second tale is about Muck City, an area in Palm Beach County, Florida, that includes Belle Glade and Pahokee, named for its dark rich soil. Quoting a story in the New York Times entitled The Way Out by Bryan Mealer in February 2013, this region in the Florida Everglades had become known for migrant workers and minorities who needed employment in the well-developed agricultural sector. The writer described this town as rundown with significant poverty, violence, drug menace and some of the highest rates of HIV infection. The mayor of the city reported rates of unemployment as high as 40%. In the February 2013 Super Bowl, the area’s two high schools located 8 miles apart, namely the Belle Glade and Pahokee high schools, had 5 players that suited up for the game between the Baltimore Ravens and the San Francisco 49ers. These two high schools have produced at least 60 players for the NFL over the years. In this very town (Belle Glade), the Palm Beach County Sheriff’s office estimated that half of the young men between 18 and 25 years had felony convictions. Mr. Mealer’s conclusion in the article was “In Muck City, the well-worn line that ‘football is like religion’ doesn’t even begin to convey its importance. Football is salvation itself, a fleeting window of escape from a place where prison or early death are real and likely outcomes” (Bryan Mealer 2013).
So, there you have it. Can football be the salvation for some people?
I recall taking care of a high school athlete, Eric (case # 6), in the early years of my career at the University of Miami; he was a star athlete. His parents were not poor but could not afford an Ivy League education. Around the end of his junior year in high school, he was by far one of the best quarterbacks in the state, and a number of well-known colleges and universities wanted him. He was from Orlando. While preparing for one of the most important games at the time, he suffered what was believed to be a moderate concussion. Initially, he did not tell anyone but continued with what they call hitting drills in football. By the end of the practice, he had trouble standing and was dizzy, felt nauseated, and had the worse headache of his life. He was taken to a local hospital in Orlando where he was seen and treated with headache medications and given Valium for his dizziness. By day three, he told his parents he was fine and wanted to return to play. His father was delighted and immediately called the coach to say his son was ready to return, however his mother had her doubts.
Around the time that this occurred, the industry was just in the infancy in terms of establishing the guidelines around return to play. Our program (University of Miami Usports) at the time had some pretty stringent restrictions on return to play. If the concussion was a Grade 3 (with LOC or had certain significant symptoms), then the athlete had to be asymptomatic for a minimum of 2 weeks before they could return to play. According to the math, starting from the time he said he was asymptomatic, he was exactly two weeks away from playing in the game where all the scouts would get to see him.
His mother’s sixth sense said that her son was still symptomatic because she recognized that he was not his normal funny and humorous self. He had trouble finding words. He had even lost his temper with his sister and gotten into a physical fight with her, something he had never done before. The father dismissed all of this as the pressure he was under to perform in the upcoming trials.
When the father found out that the mother had contacted us, you can only imagine the screaming and hostile exchange of words between the couple … the father saying that he did not have a chance to make it in football himself due to an injury; wanting to give his son the opportunity to go to a good university, get a solid education, and play football … the mother stating that their son is all they have; if he got hurt, she would not be able to live with herself … I can tell you, some of you reading this book may be going through this issue. This is the real deal of what is going on out there in America and the world with families and contact sports. I was on my way out from the university for an out-of-town trip when I received the call from his mother. The mother, father, and son drove in from Orlando to see me. Understanding the gravity of the situation, I had to reschedule my flight to see them. Listening to the mother’s comment and the concern she was expressing, I paid more attention than I would have usually, and I do pay a lot of attention as is. Eric passed the Sniff Test, and my exam showed that he had a perfect neurological and clinical exam.
When I cleared the patient to return to play, he was already exercising without any reported symptoms. The father and the son by now were giving each other “high fives.” They were both thrilled about the idea of him playing again. The mother went along with the return to play, as I believed that we had followed our guidelines. His game was 2 weeks later, and he had two games back to back. The coaches and athletic trainers noted that on the first return to play game, he was not himself; he was not engaging, seemed distracted, and had little to say. They attributed it to the fact that he had a lot on his mind, given the pressure he was feeling about success. You see, Eric was not asymptomatic. He had the symptoms all along but lied to his family, coaches, athletic trainers, his doctor and to himself. He had dizziness, headaches, and persistent difficulties with focusing and paying attention. His grades began dropping despite his excellent performance prior to the injury. I still wonder what in the world I missed; what caused me not to pick up some of the subtle symptoms and signs in this patient? After that first game, he had a tough night and could not sleep. He had a severe headache and blurred vision. He told no one except his girlfriend, who also told no one. The next game was supposed to be the game of his life; recruiters from the most prestigious colleges would be out there, looking on. “The game of a lifetime” did not turn out to be what everyone was hoping for. He had a pretty bad helmet-to-helmet collision with another player. His instinct made him literally get up and “shake off” the effects of the hit, as he could not fathom disappointing his father, coaches, scouts, and many other stakeholders who impacted his life, including the crowd. He was only able to walk a short distance, and right before the next play was to begin, he collapsed. Eric was taken to a local hospital and found to have a massive hemorrhage with diffuse swelling in the left frontal portion of the brain, causing his brain to shift from the left to the right. He did not wake up for about 2 weeks even after a craniotomy (removal of the skull to remove a blood clot) was performed to decompress the pressure in the brain and remove some of the blood. Eric was my first-ever case of the second-impact syndrome (SIS).
He was subsequently treated at a brain injury rehabilitation center and was able to regain his motor functions, sensory functions, and his cognition enough to be able to finish high school. The real tragedy of the story is that not only was his dream of attending a top university shattered despite his prior good grades, but also the dream of being a star athlete in the NFL. To the mother, the most significant tragedy was when Eric’s girlfriend disclosed that he had symptoms all along, and despite attempts to dissuade him from playing, she could not. Eric had made his girlfriend promise to tell no one. I once spoke to the mother later, and she told me that this experience had changed her life, as she no longer knew if she could live with herself.
What was even more tragic was that after his recovery from this incident, I had to convince the patient and his father that playing contact sports after the injury, especially football, was out of the question, now and in the future. This did not go over well and they sought other opinions that would clear him to return to the sport. When I reviewed the patient’s neuropsychological test results, he had clear deficits in word finding, attention span, concentration, and significant trouble memorizing things. His senior year was depressing, as he needed special accommodations and support to complete high school. He did graduate and was able to get into junior college. Eric completed two years but did not go on to a four-year university to complete his bachelor’s degree. Eric has been a patient of mine for a few years, and his story of shattered dreams has left an indelible print on my mind. So, when I have to clear another athlete after a concussion, I think twice.
Conformational Intelligence – Another Point of View
DR.
