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More Than A Bell Rung!

How about some motivational thoughts for Our Wednesday Blog?

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I guess it’s better than someone just simply daring us with some attitude…right?

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So let’s get down to business. This blog is about football and brain injury. I immediately get serious!

Jeff Bezos once worked at a hedge fund and was growing increasingly frustrated because he was unable to match the returns of another investor, Bernie Madoff. (Of course we all now know that Madoff’s yearly investment returns were all fake)

Bezos reportedly confided in Ted Leonsis (owner of the Washington Wizards and Washington Capitals) that his frustration caused him to quit his hedge fund job at D.E. Shaw. He then started a little company called Amazon. The cause and effect.

I compare a brain injury to cause and effect. You can tell if a person has a broken arm because you can physically see their cast. There is no cast for the brain. So, it’s not unusual to miss a brain injury. It’s why they are called  the “walking wounded”. The cause is usually related to trauma but the effect is usually not known until it’s too late.

Years ago, the defense called their head trauma expert to the witness stand in one of our brain injury cases. We had already put our case on and had several treating doctors testify that our client had a brain injury. Now, this defense witness had been identified as a doctor who was going to disagree with all the treating doctors.

He admitted that our client had hit her head. He even admitted that she might have had a concussion. But he went on to say that it was just like a football player who just “had their bell rung, but that didn’t mean that they had to come out of the game”. In essence, his testimony was that our client’s brain injury was no big deal.

The NFL has announced that they are considering a radical rule change. Here is an article explaining that the NFL is poised to eliminate kickoffs. Why? According to a recent study (Here) 16% of football injuries occur during the kickoff, and those injuries have a high probability of concussion related.

It probably will not happen this year. But, it would not surprise me to see no kickoff next year, with the ball starting at the 25-year-line to start the game. I suspect they are still working out the issue of onside kicks because that adds another dimension to the end of the game… and trying to catch up.

All I know, fortunately juries would no longer put up with a hired defense expert saying such nonsense as though a head injury is no big deal when you are wearing a helmet. That’s because the NFL and its former players are putting head injuries in the headlines. Plus, no one is wearing a helmet while they drive. So these injuries are possibly even worse.

And for pic o’ day, I completely agree!

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Rod Tidwell’s Brain Injury

First, a bit of work strategy to get us started!

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The movie Jerry Maguire is filled with classic moments. Like the kid (character: Ray Boyd) who randomly asks Jerry Maguire, “Did you know the human head weighs 8 pounds?”. Or when Jerry Maguire asks Rod Tidwell, “Do you want this jacket? I don’t need it. I’m cloaked in failure.” because he had lost representation of the number one pick, the night before the NFL draft.

And anyone that has seen the movie or ever heard anything about it probably remembers the two quotes that became classics. “Show me the money” and “You had me at ‘hello’“.

But the real lesson from this movie is the mindset about brain injury, and thankfully how much awareness has changed since that movie. So let me summarize to make the point.

Near the end of the movie, Cuba Gooding Jr’s character (Rob Tidwell) suffers a horrible injury at the end of the “big game”. Gooding is unconscious for several minutes, while his  distraught wife watches in horror.

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Then miraculously, he wakes up and celebrates. No longer a worry that he died in the endzone. Instead, he is breakdancing in the end zone. I am not a doctor, but that just seems like the worst possible move, after an apparent serious head-and-neck injury, just mere seconds earlier.

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The point of that is how far we have come. In the early 2000’s, I was in the middle of a brain injury jury trial in Greenville County. The defense expert testified that my client’s concussion was merely like having “your bell rung on the football field”. I believe that doctor knew better than to minimize the concussion suffered by my client.

Now thankfully, we all have been more educated on how serious a concussion and brain injury really is. Not even Hollywood would have Rod Tidwell breakdancing off a stretcher.

 

And finally, this pic o’ day cracks me up!

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Youth and Sports Injuries

I try to always give a Monday take-away thought. How about this one?

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OK, not what you were expecting from a Monday morning legal blog? Well, as Sam Elliot popularized the saying in The Big Lebowsky,  “Sometimes you eat the bear and sometimes the bear eats you”.

I probably was a little like that last week, as I fell behind on the blogging a bit. But, I am more of a lion person anyway… so I come roaring back with this morning’s blog!

