We finally live in a world of widespread concussion awareness, and for that 17-year-old Abby Cahalan will give thanks on Thursday.
She learned about postconcussion syndrome the hard way — one pounding headache and dizzy spell at a time — and has spent the past four years redefining herself as an athlete and as a determined young woman bent on overcoming a debilitating physical obstacle that could have derailed her athletic dreams.
That's why there wasn't a dry eye on the Dulaney High girls cross country team when the senior qualified for this year's Class 4A state championship race, and why there really are times when finishing in the middle of the pack is as good as gold.
If this were simply a story about a very promising youth soccer player who wouldn't give up on sports after suffering multiple concussions, it would be story enough for an uplifting Thankgiving week after-school special. But it is so much more than that.
It's about a kid who had trouble walking a single lap around the Dulaney track when she joined the team, but who still stood up at a Capitol Hill news conference four years ago to testify about the ravages of traumatic brain injury among youth athletes.
It's about a family that never gave up looking for answers when the headaches wouldn't go away and other concussion-related symptoms also made it difficult for Cahalan to focus in the classroom.
Perhaps most poignant, in a world where there are far more headlines about adolescent bullying than altruistic behavior, it's about a pair of track coaches and a group of young athletes who made sure there would be no loneliness for one fledgling long-distance runner.
By all accounts, Abby Cahalan was a very promising youth soccer and lacrosse player with a competitive streak that might have been her sneakiest opponent.
When she got knocked down, she kept getting up and going back out there, unaware that her brain was keeping count and the effects of the repeated concussions would eventually count her out of contact sports for good.
"We aren't clear on how many, to be exact, just because when I would get one I would keep playing through it,'' she said. "We were missing signs and symptoms that are so prevalent now. I came home with a headache, it went away the next day, I kept on playing. I think I had around five, and each additional concussion just added to the snowball effect."
Joyce and Jack Cahalan had no idea. They had brought up three young athletes. Abby's twin sister, Lauren, is a gymnast headed to Towson University next year. Her older brother, Joey, plays college soccer at Loyola. The occasional childhood bruise or bloody nose was just business as usual. Only relatively recently has it become clear how dangerous a series of seemingly mild concussions can be.
"The time frame is important, because this is when concussion awareness was still evolving,'' Joyce said. "For her age, the term concussion could be a little misleading because they were probably hits that jarred her brain and a lot of times it was disguised as a bloody nose, so the focus was on the nosebleed rather than what was behind the nosebleed."
It took a particularly nasty shot to the face and forehead with a weighted soccer ball to change everything.
Cahalan was playing a hybrid soccer game called futsal with her youth team in February 2008 when a defender moved out of the way and she could not react in time to a sharp pass. Of course, she shook it off and went back into the game, but this time, the symptoms didn't subside. The Cahalans embarked on what would be a long quest to figure out why she suffered flu-like symptoms after even light physical activity and suddenly had serious trouble with something as seemingly unrelated as reading comprehension.
It wasn't until they got an appointment with nationally known brain trauma expert Dr. Kevin Crutchfield at Sinai Hospital that they got their answer.
"Probably for the first three years, we were trying to put the pieces together,'' Cahalan said. "We went to multiple different places. No one could tell us why the symptoms were still there. ... Back then, they wouldn't even look at kids under 15 for concussions because they didn't think they were important enough or prevalent enough, but he took us in as a fit-in appointment, took a look at me and told me I had postconcussion syndrome. And that was a wonderful thing to hear."
Well, sort of. She finally had an explanation, but there would be no more contact sports — ever. The risk of a serious concussion with more consequences was just too great.
"I remember sitting in his office when he told me I couldn't play soccer anymore, and I was crying, and I remember him telling me I could run cross country,'' Cahalan said, "and I remember thinking, 'I don't want to run. Who wants to run?'"
Dr. Crutchfield looks back at that time and is as impressed as anyone at the way Cahalan accepted that challenge, but he is not surprised.
“I saw the perseverance and the drive in that kid’s eyes,’’ he said. “With athletes, you can tell how they have the perseverance to push through. What she has done is phenomenal. The average person would have given up a long time ago, but you’re not dealing with a common person in Abby Cahalan.”
The thought of running cross country may not have appealed to her at the outset, but it sure beat the alternative -- a life without athletic competition.
So, Joyce and Jack Cahalan went to Dulaney and asked track coach Chad Boyle if he would be willing to help them put their broken child back together again.
Boyle remembers what he was thinking that day. He was thinking about how hard it would be for a kid to join a very strong cross country program and basically have to learn to walk before she could run. It would be a little like someone who had never swung a racket joining the varsity tennis team.
"They very nicely explained to me her situation and, definitely, in the back of my mind, I'm thinking, 'This isn't going to last.'" Boyle said. "The top-level athletes in our program, there's just too vast a gap for her to be able to endure that day after day. And then, on the competitive side, she was an athlete and she wanted to compete and she just wasn't there.
"OK, maybe you can make it for a while, seeing people going by you every single day, but an athlete wants to compete. She couldn't compete. … Most kids in that situation where she was three years ago, watching the other kids go around the track and just burning up the track, probably would have left in tears."
