My son is a high school athletic trainer. We were discussing the problem of youth sports concussions recently and his responsibility to educate youth and parents about the risks. He rolled his eyes. Sports is everything to some of them, a golden ticket they all want to win at any cost. In addition, he lamented the fact that he couldn’t really DO anything for concussed athletes. He wanted to do something more than tell them to take it easy, watch out for signs, go to their doctor if needed.
I understand. As a speech-language pathologist with a 38-year-old brain injury, I want to do more for people with brain injury too. However – and this I know from personal experience: my own and others – once the damage is done it can never be undone. Brain injury can’t be cured with a pill or treatment. Brain injury is something you have to learn to live with for the rest of your life.
Dr. Robert Cantu, clinical professor in the Department of Neurosurgery at Boston University School of Medicine, best known for his role in the brain bank at BU where many deceased athletes’ brains are studied, worries about youth athletes too. He has been quoted as saying, “Kids’ brains have unique factors that put them at greater risk for injury than we adults.” In particular, the prefrontal cortex is not fully developed until a person’s early 20s.
The prefrontal cortex is right behind the forehead. It’s in charge of abstract thinking and analysis. It regulates behavior while mediating between competing thoughts and predicting outcomes. It chooses between right and wrong, governs social control and adjusts emotions and urges. The prefrontal cortex makes us human by preforming these high-level thinking tasks. It shows up on the outside as our attitude and our personality.
It seems to me that this information about what is at risk should one damage the prefrontal cortex is not getting across to youth athletes and parents. After a brain injury, what is lost is control, thought control. Now that I finally understand what is behind my emotional outbursts and tendency to get angry, I can control it just a little bit better (and medications help), but it’s still there. Having lived with slow thought processing and a jittery brain for nearly four decades I can tell you that you wouldn’t want to live this way, always a little like you’re holding on to normal by the tips of your fingernails, avoiding others for fear of a blunder.
It’s not for lack of caring that the word isn’t getting out, though. At the discussion in Boston where Cantu was a guest, the moderator asked what the biggest need in the youth concussion awareness field is right now. Everyone said that it was funding.” Forty-nine states and the District of Columbia have concussion education laws on the books and none are funded.” So websites and flyers are out there, but reading them is voluntary. No one is funded to bring the point home.