Super Bowl Aftermath

Julian Edelman, New England Patriots pic: Jeffrey Beall

It’s a Tuesday as I write, so literally (and figuratively) I do not propose to do any “Monday Morning Quarterbacking.”  I’ll leave it to others to deconstruct Pete Carroll’s decision at the end of the game (though I don’t think it was that crazy of a call, and was in keeping with other contrarian decisions he has made that actually got the Seahawks into the Super Bowl–like the fake field goal call against Green Bay in the NFC Championships).

The Russell Wilson interception obviously turned out badly for Seattle, and sent all of New England into a frenzied state of joy (though a snowstorm in the region is causing the fans there to hold off one more day from a celebratory parade through Boston).

No, I’m here to focus on sports medicine–specifically the management of Julian Edelman’s apparent concussion in the big game–and encourage you, the reader, to take a poll to stimulate conversation about the issue.

I’m sure a lot of us in the sports medicine world had a sense of deja vu when we saw Edelman stay in the game after what many viewers thought was a concussion:  in the 2014 FIFA World Cup there were several similar incidents, when several players had suspicious head injuries whose management was questionable.  In the aftermath of that tournament, we had a podcast with guests Matthew Gammons and Cindy Chang , physicians of the American Medical Society of Sports Medicine (AMSSM), exploring the issues involved with management of possible concussions in real time, in the setting of a highly visible sporting event…like the Super Bowl.

The NFL has, in the wake of much criticism, introduced new concussion protocols.  It is my understanding that “….. the NFL assigns an independent physician to each team to monitor head injuries, and there is another independent ‘spotter’ who watches players on both teams from a booth above the field and can radio to the sidelines if there is evidence of an on-field concussion.” [1] Additionally, each team has its own medical personnel to monitor the situation as well as do any necessary evaluations.

It is not clear to me, however, that there is an independent physician who is empowered to remove a player from the field of play; to mandate removal if necessary, and not just ‘monitor.’  Should there be a clinician who i) has no conflict of interest [as exists intrinsically in any dynamic that involves medical personnel employed by a team:  player safety comes first, but there are, inarguably, biases that can creep into our decisions when player performance, especially in the setting of the World Cup or the Super Bowl, is at a premium]; and ii) who has the power, and the backing from the league, to disregard the player’s opinion, the coaches’ opinions, etc. and can mandate even the removal of a key player like, say, Tom Brady, for suspicion of a concussion, on the biggest stage of their sport.

And so, today’s poll:

References

[1] The Super Bowl’s Concussion Calculation, The New Yorker, Ian Crouch.

http://www.newyorker.com/news/sporting-scene/super-bowls-concussion-calculation, accessed 2/3/15