Sailing the Seas of Cheese: Walk Your Talk When It Comes to Concussions
“Our office reviewed it with the [Bears] medical staff and it was properly handled. The team followed the correct protocol.”
—Greg Aiello, NFL spokesman.
Or so the NFL says…While this past week was devastating for quarterbacks, I am thankful the Packers were not once again visited by the concussion fairy. (Thank you Bye Week!) Unfortunately I cannot say the same for the rest of the league. QB concussions sprung up on Sunday like an epidemic. First Alex Smith and Mike Vick dropped like flies. Later in the evening, the braintrusts of Michaels and Collinsworth were to obsessed whether or not Cutler tried to pull off a Don Majkowski for a completed pass that they were completely oblivious to the fact that he had been snot bubbled in a punishing hit that obviously scrambled his brain a bit.
Yet it took until halftime–seven plays later–before Cutler either pulled himself or was pulled by the medical team. It was pretty obvious that Cutler was an impaired player at that time. Even above-mentioned braintrusts commented that he wasn’t himself during that period. They even joked about how he would benefit from the official timeout to review the play to shake that mental fog away.
A lot could’ve happened in that time from when Cutler was nailed to when he headed to the locker room. The staff could’ve realized what everyone at home did and pull him immediately. He could’ve taken another nasty hit that resulted in a blown knee or broken leg because his reaction time was decreased from the concussion. He could have taken another blow to the head.
Instead apathy or the desire to win at all costs or sheer clueless won out. Let me say this again: it took seven more plays–actually the end of the half–before Jay Cutler either took himself (or the staff did it for him) out of the game.
For all of the lip service the NFL gives to concussion and player safety, it sure as heck isn’t admitting that anything wrong happened in the Sunday Night game. Situation was “handled properly” as Greg Aiello stated above. But what the NFL adds to that comment only reinforces how out of touch its own empty policy is regarding head injuries in its league:
A critical element of managing concussions is candid reporting by players of their symptoms following an injury. Accordingly, players are to be encouraged to be candid with team medical staffs and fully disclose any signs or symptoms that may be associated with a concussion .
In other words, the NFL is still relying primarily on a player self-reporting a head injury to get its own safety protocols in motion. That makes about as much sense as expecting a drunk driver to self-administer a field sobriety test to determine if he or she is an impaired driver. After all, just as in alcohol intoxication, the very crux of the problem with concussions is neurological impairment. How on earth can a player realize that there is something wrong if they can’t remember what quarter it is or is convinced that he is Batman after taking one on the head?
But don’t expect the players to admit the NFL is failing them either. After all, players–especially quarterbacks–have been groomed since their Pop Warner days that the team is depending on them to uphold that Team Before Me attitude, that the team will fail horribly if they are not there to lead the team to victory. They are the money makers. Teams rise and fall at the success (or failure) of their quarterbacks.
So I guess I wasn’t all that surprised at what Aaron Rodgers said to Jason Wilde during his weekly radio program on ESPN Milwaukee. We all remember the December 12 game in 2010 in Detroit when Rodgers left the game with a concussion. It has been wildly publicized that it was Donald Driver that urged him to pull himself to the game and possibly was the one who alerted the medical staff that they were playing with an impaired QB. In other words, it appears that the Packers also relied on self-reporting, or in this case, another player picking up on it and reporting the suspected head injury. But Rodgers doesn’t see it that way. In his conversation with Wilde, he first denied that is how the ball was set in motion to pull him from the game:
Yeah, the story is not true. First of all, they would never put me back on the field once they got me on the sidelines. It was the case of a sudden change after we had punted the ball away and I was just trying to get back onto the field. Once we came off the sideline after we had punted the ball away and Dr. Gray examined me, there was no way I was going back on the field.
But Rodgers took that blow to the head on a Second and Five play. He did not come out of that drive until the Packers punted the ball away. Rewatch the film. It’s hard not to notice the very dazed quarterback that Tom Crabtree had to literally pull off the turf. He is obviously injured, but why was he allowed to stay in the game if those checks and balances were in place to prevent further injury?
