In the 69th minute of the Magners League final in Limerick last weekend Ronan O’Gara had another speed-bump experience. It was not unlike the one he had last year at the hands of Jamie Heaslip in the RDS. Or the episode with Pierre Spies in Loftus Versfeld in the second Test between South Africa and the Lions in 2009. They all had two things in common: O’Gara was dazed to the point where he couldn’t stand up straight; and he continued playing.
In the latest instalment he got hammered when trying to tackle Isa Nacewa, and clearly bounced his head hard off the ground. He was holding the back of his head as he tried to get up. When he did get up he couldn’t get his balance for a while. He looked all over the place. Two minutes later, after medical treatment, he was asked to kick a penalty in front of the posts from about 35 metres. He missed.
Yesterday the IRB issued its latest guidelines on the diagnosis and treatment of concussion. They include a checklist of criteria in the first place, and if the injured player ticks any of these boxes then he must be taken off and not allowed back to play that day.
So, if for example you are ‘unsteady on legs’ or have a ‘vacant expression’ you’re off. Similarly, if you have either ‘headache’ or ‘dizziness’ then you’re also done for the day. Clearly O’Gara satisfied the first two, and I’m going to take a wild stab and suggest he should have answered yes to the other two as well.
Of course I don’t know what he answered at the time, but another wild stab would be that he said he was fine and wanted to continue. O’Gara may not be the hardest hitter on the planet but no one is more competitive. So he stayed put.
And he will continue to risk his health like this until he has a radical change of approach, or until the decision is taken out of his hands. This is what the IRB needed to do with their concussion guidelines: to introduce independent medical examiners in the professional game.
Chris Nowinksi is co-director of the Boston University Centre for the study of Chronic Traumatic Encephalopathy (CTE). A former pro wrestler he suffered for five years with the after effects of too many dings in the head, having been forced to give up the sport because of repeated concussions. He has been at the forefront of the battle in the US to get American football to face facts over the dangers of its sport.
“There’s a huge conflict of interest being the team doctor,” he says. “And it’s very difficult for the doctors to perform their job adequately and show up because you know that the conservative doctors who – if they actually pulled someone out for concussion – wouldn’t be the team doctor for very long. And I firmly believe that.”
Nowinksi was the keynote speaker at a Dublin Neuroscience Conference in Beaumont Hospital earlier today. During the course of a disturbing presentation which illustrated the connection between repeated bangs to the head and the subsequent development of CTE, Nowinksi flashed up on screen the suicide note of a former Chicago and Giants NFL star, Dave Duerson (aged 50).
‘Please see that my brain is given to the NFL brain bank,’ Duerson wrote in February this year, before shooting himself in the heart – so as to preserve what was left of his brain for the pathologists. CTE is basically dementia, previously known as punch drunk syndrome because it was thought it affected only boxers. Not anymore it doesn’t.
Duerson’s quality of life had deteriorated to the point where suicide was more appealing to him. Andre Waters had been in the same boat in 2006. Nicknamed ‘Dirty Waters’ because of his technique of leading with his head so as to cause maximum damage to opponents, his brain was likened to that of a 90 year old suffering dementia. He was 44 when he shot himself.
The thing with CTE – which is entirely distinct from Alzheimer’s – is that the only way you can get it is by having your head whacked. Over a sustained period. How many times do you reckon rugby players have their heads hit hard over the course of one season? And how many times do they get a concussive belt and play on because of the unwritten rule that if you can walk you can play?
Ronan O’Gara and those who look after him need to think about this before he laces his boots for the World Cup later this year. He thought he was doing his team a favour by staying on the field last Saturday night. He wasn’t. And the person least served was himself.