Dietlose

It was late in the third quarter and Penn State was fighting not only to keep its undefeated season alive, but its hopes for a national championship as well.  As Penn State quarterback, Daryll Clark scrambled for a seven-yard gain, he collided with two 300-pound defensive linemen.  Seven snaps later, Penn State officials diagnosed Clark with having sustained a concussion from the collision and pulled him from the rest of the game.  Those watching the game could see that Clark was visibly upset by the decision not to let him return to play.

Not only did Penn State win the game and keep its national championship hopes alive, Penn State demonstrated that the health of its athlete was more important than winning a football game.  Dr. Wayne Sebastianelli, Penn State’s Director of Athletic Medicine, was quoted as saying “We know the stakes are high, but we’re pretty much dedicated to the preservation of an athlete’s well-being.  No one questioned it at all.  We knew we had to find another way to win.  That was it.”

The actions by Penn State’s team doctors and coaches should be a lesson to everyone that players who sustain concussions during sporting events should not be returned to play.  Maybe, just maybe, others will follow this example.

Last Thursday, October 23, 2008, I traveled to New York City to participate in a continuing legal education program on traumatic brain injury sponsored by Lorman Education Services.  My topic at the program was Daubert Issues in TBI Cases.  My presentation focused on the evidentiary requirements for expert testimony and steps that can be taken to keep junk science out of the courtroom.  Besides my presentation, the attendees heard from other outstanding attorneys who specialize in neurolaw as well as from Wilfred van Gorp, Director of Neuropsychology at Columbia Presbyterian Hospital.

The dangers of athletes returning to competition too soon after suffering from a sports-related concussion has been recognized for some time now.  In fact, just a few years ago, the Brain Injury Association of New Jersey invited trainers and coaches from New Jersey high school athletic departments to attend a sports concussion seminar at Giant’s Stadium in the Meadowlands. 
 
This morning I read in the New York Times that Montclair High School planned to meet this week to develop a written policy for dealing with students who sustained concussions.  This announcement came days after a Montclair High School student athlete, Ryne Dougherty, died of a brain hemorrhage. That injury came less than a month after Ryne sustained a prior concussion during a school practice on September 18, 2008. 
 
The article quotes Montclair High School’s Interim Principal Judith Weiss who indicated that she overhead at least one teammate “lamenting that he had not told school officials that Dougherty was complaining of post-concussion symptoms after he had been cleared.”
 
The failure of Ryne or his teammates to complain is not surprising. Over and over again, experts in the field warn that athletes will not bring their complaints to the attention of coaches as a result of the culture that surround these sports.
 
While it is wonderful that Montclair will now begin to develop the necessary policies regarding athletes who sustain concussions, it is shameful that this program was not in place before this tragic event occurred.  It is imperative that schools begin to educate coaches, athletic trainers and their athletes concerning the dangers that concussions pose.

A new study states that prior to becoming homeless, more than one out of every three of Toronto, Canada’s homeless had suffered from a traumatic brain injury, which furthers past theories that mental health is linked to homelessness.

A paper published in the Canadian Medical Association Journal recently found that more than half of the homeless population of Toronto had experienced a severe brain injury, and 70% of those did so before ending up on the streets. The study surveyed roughly 900 people living in Toronto homeless shelters from 2004 – 2005. Traumatic brain injuries usually result in cognitive impairment, attention deficits and emotional instability.

You can read more on this story here.

 

Last week I reported on a fascinating lecture I attended at the NABIS medical legal conference in New Orleans.  Readers will recall that at that presentation, Dr. Mary Hibbard of Mount Sinai Medical Center discussed the increased suicide following traumatic brain injury of our soldiers returning from Iraq and Afghanistan. 

Yesterday, the Washington Post reported that the army has unveiled a unique prevention tool-an interactive video to be mandatory viewing army-wide - in order to address the alarming record rate of suicide in its ranks.  The video features soldiers role playing that of an anguished infantry training man and make virtual choices that lead the character to get help or in the worst case shoot himself in the head.  The video is entitled “Beyond the Front” and “leads the viewer through a detailed drama in which [the infantryman] is hit by relationship troubles, financial problems and scraps with the law - what army research shows are major events that precipitate suicide.” 

While this is certainly an excellent first step to address the problem, it is more important that the military address one of the major underlying problems, that of making sure that our soldiers returning from war obtain the appropriate screen for traumatic brain injury and/or post-traumatic stress disorder (PTSD) and most important obtain the needed medical care to address these injuries.