What Science Doesn’t Say About Head Trauma
In an absurd collision with teammate Wayne Simmonds’s knee, Claude Giroux is now the third Flyer to jump on the concussion bandwagon. Sydney Crosby is out again due to concussion symptoms, and this series about the life and death of Derek Boogaard in The New York Times has swirled up all kinds of head trauma coverage. In fact, since my last column, the number of players with head injuries is up to thirteen and the debate over what to do about hockey’s head trauma problem has only intensified.
Despite my efforts to read about other things — like the league realignment or the recent spate of coaching changes — I find I’ve developed something of a tic whereby my finger “involuntarily” moves the cursor toward any link with the SEO keywords: hockey, fighting, CTE, or head trauma. Or: Flyers (at least I’m honest). To say I’m a little obsessed with the topic is dangerously close to an understatement.
Strangely, this predicament has caused some struggles in the writing department. The Idler doesn’t demand coverage of the latest he-said/she-said, but in this case I can’t seem to focus on anything else.
The other day, though, I decided to embrace my obsession after reading a Times article that polled neurosurgeons and neuropsychologists for their opinions on what the NHL should do to protect its players, particularly with regard to fighting. While most people would expect doctors to offer a scientific basis for new regulations or new protective equipment, many of the experts cited said that the science surrounding the long-term risks of head trauma is uncertain. Therefore, there is no conclusive scientific evidence that NHL must take action at all.
As one neurologist put it, referencing the league’s decision to ban checks to the head a few years ago:
“In essence, I would say there’s no more evidence that fighting is bad for the brain than there is that hits to the head are bad for the brain. The amount of evidence is the same — essentially, very little. Yet the decision was made on a policy level: let’s take head shots out of the game. There’s no more evidence, or less, for head shots than there is for fighting.”
The doctors raise an excellent point: this isn’t a science imperative, it’s a policy decision. In other words, evaluating the decision to forbid fighting (or not) in the context of policymaking offers an important lens through which to view this controversy. By separating what science can tell us about the long-term risks of head trauma (caused by fighting or otherwise) from the policy decision the NHL can make with the information available, it is easier to understand where all the disagreement stems from.
It may seem like I’m heading down a path already tread by Gary Bettman who, so far, has demurred from fighting restrictions. But a) separating the policy decision from the scientific uncertainty has not changed my conviction that fighting should be eliminated from hockey and b) acknowledging that the science linking head trauma to side effects, like CTE, is murky does not amount to a rejection of new head protection regulations in the NHL. On the contrary, this new framework merely suggests that science cannot form the sole basis for decision-making.
My day job involves energy and climate policy, so the first rough analogy that springs to my mind is climate change (a stretch, I know, but bear with me). Like concussions in hockey (or football, for that matter), scientific evidence supports the claim that global climate change is happening. Scientists, however, can’t yet predict with certainty the extent of the risk posed by a warming planet.
This uncertainty has complicated the climate policy discourse because it opens the door for the influence of values, politics, and ultimately, bitter disagreement. Some believe the apocalypse is imminent and there is an urgent need for extreme policy intervention, some say climate change is a hoax and no policy is necessary, and others land somewhere in the middle, recognizing that the possibility of catastrophic climate change is sufficient validation for some sort of policy intervention that promotes human development while protecting the most vulnerable populations.
To acknowledge this uncertainty demands that you wrestle with two important decisions: 1) to take policy action at all (values); 2) if we decide to use policy, what type of policy lever is appropriate given the uncertain risk (politics)?
That’s where the debate begins for climate policy and, interestingly, also for head trauma. From a policy standpoint, science is just one part of the equation. Values and politics play a critical role in designing policy, too.
When it comes to hockey, values include the integrity of the game, player health, the life quality of former players, and the entertainment potential. The politics may be influenced by the impact on the fan base, NHL coaches, and the players themselves. From this standpoint, any policy action undertaken by the NHL, if it is to be effective, will need to take all of these factors into account, instead of simply relying on an assumed scientific imperative (or lack thereof).
No one wants to see Sid or any other hockey player suffer the way Derek Boogaard did. But not everyone draws a clear line from Boogaard’s CTE and his untimely death to his career as an NHL enforcer. If you understand that the science connecting CTE, fighting, and head trauma is uncertain then that opinion has to be just as legitimate as one that says the line between CTE and head trauma is clear enough to take serious action.
A policymaking perspective does not necessarily resolve the head trauma debate. It certainly hasn’t led to any resolution of the climate debate, as yet. I guess my hope is that this more nuanced approach gives all interested parties the tools to make a more thorough, insightful case that advances the sport, but not at the expense of its players skulls.
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Yael Borofsky is a writer, editor, and Philadelphia sports fan living in San Francisco. Follow her on Twitter @yaelborofsky.
This is an interesting look at science and policy…and I don’t think your analogy was much of a stretch, either! For what it’s worth (and it may just be worth a laugh at this point)…I’ve lost my sense of smell as a result of concussions playing college football. That’s the only immediate impact as I’m still a capable engineer and nonprofit executive. But there is a part of me (like the climate change debate) that is concerned about the delayed effects. Thanks for sharing!