The Perfect Storm: Ben, Hines and a Discussion of Concussion

Let's review here.  The Steelers are reeling from back-to-back losses, the latest to a Kansas City team who had no business being in the game with them.  Their star quarteback, Ben Roethlisberger, gets knocked out of the game with a slight head injury, slight enough that Ben was lobbying to go back in the game if the Steelers got the ball again.  But they don't get the ball and making matters worse, their capable back-up breaks his wrist.  Roethlisberger practices all week, good news since Charlie Batch is out, but post-activity headaches persist instead of going away.  Having to make a tough last-minute decision, the Steelers decide to sit Ben after his teammates have scattered.  A fifth-round quarterback with one NFL pass to his resume takes a few more reps during the week, but not nearly enough.  The team happens to be playing against it's most physical rival on Sunday night prime time.  Taken by surprise, star wideout Hines Ward, a veteran who has been playing long enough to remember when concussions did not preclude most players from resuming play, makes some disappointing comments in a national interview that fit in perfectly with this quirky perfect storm.  Capping off the pre-game week, Big Ben comes strolling out of the locker in full uniform, ready to hand off as the emergency quarterback if necessary.

Forty, 25, even 10 years ago players were getting concussions on the football field left and right.  Diagnosis and testing were light years behind where we are now.  Players were returning to play at their own discretion, and doing so quickly.  I can't imagine how many concussions Terry Bradshaw and the others of yesteryear sustained.  The official medical term back then was "getting your bell rung."  Teammates actually used to joke about it.  They called it different nomenclature like "the John Wayne Walk," depicting a guy staggering along.  The world was so much different not long ago.  Concussions were often "sissy" injuries.  Ten years ago, under the exact conditions, Big Ben would have been in the lineup Sunday, probably five years ago, maybe even last year

Today, modern medicine, combined with a society of political and behavioral perfection, has heightened awareness and heightened sensitivity.  That's really an interesting combination.  We know much more about head injuries.  Add to that knowledge the political correctness of acknowledging head injuries as being much more important in the game of life than in the game of football.  This puts players, in this case Ben, in the awkward situation of wanting to do the right thing health-wise, but in conflict of also wanting to do the right thing for his team and teammates.  What's the right thing to do?  Tell the truth to the doctor?  Or lie and take risks that once were unknown?  In some ways, the ignorance of yesteryear was bliss.

It is also interesting that the leaders in this rapidly-growing medical arena are none other than doctors with the Pittsburgh Steelers.  Dr. Joseph Maroon is a world-renowned neurologist who happens to be one of the Steelers team doctors.  He developed the IMPACT test that takes baseline measurements of football players, and then uses that baseline information as comparison when any kind of head impact occurs.  The fact that the Steelers are in the forefront of this effort, and given national and international acclaim, probably puts them in a more conservative position when making decisions within their own organization.  Like the old saying goes, it's probably not a good idea to break federal law when you are hanging out in Washington.  Likewise, a player under the care of Dr. Maroon is not likely to error on the risk side.

Adding to the difficulty in grasping the rapidly-changing advances of head injuries is the fact that they are more often gray than black and white.  Broken bones and torn muscles, while certainly varying in degree, either are or aren't.  Concussions are more of a continuum measurement.  Helmets collide all the time without stopping to take neurological tests.  Only when the player shows any signs of that "bell-ringing" do the tests come into the picture.  What do you do when a player has an extremely mild concussion?  Probably let him play next week.  Each increment on the continuum makes it more difficult to evaluate playing or not playing, until you cross the line where you know a player should not play.

Ben was as close to the middle of that gray line as possible last Sunday.  Another inch on the positive side and he probably plays and the whole Hines Ward interview doesn't happen.   Another inch on the negative side and the Steelers know earlier in the week that Ben would not play.  The players know what is going on, the team prepares accordingly in practice and again, the Hines Ward interview does not happen.  Only because Ben's condition was in perfect straddle on the fence does the Ward interview ever happen.  Hines Ward is as "old school" as a veteran can get these days.  What he thought and believed is no different than most other players who played before the turn of the century.  His mistake was making his feelings public and putting his quarterback in a precarious situation. 

One final element to this "perfect storm" is the fact that NFL Commissioner Roger Goodell has issued a series of statements, just this week, about the ever-growing attention being paid to concussions and head injuries.  These statements are the result of recent inquiries into this area by the U.S. Congress.  With Goodell's statements appearing daily, it is probably not a good idea for the defending Super Bowl quarterback to play in front of a national television audience after being removed from the game a week ago due to head injury.

What a crazy week to a roller-coaster year.  Hopefully the Steelers can nail down two wins in five days and put this mini-drama perfect storm to rest.

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