Leaving It All Out on the Field

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Wide receiver Mitch Ross ’13 suffered his first and only diagnosed concussion on February 10, 2011, during a seven-on-seven drill in a Harvard football practice. Jumping for a pass, Ross collided head-to-head with a defender and fell to the ground. With his eyes closed and head still ringing, Ross got up on one knee before walking to the trainer.

Lying on the trainer’s table, Ross allayed the fears of approaching teammates who worried he was concussed. Ross had not blacked out, and he believed the hit was similar to others he had played through in the past. Fourteen stitches later, Ross thought he had received all the treatment he would need for the injury.

But then came the sensitivity to light, the constant headaches, the loss of appetite, and trouble sleeping. Ross had suffered a concussion that forced him to miss classes for the next two to three weeks.

As he made arrangements to cope with the injury, professors were helpful and understanding. The Harvard athletics department was supportive.

But the following fall, after he was cleared to play football again, Ross stopped asking for extensions on assignments. Academics became more difficult as he struggled to maintain concentration for more than an hour at a time.

Now, more than two years after he suffered that first injury, Ross isn’t better yet, and he’s not sure if he ever will be.

“I know what I was [before the hit]” he says. “And I want to live up to what I was doing then. It can be frustrating at times when you’re sitting there trying to do something, and you just can’t do it because your brain—for some reason it doesn’t function the same way.”

Like the 400-plus Ivy League student-athletes who suffered diagnosed concussions this past year, Ross is living with the ramifications of brain trauma. Most injuries only sideline players from competing on the field, but concussions affect students-athletes’ academic performances as well, hanging over students even after their return to play.

These top-tier students play in a league with some of the strictest regulations regarding concussion prevention and treatment in the NCAA, but concussed athletes still scatter Crimson rosters. This season alone, two players on the men’s soccer team, at least three players on the women’s soccer team, and four of the 14 women’s basketball players sustained concussions, according to team members. About 55 Harvard athletes in total were diagnosed with concussions in the 2011-2012 season, according to Dr. Francis Wang, the head team physician for Harvard Athletics.

With little way of knowing how long their symptoms will last, concussed athletes face hard decisions. In making these choices, they are advised by resident deans and other administrators, who help them decide whether to take time off from Harvard following a severe concussion.

In recent years, the Ivy League and Harvard have made preventing and treating these injuries a priority. Many say that the league’s policies, which seek to limit dangerous contact in sports, are ahead of the curve. Players and coaches also praise what they describe as a greater awareness of the risks of concussions in the Harvard athletic community.

But despite these changes, student-athletes still risk an injury that could jeopardize their futures every time they take the field for the Crimson. Because once athletes take the field of play, Harvard can’t stop people from getting hurt. And every year, the concussions keep coming.

A Solution in the Making

Swinging lacrosse sticks, ricocheting soccer balls, and flying elbows lead to contact that can cause the brain to shift within the skull, resulting in health effects that last much longer than the initial blow. Some athletes who suffer concussions will return to play within a few days, while others will never suit back up, facing long-term repercussions that are still not fully understood by scientists.

The Ivy League’s policies concerning these injuries were thrown under a harsh light in April 2010, when then-University of Pennsylvania football captain Owen Thomas took his own life in his off-campus apartment. His suicide sparked a national conversation about the effect of brain trauma in college athletics. It was later discovered that Thomas suffered from early stages of Chronic Traumatic Encephalopathy, a degenerative brain disease found primarily in athletes with a history of repetitive brain trauma.

By then, the NCAA and Ivy League had already been working toward a solution. In August of that year, the NCAA implemented a series of regulations aimed at improving treatment for concussed student-athletes and increasing the percentage of concussive symptoms that are reported.

The new NCAA protocol affected Ivy programs minimally, given that most Ivy League schools had already instituted strict, if not stricter, policies on the same issues. The league took a more proactive approach, beginning to research ways to limit the prevalence of collisions in 2009 and instituting its first reforms in 2011, targeting football first.

Most notably, the new policy cut the maximum number of full-contact practices per week from the NCAA limit of five down to two. In 2012, the League announced updated regulations for soccer and lacrosse teams, stressing educational programming concerning proper technique, and again restricting contact in practice.

Chris Nowinski ’00, a former Harvard defensive lineman turned concussions activist, helped the league construct its new policies.

“[The Ivy League has] really been the leader at the college level,” Nowinski says. “They have had a great approach that I wish everyone had approached it with.”

Robin Harris, the executive director of the Ivy League, says that she’s proud of what the conference has changed thus far. But she also acknowledged that given the limits of scientific knowledge, the league can only do so much.

