Other end of the spectrum
Of course, while there are lots of very protective parents, at the other end of the spectrum are some parents who, sad to say, are willing to sacrifice their child's safety and — in the case of concussions, their long term health — at the altar of a winning performance, a touchdown scored, a scholarship won, a pro contract inked.
It is not only fathers who fall into this unfortunate category. There are also many moms:
- Who are over-invested in their child's athletic success;
- Who enjoy too much doing what sports psychologists call "basking in the reflected glory" of their child's athletic achievements;
- Who are content to let their child's very identity become wrapped up in sports; and
- Who are unwilling — or unable — to make the decisions that I had to make: to end their child's dream of playing four years of high school sports, to take away something their child cherished, and, in doing so, put their child's very future at risk by allowing him or her to return to contact sports while still experiencing post-concussion symptoms or despite a history of multiple concussions.
Some parents admit that they allow their children to play in such circumstances even though they know about the potential for adverse long-term health consequences, like major depression and permanent cognitive impairment. One 2010 survey found that fully fifty percent of parents of children age 12 to 17 playing school sports knew a parent who would have their child return to sports too soon after a concussion.
In the middle — and I submit this is by far the largest group — are the parents who simply don't know what to do. These are the mothers who, like Kerali Davis, one of the moms featured in "The Smartest Team," who come to MomsTeam looking for answers, the ones I wrote about in my book, Home Team Advantage; the ones who wake up at 3:00 in the morning worried sick about their kids' safety, about what sports are doing not only to their kids, but to themselves.
These are the parents who want to protect their children from long term injury but simply don't know how to play their position on the youth sports "team," and don't know what to expect of their teammates — the coach, the ATC, the team doctor, and the athletic director.
Too many parents — and their children — still think that concussions only occur with a loss of consciousness and/or that it isn't dangerous to continue playing with a concussion. Indeed, a 2010 national poll by Michigan's C.S. Mott Children's Hospital found that less than one in ten parents (8%) of children playing school sports had read or heard a lot about the effects of repeated concussions, while fully one third (36%) hadn't heard or read anything about the effects of multiple concussions.
Too many young athletes — from 9-year old cheerleaders to star middies on high school lacrosse teams — are still failing to self-report their symptoms to the coach, sideline medical staff, their friends or even their parents, forcing clinicians to try to manage concussions without all the facts.
Silent but deadly
Kids fail to self-report because, too often, they are told by their parents, but far more often by their coaches, and, more subtly, by the very culture of sports itself, that they should remain silent:
- to avoid jeopardizing their spot in the starting lineup
- to avoid being labeled a "sissy" by their coach and/ or their parents
- to demonstrate to the coach and their teammates that they can "take a hit like a man,"
- to show that they can be as tough as their professional heroes
- because they believe that the glory of individual and team success, the promise of a college scholarship, or the lure of a lucrative professional career, is somehow worth the risk of lifetime impairment.
That silence can, in rare instances, be deadly. A case in point was one that I highlighted in a piece I wrote a while back, with apologies to poet A.E. Houseman, entitled "To Nineteen Athletes Dying Young." Among the athletes I profiled who had died playing sports in the fall of 2003 was 14-year old James Van Slette, a middle linebacker and fullback on his freshman football team in Illinois.
While preliminary autopsy results were inconclusive, I have since learned that Jimmy had suffered at least four concussions in the previous five years, three playing football and one in a car accident. Despite this concussion history, he was able to pass a pre-participation evaluation and was allowed to continue playing despite his parents' (and presumably his neurologist's) concerns.
We also later learned that Jimmy had confided to friends — but not to his family or coaches — that he was having severe headaches (by far the most common symptom of concussion) and might have suffered a fifth concussion in the team's last game of the season three days before he died. It is unclear whether he was experiencing any other symptoms of concussion before that game.
But, because he did not inform anyone other than his close friends that he was experiencing severe headaches after that game, it is possible that his brain was already injured before the game, placing him at risk of second impact syndrome.
There is also no way to know whether Jimmy's life could have been saved had he told his parents about his headaches, or if his mother had seen his vomiting as a sign of a potentially life-threatening head injury and instead of sending him back to bed had rushed him to the emergency room.
We don't know precisely why Jimmy kept his severe headaches to himself.
What we do know, however, is that he was an athlete who, like too many, failed to report injuries or underreport symptoms, which, at the very least, delays and complicates concussion management and, at worst, places them at risk of adverse long-term health effects or a fatal brain injury.