Yet Rodgers’ next comments to Wilde underscore the flaws in the NFL’s current system:
Obviously I don’t remember the conversation with Donald at the time, which makes the whole concussion thing kind of weird because there’s a loss of my memory from when the play happened to kind of starting to remember things in the locker room when I was with Daryn College who also was out of the game.
And with that, Rodgers proves my point. Amnesia can be a symptom of a concussion. Why does the NFL want to rely on a player to point out they have a head injury if the are possibly unable to recall that they were even hit in the head in the first place? Not to cast stones at Rodgers, but how can he declare the system did not fail him in Detroit when his eidetic memory was the very thing this concussion robbed him of in this situation and he has no recollection of the events at all?
Exactly a year ago the NFL issued a new policy (they like things on paper, apparently) declaring that they were going to empower the officials with concussion awareness training and the ability pull potentially head injured players. So where was that advocacy seven plays after Cutler was injured this past weekend?
That said, it’s not surprising that the Players Association is once again calling for independent (read: no conflict of interest that comes when it is in your best interest that the team/player wins and continues to contribute to the revenue of the organization) “concussion specialists” to serve as sideline advocates to identify potentially head injured player and have the ability to pull players from the game for immediate sideline assessments. After all if the player is failing at self-policing, the teams medical staff is not following through and the officials don’t have a clue, who is going to serve as the advocate for that player?
And in typical fashion, if the NFLPA declares the sky blue, the NFL wil predictably state that it is orange. Not surprising in the least, the NFL is vehemently against this request. Co-chair of the NFL’s Head, Neck and Spine committee Richard Ellenbogen went on the record yesterday by saying:
Independent experts on sidelines would make (the) situation worse, unless they had a baseline exam on each player. No one knows the players as well as the athletic trainers, period.
Having said that, some teams already have neurosurgeons on the sidelines. Having a doc show up just for a game takes away from the all-important baseline exam and continuity of care. It would be like getting operated upon by a surgeon who did not see you pre-operatively. Is that safer than having someone who saw you beforehand? The baseline is all important in making an assessment if a player is OK after a hit.
Perhaps Ellenbogen is purposely missing the point with this obtuse and obstructionist response. Sideline mental status exams which are administered from the middle school level through the pros are fairly standardized and do not require a baseline exam. They are simple to administer and serve as nothing more than a screening. They include standardized questions such as What was the score at halftime? Who scored last? What city are we playing in? What team did you play against last? As Ellenbogen is likely well aware, the baseline exam doesn’t factor in for anything in a sideline screening but rather is crucial in the serial neurocognitive testing when assessing if the player is ready to return to play after the injury has occurred and is in the healing process.
And for the record, a neurosurgeon’s diagnostic tool is a scalpel. I don’t think you need a brain surgeon determining if a concussion took place. There are hundreds of medical providers (including sports medicine specialists, internists, pediatricians and the Packer’s Dr. John Gray’s specialty of family medicine) and trainers nationwide that are not employed by the NFL that are certified by the very organization it utilizes for both baseline and post-concussive return-to-play testing protocols that are more than capable to serve as those sideline advocates. The NFLPA is not suggesting that the NFL do away with the doctor-patient relationship it already has established between team physicians and their players. What the Players Association is asking for is a safety net so that Aaron Rodgers doesn’t need to rely on Donald Driver narc’ing on him to the medical staff to get him pulled for the game or a half mercifully come to a close before someone realizes that Jay Cutler is concussed. It wants to give an impaired player a voice when he may not have the ability to find it himself.
Until that happens, it appears that the NFL is in favor of lots paper policies and protocols to safe guard its players. Until it is willing to truly put player safety first and foremost and stop treating them as disposable gladiators that bring in money hand over fist, this problem will not go away. After all, people pay top dollar to see the Rodgers and Bradys of the world light it up on the grid iron. Who the heck wants to see a Super Bowl pitting TJ Yates against Jason Campbell? Safety policies need to be driven by–what a novel concept–player safety not profit margins.
After all, wouldn’t it be nice for players like Rodgers to able to remember his wife’s name in twenty-five years or Jay Cutler to recognize his own son when he returns from college? Players are not disposable. Yes, new names will be affixed to jerseys every couple of years, but there are real humans that are sustaining very real injuries with life-long consequences.