“I can’t tell you that we have all the right answers. We have the best answers that we know for now,” Harris says. “We are just going to keep monitoring this because we may need to change things down the road as we all...learn more.”

At Harvard, the answer for treatment begins with a baseline test at the beginning of the season. Athletes who are suspected to have a concussion are seen by a team physician, and if they are diagnosed with a concussion, their resident dean is notified and typically helps them make academic accommodations. Once players are no longer symptomatic, they must go through a battery of tests—a neurocognitive test, a balance test, and an exertion test—before they can get final clearance to return to play. But in some extreme circumstances, concussed athletes are encouraged to take time off from Harvard for recovery.

While concussed athletes overwhelmingly praise Harvard’s efforts to support them after their injuries, one player calls into question a policy that requires students who take time off from school due to injuries to demonstrate stability before they return to campus.

Former Harvard lineman Nick Scheidler ’13, Ross’s roommate and former teammate, left Harvard for a semester to recover after suffering a concussion. Scheidler does not remember filing his leave of absence in the fall of 2011, but says he was told he was required to get a job in order to return to Harvard the following spring—a requirement that he says got in the way of his recovery.

“I had to find the most mindless place I could because my brain wasn’t functioning well, so I chose Dick’s Sporting Goods,” Scheidler says. “Personally I feel like I needed to rest and recover more.”

According to Secretary of the Administrative Board John “Jay” L. Ellison, students who take a leave of absence for medical reasons must “demonstrate a stability that would indicate a readiness to return to the College and be successful” before re-enrolling. Students often fulfill that requirement by finding jobs or taking classes, Ellison wrote. He stressed, however, that adhering to the advice of medical professionals regarding a student’s treatment should take precedence.

Attitude Adjustment

Though many unknowns about the proper prevention and treatment of concussions remain, years of improved understanding and policy updates have coincided with a change in attitude at Harvard surrounding the issue of head trauma. Throughout his long term as the Crimson football coach, Tim Murphy has seen this shift take place firsthand.

“There was a time when the sport of football had a kind of warrior mentality, and there was a perception that if you went to the trainer with a headache or a concussion issue, that it was perceived by your peers as being a little bit soft,” says Murphy, who has led the Crimson since 1994. He thinks that in recent years, there might be more athletes who aren’t concussed being pulled from the field out of caution. “But that’s a good thing—it beats the heck out of the alternative,” he says.

Freshman Brooke Dickens is a member of the first class of women’s soccer players who will follow the Ivy League’s new rules on concussion prevention for four years. This year, the team devoted more practices at the start of the season to learning safe ways to head the ball, and Dickens, who suffered two concussions before coming to Harvard, says she thinks that her team respects the dangers of head injuries.

“I feel like the culture here is that people are generally open and honest and upfront about it, because we recognize that there is much more at stake besides our sport—it’s our health for the future,” Dickens says. “And I feel like being at Harvard, we are student-athletes, so it definitely would compromise the student part to not make a healthy decision regarding a concussion.”

Some players, however, aren’t always as cautious when dealing with their own personal health. Chase Sippel ’13, for instance, did not initially report concussive symptoms he experienced in the fall of his senior year.

“I didn’t want to go out like a punk, so to speak,” Sippel explains.

But eventually, a teammate told a trainer about Sippel’s state, and after being diagnosed with a concussion the senior was forced to end his Harvard career early and drop his senior thesis. He was heartbroken. But while watching a segment about concussions in college football on HBO’s “Real Sports with Bryant Gumbel,” Sippel finally realized the severity of his injury.

“I actually cried when they showed that Harvard guy that has ALS,” Sippel says, referring to former defensive lineman Michael Vollmer ’90, who, at 36, was diagnosed with ALS, a disease that has been linked to the type of repeated head trauma football players often endure. “They showed his helmet from Harvard, and I started to cry like a baby because that just hit home with me—that that could be me in 20 years.”

The Kids Aren’t Alright

Even with new policies and a cultural shift, Harvard can’t eliminate the dangers inherent in contact sports.

What Harvard does do, however, is tell concussed athletes to stop: stop playing, stop exercising, stop everything.

According to William Meehan, the director of the Sports Concussions Clinic at Children’s Hospital Boston, the only way to recover from a concussion is to rest. Any activity, physical or mental, saps from the brain energy that is essential to recover from the trauma.

“They’re like, ‘Everything that’s gotten you to Harvard, don’t do those things—be lazy, be useless for like a week,’” recalls women’s soccer player AJ Millet ’13, who was kept off-field for the final three weeks of her senior season after suffering her second diagnosed concussion at Harvard.

