"The Concussion Crisis: Anatomy of a Silent Epidemic," by Linda Carroll and David Rosner outlines the dangers and risks of concussions and other brain trauma that go undiagnosed or ignored. Both Carroll and Rosner are journalists. Carroll has written for msnbc.com, Newsday, and The New York Times over the past twenty years with many of her articles covering women's health and investigative stories on brain science. As for Rosner, he was also a writer at Newsday at one time but his interest and experience with the human brain has come from working as an editor for Neurology Now; a magazine for patients from the American Academy of Neurology. "The Concussion Crisis: Anatomy of a Silent Epidemic" is the first book to be authored by either Carroll or Rosner, and it is obvious that they are journalists in the way they divided up the different topics within the book. The chapters are on various topics, and each chapter is broken into several segments of stories of people with traumatic brain injuries. Each of the segments within is written in a style similar to a journal article that follows the patient from induction of the injury to present day, and how they are coping with their newly acquired impairments. I really enjoyed the book because of the journalistic approach within each chapter allows for a unique flow and allows for the authors to group together people whose traumatic brain injury, and it's side effects, share a resemblance.
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.
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