Because so many kids are playing youth sports, not to mention the expense of equipment. By the way, have you seen the price of a baseball bat? Makes you want three, Right? But I digress.

Sports are more competitive than ever. With competitiveness comes the risk of concussion. I thought about this as I saw a kid riding his bike without a helmet on Sunday. No good!  

So, I thought I would do a short blog on concussions. A good website to read on this, was put together by the nonprofit group Cleared to Play, arising out of an orthopedics practice (Here

Sports concussions can have a lasting impact on a life. Some athletes end up experiencing a life of cognitive and neurobehavioral difficulties.(PubMed) Doctors sometimes call this post-concussion syndrome. No different than what can happen in a car crash or on the battlefield.

Symptoms include chronic headaches, fatigue, trouble sleeping, dizziness, short-term memory loss, and even difficulty with problem solving. Sometimes trying to do simple math and addition of pocket change becomes difficult.

Those who experience untreated concussions and multiple concussions are also at high risk for developing permanent brain injuries and brain damage. Symptoms like depression and anxiety take hold.

Athletes who return to practice or the game too quickly before they have recovered from a concussion are at great risk for second-impact syndrome. According to statistics shown on the website, fifty percent of second-impact syndrome incidents result in death.

Again, for “quick-clicking” purposes and to learn more about sports concussions,go to clearedtoplay.org. Serious stuff!

 And for pic o’ day….

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Those Personality Tests

In ninth grade, a book circulated through our class called Spirit-Controlled Temperament by author Tim LaHaye. (Amazon) It encouraged readers to identify the personalities and do a self-evaluation.

It caused a bunch of us as ninth-graders, to talk about personality traits instead of whether the Orioles had won or who was starting for the Colts. A pretty amazing feat.

The reason it was able to do that is because we all are interested in understanding ourselves. I remember after reading that book, I became a little concerned that I couldn’t decide which personality that I was supposed to be. It seemed like I fit in all the categories… seriously.

I later read criticism about the book’s attempt in categorizing everyone into 4 types of personalities. Probably a little to intense for me in ninth grade.

There is a test called the Myers-Briggs Personality Indicator (MBPT) which some firms use relating to employment.  It also helps individuals to identify job skills that they might use in looking for employment. It divides the test results into the following:

     E (extravert) or I (introvert), in interacting with others

  • S (sensor) or N (intuitive), in processing information
  • T (thinker) or F (feeler), in making decisions
  • J (judger) or P (perceiver), in dealing with the outside world

A person probably knows that they like people and are extroverted. This testing is to indicate that they might thrive in team building tasks. The extrovert probably shouldn’t try to take a job alone on some Alaskan science station.

Part of our interviewing process includes testing for job candidates. There are no right or wrong answers but the testing does attempt to quantify energy, focus and current stress levels; and whether someone is willing to work under supervision and within a team.

When I speak to the attorney candidates about the testing, without fail they ask me, “How did I do?”. I like it that it matters to them.

That brings me to the opposite spectrum. Our firm represents several clients who have suffered brain injury from a crash or even from getting slammed in the head with an airbag. It might have saved their life on impact but airbags can sure jerk your head back when they pop out of the steering wheel.

Some of our clients are diagnosed with mild traumatic brain injuries. That doesn’t mean that the injury is not serious, but it generally has more to do with the how long they were unconscious or  whether they were in a coma, to be categorized differently. The National Football League has also been responsible in part for helping the public understand the significance of a concussion.

The practical side of that is that many brain-injured clients are greatly fatigued, suffer personality changes or lose interest in things that meant a great deal to them before the crash. Ultimately, I have noticed that these clients don’t call and ask “How did I do?”. Unfortunately, part of the damages in these cases involves a loss of self.

If a person breaks their arm, doctors can put a cast on the arm. The sad part in a brain injury is that there is no cast that can repair a brain injury.

And for pic o’ day… here’s some real concern!!!!

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A New Helmet of Technology

While watching the Super Bowl on Sunday night, the announcers told us that one player was being helped to the sidelines and then to the locker room because of “concussion-like symptoms”. Then, they showed the replay of a helmet-to-helmet hit that showed the players head being struck.

Currently the NFL has a concussion spotter and  doctors and neuro-consultants on the sideline who ask initial basic questions of a player suspected of a concussion such as: What quarter is it? Who scored last? Do you have a headache, Dizziness or NauseaWhat month is it? What day of the week is it?

