How Times Have Changed: A Look at Concussion Care

By Dr. Barry Willer, Ph.D.

In February 2000, Emily was a young mother heading home from her job as a software engineer when the accident happened. Her car hit black ice, spun out of control, and slammed into a tree. Her next memory was hearing a stranger asking, “Are you alright?” She reached up to touch her face and felt the blood coming from her ear.

In the ER, a young doctor stitched her ear and asked her if she had lost consciousness. She said wasn’t sure, but she did have a gap in her memories. The doctor didn’t pursue it further and instructed her to rest until she felt better.

Emily saw her family physician a week later because she was having unrelenting headaches. Her doctor also told her she just needed to rest.

Emily told me her story in 2018, when we were treating her son for a concussion. Her son is a very talented lacrosse player. We tested him on the treadmill and examined him for visual disturbance, neck problems and balance. My colleague, Dr. Leddy, gave him an exercise prescription and an instructional pamphlet on eye exercises. Because Jimmy was involved in our research, I had the pleasure of meeting him and that’s when I heard Emily’s own story.

“When I had my accident, no one told me I had a concussion. No one told me what to expect. It was months after my accident before I saw a specialist… a neuropsychologist I think… and she gave me a bunch of tests. She told me that because I did so well on the tests, there was nothing wrong with me and I was only having an emotional reaction to the accident.” Emily’s eyes were beginning to fill with tears.

Emily had many questions. I told her it is impossible to say exactly how severe her brain injury was, but the amnesia alone indicated that she certainly had a concussion. She added, “I had constant headaches, I could not concentrate at work, I had trouble sleeping. I just had so many problems and this doctor was telling me that it was all in my head. And she wasn’t the only one. I saw a neurologist who told me that a concussion, by definition, is temporary. When Jimmy was injured I was so afraid he would have the same problems I had. It was years before I felt right again.”

As our lab staff assessed Jimmy for physiological responses to his concussion, I explained to her that most neuropsychologists today recognize that the primary cognitive issue faced by those with concussion is fatigue, which cannot be assessed with tests. I also assured her that her headaches and concentration problems were the result of her concussion and not a sign of her psychological failing. She thanked me and said, “I wish the doctors had known all these things when I had my accident. I’m just so glad that Jimmy doesn’t have to go through everything that I did.”

Click here to read more about Dr. Willer’s important new research in concussion.