Misconceptions About Sports-Related Brain Injury
by admin on 21/04/10 at 10:20 am
I read with surprise a blog in the Harvard Crimson entitled, “Pigskin on the Brain” which commented on the NFL’s decision to donate $ 1million to brain injury research. The crux of the blog was that the responsibility for not resuming play too soon after suffering a closed head injury rests soley with the players, to wit:
What must take place, not just in football but across the sporting world, is for players to exercise personal responsibility over when and how long they compete. This should be the case for all injuries but especially in the case of head trauma. A team’s medical staff is critical to the diagnosis and treatment of injuries, but the player must know the risks involved and be able to make the tough decision of sitting out a big game or staying off of the field for the fourth quarter.
This statemen strikes me as rather naive. The author, Marcel Moran ’11, states that he is a “human evolutionary biology concentrator.” The problem with Mr. Moran’s statement is multifactorial. First, he assumes that the player’s concussion will be correctly diagnosed and communicated to him or her. Second, he assumes that the training staff on the team in question will understand and communicate to the player the proper treatment course for a mild traumatic brain injury. Finally, and most significantly, Mr. Moran’s premise seems to lack worldly wisdom. One wonders whether he ever played a contact sport and was subject to pressure from coaches and peers to “get back in there” following a concussion. One also wonders whether this Harvard student ever read the chilling accounts in a series of New York Times articles of New England Patriots’ linebacker, Ted Johnson’s pressure from his head coach, Bill Belicheck, to resume full contact practice following repeat concussions. Mr. Johnson succumbed to the pressure and now suffers from dementia-like post-concussive symptoms and severe depression. Putting the onous on all players to sit out of practice or a game ignores the reality that doing so may cost them their career. Also lost in this laissez faire approach to brain injury prevention is a realization that policies adopted by the NFL affect the policies of the NCAA, high school and youth football. Are ten year old youth football players to be expected to stand up to their coaches and refuse to re-enter a game or resume practice following a ding to the head?
Marcel Moran
Sep 11th, 2010
Dear Michael G. Phelan,
My name is Marcel Moran, and I am the writer of the Harvard Crimson article you addressed in your above blog post. I am currently a senior at Harvard College, and my concentration (Harvard’s term for a Major) is Human Evolutionary Biology. I am also a pre-medical student and have taken many courses that deal with the brain in health and disease. That Mr. Phelan characterized me as “naive” without knowing much about my background in science or athletics strikes me as odd. I would like to now respond to his critique of my article.
It is certainly true that diagnosing concussions and other forms of brain injury is not an easy process, especially for teams that have far less funding that Professional teams, but that statement really has little to do with my thesis. My point is not that we should be improving the medical care of brain injuries (I think there are few people who would disagree with that), but rather that the players themselves need to exercise personal responsibility for their bodies and brains during the course of a contact sports career. The NFL is clearly upgrading their mental health care for its players, now taking an MRI of all players after they are drafted to serve as a baseline, but I am calling upon those very players to educate themselves on the risks of the game they are going to play. I am asking them to consider that the average lifespan of an NFL player is 55, and that for the heaviest lineman, studies have shown they are even more likely to die before they are 50.
(http://sports.espn.go.com/nfl/news/story?id=2313476)
(http://www.cbsnews.com/video/watch/?id=5377319n&tag=api)
I would also like to address Mr. Phelan’s claim that I “lack worldly wisdom.” The troubles that Ted Johnson faced were sad ones, and as a native of New England, I remember learning of his entire saga while a member of the Patriots. It is true that in his situation, and countless others that there is pressure from the coaching staff to continue to play, but the pressure to do harmful things to ourselves is always present. If I am not mistaken, the large majority of the men in the NFL are legal adults, and college educated, more than fit in my mind to make decisions about their bodies and their health.
I completely agree with the notion that sitting out may cost them their career, and reflecting rationally on that decision seems like the better thing to do is to lose the millions, and keep your health. Mr. Phelan mentions also youth football and the decisions the children of those leagues have to make. In no way am I putting the onus on those kids to understand the mental health risks, but I do expect their parents to. I may “lack worldly wisdom” in Mr. Phelan’s mind, but I can probably make up for that in data, like the fact that when the late Cincinnati Bengal’s receiver’s brain scan showed that the damage in his brain was more similar to an 80-year-old’s brain for that then 26-year old. There’s also that the Center for Disease control has now categorized concussions in sports in America as an epidemic. Perhaps the most frightening study is the one conducted by the NFL itself, they did phone interviews with 1,000 retired players, and found that for those under the age of 50, they were 19 times more likely to be diagnosed with Alzheimer’s and dementia than the general public.
Ted Johnson in a Sixty Minutes interview about concussions in football said that he continued to play because, “I didn’t know any better.” With all of the information available today about this serious problem that should no longer be the case for any professional player, college player, or the guardians of a young athlete.
To finaly respond to Mr. Phelan’s idea that, “One wonders whether he ever played a contact sport and was subject to pressure from coaches” in fact that did happen to me. Throughout my youth I played Baseball, and was a pitcher from the time I was twelve until I was 18 years old. When I was a junior in high school and a pitcher for the Varsity team I began to suffer many arm and shoulder problems that required extensive and expensive physical therapy, and chronic pain. Rather than to continue to pitch following a full year of those problems, I ended my baseball career to protect my health.
Thank you for this space to respond to your blog post. I am happy to discuss this further with Mr. Phelan or anyone else, and I can be contacted at my email address: mmoran@fas.harvard.edu
Marcel Moran
Harvard College
Class of 2011
admin
Sep 11th, 2010
Mr. Moran:
Thank you for your thoughtful rebuttal. I appreciate your persistence and conviction, and agree with your data. I am the type of person who can be characterized as a hard-ass on issues of personal responsibility, so it is not without reflection that I disagree with some of your thesis. The public is so poorly educated about brain injury that it is hard to expect all parents of youth league athletes to appreciate the risks of concussion. Indeed, for years the NFL and much of the medical community were guilty of perpetuating the “misconceptions” about brain injury, and previous generations were taught that getting one’s bell rung was not a health risk. And, with respect to pro atheletes, I do believe one’s perspective changes with age. A person with a family to support may not have the luxury to tank his career to protect his health. Belicheck should not have put Ted Johnson in a position to make that tragic choice. Having said all of this, I do believe the good work by the folks at Boston University and the reporting by the New York Times have increased awareness to the point where NFL players are more likely to choose health over returning to the field following a concussion. The Chris Henry case has many of these athletes scared because there is no record of him being treated for a concussion. Thanks again.
Michael Phelan