On Paul George, Concussions, and Trying to Perfect an Imperfect Process

I am an athletic training student, and as such concussions are on our brains (haha #nailedit) every day. Whether it’s learning about them in class, assessing an athlete for one during our clinical assignment, or hearing about the numerous studies going on in regards to the NFL, there isn’t a day that goes by in which concussions aren’t relevant. After seeing and hearing about Paul George’s experience, I had some thoughts.

From a medical perspective, brain injuries—concussions in particular—are among the most difficult to deal with. The main reason being we can’t see anything. There’s no gash to stitch up, no bruise to ice, no broken bone to set in place. On the outside, a person suffering from a concussion can look normal, like nothing has happened at all. It forces clinicians to rely almost wholly on what the person tells them is wrong. While there are tests that can determine if someone has, in all likelihood, suffered a concussion, there is nothing we, as clinicians, can do to prove someone is dealing with a headache, feeling nauseous, or has blurry vision. The injured person can withhold information from us, and as such we may never know they were dealing with certain symptoms. Another issue is that symptoms can take time to develop, meaning someone can appear fine in the initial aftermath, but still have suffered a concussion. In the most relaxed and devoid of pressure situation, concussions cause a number of issues for a clinician trying to diagnose them.

A few minutes remaining in the fourth quarter of Game 2 of the Eastern Conference Finals is an intense, pressurized situation, and that makes dealing with a potential concussion all the more difficult, on top of the problems already detailed. It’s the exact difficult situation athletic trainers and medical personnel discus often. There’s pressure on the player to remain in the game and try to help his team win. After all, he’s worked all season to get to this point. There may be pressure from the coach on the medical staff to allow the player—especially when it’s a star—to keep playing. Of course there’s also pressure on the medical staff to make a correct diagnosis amidst all the chaos going on around them. Making the perfect decision is borderline impossible for the medical staff.

Examining the situation last night with Paul George and the Pacers, it’s easy to say the Pacers did wrong by George by allowing him to continue playing—especially in wake of the team announcing this afternoon that George did indeed suffer a concussion. However, it is impossible to say for certain without being there and knowing the exact things George told the staff and the exact tests they administered. We know now that George did indeed withhold information from them, and as explained earlier, that makes the medical staff’s job tenfold more difficult. There’s nothing the staff can do to help someone through something when they don’t know it’s going on in the first place.

So I guess all of this has just been a long-winded way of saying that concussions are the worst, and trying to properly assess and treat them is an arduous process, often filled with numerous variables. Was the Pacers’ medical staff perfect last night? Probably not, but there in lies the problem with dealing with concussions on the sidelines of sporting events. It’s always going to be an imperfect process until technology advances enough to allow us to administer instant CT Scans or MRIs that could give us a better idea of what happened. No one wants to miss something, and the Pacers’ staff is probably kicking themselves today. It sucks. But I feel confident in saying that last night the Pacers’ medical staff worked to the best of their abilities and resources to make the correct diagnosis and keep George safe. And if they didn’t, then they’re in the wrong profession.

Jack Maloney