March 20, 2013: I Love To Tell The Story

Since my kids have had concussions, I've heard so many more concussion stories. It's like everyone who has played a contact sport has had a concussion. Maybe there’s a little retrospective bragging going on – you know, “I was so tough I played five games in a row without ever once knowing the score, or even who I was playing for” – but you wouldn’t think so. Not these days.

This weekend I was talking to my brother about Andy and he told me his concussion story, which I had heard many years ago and forgot (because many years ago, who cared about concussion stories?).

He was in a boxing class at West Point – Kiefers have a history of getting kicked out of West Point – was matched against a 145-pound Boston-area Golden Gloves champ, and wound up in the base hospital for a week, counting bluebirds and butterflies.

My boss’ son was dropped on his head in a wrestling match. My old boss got a concussion when he was blindsided when he was playing linebacker for Stevens Point High. The neighbor girl headed a soccer ball. My youngest son’s friend has head three, one that came with a skull fracture. If we're not in the midst of a concussion epidemic, we're smack-dab in the middle of a lying-about-concussions epidemic.

Along with the concussion stories have come – I won’t call them angels for fear of being raided by the Cliché Police – buoys in a dark sea.

Andy’s coaches were remarkably understanding. Never once did they try to force him to play when he shouldn’t have played. (Of course, the fear of litigation impressed upon them by USA Hockey may have had something to do with it.) The same with Molly’s dance teacher, though that was to be expected. She didn’t get to be the National Dance Educator of the Year by being a blockhead.

Then there was my first roommate out of college. We shared the experience of getting kicked out of rental units in Knoxville, Tenn., in anticipation of a World’s Fair-fueled influx of tourists that never came. He found me after 30 years around the time of Andy's first concussion. It turned out he was living around Madison, and we made plans to vist during state hockey. Then the concussions came, and the gray fog, and the visit never was made. But he said he was praying for all of us nonetheless.

To all the people who volunteered to wrap our kids in bubble wrap, thanks. We get the joke and we'll take the bubble wrap, any time you want to pony up. Same for all of you who asked whether we beat our kids. (The answer is yes. I beat them in tennis and Ann beats them in math.) You meant well, give or take.

And then there was Rich. Things were really bad a couple weeks into Andy's first concussion. We didn't know what we were in for, so every day started optimistically and ended in a state of extreme panic. Approaching the end of my rope on one of those hard-time days, I sent an email to my friend Rich Diana, the former chief orthopedic surgeon of the Boston Red Sox, an ex-NFLer who played in a Super Bowl with the Miami Dolphins, a college-football hero at Yale (and the last Ivy Leaguer to finish in the top 10 in Heisman balloting), and a collaborator. He wrote an arthritis book; I edited it.

Dr. Rich came back with the message not to worry, that Andy's young, that he'll heal in a couple of months, it'll be no big deal long-term, and here's the supplements he should take to help the healing process. (I forgot to mention: He does a lot of research on inflammation and injury, and inflammation on chronic disease, and which supplements help with inflammation.)

It may not seem like much, but it was exactly the message I needed to hear at the time. Yes, you can do something, and here's what you do.

It was the certainty I needed, the certainty we've come to expect -- and demand -- from our doctors. (See "certainty, medicine and," previous entry.) Everything got a little easier after that, and even without taking the supplements Andy began to get better.

So there are buoys everywhere in this big, dark sea. We may be lost in a sea of head injuries, but we're nowhere near as lost as we might have been.

March 18, 2013: Ready or Not

The kids are getting better, but it’s slow. It’s been two weeks for Molly – about the time you’d expect her to start to show improvement (understanding that these are concussions, every one is different, and the experience of one is absolutely not the experience of any more than one). Andy is closing in on one week, and his headaches are almost gone, but his concussion never seemed bad to start with. Just bad enough.

I say these things with the understanding that I will be proven wrong. A mild, slight, intermittent headache that persists for three weeks is still a headache. There’s really no difference in treatment or recovery time if you spend three weeks with an occasional twinge or three weeks dreading light and sound, seeing stars and feeling queasy. Molly and Andy could reach a state of almost-thereness and then plateau for days, weeks, months, or they could be back in action in a week. There’s simply no way of knowing.

Of all the ways concussions mess with modern medicine, this might be the most galling. What we expect from modern medicine, above all, is certainty. We may not be any better able to treat Lou Gehrig’s Disease than when Lou Gehrig first stumbled going for a ground ball, but by God, we’re hot stuff at knowing it when we see it.