The doctor on the sideline might ask certain word recall that could include the player repeating back the following words:  apple, elbow, carpet, saddle and bubble.

These are just some of the  NFL protocols in dealing with a player suspected of a concussion. Conversely, in my law practice I have seen just the opposite. Emergency technicians ask my client at the scene whether they were knocked unconscious. That is the extent of the screening. Relying on the worst historian of the possible medical condition… the person who is dealing with the symptoms.

In football, there’s some hope that there is new technology on the horizon to help identify concussions during the game. According to Fortune Magazine, Helmet-manufacture Riddell has produced a helmet called a SpeedFlex helmet, which relies on an InSite Impact Response System

It’s being tested at some Division-1 programs like Arkansas. Among other features, the helmet disperses energy at the point of impact to minimize damage and can send a signal through state-of-the-art  software, to personnel on the sideline regarding certain hits and impacts.  if an impact falls beyond a certain safe range that has been predetermined, the helmet alerts coaches wirelessly through the helmet’s software.

Attention to this problem has brought research and progress; and more importantly awareness to the issue of concussions. As a lawyer, I am glad that football has now helped to bring some education to juries regarding symptoms of concussion and the severity of a concussion that might occur in car crashes.

In the past, I had to listen to one defense doctor describe a concussion as no big deal because it was just getting your bell rung. Thankfully, I don’t think that such testimony will even be considered by a jury.

And for pic o’ day, I am posting a cartoon. The opposite of bulls running must be bulls telling jokes!

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A Witness to the Injuries

My parents told me that we were moving. My dad had been teaching in Tennessee and now he was accepting a position at a church in Maryland.

When you are about to go into the third grade, you don’t  have any say on whether you want to move. In fact, I think that I was a bit excited to go to a new place, even though I would miss my friends.

I remember the first church service we attended in Maryland after moving. A boy introduced himself to me (for the blog I will call him Roy) and we soon figured out that we were both going into the third grade and would be in the same class. At that age, you don’t really have much of a filter. What you think is what you say and it’s true honesty.

When I met him, I noticed that he had scars on the sides of his head. I asked him about it and he told me that he had been in a bad  accident  a year earlier. He had been riding in a school van that got hit and flipped over. He was knocked out and in the hospital for a while. The rest of the summer, I would sometimes see him in church.

Then, the first day of school, he and I saw each other again and we sat together at lunch. In the coming days, I became better friends with him. Throughout the school year, I would see him study real hard and he did get good grades. Unfortunately, he wasn’t very good at any playground sports like kickball or basketball. We would also play a game called Four Square and he sometimes didn’t play because he would get knocked out at the very beginning. He just did not  have very good hand eye coordination.

I remember that he did pretty well with his grades but that he didn’t have many friends in the class. At that age, when they told us that it was time for recess, we would tear out of the classroom while hearing the teacher call after us, “Don’t run”. Unfortunately Roy could not run very fast. He just didn’t have good balance either.

Later in the school year, I remember going over to his house to play. We went out into the woods and built a fort out of branches and a blanket and then just sat there and talked. That’s when he told me that he wished that he was like he used to be. Then he told me that one of the things that bothered him the most about school was that he was always picked last on the playground.

We moved from Maryland after sixth grade. I admit that I had forgotten about Roy until recently. I thought of Roy when I called an adjuster on a case involving a brain injury.

The adjuster offered an amount of settlement that was far from what I believed to be a fair market value for the case. The adjuster said that because the client had finished school; had gotten a good job and was not getting any additional treatment, she did not see the case as being very significant.

I tried to remind her of some of the things in my client’s medical records. Then, I told her what my client’s family was going to say, about the things that my client could no longer do. A client’s losses are usually best described by family, friends and co-workers. I tried to convince the adjuster that my client’s claim was more than just physical injuries.

Then, I thought of Roy. At third grade, when the only worries a kid should have relate to such things as “What’s there to do?” or “Can we go to McDonald’s?”; as a kid, I had witnessed the emotional scars that are probably still with Roy. Things that might not show up in medical records.  All he wanted was not to be picked last. What is the value of that hurt?

Well, it definitely is getting colder. So, my Mom sent this for our pic o’ day. Are you ready for cold weather?

