HJNO Nov/Dec 2023

HEALTHCARE JOURNAL OF NEW ORLEANS I  NOV / DEC 2023 23 was taking care of my dying, former player husband whose brain was filled with glio- blastoma and also was confirmed to have CTE at 54. What struck me in your answer is the part about trying to reduce helmet-to-helmet hits, although it is still happening. My hus- band’s friends periodically send me videos of some of Smith’s catches during a game. Where these were once celebrations, all I can see now is how he lands and how his head hits the ground. I believe I even sent one to you, asking if you thought his brain was damaged during that catch. The other day, I was driving past little kids on a football field. They were so little — they had to have been five, six, maybe seven — and I watched them practice, and the coaches were yelling at them, “This is tackle football. You run up to them and you have to hit hard,” trying to teach them how to play. They’re walking around like bobbleheads, and they’re trying to figure it all out. The coach keeps yelling, “Right shoulder to right shoulder.” Half of them don’t even know what the right shoulder is, so they hit in the middle, but I didn’t see a lot of direct head hits. I saw one kid with the Guardian helmet on, and I was wonder- ing, “How impactful are those? How jarred are you when you get hit at those G-forces we know players get hit at, and what is that doing to the brain? Is the game safer now? And will it take us two decades to know be- cause the players now are playing a little differently?” Stern And we can’t wait, obviously. Yeah. Editor Yeah. Stern We don’t know. Anything that reduces the amount and severity of the hits is great, but they are still hits. Yes, kids are tackling differently in general. Coaches are trying to reduce head-to-head. That’s great, but the heads still do hit, and the kids still do fall on their heads all the time. With every big tackle, no matter what, someone’s fall- ing on their head, and if they don’t fall on their head directly, they fall on their back or side or, somehow, their neck snaps back and they hit their head. So, oftentimes, there’s a double whammy to the brain by, first the body making the head move quickly, vio- lently, and then the head hits the ground or sometimes head-to-head and then the head hits the ground. What I suggest is walk by, maybe even those same kids, during a game, and see how many kids are falling, how many kids are actually hitting their heads. Things are getting a little bit better, but you have to think about what human beings are supposed to be. We were given these big brains, or we evolved with these big brains based on the survival of the fittest. Those bigger brains were what made us humans, able to do all the incredible things that we have done. Those brains are at the top of our bodies. They’re inside our heads, inside the skull. They’re not in our kneecaps, they’re not in our abdomens, they’re not in our feet. They’re up there, and there’s no reason at all for human beings to hit our heads repeat- edly. There is no reason, as animals and as intelligent, cognitive creatures who are able to learn and alter our behaviors based on things that can hurt us. As we evolved, we alsomaintained a lot of the “animal”without those big frontal lobes and all the different levels of animal with limbic systems, those reptilian systems, that are as early as can be in the animal world. These have to do with power, our reptilian emotions or responses and reactions to things without thinking or filtering. In other words, we still love violence. We like to watch it. We go back to the days in the Roman coliseumwith people screaming and yelling. That hasn’t changed. We, as human “There's now adequate research, time after time, in college studies, high school studies, even youth studies, that show that just one season of play can have significant changes to the structure of the brain, including the white matter of the brain, to the functioning of the brain using a variety of techniques, to various blood-based biomarkers demonstrating various types of injury to the brain, to cognitive functioning, intellectual functioning.”