, Finding yourself after a brain injury. First step: Recon. Brain injuries themselves are unexpected, so you don’t know what presumptions to make that will allow you to generate expectations. You’re already starting off on the wrong foot. It’s not so much the issue of living up to, not meeting, or exceeding expectations, it’s more about the expectations themselves that I will write about.

After considering a patient’s health/medical history, age, other essential factors and the severity of most injuries, conditions, or diseases, doctors can only base their ultimate prognosis on probabilities. This is where expectations begin to go awry. Not to get into statistics or anything, but if the probability of surviving a coma of a certain length and severity is low, it’s because it hasn’t happened very much, therefore there will be few cases upon which to build expectations. The fewer cases, the fewer reliable prognoses can be made, hence few, if any expectations.

Those are for others to make. The most important expectations are the ones you make for yourself. I had been making those ever since I can remember. When I was a kid and used to catch insects, I had a book that told me all about them, where they lived, what they ate, and I would set my expectations on catching an exotic scorpion or centipede that only lived in the tropics. To me though, there was always a chance that I’d find one here, on a rock in the north Atlantic. Then, I started a new hobby, tree climbing. Those expectations were limited by the tree height and when they became easily attainable I started dreaming about becoming an astronaut. I read a lot of books about being an astronaut and I was  always looking for more. After one of the first books I read, I found out that to actually fly a shuttle, you had to have been a pilot in the U.S . military. So, that wasn’t happening. Nevertheless, I wanted to read more about becoming an astronaut.

That was a dream more than an expectation, but I’ve never been good at discerning dreams from expectations. I think that’s because I’m too literal and I like being right. What I expect to happen is usually fairly boring and doesn’t show much faith in other people (family and friends excluded). Too often I try to match the answer of ‘what will happen?’ to ‘what do you expect to happen?’ It was probably this same attitude that has allowed me to be successful in my rehabilitation and recovery, but it is also this attitude that gets me angry or frustrated. Anyway, the sort of path my expectations follow is not necessarily on the route to reality.

As of August 1, 2003, the way I made expectations changed. Through stubbornness or ignorance, I simply expected that I would get back to my pre-brain injury level of energy and physicality. Honestly, I was confused with any congratulations I received during my rehab.  I was comparing my new physical self to my old physical self, as though time would stand still while I recovered and rehabilitated. I was really annoyed by the patronizing way people would give me encouragements. Like before, my expectations were made and a plan was developed to get me there. Now, however, I didn’t make my plan, or necessarily know what the plan was. Nor were my expectations the same or even in the same area. At first, of course, my expectations and plans were centred around my physical rehabilitation. Once I had accepted how long and difficult it would be, I realized that I could control that part of my recovery. Then, my mind went to other expectations, long term expectations. Obviously, those were tougher to control and, like many of my erstwhile expectations, very malleable. Malleable to the point that I realized expectations have their place. In rehab and recovery they were goals and good motivation, they gave a structure to that experience that made it feel more like training/practice than something annoying or disheartening.

Maybe it’s my overly literal self writing again, but I think ‘making an expectation for yourself’ and ‘expecting something of yourself’ are two different scenarios. I expect a lot from myself, but I am getting away from really making expectations. I don’t know if that clears it up or not? I make it sound like an inner search in which I am examining my soul, while in reality, my family and friends are the ones who gave me such incredible support that all I needed to do was focus and work hard.

As has been said countless times in countless articles about brain injury, “every brain injury is different”. I don’t know and don’t care to know how many times I’ve heard or read it. That phrase is used primarily for the benefit of the general public to explain or define a lasting injury about which little is known. Although geared towards people who have – seemingly – little or no experience with brain injury, the statement should alsos be understood as fully as possible by those of use who have such experience.