And once we know it, our doctors can dish out a pretty firm prognosis. Look here. See that? Surgery can fix it. We’ll cut here, pull this out, put this in, shunt this down through there, close you up, wheel you out, and you’ll be good as new in three weeks. Give or take 15 minutes.

Or not: Look here. See that? You have six months without surgery, four years with chemo, maybe 10 with chemo and surgery. It’ll progress until you have to be institutionalized. Five years. A year. Nine months. Three months. Say your goodbyes now.

No matter how it breaks, we know. We know and we can move on. Get the recliner ready. A first-floor bedroom. A handrail for the bathroom. A cemetery plot. A nursery. An ambi-van. A minivan.

Concussions have none of that. We don’t know when you’ll get better. You tell us. When you think you’re better we’ll give you some tests. They may show something, but they may not. We’re not sure. It’s the brain. We don’t know much about the brain.

Frustration over medicine’s inability to divine our future is a recent malady, like texter’s thumb. There was an ad a while back – for GE Healthcare, I think – that traced the history of medicine in the form of its ability to diagnose the cause of a stomachache from primitive man to today’s resonating imaging thingamabobs. The point was that we’ve become much more adept at figuring out why we’re wrong, and that’s a good thing.

Of course it’s a good thing. Any person whose definition of cures has progressed past an onion on the ear on a lock of hair buried under a new moon can see it’s a good thing. However, this good thing in the course of becoming a good thing has destroyed our tolerance for equivocality in medicine. An indefinite timeline for an injury marked by indistinct symptoms is unacceptable to modern patients (and modern practitioners, too, I’d imagine), which is why I think many people with concussions just resort to lying and move on. If medical science isn’t going to tell me I’m okay, I’m going to decide. And I’m okay … though I do sorta have this headache.

Ann and I can knock out a dead-solid imitation of people handling the uncertainty of a concussion, but only because we’ve done it before. Molly and Andy #2 are our second and third children, concussion-wise. Similarly, Andy is handling his second concussion better than his first, because he knows what’s coming and because he’s out from the shadow of hockey. He’s going to run junior-high track, but big deal. The difference between playing youth hockey and running long distances for a junior-high track team is the difference between Marquette University and Marquette Elementary.

Molly is getting better at dealing with not getting better at the rate she thinks she should get better, but that may be the toughest aspect of any of the recoveries. Andy never gives a sense of being ready to be done; as I’ve said before, concussions play to his inherent indolence. Molly is so over her concussion, only she’s not over it.

And so it continues. The end may be in sight, or not. But we’re ready for whatever comes our way. Or not.

March 14, 2013: Hide Your Head

I slept on the sofa-sleeper last night.

The reason isn’t what you think, assuming you were thinking what people usually think when a husband winds up on the couch. Earlier in the evening Molly hit the wall. (Figuratively, I mean.)

She went to dance but didn’t dance because she can’t dance because of her concussion, though outside of a slight-and-getting-slighter headache she was feeling just fine – a little tired physically, but more than anything else tired of being restricted, tired of being told she couldn’t do things that she knows she can do and very much wants to do.

A week and a half of frustration surfaced volcanically. She wept, she sobbed, she moaned about being tired. All she wanted to do, she said, was curl up with her mom and watch wedding shows. So she and Ann got the big bed and I got the couch.

One of the most insidious things about concussions is the way they recast the definitions of sick and well, or perhaps “injured” and “non-injured.” Though there is absolutely nothing Molly is unable to do, she is injured. Andy is injured. They’re in far less pain than I am – thanks to the dynamic duo of three sets of tennis and a Hide-A-Bed – but they can’t run, can’t dance, can’t lift weights, can't shovel snow, can’t play in band, can’t drive, shouldn’t watch TV, shouldn’t be on the computer, shouldn’t play video games, should only do the minimum amount of homework, and should spend as much time as possible in a quiet room with the blinds drawn.

And except for the days where Molly wore sunglasses to school (and did laundry), their behavior hasn’t betrayed their injuries. Andy and I loaded a godawful heavy snowblower into our van last evening, and he fired it up after it was unloaded – all supposedly taboo, but what are you going to do? Numerous friends have joked that we should bubble-wrap our children, but they can only stay wrapped up so long. Like Ted Williams told a friend of mine, “Hell, it’s a long season. You gotta live a little.”

I have a problem reconciling my children’s appearance and behavior with their injuries, and I know based on last night Molly has a hard time coming to grips with her injury, so I can only imagine how teachers, friends, teammates, and others on the outside comprehend these injuries.

(Interestingly, Andy has had a much easier time dealing with his concussions than Molly has had dealing with hers. I think that’s because of the importance dance has in Molly’s life, Andy’s level of concussion awareness – including the research paper on concussions he wrote just before he got his first concussion -- and the fact that a life of indolence just plain suits Andy.)

