I really appreciated Dionne Koller's recent commentary regarding high school football ("High school football: a dangerous game," Nov. 20). I concur with her statement that we are in a "culture of resistance," especially when it comes to the game of football. I have seen athletes whose grades started to drop drastically because they were unable to concentrate on their studies. I personally witnessed an athlete with a pretty severe (Grade II) concussion doctor-shop to try and get a release to return to play when the team physician clearly said no playing until symptoms were resolved.

The parents seemed very understanding on the field after the team doctor (a concussion specialist) told them of his diagnosis, gave them his card and told them to bring him to his Saturday clinic. I made sure he had done all of the necessary tests and provided his standardized tests from the before the start of the season — along with a detailed report and notes from the field after his parents took him to the hospital.

But, as I got to the athletic training room, his father started to question the tests I had performed, questioning why he had to do that with a "What the heck does counting backward by seven have to do with getting his bell rung?" Sadly, he kept referring to it as getting his son's "bell rung," but not a concussion. The young man was unconscious for a good 3-to-5 minutes! So I knew I was going to have problems and spoke to the team doctor so that we would have a united front with the diagnosis, plan of care and return to play criteria.

I didn't have a great relationship with the school's athletic director because he thought I diagnosed too many heat-related illnesses when there was a heat index of 120 in Phoenix, Ariz. This posed a problem because he also tried to overstep his boundaries by questioning my examinations having no real education about how to test for any injury.

The player came in Monday and complained of a headache, having a hard time concentrating and that the training room was too bright. I asked if he went to the Saturday clinic and he replied that he hadn't. After he repeated all of the tests given at the time of his hit to the head, I told him that he was not going to be cleared to return to play on Friday night's game. The father called the AD and coach, they sent him to several doctors, one of whom was a chiropractor and another a friend who was a very young doctor with very little prior interaction with athletes.

Tuesday, I had visits from the AD, the head coach, the father and the student-athlete himself questioning everything I did and said. They thought "a little headache" was no reason to not play. I stood my ground and in an unbelievable move, his parents and their attorney went to the district and pretty much demanded that their child should be able to play since they were the parents and knew if he was in harm's way. They won with a document agreed upon by both the family and the school's lawyers and he suited up Friday night.

Friday night, we were busy getting ready for the game and the player and our athlete came in and wanted to get his ankles taped. As head athletic train, he asked me to do the job. I told him that I was sorry but I am not going to do that since his decision to play ran counter to the advice of the team doctors who supervise my work. While I had him standing like a deer in head lights, I sneaked in a vision exam to assess whether he had photophobia, which he did. My assistant (who the AD loved) told him that she would handle the taping.

Well, the game started and on the fourth play, the student-athlete got horribly and completely sacked with a helmet-to-helmet hit and lay unmoving on the 15 year line. I ran out, kept him stable and waited for the EMTs and ambulance to arrive since neither I nor the doctors were now allowed to treat him. The parents took him to the doctor and since in our school district requires those records be made available to myself and the school nurse, I received a full report.

He was deemed to have Second-impact Syndrome with almost a Grade III concussion. He was ordered to see a concussion specialist (our team doctor refused to treat him) and he had to drive approximately 35 miles away. He was also ordered to get biweekly IMPACT tests combined with physical examinations that included balance, agility and impairment tolerance taken with time of symptoms reoccurring during all of the variables in the exam. His time out of football was a month. He had difficult concentrating. His grades dropped. He was averse to bright lights and sound. All of which made it impossible for him to return to play for more than a month — which his parents challenged. But this time, the emergency room doctors held their ground. They explained that the brain is fragile, that it can't be operated on to repair or fixed with physical therapy and that the parents had been gambling with their son's life.

When he returned to school a week later, the athlete came in to let me know that he would be doing the only therapy available — rest. Both he and his father were apologetic about doubting our medical team's assessment and hoped we could accept that. I accepted their apology.

It's hard for some of these macho coaches to listen to a female trainer, especially with the "don't go to the trainer" or "are you hurt and you want mommy to fix your booboo" kinds of comments I know I have heard. It makes it all the more difficult when the people who supervise teams have no medical training and are far more worried about winning, especially in some areas where winning keeps your job and losing gets you fired.

Sarah Jamie Johnson, Ahwatukee, Ariz.

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