Will Power slides into his No. 12 Verizon Chevrolet machine on pit lane prior to practice for the Firestone Grand Prix of St. Petersburg. [Photo by: Shawn Gritzmacher]
by Allan Brewer
In the same week that shirtless soccer champion Brandi Chastain donated her brain to science, Roger Penske pulled Will Power from the driver’s seat of a pole-sitting Team Penske IndyCar on Sunday at the St. Petersburg Grand Prix because of a concussion. Despite suffering from nausea throughout the day on Saturday, Power drove through three rounds of qualifying (and posted a new track record) after incurring the concussion, which was caused by a hard crash into the concrete barrier at Turn 9 during practice at St. Pete on Friday.
Update
Read the March 16 Medical Update for Will Power
Chastain remains best known for scoring the winning shootout goal in the 1999 womens’ World Cup final against China and for the jersey-shedding celebration that followed. Now 47, a mother and a coach, Chastain hopes her latest move will do more for soccer than that. She has agreed to donate her brain to the Concussion Legacy Foundation and researchers at Boston University, pioneers in the study of concussions and chronic traumatic encephalopathy, a degenerative brain disease. Chronic traumatic encephalopathy has been found in several male soccer players, and researchers believe that heading the ball is a primary culprit. The disease has been identified in women victims of head trauma, though not yet in enough female soccer players to validate a sample size suitable for scientific purposes.
Some may react with shock that the IndyCar series would put a driver on-track if there were any question of his or her fitness behind the wheel; but in fact, what happened with Power is testimony to just how difficult neurologic injury can be to identify and prove regardless of technique and protocol. And in a sport, auto racing, whose lethality is undeniable, it was refreshing to see transparency around an issue that has been denied, underreported and even cloaked in secrecy by some of the world’s greatest and most powerful sporting industries — to whit boxing and football.
In Will Smith’s full-length movie, “Concussion,” the former NFL player Dave Duerson confronts Dr. Bennet Omalu, a Nigerian physician whose findings of chronic traumatic encephalopathy in pro football players shook the league. In one of the movie’s most memorable scenes Duerson blocks Omalu from entering a medical conference, calls him a quack, and tells him to go back to Africa and to “get away from our game.”
Omalu, played by Smith, retreats in shock.
The movie is based on an article by Jeanne Marie Laskas that appeared in GQ magazine in September 2009. It has been widely characterized as a fact-based accounting of what happened when Omalu’s findings collided with a multibillion-dollar league that was disinclined to illuminate the dangers of repeated brain trauma. In the article Laskas describes how Omalu, while working in the Allegheny County coroner’s office in 2002, performed an autopsy on Mike Webster, a former Pittsburgh Steelers center.
Webster had in the years prior to his death endured a strange, disturbing slide into the abyss — he had taken to using Super Glue on his rotting teeth and to stunning himself into unconsciousness with a Taser gun to relieve his back pain — that ended when he suddenly dropped dead at the age of 50. Puzzled by the hall of famer’s troubling behavior and the seemingly inexplicable cause of his death, Dr. Omalu began studying Webster’s brain, and discovered splotches called tau proteins typical of a progressive degenerative brain disease. Tau proteins are also associated with Alzheimer’s disease. Omalu noted that the buildup of tau proteins had done a horrific number on Webster’s brain, acting as a toxic sludge, clogging up the works, killing cells in regions responsible for mood, emotions and judgment. Omalu diagnosed Webster with chronic traumatic encephalopathy.
A concussion can result from a fall, sports activities, or (as in Power’s case) car accidents. A jarring movement of the brain in any direction can cause a person to become unconscious, and the duration of loss of consciousness may be a sign of the severity of the concussion. In some cases, such as with Power, a concussion does not result in loss of consciousness. Indeed, most people who have a concussion never pass out; but they may describe seeing all white, black, or stars. Acting confused, feeling spacey, or not thinking straight are common descriptions offered by people who are injured by concussion.
