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The Concussion Crisis: Anatomy of a Silent Epidemic Hardcover – September 13, 2011
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“The parents of teenage athletes should take a careful look at this book.”
—Abigail Zuger, M.D., The New York Times
“Thoughtfully passionate and comprehensive…. Quite a devastating testament. It lays it all out and forces us to ponder how a civilized people can blithely accept an entertainment that does such damage to young men’s minds.”
—Frank Deford, The Washington Post
“The Concussion Crisis should be required reading for players at all levels, parents, and coaches…. [One of] the 10 best [sports] books of the year.”
—The Boston Globe
“In The Concussion Crisis, health writer Carroll and sportswriter Rosner team up to offer a jolt on the head—intellectual only—to those who’ve tended to dismiss blows to the noggin as innocuous…. The book is a clarion call to take full measure of the broken brains and bodies among us.”
—The Globe and Mail of Canada
“Important…. A book everyone involved with football or concerned about the sport must read.”
—Gregg Easterbrook, ESPN.com
“A very hot topic…. This noteworthy book issues a challenge to the ‘macho play-through-the-pain’ sports culture and urges a rethinking of safety versus spectacle.”
“A powerful call for action on the part of parents, coaches, and older athletes…. A good primer for parents whose kids play contact sports such as football.”
“The Concussion Crisis puts a human face on traumatic brain injury through real-life stories of athletes and soldiers. The authors define the problem, explain the science, and accentuate the need for prevention. This informative book sounds a much-needed alarm for medical intervention, continued research, and a reassessment of how we play sports.”
—Michael J. Stuart, M.D., co-director of the Mayo Clinic’s Sports Medicine Center and chief medical officer of USA Hockey
“There is no injury I worry about as a coach more than concussions, and this book shows why. It’s a must-read for athletes and their parents.”
—Anson Dorrance, coach of the USA’s first World Cup women’s soccer champions and of UNC’s 20-time NCAA champions
“Carroll and Rosner tell some utterly heartbreaking stories, but their book, ultimately, offers hope by giving readers the information and resources they need to confront a public health crisis. They show us that a concussion does not have to be a life-altering event, but it can be if it is not properly recognized, respected, and treated.”
—Michael Sokolove, author of Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports
About the Author
Throughout her two decades as a nationally respected health and fitness writer, Linda Carroll has mastered the art of making complex subjects entertaining and accessible for the average reader. She has written for a wide range of prominent publications, including The New York Times, SmartMoney, Health, and MSNBC.com. Currently, she is a contract writer for NBC News, covering health and business. An accomplished equestrian, Carroll brings more than thirty years of experience in breeding, training, and showing horses. For the past two decades, she has owned and operated Fiery Run Farm, where she has hands-on control of breeding and training her twelve Arabian and Oldenburg sport horses. For more information, visit the farm’s website at FieryRunFarm.com.
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The book gave innumerable examples of concussions, second impact syndrome, Alzheimer's disease, "punch-drunk" syndrome, and also chronic traumatic encephalopathy. All of these examples of diseases were humanized with several examples of people suffering from them. The purpose of the book was to raise awareness to the severity of head injuries and how easy it is to overlook the symptoms. The book also laid out several examples to show that concussions are not limited to contact sports like football and ice hockey. Stories of soldiers, cheerleaders, female soccer players, housewives, and car accident victims are thrust into the forefront of the book. How these people live their lives after brain injuries; injuries that may not have been realized until several hours, days, weeks, or years after the incident that caused the damage.