In 2003, until making a hard and fast right turn on my bike on a hill in Victoria, BC, I had every intention of completing my upcoming 8 month MPA work term with the Auditor General in Ottawa, and while there, continuing to ride my bike and join a local water polo club. When I finished my MPA I would work somewhere for a few years, then, hopefully, pursue a PhD.  The next morning, all that changed. Two weeks later, when I woke from my coma, I was a different person. Not completely different – I was lucky – but different enough that I had to change my plans for my future.

My focus wouldn’t be on finding an apartment in Ottawa or impressing my boss at my work term. It wouldn’t be on finding a good cycling route or finding a water polo club to join. It would be on rehab: learning to walk, learning how to deal with the many daily challenges, including my speech. So, instead of working, hanging out at bars or parties with others my age, playing water polo, and cycling, all those options were off the table. I had to figure out who I was and how my brain injury effected me. I don’t want to understate how lucky I consider myself, especially after meeting others whose brain injury has been truly devastating.

I couldn’t evaluate my progress in rehab against some reliable standard, because there is no standard that encapsulates the way each brain injury effects each different person – there was the Berg, but that was a balance standard, not a brain injury standard. Nor could I make self evaluations based on what somebody else did, because “every brain injury is different”. Self evaluation was based not on “how badly you want it” (that phrase really bugs me because it discredits the agonizingly hard work that people put into their recovery, but, for whatever chance reason, don’t see results), for me, it had to be based on if I was happy with myself – not my progress – everyday. Being fit and physically active before my brain injury has undoubtedly been advantageous since, as it helped my immediate recovery go more smoothly and kept many frustrations at bay.  It was therefore difficult not to measure my happiness based on my physical progress.

However, as I noted above, I was a different person. I didn’t have to like where I was physically, but I had to accept some realities or risk never being happy. I worked hard immediately after my injury and I continue to and I’ll be damned if I’m not going to enjoy some happiness for all that. Otherwise, what’s the point? One of the hardest parts is accepting – in the most superficial definition of the word – the new reality. It’s important to have dreams and goals, just know that there’s more than one way to reach them. While “every brain injury is different”, I think it’s safe to say that TBIs (traumatic brain injuries) change lives. Knowing where you are after a brain injury is essential. From there you can pick the best way to go after your dreams and goals. Don’t be convinced that there’s only one route.

It’s cold, it’s wet, it’s small and claustrophobic, it’s isolated, and it’s home. I love it. The climate is terrible – last summer notwithstanding. It’s ridiculously windy. It could’ve been the wind that’s lifted us toward the wing-melting economic sun. Could’ve, but isn’t. It’s the oil.

My hometown and my current city is St. John’s, the largest city in, and the capital of, Newfoundland and Labrador, Canada. The island of Newfoundland sticks out into the North Atlantic, seemingly begging to be battered; by the ocean currents and the Gulf Stream, by wind, and by economic whims. This place has seen its share of economic tumult – truth be told, this is the umpteenth edition of this post as I tried introducing a bit of economic history, but I finally decided that that opened a whole new can of worms; so many interpretations, so many ways to get off course. So, I abandoned it. In fact, this post will mostly be about forcing ideals to fit into a predefined system. It sounds very complicated, like some academic pursuit, but I just couldn’t decide on a better way to say it. I hope that didn’t deter many people from reading this.

When I was growing up in the 80s and 90s, there was far less money in St. John’s. The oil boom hadn’t hit yet and, in fact, in the 90s, a moratorium was placed on cod, the biggest fish catch for the city and province. ‘Fish’ in St. John’s, meant ‘cod’. When that fishery was closed down, the province’s population was at its peak of about 580,000, over 30,000 of whom lost their jobs. People had to leave to find work. Then, in the late 1990s/early 2000s, oil production ramped up, more wells were discovered, vast mineral deposits were found and by the mid 2000s, money came into this province like never before. The money, however, doen’t change the fact that Newfoundland and Labrador (the island is Newfoundland. The bigger, northern and western, land portion is Labrador) hasn’t moved. It is where it is and all the money in the world is not going to change that. We’re still at the eastern edge of an enormous country and continent. There’s a small population. However ‘connected’ we think we are, there’s still geography to contend with. The rest of North America is not ‘right there’ – unless you take that to mean, ‘on your computer or phone’. I went to university in Ontario and 4 of my former roommates and best friends live near Toronto, I don’t have the option of going to hang out whenever I feel like it. It’s not a matter of hoping in a car for a couple hours. I need to pay for a flight, a three and half hour flight, on an airline’s schedule. That’s life. We see each other when we can, but it is, and has always been, 2000 kilometres away.