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Brain Myths

At the firm, we represent several clients who have problems after hitting their head in a car crash. Sometimes, it may have been the airbag that causes an issue. Other times, it could be the acceleration/deceleration of the crash.

The airbag is something that probably saved their life or at least lessened any physical visible damage, but the force of the airbag can sometimes cause brain injury issues. The brain injury symptoms can become more readily apparent, days after the crash.

With clients having these issues, it causes me to read and research new information that the medical community produces. Also, now that the military recognizes brain injury issues, there is fortunately more attention that is being brought to these issues. No longer is someone just referring to it as “no big deal, it’s just having your bell rung”, as one defense expert proudly announced in one of my trials.

With that backdrop, I came across an article titled 5 Brain Myths That Won’t Go Away, that discusses some interesting brain information. I have attached the article,. I am not vouching for its findings. But here are the 5 myths:

Myth 1: Alcohol kills brain cells.

Myth 2: You are either right or left-sided dominant.

Myth 3: You only use 10 percent of your brain. (Apparently contrary to the Lucy movie now playing)

Myth 4: Brain damage is permanent. (the article does discuss that some brain damage is permanent)

Myth 5: Your IQ is a fixed number.

Scientist continue to study how the brain works. Knowledge will help us recognize the silent epidemic of brain injury and brain damage.

What’s in a name? DID YOU KNOW that Donald Duck’s middle name is Fauntleroy?

And for pic o’ day… how about those Cheetos?

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Pam Oliver’s Brain Injury

It is a story that happens in many car crashes. The person that gets hit tells the other driver, or the police officer that they are not hurt. Many times, they say that they don’t need any medical attentiion or even any help getting home. Sometimes, they proceed to work directly from the crash scene.

The next morning, that person wakes up in pain. Or, they have a headache. They don’t know if they can go get treatment. They aren’t always sure exactly what caused this throbbing pain, because they felt fine yesterday. Now, can they even go to the doctor? Who will be responsible for their bills.

In the NY Daily News, there’s a story titled “Concussion story gets real for Fox’s NFL sideline reporter Pam Oliver“. It happened on August 18th. Pam Oliver was on the sideline for Fox, covering the Colts/Giants NFL  football game. During warmups, she was talking to NFL referee Ed Hochuli, for a story that she was doing on officials for Showtime’s “60 Minutes Sports”.  While on the sidelined doing the interview, the third-string quarterback of the Colts let a ball slip out of his hands while attempting to pass the football.

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Oliver did not see the ball coming and it hit her right in the side of the head. She continued to cover the game. In fact, she was in the broadcast booth at the beginning of the game. As a Colts’ fan, I saw the replay and I also saw how Joe Buck and Troy Aikman, the announcers, comment on the event. Production replayed the football hitting her and then they all laughed about it.

The announcers called her a trooper for continuing. She said later that she really didn’t want to talk about it. She finished the interview and then she did the entire game “on adrenaline”. As she put it, “You don’t want to be wimpy, you just push through it”. After the game she went home without getting any treatment.

The next morning she woke up with such a terrible headache that she had to hold her head. She felt tremendously sensitive to any light and had to close her blinds. Even the light from her TV “was her enemy”. She was later diagnosed with a concussion.

According to Oliver, she is still experiencing headaches. She hopes that all her symptoms go away by her opening game in San Francisco, where she will be the sideline reporter for the Packers/49ers game.

Statistically, studies show that approximately 85% of those that suffer a traumatic brain injury fully recover. However, approximately 10-15% have long term symptoms that may include headaches or sensitivity to lights.

If this were a claim that I was handling, I would fully expect an argument from the insurance company about her not leaving the game or even getting treatment. Their computer apparently doesn’t understand reality or the adrenaline of real life. I have heard stories about people being told that they can’t go get treatment.

Stories like Oliver’s are a reminder of what really can happen. Injuries like a concussion, even in the emergency room, can go undiagnosed.  Hopefully, we will see Oliver out there on September 8. As a sidenote, that quarterback didn’t make the Colts team in the last cuts. I am sure that he wants another opportunity. In the report, it said that he felt so bad that he tried to send her get-well flowers.

DID YOU KNOW that it is physically impossible for pigs to look up into the sky. Could that explain why pigs do not enjoy astronomy? (or not)

And for pic o’ day, Mom sent me this one that has a bit of looking up!