The actual science of brain injury was not touched upon until the second half of the book. Interesting facts are explained in a way that allows for someone without a background in neuroscience to understand. For example, the axons of people that have been diagnosed (post-mortem) with chronic traumatic encephalopathy (CTE) are significantly different than the axons of healthy people. They are characterized by the deposition of the protein tau throughout their axons. This tau protein shows that the axon has been damaged to the point that it can no longer function properly and it's structure has been irreversibly changed. The accumulation of tau was shown in sections of brains from people aged 18 to 80. When the lead scientist studying these brains was questioned about how she knew the deposition of tau was not a regular process of aging, she said that she had seen the brain of a hundred and ten year old person that was "pristine," with zero evidence of any tau protein. In patients where CTE has been present for a long period of time, there is another protein at the terminal ends of neurons called amyloid beta that contributes to amyloid plaques within the brain. Researchers finally pieced together the similarities between patients with CTE and Alzheimer's disease; both have tau protein deposited in their axons and amyloid plaques from amyloid beta. However, with Alzheimer's patients, the tau protein and plaques are systematically taking over the brain, but with CTE patients the only places that show significant tau and plaque deposits are places where trauma has occurred. These findings are presented in a way to allow a person with no scientific background to understand that repetitive blows to the head cause permanent changes in brain structure, regardless of age.
The authors have laid out a factual, and evidence based argument about how the processes of identification and treatment of concussions must change. They do this by writing each individual person's story almost as a journal entry or case study. This allows for the book to be broken up into chapters by specific topic, and within each chapter to be broken into several smaller journal-like case studies that chronologically go through each person's injury and the aftermath of their injury.
Overall, this book was informative, heartfelt, and real. By taking examples of everyday people suffering from various types of traumatic brain injury, the authors have been able to make the symptoms and suffering associated with head injury apparent to people who may not understand the severity of their conditions. The book also goes into great detail about the attitudes of athletes, both in the past and the present, of not removing themselves from a game even though they were expressing symptoms. The competitiveness of athletes with head injuries makes them a danger to themselves because they will try any way possible to return to the field of play in the shortest amount of time. A traumatic brain injury cannot be treated like a pulled muscle or a broken bone; it is not a situation to play through the pain. This book relates to athletes by showing them that big name athletes such as Steve Young, Troy Aikman, and numerous others had to make decisions regarding their mental health and end their careers prematurely because of recurrent head injuries and returning to play too early; which did not allow for proper recovery time for their brains. According to the authors, the days of "stingers" and "getting your bell rung" are a thing of the past, and must be removed from the culture of contact sports. As addressed in the book, people that are involved in a sport where traumatic brain injuries can occur must be aware of the warning signs to protect themselves, and the athletes around them.
I would recommend this book to people that know, or could know, someone that has suffered from a concussion or a traumatic brain injury. By reading this book, you are not only educating yourself to the warning signs of people with a potential concussion, but you are also educating yourself on the recovery process and how frustrating and confusing it can be. I am going to give this book a 5 out of 5 star rating because it was both enjoyable and informative. The ability of the authors to convey the importance of proper identification and treatment of concussions using scientific examples and case studies without losing their audience in scientific jargon is what makes this books so special. In my opinion, the most useful purpose of this book is to educate parents, athletes, and coaches of kids in any sport or environment where it would be possible for them to suffer a concussion. As the coach of a youth hockey team, I feel much more educated about possible symptoms and I will recommend the book to my fellow coaches and the parents on my team.
The stories they use to highlight the immense damage concussion ignorance has done to many great people will break your heart. And open your mind.
You should buy this book and get copies for anyone, especially young people, who play competitive team sports.
This book takes you through the stories of several kids - from the kids perspective and intersperses these stories with research on brain injury. We all need to be more aware of the signs and that our kids, who are avid sports players, will want to hide the signs in order to continue to play. You owe it to every kid in your life to read this book.
The majority of the book takes shape as accounts of those affected by concussions, and not just the immediate victims. The early chapters focus more on young athletes and display their general lack of knowledge regarding concussions as well as the environment that fosters such a lack of knowledge, created by coaches, teammates, the victims themselves, their parents, and even team physicians. These stories are written in the style of a news magazine unearthing a dark and disturbing underground culture where player safety is sacrificed in the name of the game, be it soccer, hockey, football, or others. Often times the afflicted are simply unaware of what a concussion is and whether they've sustained one; other times they underestimate their severity and potential long-lasting consequences. In several separate instances, a young athlete primed for success succumbs to multiple sustained head injuries, falling behind in both school and sport. Others, such as the case of Zackery Lystedt, are true tragedies resulting from a single vicious impact leaving them crippled for life. Lystedt becomes the namesake of the Zackery Lystedt Law, which aims to keep athletes safe by pulling them from a game after sustaining a head injury of any kind. In his own words, Zackery "just [wants to] make sure this doesn't happen to anyone else."
