Football's Big Headache

THERE WERE two moments of pin-drop silence last Saturday afternoon at Ridgewood (N.J.) High's football field. The first was just before the game between the undefeated Maroons and the Montclair Mounties. Several hundred heads bowed in memory of Ryne Dougherty, a junior Montclair linebacker who died last week after he suffered a brain hemorrhage while making a tackle in a JV game, less than a month after suffering a concussion in practice.

The second came with the game tied at 14 and 1:42 left in the third quarter. Montclair's senior quarterback Luke Iovine had scrambled toward the right sideline as a wave of Ridgewood defenders washed over him, one of them putting a helmet right on his. Iovine lay motionless on the grass, a faint streak of maroon paint splashed across his white helmet. After several minutes the dazed QB was helped to the bench, where Anthony Delfico, an orthopedic surgeon who was serving as Ridgewood's team doctor for the game, gave him a thrice-over.

"Do you remember who had the ball on that play?" Delfico asked.

"I did," Iovine replied.

"Do you remember what the play was?"

Iovine thought for a moment and then shook his head, no.

Delfico told Montclair trainers that Iovine had a concussion. Iovine's father, also named Luke, a lawyer who was a standout QB for Montclair in the 1980s, made his way down from the stands to make sure that the man examining his son was not being overly cautious because of Dougherty's recent death. "He got hit in the head, he's dizzy, he has a headache and retrograde amnesia," Delfico told the father. "That's the definition of a concussion." Meanwhile, Luke was in tears, insisting he be put back in the game, which Montclair won in overtime. "I can go back in," he repeated. "I don't understand why I can't go in." On the way to Valley Hospital, Luke, 17, begged his father to turn the car around.

Luke's plea underscores the biggest obstacle in football's ongoing battle with concussions: unreliable victims who are part of a macho culture in which playing down injuries is a hallowed tradition. Concussions "don't show up in brain imaging," says Kenneth Podell, director of neuropsychology and the Sports Concussion Safety Program at the Henry Ford Health System in Detroit. "A lot of times it's based on self-reporting of symptoms, and it's believed about 15 to 20 percent of athletes fake having no symptoms to get back in the game."

Lying through their recently rattled teeth is not just a problem with overeager kids. Last year, the NFL faced criticism after reports of several former players who had brain damage before their 40th birthdays. Those men often took little or no recovery time following a concussion, and a second concussion before the first is healed can cause serious damage. However, the outlook for current pros (on average, there is one concussion every two games) is brighter than it was for their pioneering forebears. Every NFL team now gives players a neurocognitive test—a battery of memory and concentration exercises—before the season. If the player takes a hit, he can be benched until his scores return to the baseline.

But as long as self-reporting is part of the evaluation, players can, and will, talk their way back into action. What's truly scary about Dougherty's death—the second fatality caused by a brain injury in New Jersey high school football this season—is that doctors took significant preventive steps in the days before it happened. Dougherty suffered a concussion on Sept. 18. He was given a neurocognitive test and a CT scan and passed both, but he hid the fact that he was having headaches from doctors and told them he was ready to rejoin the team. He was cleared on Oct. 6. "He wanted to play football so bad," says his mother, Marinalva Schnarr. "That's why he [told doctors] he felt fine." He died on Oct. 15, two days after being rushed from the field with a bleeding brain.