Pride has No Place for Certain Injuries

As the Hudson River bends around West Point on an August summer day in New York and the Corps of Cadets wear their dress whites during their second week of school, up on the top floor of the new Jefferson Library overlooking the marching fields with a backdrop of the Hudson, General and the Chief of Staff of the U.S. Army, Raymond Odierno and the Commissioner of the National Football League (NFL), Roger Goodell, came together to do all that they can do for the health and welfare of their soldiers and players in regards to traumatic brain injuries (TBI).

With 150 cadets in the room, Odierno and Goodell signed an agreement of partnership in their resolve to bring visibility to and break the stigma associated with these injuries and to further share their similarities, challenges, and opportunities that TBIs bring to the two institutions and their personnel. The U.S. Army and the NFL can make a big difference by sharing research and bringing greater awareness to society, beyond the NFL and the Army, to help prevent, manage, and heal TBI.

TBI and Post Traumatic Stress Disorder (PTSD) are two of the most prevalent wounds amongst our thousands upon thousands current wounded warriors and veterans. In the decade long war on terror, TBI and PTSD are caused by Improvised Explosive Devices (IED) in Afghanistan and Iraq. TBI and PTSD are invisible wounds that show no outward scarring or physical deformity. These wounds are still being understood as to the specific damage, both physically and psychologically, that a concussion can cause and with that uncertainty it is an injury that, at this time, is a challenge to heal, prevent, and recognize. 90 percent of people that endure concussions are not knocked out and most do not know that a concussion has occurred. The NFL and its players, both current and past, have received concussions as a result of direct angular contact to the head. The NFL and the U.S. Army have the same challenges in prevention, recognition, and healing of brain injuries.

Yesterday’s open forum discussion at West Point focused on the awareness of pulling soldiers and players from the battle field and the field of play after a TBI occurs while the ethos of a warrior and the pride of a professional athlete, who does not want to let his teammates down or perhaps lose his position, puts them back on the field where they battle sustaining more injuries to the brain that put their battle buddies and team at risk and other solider lives at stake. The delicate issue of having leadership step in and make decisions to bench and pull TBI victims goes beyond, in the case of NFL, a medical doctor on the field that has complete veto power to override the coach and player in their personal and intimate combat atmosphere where they depend exclusively on their battle buddies to their left and right for survival. It is the compassion of leadership, in a fight, that causes a man to sacrifice his wounds for his soldiers safety. These actions are both bound to him through his instinctive and learned warrior ethos culture. It is a thin line that can border heroism and valor for a soldier to withdraw from the fight and leave his battle buddies. The lack of clarity of rational decision making after a concussion added to the fog of battle makes it very difficult to self govern and police . The NFL football player, to a lesser extent, has similar values and dedication, both internal and to his peers, of letting the team and his teammates down by stepping out of the game.

Culture has to be broken and changed. This is as difficult as teaching an old dog new tricks. The U.S. Army believes it is doing this with their leadership and the chain of command who control these soldier’s daily lives in downward and upward conversation to create a continual dialogue so that there is no retribution for coming forward when you cannot see the injury and peers question toughness. To the NFL it has not been as clearly defined, the NFL is looking towards the next generation of players in re-educating them and changing the environment at their youth to break this stigma as well as amplifying the reasoning of long term benefits in extension of a player’s career if you pull yourself out of the game rather than abide by the peer/job/win pressure of withstanding and risking greater injury throughout the length of a game. Changes of culture are not easy and they take time.

This was a great high profile event with the highest levels of leadership that brought two of America’s most identifiable institutions that share so much together in their make up to compete, persevere, and win as they take the first small step on common ground to jointly challenge and fight together in bringing awareness to soldiers, players, and to our society in regards to TBI. Due credit and adulation must be given to these leaders and their vision and courage to begin to assault this complex injury that has repercussions unknown and class action lawsuits that could bring down the game itself.

The next steps beyond awareness and breaking the stigma must continue to have courageous leadership forward to identify the specifics of the injury with accumulating research samples of MRI scans tagging genetic traits and tau proteins of those with concussions right after injury occurs and comparison to those in the same blast zone who did not receive concussions. Clearly identifying the cause allows you to be much more efficient and effective in the ways of healing the injury. Prevention must also look at restrictive mobility of the head to reduce angular movements on contact which cause most concussions.

There is much more to be exponentially gained for our soldiers, players, past, present, and future, of these iconic American institutions to understand, prevent, and heal traumatic brain injury.

It is with tremendous satisfaction that the facilitation of bringing Dr. John York, the Chairman of the NFL’s Health and Safety Advisory Committee and Owner of the San Francisco 49ers together with the former U.S. Army Vice Chief of Staff and one of the most prominent advocates for TBI and PTSD, Peter Chiarelli at the NICoE at Walter Reed on November 5th last fall to be introduced, briefed, and to visit the victims under the full support of the Chief of Naval Operations, Admiral Jon Greenert which has led to this significant agreement between the NFL and the U.S. Army.

As an advocate of our United States Military, a supporter of our wounded warriors, a former 10 year NFL veteran sustaining multiple concussions, and having a son who plays in the NFL it was a honor and a privilege to be invited to this event to applaud and commend the leadership and vision of General Raymond Odierno and Commissioner Roger Goodell in their efforts on TBI.

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