There have been notable changes in this city in recent years. There are more flights. There are more stores. The tourism industry has really improved. There are more jobs. St. John’s, especially, is attracting more, and different businesses. One thing that hasn’t changed is that people need to live here. Money’s spent and taxes are lowered to encourage more ‘development’, but keeping this city accessible year-round doesn’t appear to have caught on as part of ‘development’. In January and February, it snows here. In March and April, it snows and slowly clears. In January and February (a little bit in December too), the snow makes the roads narrower, and makes the sidewalks non-existent. In fairness, there are sidewalks around schools and around some businesses, but if you want to, or have to walk from your house to anywhere, you’re walking on the narrow, often slippery streets with the cars. That’s the situation I find myself in, I don’t drive (due to my brain injury), but I do walk and I love walking around this town. It’s also my main/preferred mode of transport. When there are places to walk. Unfortunately, I have to take a cab, or a bus that goes primarily to the mall, for a third of the year.

I love this place, and not because it has box stores or because new, big companies have come. Every city has a couple of landmarks that are unique. I’m lucky enough to have grown up, and now live in a city that has, as its landmark, it’s geography which has permeated into a culture and attitude that make this place so special to me. I hope we’re not losing it. I hope this city doesn’t get the idea that this oil money is going to carry us through for eternity. It’s not. For the another 20 or so years, maybe, but let’s not get carried away. This is not the fault of oil or even the money that came with it. It’s about everyone who lives here. What’s forgotten in our pursuit of some imaginary utopia full of endless choice and perpetual opportunity, is that we elect a government to run the city/province/country for us, so not everyone has clean the streets, run the port, manage the sewer system and do all of the other stuff that allows a bunch of people to live in a small area. That’s where the idea of government came from. That’s the reason for it to exist. We elect people and parties, not because they bring tangible objects with them, but because we like their organization of priorities.

The priorities of this town have shifted and they’ll shift again to something else that some people won’t like and some people will. That’s how government works. Governments don’t have endless supplies of money, especially now. They (those people running government) also don’t get to keep the money they don’t spend. It goes to other priorities. Therefore, government can’t keep on encouraging further developments/expansions/attracting business by giving tax breaks or by providing other economic incentives, without cutting back in other areas. Or, they could try raising taxes, but it’s much easier to complain about government services than to help pay to make them better.

No matter the new money coming into this city now, it won’t last forever. I gave a very brief synopsis of the very recent economic times of this city, to try to bring to mind the economic cycle. There are ups, that we try to make last as long as possible, and there are downs, that we tell ourselves are only momentary. What makes this city great is that people live here. Why should it be that for a city in 2013, with a relatively new source of additional income, it’s residents are denied the freedom to go places without a car? Snow is not a new development in St. John’s. It’s always snowed here. It’s not a shock. Nor is the abrogation of responsibility of City Hall to do anything about it.

This is not a plea to City Hall to clear sidewalks, this is a reminder that a city should be accessible to its residents, for the whole year.

Continuing with my analogy from my last post, “Brain injuries and pro contact sports: Bubble times” , in which I compared the concussion issue in pro sports with the financial crisis, I thought I’d try to complete the comparison without, hopefully, forecasting the end of contact sports, notably the NFL and football in general.