As the book progresses, the focus shifts to more ordinary people, those not even involved in sports. Carroll and Rosner try to communicate to the reader that it isn't simply the young and oblivious who can fall victim to the debilitating effects of brain injury. In one account, a young woman sustains what appears to be a minor bump on the head during a fender-bender. What she comes to realize is that she's sustained serious trauma to the brain, which affects her ability to perform the duties required of her job and causes her to "[find] herself losing her temper and screaming at people for the most minor of infractions." Lacking the knowledge to find therapy, her condition proceeds to deteriorate, resulting in a mind so disconnected that a messy house filled with sticky notes becomes her home due to her inability to remember to do simple tasks. Finally with the years, technology and knowledge advances, and she's able to find the therapy she so desperately needed long ago--but perhaps a little too late to completely restore her cognitive functions.
The rest of the book follows a similar pattern, bringing back a few recurring "characters" such as the scientists who study traumatic brain injury, the physicians who treat it, and the afflicted who seek to bring about change in the culture, be it the culture of boxing, professional football, or working Joes. Despite the inclusion of neurologists who made such pivotal discoveries and advanced the cause, only the fundamentals of the science itself sufficient to understand the basic storyline is included in the book. Those with no background in biology or medicine can easily follow the descriptions of various procedures and references to the brain and what it means when said brains contain unnatural bundles of protein following trauma to the head. While this is good for "getting the word out" so the layman can understand the severity of this "epidemic," as the authors put it, it leaves something to be desired for those who want to delve deeper. If anything, though, the book could surely encourage someone generally uninterested in concussions before to eagerly seek out other sources of information though; this, I think, is what the authors were aiming for. This isn't scientific literature; it's essentially a greatly extended piece of advocacy journalism. The cover alone indicates as much. It's not an image of a brain, showing areas typically damaged in mild traumatic brain injury or slides of tissue with characteristic markers of damage; it's a young athlete racked by the symptoms of post-concussion syndrome. This is meant to stimulate the heart into action more than the mind into deep analysis of facts.
As the focus is exposing widespread ignorance in a culture that downplays injuries as signs of weakness, there are many examples of real people finding themselves in tough situations dealing with head injuries themselves or watching everything unfold for someone else. There are many, many examples of this. The book is a relatively long read, with every chapter being a healthy chunk of 20-30 pages. Each chapter may cover just one person's story or several related accounts. Many of these stories unfold in a similar fashion, feature similar themes, and cover similar information. Often times reading the book I felt that the inclusion of so many stories was for the purpose of padding--and the writing style is full of typical journalistic embellishment. None of this is a bad thing exactly, but I do feel the book could have been significantly shorter and more easily digestible had a few of the accounts been cut. Once you've read a few stories of someone losing their hopes and dreams at the throes of traumatic brain injury, you get the point. Perhaps clearing out some of the padding would have left room for a more in-depth examination of the science involved, including a more comprehensive overview of the brain itself and why we should expect this organ to be so sensitive. The book makes it clear that concussions cause brain damage; but why is the damage so pervasive, so stubborn in its refusal to dissipate like so many other afflictions? Even a brief introduction to brain anatomy and function would have been helpful in linking everything together in the reader's general understanding of the issue. I don't mean to imply that there is no discussion of the science here; there's plenty to understand what's going on, but it could use a better foundation. As one with a basic knowledge of neuroscience myself, this was not an issue, but I can't speak for those who lack such knowledge.
It's missing the point to focus too much on these shortcomings, though. From those looking to peer into a world they may not be aware of to victims coping with the effects of concussions themselves, "The Concussion Crisis" is a generally rewarding and very informative read. If nothing else, the affected will come to know that their fight is not one they fight alone, and there exist those who understand and can help. The stories contained within serve the purpose of caution so that others may learn from mistakes already made. The reader, no matter their purpose, will also be made aware that the culture is changing, and the future grows ever brighter for those whose lives have been made so foggy and dark from a truly unfortunate and in no way "mild" injury.