Sometimes I think concussions would be easier to deal with if they came with a set of outward manifestations: a limp, a bruise, a twitch, something to make people believe damage has been done and repair is needed.

I don’t really care about what people think, even Andy’s teammates, who saw him loose and goofy – totally himself, in other words – before their biggest game of the year, yet didn’t see him on the ice during the game playing with the verve and aggression that usually accompanies the loose-and-goofy.

I do worry that my kids start thinking of themselves as plague dogs or pariahs. It’s healthy in a way that Molly and Andy both have concussions; they can relate to each other. They have an on-again, off-again contest to see who’ll be back in action faster. (I say Molly. Andy likes the concussion life a little too much.) But I don’t want them thinking that it runs in the family somehow.

Taking Molly to school this morning, it was apparent the night of snuggling with her mom was not a success. “She breathes funny,” Molly said. “She makes noises.”

So the sofa-sleeper is no more, thankfully. But the concussions remain.

March 12, 2013: Right vs. Right

I’ve been dealing with a lot of guilt over the last couple of days. As I mentioned earlier, my previously concussed son Andy played in his level’s state hockey championships over the weekend. Midway through the first game he tripped over an opponent and slid head-first into the boards and immediately removed himself from the game. He didn’t play the rest of the tournament, complaining of slight, intermittent headaches. His team won that game, and the next, but lost in overtime in the finals.

The likelihood was great that they would have won. The likelihood was also great that continuing to play would have done him no long-term harm. So should he have played?

“Of course not,” you say in unison, and I get that. That was our decision, too. We were good parents. He lives to play another day. But as time goes on, I find more merit in the counterarguments.

First, the medical facts as we know them: Second concussions are not a good thing. Receiving additional head trauma when you have a concussion – even a first concussion -- can result in something called “second-impact syndrome,” and that can result in death.  A handful of athletes die each year from second-impact syndrome.

A number-cruncher would tell you there was a slight risk to my son’s life from having him play, which is true, though the additional risk was only a very, very small amount greater than the risk to anyone’s life from playing hockey. You can die playing hockey no matter how your head feels, yet we continue to play hockey.

There are good reasons why, of course. Your risk of dying while playing hockey is about the same as your risk of tripping on a Higgs boson. More importantly, if a player’s throat is cut by a skate blade and he bleeds to death on the ice, it’s a freak accident. The survivors can sue all they want, but who are they going to sue? The skate manufacturer? The skate-sharpener? The rink? The program? The parents? Liability is scant. No one’s going to walk away rich from a lightning strike like that.

On the other hand, if a coach knowingly plays a kid with a concussion and he gets hurt, the coach and the organization are liable to the gills. So like a lot of safety decisions, the decision to hold out players with concussions has a candy shell of compassion and a dark center of money.

Ah, but there is philosophy. Philosophically, we respect life. We don’t treat lives cavalierly. We’ve know implicitly that it’s wrong to throw a 13-year-old boy onto the ice with a known injury so his team can stand a better chance of winning a made-up tournament for a pretend league created by drawing boxes around a bunch of players and teams.

It’s so clear, yet this is where things get murky.

Respect for life is a Judeo-Christian ethic, but so is noble sacrifice, putting the good of all above the needs of one. The Unknown Soldier fell on the grenade; Jack Youngblood played the Super Bowl with a broken leg; Jesus died for our sins. From the bloody sock to John Wayne in The Searchers to Joan of Arc dying at the stake we make these sacrifices a part of our mythos, no matter how hackneyed their truths might be. (The Searchers was fiction, Joan of Arc might as well be, and what does it really matter that the Boston Red Sox won a World Series?)

Many of Andy’s teammates had never won a state championship in anything. This was their last best shot at something – no matter how made-up it might be -- that they would cherish the rest of their lives.  By choosing to accede to the sliver of risk and not let Andy make the modest sacrifice of playing, we were depriving these kids of a glory that was rightfully theirs. We chose the selfish Judeo-Christian ethic over the selfless one.

We have a hard time with selfishness. We repudiate it, yet the most important decisions we make in life and the emotions that play through those decisions are essentially selfish. All that’s asked of us is that we balance selfishness and selflessness. If everyone in the World Trade Center was selfless, they all would have died trying to get each other out; if everyone was selfish, they would have clogged the exits and perished.

Selfishness and selflessness only stick out when we they contradict expectations. We close our eyes to the charity done by the robber baron; we turn our face from Lance Armstrong’s blood-doping; we feign outrage when parents force a teenage athlete to play through a concussion.