In my previous post I said that fans, teams, and leagues play the same role in the concussion issue as the banks/financial institutions did in the recent financial crisis; interested only in their short term benefit, making them unintentionally complicit in the looming collapse. Players are like the borrowers; they want to play the sport they love and make lots of money doing it. Consequences be damned. Just like people wanted to buy houses and a bunch of other stuff, not thinking, wishing away the potentially negative long term consequences. It’s about the looming collapse that I will write.

Since my last post, I have listened to Malcolm Gladwell talk about the undesirable, yet inevitable decline of football. Then I read an article on the Oxford University Press blog ‘Why football cannot last’ discussing Chronic Traumatic Encephalopathy (CTE) – a neurological disorder resulting from repetitive blows to the head. It got me thinking about the optimism shown at the end of my last post – had I not considered the situation fully? Was it simply wishful thinking?

Gladwell makes a convincing case for the demise of football (NFL) as we know it. He’s a big football fan, and he’s not encouraged  by his conclusions, but he thinks that in the not-too-distant future the NFL and football is likely to go the way of sports like boxing today – still watched by many fans, still lots of money, but not in the mainstream as it once was. When reading about boxing, you’ll read one article using words like “pure” and “artful”, while the next will use words like “undignified” and “barbaric”. This seems to be the way reporting on football is going. How long can the money keep the NFL (and CFL for that matter) prominent?

I live in a city, a province, even a timezone, without a pro football team. Without high school teams. Without any sanctioned contact football leagues. Still, from September to February, every Sunday friends and I sit in front of my TV with food, with beer, watching every game and every snap. It’s a lot of fun. Side note: My favourite team is the San Francisco 49ers. You cannot live in North America and live farther away from your favourite team (unless you root for the Chargers).

When I watch games, I see the receivers make incredible, sideline, toe-tapping catches, running backs perform amazing cuts and spin moves, and quarterbacks throw passes at finger-breaking speed just before being tackled by a big, powerful, yet somehow graceful, 250 lb  linebacker. It’s a spectacle to be sure, and I love watching all of it. Problem is, it’s not sustainable. We don’t know how many hits are too many. We don’t know how big a hit is too big. We don’t know a lot. The big hits are the worst obviously. Right? Maybe not. The offensive and defensive linemen are big, and not 6’1″, 225 lb big either. More like 6’4″, 300 lb. Large men. They run into each other, receiving sub-concussive hits on almost every play. These hits aren’t big enough to knock anybody out, but their frequency is enough to cause major disruptions in brain functioning.

There are millions of football fans, it’s the sport in many Canadian and American cities, and there are billions of dollars in TV contracts to support it, so it’s got to go on forever. Not if no one’s playing it doesn’t. We know much more about the effects concussive and sub-concussive hits have on long-term brain functioning now than ever before. That said, we know very little. We know enough to say that knocking your brain around your skull isn’t good, that it will do damage, but not enough to say who is most likely to be effected, or how many hits a player can take.

There is mounting evidence of the effects playing football and taking all those hits has on mental health, and it’s not good. To choose only the famous players and well-documented cases as examples has been done and those extreme cases gloss over the more common, but still debilitating brain injuries that many former players deal with everyday. When these brain injuries were first truly noticed, the question was, at what age should children begin contact football? Now it’s, should we introduce contact at all? 

Back to my analogy: The financial crisis began as interest rates went up and borrowers (players borrowing from their future) began defaulting on their mortgages (loans from banks, i.e. fans, teams, leagues) – granted, there were more financial shenanigans going on that made it more of a mess than it needed to be. The interest rate is simply the cost of borrowing. As players realize the devastatingly high cost of borrowing from their future they will; demand more money up front, seek a lower interest rate (i.e. less contact), or not borrow at all (i.e. not play contact). None of these are conducive to hard hitting football.