But for some concussed players, rest is not enough to avoid debilitating consequences.

Women’s hockey player Josephine Pucci ’13-’14 was one such athlete. During her senior fall, Pucci tried to cope with the symptoms from a concussion she had suffered in August while playing for the United States Under-22 Women’s National Team.

After returning to campus following the trauma, Pucci stayed off the ice. But her symptoms still worsened: soon she could not read without becoming ill. She met with a specialist at Massachusetts General Hospital, and their conversation led her to conclude that she shouldn’t finish the semester. Pucci ultimately elected to withdraw for a year to recover.

“I think that [the specialist] sort of gave me a wake-up call—like this is a very serious thing that’s not going to get better unless you treat it in the right way and rest, and totally take off from hockey and school, and not put your brain under any more pressure or stress,” Pucci recalls.

Pucci’s decision to leave meant giving up the captaincy of the women’s hockey team, eliminating her chance to compete at the 4 Nations Cup in November and the women’s World Championship this spring, and graduating a year later than she had expected. But she doesn’t regret the decision.

“I knew it was what I had to do,” she says.

Scheidler, the offensive lineman who worked a job during his time off from Harvard, faced consequences that lasted even longer. He was rising up the depth chart on the offensive line before suffering his second diagnosed concussion at Harvard, which sent him into intensive care and eventually ended his football career.

“I did not know my name. I did not remember the day. I did not remember anything,” says Scheidler of the moments after the hit. Scheidler was rushed to Mt. Auburn Hospital, where he spent two days in the intensive care unit.

While Scheidler recovered at Mt. Auburn, his mother flew into Boston. After his release, she took Scheidler to a speech therapist. The pair left the appointment in tears, Scheidler’s mother wheeling her son out of the door.

Weeks after the collision, while recovering at home in Indiana for the semester, Scheidler was still dealing with the long-term effects of his injury. He slept over 14 hours each night. He cried for no reason. “I definitely suffered a little depression,” Scheidler says, referencing one of many symptoms associated with repetitive head trauma.

Some of his darkest points that semester came while listening on the radio to his teammates battle on the football field from nearly 1,000 miles away.

“It was a torture,” Scheidler says.

Listening as his team fell to Holy Cross in its first game of the year, Scheidler broke down.

“I could not take it,” he recalls. “I was like, ‘I need to get out. I need to get out of the house. What’s some normal activity I could do to show myself that I’m getting better?’”

Seeking a sign of progress, Scheidler went mini-golfing with his younger sister. But after the fifth hole, he was so tired that he had to take a nap on a bench.

When Scheidler returned to campus at the start of the spring semester, his troubles continued. During a math midterm, it became clear that his mind had not fully recovered. “Every single problem I looked at, I was like, I know how to do every single one of these problems, but I just can’t,” he recalls. “For some reason, I’ve lost it.”

As a result, Scheidler went to a sports neuropsychologist who put him through a barrage of tests so mentally taxing that at one point the recovering athlete fell asleep on the doctor’s couch. Scheidler, who had scored in the 90th percentile on the SAT in high school, placed in the 78th percentile and was diagnosed with a temporary learning disability.

*****

At a time when prevention and treatment of the injuries affecting players have never been more advanced, it has become clear that the consequences of concussions are more serious than had been previously envisioned.

Concussed players can only guess how extreme these consequences might be. Some worry they might struggle to concentrate for years to come, while others fear that the emotional effects of head trauma may dog them for the rest of their lives.

Head athletic trainer Brant D. Berkstresser says he thinks that for now, there’s not much more Harvard can be doing to alleviate these risks. He points out that scientific research holds promise, and Harvard is continuing work to prevent the mental, physical, and emotional consequences of concussions.

Yet even at a school that is doing all it knows how, the best possible treatment may not be enough.

—Staff writer Jacob D. H. Feldman can be reached at jacobfeldman@college.harvard.edu. Follow him on Twitter @Jacobfeldman4.

—Staff writer Maya Jonas-Silver can be reached at mayajonas-silver@college.harvard.edu. Follow her on Twitter @mayajonassilver.

—Staff writer Martin Kessler can be reached at Martin.Kessler@college.harvard.edu. Follow him on Twitter @MartinKessler91.

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This article has been revised to reflect the following correction:

CORRECTION: April 4, 2013

An earlier version of the caption accompanying a video of Nick Scheidler '13 discussing concussions incorrectly stated that Scheidler is a former Harvard linebacker. In fact, Scheidler is a former lineman for the Crimson.