• “….Meetest for death, the weakest kind of fruit / Drops earliest to the ground, and so let me…”

    - William Shakespeare, The Merchant of Venice

Posted: August 30th, 2013

Twenty-two year old Derek Sheely of Germantown, Maryland died in August 2011.  He was a Frostburg State University football player.  He died after suffering a second concussion in practice, returning to the field despite bleeding from his forehead during four consecutive practice sessions according to the Washington Post.  In a wrongful death lawsuit, it is contended that he was never checked for a concussion, nor even to see if his helmet was fitted properly.  His teammates have publicly described the drills and practices leading up to the injury as “completely out of control” and “gladiatorial” high speed hitting drills where players were urged to hit each other head-on at full speed.  The lawsuit further alleges that the coaches treated all injuries the same, whether brain or ankle, you were simply expected to play through the pain. 

The point of these types of drills, to these types of coaches, is of course to “cull out” the weak and identify the strongest.  This type of coaching mentality used to be the predominant one in football.  In his early days of coaching in Texas, Hall of Fame coach “Bear” Bryant used to allow his recruits only one water break per day in their hundred degree plus heat because he thought it made them “tougher” and because it identified those who weren’t “tough” enough.  Of course today this type of behavior would be criminally negligent and football programs like Alabama have hydration policies and understand how important it is to keeping players healthy both on and off the field.  There is no excuse for a coach at any level to plead ignorance about hydration today.  Likewise, there can be no excuse for pleading ignorance today about brain trauma.

In his brilliant book on cancer, The Emperor of All Maladies, Dr. Siddhartha Mukherjee quotes an open letter from the Tobacco Industry to the American Public, published nationally in 1956.  The link between lung cancer (and others) and smoking was beginning to gain scientific credibility and the tobacco barons meant to clip this new threat in the bud.  In addition to castigating the “controversial” studies asserting this link, the Industry proclaimed that they were going to fund research themselves, and lots of it.  The brilliance of this ploy was not just the doubt they created about existing research, but the very image that somehow this research was still in its infancy and that therefore nothing was really known yet. 

I believe we were at a similar point in the story on brain trauma.  The football industry had taken a page out of the tobacco industry’s playbook.  The NFL had done exactly the same thing, questioning the newly discovered links as early-stage research and emphasizing all of the “still” unknowns; they then pledged over a hundred million dollars (over ten years) to various “long-term” research efforts; all creating an impression that we really didn’t know anything about this area yet.

True, doctors in 1956 didn’t know what “caused” cells to grow wild in patients’ lungs; they didn’t know what “caused” cancer in a scientific sense.  But they KNEW that the longer you smoked the more likely you were to get lung cancer.  They KNEW that the more you smoked the more likely you were to get lung cancer.  Whatever was happening at the molecular level, smoking was in fact a significant cause.  Today we KNOW that getting hit in the head is bad for you.  We KNOW that the more you get hit in the head, the worse it is; and we KNOW that the harder you get hit in the head, the worse it is.  We also KNOW that it takes a progressively longer time for the brain to recover from recurrent injuries; and that two identical “hits” temporally close together, or separated by (say) a week, can have vastly different impacts.  To simply harp on what we don’t know about the science of brain trauma is to ignore the significant causal effect of trauma.

On a recent NFL pre game show a panel of ex-pros, to a man, stated that they would rather be recovering from a concussion than a knee injury.  These are hyper competitive types, and the fame and money and simply love of the game will always push them to challenge the limits.

The NFL has now settled its lawsuit with over 4,000 plaintiffs alleging various harm from various traumatic brain injuries. Hopefully, this means we will not have to slog through a decade of constant attacks on the science of brain trauma, and that progress in diagnosis and treatment will come faster than it otherwise would have.  Hopefully this acknowledgement of the real danger will trickle down to all levels of the sport and we will be wiser and more prudent with practices and techniques; and more vigilant in catching problems.  But the “warrior” mentality of football will not change.  It is sad to say that only fear of attorneys and liability has begun to change this at the coaching level; I do not know what it will take to change the “risk/benefit” calculation at the player level.  But this is a start, and hopefully we will see no more Derek Sheely tragedies.

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