In the last paragraph of my last post I wrote, I think there’s hope, then I wrote, If attitudes can change quickly in a large society in which rules, regulations and ‘socially acceptable norms’ are more difficult to enforce, then surely attitudes towards brain injury in pro sports – a smaller society in which rules and regulations can be relatively easily enforced – can quickly adapt. While I think/hope this is true, after reading, listening and thinking about it more, I believe that the attitude that needs to change is our attitude toward contact. Fortunately, though there will be a lot of kicking and screaming from fans, players, media as changes are gradually applied, the general attitude shift should occur gradually. If leagues like the NFL and CFL are to last, it will depend on the innovative ways in which they foster and accept the new reality. I agree with Anthony Scioli, author of ‘Why football cannot last’ that pro football as we know it is coming to an eventual end. How long it will take to reach this end depends on how quickly, or if, fans accept it.

King-Devick Test, a Rapid Sideline Screening Test, Accurately Identifies Unrecognized and Unreported Concussions in Minutes

Concussion detection increases ten-fold compared to

previously reported concussion injury rates in rugby league

CHICAGO, February 1, 2013 – A rapid sideline screening test was able to accurately identify athletes who had not shown, or reported, any signs or symptoms of concussion but who had meaningful head injury, according to researchers from the Sports Performance Research Institute in New Zealand.  The King-Devick Test detected 17 unrecognized and unreported concussive incidents and 5 witnessed concussions in an amateur rugby union team’s full competitive season.  The study appears online now in the Journal of the Neurological Sciences.

In addition to witnessed concussions where play was stopped, researchers noted the number of un-witnessed and un-reported concussions – a ratio of 3.4 concussions identified by the King-Devick Test for every witnessed concussion.  The current rate is a ten-fold increase in the previously reported concussion injury rate.

“As a direct result of the findings using the King-Devick Test, the club has implemented a wider concussion awareness program to assist in identification and management of concussion for the upcoming season,” said Doug King, PhD (in no way related to the King-Devick Test) and senior author on the paper.

This study found the King-Devick Test to be a practical sideline concussion “remove from play” screening tool and useful in identifying players that had a concussive incident providing instant feedback to the player and team management on the sidelines in minutes.  The test has the potential to be utilized with all contact and collision sports by coaches, team managers, athletic trainers or even parents.   Other sideline tests were evaluated and the King-Devick Test was found to be a superior method due to the rapid assessment of concussed players in a limited time frame.

In addition, this study provides further evidence supporting previously published peer reviewed studies which confirmed the King-Devick Test as an objective, accurate “remove from play” sideline concussion screening test. And as in previous studies, the effects of fatigue were tested by all members of the premier rugby team related to their performance on the King-Devick Test and fatigue was determined to not be a factor.

The King-Devick Test is an objective two-minute test that involves an athlete reading single digit numbers on three test cards or an iPad and captures impairments of eye movement, attention, language and other symptoms of impaired brain function.  The test is scored based on speed and accuracy and athletes who experience head trauma have an increase (worsening) in the time needed to complete the test compared to the athlete’s baseline time. In this study, concussed athletes scored an average of 4.5 seconds slower (worse) compared to their best baseline score.

About King-Devick Test
The King-Devick Test (K-D Test) was developed more than 25 years ago and has been used worldwide as a proven indicator of saccadic eye movements as they relates to reading ability and dyslexia.  The test is an objective physical test based on the measurement of the speed and accuracy of Rapid Number Naming.  It involves reading aloud a series of single digit numbers from left to right on three test cards.  Subjects are asked to read the numbers on each test card from left to right as quickly as possible without making any errors.  The sum of the three test card times constitutes the summary score for the entire test.  The test can be administered in two minutes or less.

Other recent publications in Neurology and the Journal of the Neurological Sciences, have called the King-Devick Test an “accurate and reliable method for identifying athletes with head trauma.”  In the Fall 2012, the Dave Duerson Foundation donated King-Devick concussion screening kits to all Chicago Public Schools’ high school football programs.