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Brain Injury and Talking Teeth

   As a child, my parents would take me to a Dentist named Dr. Evey. Now, most kids are scared of the dentist and so was I. Dr. Evey  had experience in dealing with those fears.

     Every time I would go for a teeth cleaning, that same fear would creep on my shoulder. So, he would make great effort in making me laugh.

     He kept a collection of false teeth and would pretend like the teeth would talk to me. It was almost like a puppet show, but they were just talking teeth.

     I would laugh my fears away because of those talking teeth. In fact, I always would ask him to pull all my teeth, so I could have my own set of false teeth.

     I thought that it would really be fun to pull those teeth out and play with them. I had no thought of the consequences. My brain was not developed enough to understand a future of Polident; scary corn on the cob events; and the fact that teenagers are not humored with false teeth, like a kid might be.

     Thankfully, Dr. Evey did not take me seriously. He just cleaned my teeth and sent me on my way until the next “tooth show”. My brain was not developed to appreciate that pulling all my teeth was not a good idea.

    Decision making is made in the frontal lobe of our brains. When someone gets in an accident and hits their head, it can have a long term effect on the executive functioning and thinking.

     Our practice represents many people that have hit their head in a car crash. Many have their symptoms resolve in a year. Some, though, have permanent problems that effect them for life.

     Brain injury can occur without bring knocked unconscious. Sometimes, even the force of an airbag can cause such trauma.

     The impact on the person extends to family members. Some describe the event as “the day I lost my wife or husband” . The person they married is changed and it’s because of someone’s carelessness.

     For brain injury, help needs to be given to the individual and to the family. The Brain Injury Association of America (BIA) provides information on treatment and support groups. It also helps families cope with the issues of brain injury.

     Sometimes, just understanding the issues and symptoms becomes a big relief to families. A brain injured person is helped to overcome being a victim; to become a brain injury survivor.

NFL Helmets and Concussions

     I was in the middle of a brain injury case. It was a jury trial in South Carolina. The defense had their defense witness on the stand, testifying about my client’s injuries and resulting problems.

     This was the kind of doctor that had an answer for everything. He bills for medical reviews, based on how many records he reviews. That’s not that unusual, until you ask him to describe the billing practice. “I put the medical records in a pile; put a ruler next to the pile and bill by the inch”. The jury leaned forward a bit there.

     His basis for testimony that my client couldn’t have any long term effects from the crash, was compared to  his knowledge of high school football. He looked at the jury and smirked, “you know how it works out there; a football player might ‘have his bell rung’ but that doesn’t mean that he can’t play next week”.

     That testimony was back in 2004. Since that time, the public awareness of brain injuries has become more prevalent. Almost everyone has seen a news story on it and most football fans can probably  even discuss a football player that still suffers from a head injury during their career.  

     If you get the new PlayStation Madden 2011 football game, it even has players suffering concussions. Then, they are unable to play the following week. It’s make believe but it’s based on our growing knowledge of head injuries.

     Sports Illustrated is also reporting on a Virginia Tech study of NFL football helmets. According to the study just released by a professor of biomedical engineering at the college, Stefan Duma; 40% of NFL players last year, wore a helmet model that got the second lowest rating for reducing the risk of concussions.

     More attention is being paid to prevention. More players are now aware of recovery issues and long term effects. No longer is it considered a badge of honor to dust yourself off and run back in the game. Then later, brag about the fact that you played and can’t even remember really being out there.

     In jury trials, juries are now in possession of more common knowledge about the long term effects of brain injury. No longer can a defense lawyer simply pay someone to come in and testify. Well, they still might pay them to testify but it doesn’t mean that what they say carries a lot weight anymore.

     I remember hearing the illustration about the Hubble Telescope.  When it first was carried into orbit in 1990, it captured clusters and galaxies that we never knew existed. Just because we had never seen all that amazing astronomy did not mean that it was not there. We just did not have the technology to see and understand.

     In brain injuries, there is more research that helps us understand the problems and solutions of head injuries and concussions. Even better equipment for NFL players is being explored. It’s understanding and then finding solutions. Meanwhile, these defense doctors will have to come up with different testimony, if they want to keep getting paid by the defense.  Maybe the next defense will be,  “you see it but it’s not really there”.

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