CONCUSSION: Bioethics, Foot Ball and Post Traumatic Lies.

Concussion is a documentary biography about medical science’s triumph over a social and corporate conspiracy to suppress evidence of a serious preventable disease. Forensic pathologist, Bennett Omalu, MD, discovered a pathognomonic sign confirming chronic traumatic encephalopathy (CTE). He happened to find it in a cluster of professional football players during autopsies. Concussion was written and directed by Peter Landesman, who managed a riveting story pace, despite most of the visuals occurring in the inglorious world of microscopes and morgues —done to death on television. 

Will Smith’s Dr. Omalu in the lead role is a flawless interpretation of African born Omalu. The supporting cast includes Alec Baldwin, Gugu Mbatha-Raw, Luke Wilson, Albert Brooks, Adewale Akinnuoye-Agbaje and others. Ridley Scott is the principle producer. This is a heavy hitter production. Though several Black film awards recognized the work, few others have. Perhaps this is because the lead character is a Black man who is not blowing up anything, except the gladiator culture we like to call Football.

Concussion is a gentle story where a brilliant man driven by unflappable moral instinct does the right thing. Others join him, many kicking and screaming, eventually recognizing the effects of repetitive concussions in football and so elsewhere. The fact that this bold faced David and Goliath story, taking on the industry of Football, has had such a poor reception is a shocking, though not a surprising, eyebrow raising event. As the old word play goes, “Denial is more than a river in Africa.” 

Traumatic Brain Injuries from bomb blast during war, car crashes, playing football and other sports, share similar features.(See Going the Distance on this blog.) Exploring Concussion makes viewers understand the randomness of traumatic brain injury (TBI) especially with all those shots of players on the film colliding, pulled from game stock footage. It is similar to watching car accidents from a helicopter.

The effects of CTE develop progressively over a long latent period, often 1-1.5 decades into a football career. TBI goes to dementia more often than not if, a person lives long enough. Dementia is certainly the insidious boogyman many adults in the wealthiest nations most fear. 
If syphilis was considered the great masquerader during the first half of the twentieth century, and AIDS that of the latter half, TBI is vying for the role in this millennium. 

The emergency room is often where patients with traumatic injuries are first seen. How fast was the vehicle moving? What did it hit? These are among the first questions asked by ER clinicians. They are quickly estimating the amount of G-Force the person has been subjected to upon encountering an immovable object, like another car, or another players football helmet. 

When patients leave the ER, they often are relieved by the proclamation that a “brain scan” showed no bleeding. They do not understand the comment does not mean brain injury is absent. It only means one kind of brain injury has not been seen, bleeding. Bleeding is an acute brain injury which is treatable if recognized. CTE so far is not treatable, only preventable. 

When the injured ER patient is they told to come back if they vomit, have unequal pupils, and to have someone around to do “neuro checks,” they do not understand, these are signs of  brain swelling from edema or bleeding. The complications of repetitive, or single concussions do not usually manifest immediately and tend to be very subtle initially. People need to be told watch for those signs down the line and seek clinical assistance even if distant for the incident of injury. 

G-Forces of 50G or greater against a head causes a concussion. The outcome of that concussion only becomes clear overtime. Football players routinely suffer greater than 90G hits repetitively. The luke warm public response to the film Concussion reflects the reality that this “message film” convey’s at least one notion so terrifying that most parents and football fans, do not want to hear. The most poignant scene of the film is the final one, when you see it, you will understand why. 

Recent science and trauma protocols suggest neurological logical rest following brain injury improves late outcomes. Rest is a more appropriate instruction than, ”you are fine.” In bioethics, beneficence or doing good with the knowledge of science, out ranks both autonomy 


Concussion directed by Peter Landesman (2015) Star Capital
Village Roadshow Pictures,Scott Free Productions,The Shuman Company
Cara Films, The Cantillon, Company Star Capital (USA)122 min.


 "Concussion by Jeanne Marie Laskas | PenguinRandomHouse.com". PenguinRandomhouse.com. Retrieved 2016-01-11.

The Concussion foundation http://concussionfoundation.org/

Boston University Brain Research Bank http://www.bu.edu/cte/our-research/brain-bank/

Center for Disease Control Brain Injury Recovery http://www.cdc.gov/traumaticbraininjury/recovery.html