More information can be found at: www.kingdevicktest.com

As much as I can, I read about and watch professional contact sports. I also read, and have read, a lot about the financial crisis; more specifically, what led to it. Naturally, since I was brain injured in 2003, I have become very interested in brain injury. Hence this blog.  I have also taken a bigger picture view of almost everything and, influenced by many books I’ve read, notably Collapse by Jared Diamond, I’ve been noticing similarities between different situations and events in society. Not connections or links. Similarities in our perception. They make sense to me – that’s why I thought of them. They’re not perfect or identical, they’re similar, the theme is the same. I see the same prevailing theme in the lead up to the financial crisis as we have seen in the current concussion/brain injury issue in professional contact sports.

For the purposes of this post, I’ve picked two themes that I think run through both situations; “arrogance” and “wishful thinking”. It was arrogance on the part of banks who thought they could make the market do what they want, creating financial instruments (and fitting mortgages into these securitized instruments)  that would generate big short term profits, ignoring the long term consequences. The bankers had to sell/lend these instruments/mortgages to someone. Whether the buyers/borrowers were deceived or not is not what this post is about. The buyers/borrowers of these financial instruments ended up losing a lot.

The banks are like the teams, leagues and the fans. For teams and leagues, they give players contracts to play, and the teams and leagues reap short term profits from tv contracts, merchandise, and ticket sales, arrogantly assuming that they can benefit from watching players play very physical sports, delivering big hits, never considering what toll this would have on the longevity of the players or the league itself.  Fans give the leagues and teams money so they can be entertained and watch their favourite players play (whether by buying tickets or watching it on tv). Basically, the lenders. Players are the buyers/borrowers. They want to play the sport they love and make lots of money doing it. Consequences be damned. Just like people wanted to buy houses and a bunch of other stuff, not thinking, wishing away the potentially negative long term consequences.

I told you it wasn’t perfect, but I think it fits with the general attitude of society. Just as there was a massive housing market bubble in the U.S, pre-financial crisis, there is a bubble in pro contact sports where players hit as hard and as often as they can, thinking only of the short term benefits, while ignoring the long term and recurring consequences. As many borrowed beyond their means from banks, many players are borrowing from the future, from their long term health. Since retirement in pro sports comes at such a young age, their long term health means most of their life. Fans, leagues, and teams are all eager to pay to watch players make these big hits. Insurance companies were also part of the financial crisis, and I think they could be one of the deciding factors of the longevity of professional contact sports. Recently, Bernard Pollard, safety for the Baltimore Ravens and one of the hardest hitters in the NFL, said that the NFL wouldn’t exist in 30 years because fans will become fed up with the new rules protecting players against hard hits. There have been comments from former players that they wouldn’t let their sons play, and U.S. President Obama that, if he had a son, he wouldn’t let him play. Although arguing different points, Pollard, some of those former players, and Obama all support the argument that the NFL will have difficulty recruiting  - players or fans – due to lack of interest. What about insurance? It would seem logical that insurance would become prohibitively expensive if brain injuries continue to sideline athletes.

In the financial crises, interest rates shot up, leading people to default on their mortgages, the snowball effect then led to the collapse of several financial institutions in the U.S. Why won’t that happen to pro contact sports? Won’t the insurance  premiums go way up, leading to teams not willing or able to spend on players, snowballing across the league?

This is one of those big picture views, but it’s by no means an endorsement of the conclusion. How sad would it be if people stopped playing amazing team sports due to financial issues? I think there’s hope. I saw Bob Costas on The Daily Show, and Jon Stewart and he were talking about the “gun culture” in the U.S. Costas was talking about how society’s attitudes toward many issues have changed, for example, how quickly society’s views on smoking have changed recently. If attitudes can change quickly in a large society in which rules, regulations and ‘socially acceptable norms’ are more difficult to enforce, then surely attitudes towards brain injury in pro sports – a smaller society in which rules and regulations can be relatively easily enforced – can quickly adapt.

