The Concussion Movie - A Sports Neurologist's Perspective

I had the opportunity recently to pre-screen Concussion, the new movie starring Will Smith as Dr. Bennet Omalu, the famed forensic pathologist credited with bringing the degenerative brain disease chronic traumatic encephalopathy (CTE) to light as it relates to repeated head-trauma, namely in sport. While I am by no means a trained cinema critic, Concussion is an excellent movie. But perhaps more importantly, it provides another fantastic opportunity for the medical community to educate our patients and the public at large about brain trauma – with a few caveats, of course.

While this article will publish in advance of the movie’s release on Christmas Day (December 25, 2015), I predict that individuals who play sports or who have relatives/loved-ones who do will experience at least some (if not significant) anxiety after having watched Concussion. With that anxiety will likely come a number of questions regarding risk as well as safe participation in sports at all levels of play. Dialogue is good and information is powerful – as long as it is accurate and backed by the rigors of scientific analysis.

So that the scales of the collective psyche do not tip toward total fear, what is important for us physicians to do is to deliver an appropriate transfer of knowledge to our patients and communities, without an agenda. Good movies make us think and many serve as catalysts for constructive dialogue, but the conversation must be framed accurately for the benefits to be lasting, meaningful and helpful.

In my scope of work as a neurologist, I have the incredible opportunity to work with some of the brightest minds in this field. This year, I served as a sports advisor at an international concussion retreat and along with several well-respected authors, helped to develop a white paper aimed at providing practical solutions to the concussion crisis. The paper does an excellent job outlining the medical community’s current concussion thinking and understanding and can be read in its entirety here. Paying particular attention to the discussion of CTE, the article states:

“In the absence of prospective trials with proper design and methodology, we are currently unable to make a determination on the risk and incidence of CTE in professional athletes. (61, 62, 69, 79-82).

However, despite the lack of data, the professional sports leagues should be encouraged to continue with their efforts to advance concussion education, management and research.

It is incumbent upon the medical and scientific community to work with the leagues to protect past, current and future players while maintaining the value of athletic participation. The following 5-point plan is a first-step in solving the concussion crisis in sports:

1. Education and prevention surrounding concussions at the grassroots level amongst children as a joint project between the medical community, league and the players association as a measure to prevent declining enrollment at all levels of sport.
2. MDC (Multi-Disciplinary Care) for all athletes suffering from Post-Concussive Syndrome (persistent symptoms of traumatic brain injury) (31, 83-86).
3. Ensure athletes are managed with the most up-to-date concussion protocols.
4. Include the current known risks of concussion in the existing education process for athletes, parents, coaches, and other stakeholders.
5. Continue to invest in concussion research and development beneficial to athletes in all sports, specifically in the areas of education, prevention, diagnostics, management and treatments.”

I recognize that this collective scientific thinking on CTE may not seem like “enough,” yet. It isn’t. And your doctors don’t think so either. We’re working hard to get the answers we all want – for our children, our sports heroes and everyone around the world. I’m confident we’ll get there. While we work on it, here’s what science has told us for absolute certain: a strong focus on brain health and neurological contributions to performance is important across the entire lifespan and in all areas of human function. What that means is that our brains deserve not only protection from traumatic injury, but also to be tended to and cared for throughout our entire lives. Every single one of us can derive immediate benefit from that.