Sunday, September 1, 2013

football's more dangerous cousin, war

I'm a nerdy girl. I'm not a full on nerd. There are only a few comic books I like (Terry Moore's Strangers in Paradise; Neil Gaiman's Sandman and Endless series). I never got into Buffy the Vampire Slayer (the tv series; the movie was 1990s movie gold) or Doctor Who. However, I did get a letter jacket in high school for Mock Trial, which is pretty nerdy. I read a lot. When I was told my daughter probably should not play sports because she was born with a solitary kidney, I wasn't too concerned. My husband, who owns way more comic books than me, lettered in marching band in high school. It is unlikely the two of us would somehow produce an athlete.

Our daughter was born in 2008. All I knew about football then was that it involved throwing a ball and tackling people, weird dances when your ball went were it was supposed to and eating lots of queso every January or February. In 2008 I knew even less about brain injuries than football, despite my husband having driven over a bomb the year before. I had no idea that my husband had a life-changing TBI (Traumatic Brain Injury) or that his injury was relatively common in football players.

I now know more about TBI than at least one neurologist I've encountered in the VA (Veterans Affairs) health care system. I still don't know anything about football except that football season just started and that brain damage is very common in football players. This year when I watched the Super Bowl I was the life of the party. Whenever big burly men would slam into or pile on top of each other I would exclaim, "ooooo that's a TBI!" My knowledge of TBI and its sneakier, scarier cousin CTE (Chronic Traumatic Encephalopathy) have led me to care about football players, if not the sport itself.

I have read several articles about whether or not watching football is a moral issue and I have asked others that myself. What concerns me though isn't the moral character of football fans. What concerns me is the visibility of football players with CTE. When I see a Sports Illustrated cover with a football wife proudly standing next to her husband, I feel compelled to read about her fears that one day he will not know who she is. I share her fears, but no one cares about me or my husband. He is not as marketable a story as a football hero. After all, he was only a soldier. He never earned millions chasing a ball down a field. He instead spent his time chasing men who were trying to kill him. He did not earn a single champion ring. Instead, he earned a CIB (Combat Infantry Badge). We don't have the money to see the best doctors money can buy. Instead we see whomever the VA gives us or whoever will take Medicare.

Sometimes those doctors listen to us. More often, they pass the buck, asking us why speech pathology or a neurologist hasn't taken care of us yet. A speech pathologist at the VA said my husband was lucky he was smart enough to make accommodations for himself. He also gave Karl a list of websites with games that may help improve his memory and processing time if he plays them often enough. In Karl's only appointment at that clinic, they told him they were so busy with men who were worse off than him that it was unlikely they would see him again and they haven't. Another time, a psychiatrist ordered my husband a battery of neuro-psych testing. The results of his testing showed delayed processing and short term memory loss, but no one had followed up with us. When we went back to the psychiatrist a year later, I sat in her office and cried. She sent us to a neurologist who denied my husband could have any long-term effects from driving over a bomb.

"He's just depressed," the man told me as I looked at him with a befuddled expression on my face.

In the past decade, there has been significant research proving that even a single blast-wave can cause permanent, life-altering damage to a brain.

Unfortunately, we are at the mercy of the system. When there is only one neurologist in your area at the VA, you will see that neurologist, whether or not he understands the constantly evolving field of brain research. When the VA's speech pathology clinic in your area is inundated with other veterans who also have TBI, you will not get another appointment unless you are a severe case. We have had slightly better luck with doctors whose offices accept Medicare, but they have extraordinarily long waiting lists. Consequently, when people ask if my husband will get better, I have no answer.

Clinically speaking, each TBI is different. There is no way to predict whether or not a brain will find ways to reroute its information. Furthermore, CTE is only detectable post-mortem. This means, in the simplest terms possible, that if a football player or a mere mortal starts exhibiting signs of dementia or memory loss following a head trauma, no one knows what exactly is going on or what is going to happen next. Some neurologists are now saying that even TBI is degenerative.

I hope the football players are getting better care and more answers than we are. I hope they do not let the NFL or anyone else pay them off and sweep them under the rug. My husband is at the mercy of an overwhelmed system, but men with money, power and a public face are not. They can use their notoriety to call attention to brain injuries. As we learn more about their brains, we are learning more about the brains of men and women who suffer head trauma in war.

I still do not understand football. I know only that it involves a ball, some dancing, a Bowl, some queso and there are over a thousand professional football players every year at risk for brain injuries. Men whose names are known, men who are considered heroes, men who are visibly and vocally suffering through the "signature wound" of the wars our country has been fighting for over a decade now. These men have the ability to help further brain research for another kind of hero.

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