Nevertheless, Boyle and assistant coach Julie Kramer set about building a structured, heavily supervised running program that started — to paraphrase a very famous Chinese proverb — almost with a single step. Cahalan started by walking one or two laps around the Dulaney track, then the distance and the intensity of the workout was increased very gradually over a period of 2 1/2 years.
"Coach Julie played a big role in the hand-on component of it,'' Cahalan said, "checking in with me every day on how I was feeling … taking each lap as a new strike and a new accomplishment. That made me feel it was productive and it was worth it."
Boyle understands that there's no way a football or basketball coach in an elite prep program could have taken on a challenge like this. But the unique relationship that track offers between individual and team is one of the reasons he gravitated to running during his scholastic years and gave up a budding legal career to coach high school track and cross country.
"Obviously, what a lot of people don't understand about track and field and cross country at the scholastic level is it really is a team sport,'' he said. "With that being said, Olympic sports generally tend to be individually driven sports. Michael Phelps in swimming is the best example in this area. So we get the best of both worlds, because we can allow a kid like Abby to train at the same time with a kid like Isabel Griffith, who is our 4A state champion this year."
"They're classmates, so they were on the same track at the same time doing vastly different workouts, but because of the individual nature of the sport it does allow us to treat kids very differently."
Still, the Cahalans didn't want to put Abby into a situation where she would become a burden on Boyle and his program.
"I knew that he was a highly successful, highly regarded track and cross country coach,'' Joyce Cahalan said. "I thought, 'How in the world is this very busy coach going to have time for this?' I mean, we were asking this indivdual, can you help rehab my daughter?"
Boyle, who was The Baltimore Sun's Cross Country Coach of the Year in 2011, isn't your stereotypical whistle-wearing high school coach. He's soft-spoken and small in stature, but he was about to prove that you don't have to be an imposing physical presence to become a towering figure in one kid's life.
There is a quotation posted on the white board in Boyle's classroom that pretty much sums up his philosophy of coaching:
Be motivated and enjoy this team because it is a special team. But don't just be a part of it. Be the reason it happens.
It didn't come from Vince Lombardi or some other high-profile professional coach. It came from renowned Division II cross country coach Damon Martin of Adams State University in Colorado, and it struck a chord with Boyle, who has spent 17 years teaching government and coaching track at Dulaney.
He has boiled it down to a concept that pervades a program that also features another feel-good tale of personal triumph on the boys team, where Eric Reyes has overcome autism to be a very competitive cross country runner.
Every person is important.
"I say that every year, and they are very inclusive with one another,'' Boyle said. "It's pretty remarkable. It's one thing to say that. Our athletic director says, 'I don't like slogans. People say slogans all the time but they don't live them.' But I think that's one that the girls live — that they really do appreciate the efforts of every person on the team regardless of whether they're a state champion or someone in the middle of the pack."
The results are impossible to dispute. The Dulaney girls won the Class 4A North Region title this year with Griffith winning the individual title and four teammates — Brynn Jones, Maria Andrade, Cahalan and Lily Klein — finishing among the top 13 in a field of 74 runners. Griffith would go on to win the 4A state meet and Dulaney would finish ninth overall, with Cahalan finishing 72nd out of 163 runners.
"We have tremendous leaders in this program,'' Boyle said. "Lily Klein, Abby's senior counterpart, was accepted into the Naval Academy. Isabel Griffith is probably going to go to an Ivy League school. They're a tight-knit group. They have a special community, I believe, within our team. It's not just the athletes. It's the parents as well. It's the coaches. It's a triumvirate, as I like to call it. They embrace each other regardless of their abilities."
The Cahalans can say a resounding "Amen" when they sit down to Thanksgiving dinner this year.
"This is,'' Abby Cahalan says, "a special place."
The happy ending
Cahalan has spent more than a third of her young life dealing with concussions and the aftereffects, and not just on a personal level. She took her story to the halls of Congress when she was 13 to support legislation intended to focus more attention and funding to traumatic brain injury in youth sports.
Everyone's talking about concussions now. The NFL recently reached a tentative $765 million settlement to fund research and compensate victims of traumatic brain injuries in football. Locally, Orioles second baseman Brian Roberts returned full time this past summer after a lengthy recovery from pair of concussions. For the longest time, however, nobody was talking about the kids.
Cahalan had no idea back then that today she would be trying to decide whether to continue her cross country career in college. It probably would have to be a Division III program, but Boyle looks back down the terrain she has covered during her high school cross country career and cautions against putting any limitations on her.
Whether she continues to run competitively or not, Cahalan said she will continue to run. She already has proved that the race doesn't always go to the swift and she has redefined what it means to be an athlete.
Postconcussion syndrome never really had a chance.
"I wasn't going to let it define me in a way that it stopped me from doing what I wanted,'' she said. "Running was my outlet for that, because I had to prove to myself that I was an athlete and I could still be competitive. I would never have thought in a million years that I would call myself a runner, but I'm proud to."
Joyce Cahalan still marvels at how her daughter has persevered.
"We never expected to have this type of ending,'' she says, a bit teary-eyed, "because some of her symptoms she will always have to work through. If you look back to those early times when I would pick her up after practice, I didn't know why she didn't quit."