At IndyCar the doctors perform a physical exam and the person’s nervous system is checked for changes in pupil size, thinking ability, coordination, and reflexes. Memory loss of events before the injury or right after are also common, as are nausea and vomiting—which were the apparent symptoms Power suffered on this occasion. Surprisingly, the data collected from Power’s ear accelerometers, which provide data specific to the impact on a driver’s head, failed to indicate a need for further scrutiny of the incident. Power showed no signs of injury initially and was evaluated and cleared by the IndyCar medical team to continue racing. It was only after Power reported symptoms of illness following qualifications on Saturday evening that he was retested and diagnosed with a mild concussion.
Recovering from a concussion takes time: it may take days, weeks, or even months. Regardless of how severe the concussion may be, there is a basic tenet that must be followed in recovery: do not do activities that can cause further head injury. The requirements for healing also include avoidance of tasks that require concentration or complicated thinking. These include reading, homework, and mental strain as well as avoidance of bright lights and loud sounds as both can overstimulate the brain.
Naturally, the forces that persuade men and women to continue in play or profession when their livelihood is tied to the activity that may lead to concussion are strong motivators to overlook—even deny—the subtlest signs of the condition. There are incentives for organizers to avert their gaze as well. The NFL has been accused of pressuring its business partners to step back from issues that are potentially embarrassing to it, including brain damage from playing football and its repeated traumatic blows to both head and body.
Duerson’s professional football career ended in 1993. After his death, doctors at Boston University found that he had chronic traumatic encephalopathy, and his family sued the NFL, saying it had hidden the dangers of repeated head hits. Andre Waters, another former player who also suffered from chronic traumatic encephalopathy after repeated concussions, and whose application for disability benefits was denied by an NFL players’ retiree board, committed suicide at 44. Junior Seau, a perennial pro-bowling linebacker for the San Diego Chargers, followed suit as well taking his life in a plunge over a cliff in his automobile.
Even when everyone agrees there has been an incident conducive to or suggestive of concussion, it’s not always a given that the proper procedures are followed. Power’s concussion could have been suspected from the armchair of any viewer observing the hard blow the car took to the wall as they watched on the in-car camera. Another prominently broadcast case brought to the home TV screen is that of St. Louis Rams quarterback Case Keenum, who was not removed from a November game against the Baltimore Ravens despite being disoriented from being knocked to the ground.
The NFL has acknowledge that it is re-examining its concussion protocol after coaches and officials mishandled Keenum, who tried to get up after the hit, wobbled and fell back down again. Dazed, he was helped to his feet by a teammate. The Rams’ trainer, Reggie Scott, ran onto the field to look at Keenum, but was told by an official to leave the field or his team would be charged with a timeout, so he returned to the sideline. Two plays later, Keenum was sacked, and he fumbled; and only then was he evaluated by the team doctor on the sideline and found to have suffered a concussion. He did not play again for two weeks.
The NFL has said that the number of documented concussions increased by 31.6 percent in 2015 compared to 2014, partly because the number of players who were screened for concussions doubled. Moreover, the league acknowledges that more players are self-reporting concussions. How these numbers will stack up against actual cases of chronic traumatic encephalopathy and sad decline into madness is unknown as the condition can only be diagnosed at autopsy. But growing awareness and numbers of athletes willing to undergo testing post-mortem is an encouraging sign of progress toward better understanding and perhaps a cure.
“If there’s any information to be gleaned off the study of someone like myself, who has played soccer for 40 years, it feels like my responsibility,” said Chastain of her decision. “People talk about what the ’99 group did for women’s soccer. They say, ‘Oh, you left a legacy for the next generation.’ This (the donation) would be a more substantial legacy — something that could protect and save some kids, and to enhance and lift up soccer in a way that it hasn’t before. That was the impetus for saying yes. If we can learn something from studying my brain after I die, we should. After all, I won’t need it.”
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