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,
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:
- 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.
- MDC (Multi-Disciplinary Care) for all athletes suffering from Post-Concussive
Syndrome (persistent symptoms of traumatic brain injury) (31, 83-86).
- Ensure athletes are managed with the most up-to-date concussion protocols.
- Include the current known risks of concussion in the existing education
process for athletes, parents, coaches, and other stakeholders.
- 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.