In retrospect, it will be one of the most analyzed plays of the 2011 season, although few people noticed it at the time.
It was a seemingly innocent block early in the fourth quarter of a game on October 23. A Pro Bowl guard fell to the ground after a block of Jets linebacker Calvin Pace. He staggered to his feet as CBS’ Jim Nantz told viewers that the player was “a little shaky and wobbly.” He appeared to wave off the umpire as if to say he was able to continue playing, and he remained in the game.
So why has the play and the television footage of it now been scrutinized by the NFL, the NFL Players Association, doctors representing the union and the league, and media all over the country?
Hours after the game ended, on the team’s flight home to San Diego, Chargers left guard Kris Dielman suffered a grand mal seizure.
Dielman was reportedly hospitalized overnight and later released. He has continued to experience lingering effects of the concussion, so the Chargers placed him on injured reserve. Fortunately though, his tests were said to be normal. Doctors have told him that that he should fully recover without complications. He is expected to return to play next season.
Now as scary as a season-ending concussion and seizure are, that isn’t the aspect of this incident that has drawn so much attention. The evaluation of Dielman’s concussion, or apparent lack thereof, has drawn criticism from many observers.
Much of the outrage stems from the fact that television cameras showed Dielman visibly stumbling. Footage also seemed to show umpire Terry Michalek witnessing Dielman as he struggled to get off the ground. He supposedly started to whistle an injury time out, but the player waved him off.
The Chargers doctors and trainers did not pull Dielman out of the game. Reportedly their view of the play was obstructed, and they were tending to another injured player. Doctors did not diagnose Dielman’s concussion until after the game. ESPN’s Chris Mortensen even reported that the team wasn’t alerted to the injury until a teammate brought it to their attention.
I am not at all criticizing the Chargers’ doctors because I don’t know what they saw in that last 12:30 of the game or in the locker room. It is very possible that with as many players, coaches, staff, and television personnel on the sidelines, the doctors could not see Dielman’s loss of balance and coordination. And it is football, so the medical staff is often very busy evaluating and treating many players.
This event highlights one of the problems with concussions, though. Players are simply not reliable for pulling themselves out of a game. They understandably want to play, and they likely will downplay their symptoms to stay on the field.
The NFL responded by trying to educate game officials on the signs of concussions. While critics argue that officials are not doctors, I would argue that few additional pairs of eyes to see what doctors on the sidelines might not has to be a step in the right direction. Instead of being waved off by players intent on playing through a concussion, officials could simply alert the medical staff.
But I expect that educating officials is only the beginning. NFLPA medical director Dr. Thom Mayer wants a medical observer in the NFL command center, where all games are viewed on big-screen monitors, to look out for players exhibiting signs of concussions. The NFL is said to favor placing an independent neurologist on the sidelines of each game. Other ideas that are being debated include mandating that any player who suffers a concussion undergo a CT scan the same day and creating guidelines to determine if players are allowed to fly home with the team.
I’ve always admired professional athletes for their determination to play, often despite tremendous pain. But as this incident demonstrates, physicians, trainers, coaches, officials, and the league must be able to protect the players from themselves when necessary. Hopefully Kris Dielman’s injury sparks changes that prevent future concussions from having even more catastrophic consequences.
Do you think the NFL does enough to decrease concussions? What can the league and its players and doctors do better? Share your thoughts!
Note: The following post appears in my sports medicine column in the November 23, 2011 issue of The Post and Courier.