Go Niners!

This post is not about brain injury, but I wanted to write it anyway.   

When Oprah asked Lance Armstrong what he thought the moral of his story was, he began by talking about “the ride”; getting caught up in it all and, of course, the betrayal of lying so fiercely about everything. Interesting. That wasn’t just Lance, it was the entire public/media. There are people that he has hurt personally by his bullying and lying and I don’t know what it would take for them to forgive him, but certainly getting forgiveness from the media will take nothing more than time. News media (North American  news media) is upset now because they messed up! They didn’t do their job. They were caught up in the hype like everyone else, but their job is not to get caught in the hype. So much so that they attacked their own in the French press who were suspicious from the beginning. The media hype certainly was a good thing when it raised Armstrong’s profile and helped to raise millions for cancer awareness and research. Now, their contempt is hypocritical. Their ‘disgust’ is how they’re avoiding criticism for their abdication of responsibility.

What do you think of Lance Armstrong’s answers in his interview? Genuine, fake, or just the beginning? What do you think Lance should do now? Crusade against doping in sport, or try to repair his relationships with former friends and fans? Who won the 2012 Tour de France? Exactly.

Obviously, some people will know the answer to the last question, but by no means everyone. It should be easy, because he also won the cycling time trial in the Olympics. I’m not trying to make a point about how most people don’t follow or know anything about cycling, and, as far as Livestrong goes, I’d like to think that I’m not making an argument for ends justifying the means – but in this case I can’t help but think they do. If all Lance Armstrong did was win bike races that hardly anyone in North America paid attention to, this wouldn’t be much of story. He is so famous because he did all of that after having cancer and because he raised so much money for cancer awareness and research, but now it’s the doping in the erstwhile ignored races that has everyone up in arms.

For me, rooting for Lance was a bit of fun, but in all honesty, he wasn’t my favourite cyclist. Everyone just assumed he was because most people don’t follow cycling, they’d heard his name and knew he was good. And that was ok. Instead of telling everyone that I wanted Ivan Basso or Alexandr Vinokourov to win (both later suspended for blood doping), I just let people think I was a big Armstrong fan. It wasn’t that important. It’s not that I didn’t like him, I just wanted someone else to win. However, since he retired, I found myself becoming a somewhat cynical supporter of Lance Armstrong. I thought it was likely that he did take drugs, but, I wasn’t ready to say ‘he was defintely using drugs’, because I didn’t know. It’s more fun to pretend whoever you’re cheering for is the greatest person who ever lived, but that’s only fun because you know that it’s not true, or at least that’s not why you’re cheering for them. Maybe he/she is a genuinely good person, that’s not the point. The point is to have a rooting interest, but not to confuse that with idolization.

This righteous indignation with which the news media is treating this whole confession situation is blatantly hypocritical, showing a severe lack of self awareness. They (the news media) couldn’t wait to jump on the Lance Armstrong bandwagon/gravy train and, forgetting their role, became huge, obnoxious fans. Now the bandwagon has broken down and the media is all too eager to jump off and yell at the driver about how bad the ride was.

I know I see this situation differently than most people. People who are fierce competitors, like professional athletes, are still people. They ain’t perfect. The real situation, as I see it, is that the media and the public tried to make him into something he wasn’t. Above all else, he was a competitor. He wanted to win. He was narcissistic and arrogant. That was known before any of this. If those are traits that are so wrong and you don’t like them, then you weren’t a fan of Lance Armstrong to begin with, you just liked that he won. As critical as I am of the media, they too are just a group of people who reflect the public.

Anybody who knows Armstrong and was personally lied to and hurt is probably looking for an apology. For the rest of us, Lance Armstrong was a cyclist who ‘conned’ millions of people and a bunch of corporations into donating to cancer awareness. What a jerk! Believe it or not, worse lies have been told, by people in much greater positions of trust, and to a public who had a greater role in their ascension to the position.