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Guest Post: What we’re still getting wrong about Paul George’s concussion

May 20, 2014; Indianapolis, IN, USA; Indiana Pacers forward Paul George (24) lays on the floor after an apparent injury as his teammates guard George Hill (3), Lance Stephenson (1) and center Roy HIbbert (33) gather around to see if he is okay against the Miami Heat center in game two of the Eastern Conference Finals of the 2014 NBA Playoffs at Bankers Life Fieldhouse. Miami defeats Indiana 87-83. Mandatory Credit: Brian Spurlock-USA TODAY Sports

Ed. note: Dan Diamond (@ddiamond) is a journalist and health care analyst living in Washington, DC. You can read his initial article on Paul George—which annoyed Jason Whitlock—at his Forbes blog.

I write about health care for Forbes and other outlets. I write about basketball for ESPN’s TrueHoop Network. Sometimes the two topics collide—like when Dwyane Wade’s knee hit Paul George’s head in Game 2 of the Eastern Conference Finals.

Perhaps that’s why George’s immediate disappearing act seemed like such a red flag for me. And why I figured that sportswriters, accustomed to writing up play-by-play, would’ve jumped on a potential story.

After all, a few events were beyond dispute: George got kneed in the head, collapsed to the floor, and later complained of blacking out and suffering vision problems. Yes, he’d performed poorly for much of the game—but there’s a difference between merely missing shots and becoming a confused ghost on the court.

And yet, the dominant narrative about George following the game was…well, not what I’d expected.

There was the story that bizarrely treated George’s blurred vision as a plot point—that the speed of the Heat had somehow left the Pacers dazed and confused.

There were the tweets from Jason Whitlock—a journalist that I enjoy, although he said he was tweeting as a fan—that suggested George was “immature” for not removing himself from the game.

Even as late as Wednesday afternoon, ESPN’s Around the Horn featured a segment framed around the question of “Did Paul George have a concussion?” As though blacking out after getting hit in the head could be chalked up to something else.

In this era of concussion awareness, sports reporters—and fans—need to be better.

It took far too long for journalists to make the connection that George’s symptoms were a clear signal that he’d had a concussion. Too much virtual ink was wasted on the fake debate over whether he was actually injured.

And too many sports fans are still suggesting that George might’ve been claiming a concussion in order to abdicate responsibility for his bad game.

We should know enough about concussions now to understand what they are (a low-level trauma to the brain) and what they’re not (the fault of the player).

The biggest challenge is the one that Jack Maloney points out: Concussions are invisible injuries—they’re tough to diagnose and require an athlete to be fully cooperative. And they’re incredibly unpredictable, too. Symptoms can range depending on where and how serious the blow to the head is; they can flare up after being hidden.

Many concussions often produce such minor symptoms that they end up getting overlooked. I’d bet that every NBA player has had an undiagnosed concussion and played through it at some level of his career. (With the benefit of hindsight, I know I toughed out several undiagnosed concussions when playing basketball as a teenager and into my 20s.)

But here’s the thing: Most concussions are reasonably manageable and eminently recoverable.

The reason we should want concussed players to take time off is to avoid repetitive blows and potential reinjury. Just like a fan doesn’t want Russell Westbrook to play through a sprained knee and risk further damage, we shouldn’t want NBA stars to run around when their brains are most vulnerable. When I spoke with Carlos Delfino about this a few years ago, it was clear that Delfino’s problems had multiplied because he had suffered repeated concussions.

The worst thing for George on Tuesday night was to stay out on the court, where he could continue to collide with 250-lb men soaring to the hoop.

Meanwhile, the Pacers training staff has fallen under scrutiny, but it’s true that there’s not a lot they could have done if George wasn’t being forthcoming. If anything, it’s a reminder of the real need for sideline testing that can be quick, accurate, and scientific—something like a thermometer for your brain. (And that’s not as far away from reality as you might think.)

Given questions over George’s availability to play Game 3—specifically, whether he’ll be cleared and how many games he might miss—the story of George’s concussion is going to stay in the news for at least a few days.

It’s an opportunity for discussions about the issue to move past knee-jerk reactions questioning toughness and maturity. Here’s hoping that we take up the challenge of grappling with the slippery nature of brain injuries.

Hardwood Paroxysm