Monday, October 8, 2018

A concussion story

One year has passed since Tommy Hatton took his final hit on a football field, the one to the side of his head that resulted in his fourth concussion – the one that made him decide, after months of headaches, dizziness, light sensitivity and pain, that he could no longer risk his future.

Before that hit, Hatton had been perhaps the most respected member of The University of North Carolina football team’s offensive line, a player who took great pride, in his words, in “just physically dominating dudes for four quarters.” He’d been a freshman All-American, a leader among his teammates. At 6-2 and 305 pounds, he was an undersized but ambitious player set on reaching his goal of playing in the NFL.

After a relatively routine blow to the head on Aug. 3, 2017, he felt debilitating effects that caused him to fear for his long-term health. Hatton remembers little about the hit, or what he felt in the immediate aftermath. The next morning he felt sick. He said it was “like I drank three bottles of Smirnoff.” And so began his journey from football player to case study…

His story has unfolded, too, amid the backdrop of a prominent university whose opposing interests accentuate the conflict between the violence of football and the scientific quest to understand the carnage unseen.

At UNC, that dichotomy lies in the middle of campus. On one side of Stadium Drive is Kenan Stadium, a cathedral to the sport where tens of thousands gather on fall Saturdays to take in the spectacle. On the other side is the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, where researchers attempt to understand what those fall Saturdays do to the brain.

Hatton came to experience both the adrenaline-charged game days and then, finally, the quiet of the Gfeller Center, where he sought counsel about the damage he’d endured. For the longest time, football was his identity, and his progress in the sport was how he measured his progress in life. After his fourth concussion, everything Hatton knew began to change…

During the first days and weeks after his fourth concussion, Hatton said he felt so incapacitated that “honestly, legitimately, it was almost like I was paralyzed.” The effects were immediate, and relentless. First was the short-term memory loss – the 9 ½ hours he couldn’t account for until he came to in the hospital, still wearing his uniform pants.

Then there was the sensitivity to light, so much that Hatton spent the majority of the next three months either in darkened rooms or wearing special sunglasses. Perhaps worst of all was the severe dizziness, the spinning sensation that made Hatton want to remain still, so as to not disturb the delicate mechanisms in his brain that had been thrown into disarray.

He suffered his fourth concussion during the first week of the Tar Heels’ preseason training camp, a weeks-long event coaches design to maximize football lessons and team-building. Players share hotel rooms. They eat together. They attend meetings together. And, every morning, they ride a bus to practice together.

Hatton could not practice. He entered a “concussion protocol” in which UNC’s medical staff monitors the athlete’s symptoms and recovery. Nonetheless, for the sake of team unity, Hatton was still expected to ride the bus to practice every morning to Kenan Stadium.

It was a short ride, less than one mile each way. Still, the bus created an environment that, for Hatton, was especially uncomfortable in the days following his injury. UNC’s concussion policy calls for concussed athletes to avoid mental stressors – reading, for instance, or texting – and it calls for “cognitive rest.” At times, like on a noisy bus, the natural environment of training camp made cognitive rest a lofty goal…

Hatton feels a dream was stolen for reasons he’s still making peace with. Yet he feels fortunate, too. He is, after all, still on scholarship, which is standard at UNC for football players who can no longer play due to injuries. His education is paid for by an athletic talent that became too dangerous to pursue. The game hurt him but it also has provided. Hatton feels beholden to it, and to his coaches…
One week after Hatton’s fourth concussion, his symptoms had not improved. Another week passed and then another. A month turned into two. The more time passed, the more questions Hatton, his family and his doctors had about why his recovery was so slow.

When Hatton’s mother, Mindy, traveled from the family home in New Jersey to comfort her son in the days after his concussion, she said she wasn’t prepared for what she encountered. She knew Hatton to be energetic, gregarious, one who brought energy to a room. Days after his concussion, he was none of those things…

From the beginning, Hatton knew that the hit that caused the damage had not been a ferocious one. It was, instead, ordinary – the sort of head impact that happens nearly constantly throughout a game. Though he knew it had not been a particularly violent blow, Hatton needed months to build the strength to watch the moment over again…

He found the video from the Aug. 3 practice. With the press of a button he appeared on the screen, back on the field, working toward a future that, in the moment captured, was still possible.

Then came the hit that changed everything. As he watched, knowing all that unfolded, it seemed almost anticlimactic. Hatton watched the screen while he moved up the field, clearing a running lane. A linebacker, Cayson Collins, came into his path. Collins’ helmet collided with the side of Hatton’s. That was it.

“It didn’t look bad at all,” Hatton said.

Yet it felt excruciating…

Eleven days after his fourth concussion, Hatton still had difficulty functioning. He spent most of his time asleep.

Hatton’s fourth concussion resulted in his most severe symptoms, by far. And yet the severity of those symptoms, and the slow recovery, confused even Hatton’s doctors, all of whom understood that treating concussions didn’t necessarily come with a widely applicable blueprint. No one could offer a complete explanation, Hatton said, of what made this concussion so traumatic. It simply was.

His mother has wondered whether its severity could be traced to how quickly Hatton returned from his third concussion, which happened during his first preseason training camp at UNC. By then, Hatton had already been diagnosed with two concussions – the first when he was in seventh grade, and the second during his sophomore year of high school.

The third one happened like the fourth: in an early-season practice, during a drill that invited contact from a defensive player. At the time, Hatton hadn’t had much of an opportunity to prove himself. Every practice – every opportunity to impress a coach or make a name for himself – was an opportunity that could not be squandered…

Even now, Mindy Hatton wonders, like all mothers would, whether her son was really ready to play again after his third concussion. In hindsight, Mindy, who affectionately describes Hatton as “a monster” on the field, has concluded that Hatton “rushed to get back because he was a freshman.”

“So I think that that was more of a pride (thing) and a wanting to fit in and be viewed as tough than it was that he was really symptom-free,” she said. “We’ll never know.”…

There’s another unanswerable question: What about the hits whose effects were noticeable, but might not have risen to the level of a concussion that could be diagnosed? A couple stand out in Hatton’s mind. After one, in high school, he became confused and walked back to the wrong sideline. His teammates turned him around, he said, and he wasn’t evaluated for a concussion.

Then there was UNC’s game at Miami in 2016. During one play, Hatton said, he was “cracked,” though in his description he stretched out the word for emphasis: “caaaaaah-raacked.” Immediately after, Hatton said he saw stars.

“For 10 seconds, I blacked out,” he said. “The whole stadium was just black. And then I heard the play-call, I took a hit, and I swear to God, this is my take on it, I got hit again and it, like, un-concussed me or just made me snap right back into the situation.”

He never told a trainer or a member of the medical staff. Hatton continued to play. On the plane ride home, he said, pain pulsed through his head but that wasn’t anything out of the ordinary after a game. It was, in fact, ordinary to feel that way.

“You’re banging for three and a half hours, you know?” Hatton said. “Your head is just like – you literally just felt like you just have no brain after the game.”…

In the weeks and months after his fourth concussion, Hatton sought answers from five doctors. He visited with a headache specialist, and an expert in treating balance disorders. Hatton said he was prescribed, at various points, 20 medications, some for pain management, some for anxiety, some for sensitivity to light.

“I looked like a junkie,” he said…

The most convincing insight he said he received, though, was this: “Guskiewicz said if you were my son, I would definitely not let you play. Like, you’re in a really bad category – a category you don’t want to be in in terms of concussions.”

By the time he and his parents left the meeting, Hatton found clarity. He could have kept playing, had he chosen. No one would have stopped him. Yet now he knew there was no choice to make. 

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