However, in this case had we allowed Andy to play and had his team won, this act of selflessness and sacrifice would have come at his opponents’ expense. A once-in-a-lifetime thrill would have been transferred, not created. There would have been no additional winners, only different winners.

To me, the only meaningful justification for our actions is that we wouldn’t have made anything better by letting him play. We only would have created an alternate ending.

In the end, we made a right choice, not the right choice. There were others.

March 11, 2013: I Gotta Wear Shades

I drive Molly to school these days because first hour is band, and band is bad for people with concussions, so she might as well spend that time resting and hacking at the piles of homework that have been mounting since her injury.

Molly wears sunglasses to school. They’re squarish, oversized models in a shade of seafoam green usually seen on Stratocaster guitars and Chevy Belairs. She doesn’t wear them because the drive is bright – the gray-flannel skies, decaying snow and bare trees make you feel like you’re living inside a pair of sweatpants – but because the lights at school bother her.

“It’s not that the lights are so bright,” she said. “It’s just that after five hours it starts to wear you down.”

Molly is exhausted after a day of school. She’s weepy. She drapes herself on us. She craves hugs from Ann. For the most part she functions normally, but the aggregate is not normal. It’s a half-bubble off. It’s like yesterday, when I texted her on the way home from Madison and asked how she was feeling.

“The same,” she texted back, “but better.”

I called her out on the contradiction, but I know what she means. The same is the concussion. But better is the coming out.

She’s determined to come out. Since the first day she was diagnosed her goal has been to recover faster than her brother.

“That shouldn’t be hard,” I told her, “seeing as his idea of recovery was sitting on the couch playing video games and watching Duck Dynasty.”

(Andy's definition of brain rest and the doctor's may seem to be at odds, but after negotiating a couple episodes of Finding Bigfoot I realize they're actually not as far apart as they think.)

However, Molly is learning how hard brain rest can be. She’s done more laundry than she’s done in her life. She’s cooked. She’s baked. She’s done crafts. She goes to dance and watches the other girls dance.

She tries to watch less TV. But she can’t totally walk away from Say Yes To The Dress, nor should she be expected to. Trite as it may seem, a big part of her recovery is wrapped up in feeling good, and occasionally in the course of all this you need to do something bad to feel good.

An extra half a concussion day for a little solace along the way? It goes against doctor's orders, but at times it’s a deal worth doing.

March 10, 2013: A Bruise Of The Head, A Break Of The Heart

The weather has been dismal in Wisconsin this winter. Rejecting the idea of global warming on its face, winter started late but has more than made up for it with apoplectic fits of snow that barely clear before the skies cloud over and the next attack commences.

Now that I think about it, our winter really arrived about the time of Andy’s first concussion. Christmas weather was benign, with a trace of snow. The new year began placidly; we could play basketball in the driveway and lacrosse on the lawn, and the winter bore all the signs of one of our new winters, quiet and temperate. Around the middle of January everything changed. The clouds gathered, the north winds blew, the snow fell, and the world went bad.

Funny how so much of our mood is directly related to the weather, even in retrospect. I think back over the past few months and see it as a time of cloudiness, gloom, overcast, storms, drear-benighted days, outside and inside. Concussions are inconceivable in the warmth of summer, among the greens, blues and yellows. No one stumbles hazily through the bright months. Concussions are a gray affliction, a cold affliction, a condition of sleet and damp winds.

This morning dawned wet and full of dense fog, so there was no question what sort of day it was. It was another concussion day.

My son woke and initially said he felt fine, temporarily buoying our spirits. Maybe he is all right, we thought. Maybe he can play in the state-championship game. Maybe there is redemption in all of this.

Upon further questioning, he was not all right. He was having intermittent headaches. He could not play in the state-championship game. And I cried.

I cried for myself more than anything, and that is not indefensible. Grief is a selfish act. When we mourn, we cry for ourselves. I cried because I was being deprived of the deep, quenching joy of watching my son play hockey, in the type of game he has always played heroically. At the same time, I had to watch other people’s sons play, and their parents – if they were fortunate enough to see it so – experience that joy.

“Are you mad?” my wife asked. No, I wasn’t mad at anyone other than the person who gave my son a concussion in the first place. I could have laid a baseball bat upside his head at that moment, an act of meaningless bravado made plausible by the fact that he was hundreds of miles away at the moment. I couldn’t be mad at the player who fell down, causing my son to trip and slide into the boards. I was mad at a concussion, but concussions in the late winter don’t leave you many outlets to express your anger. I split a quarter-cord of wood in a blind fury one day, but the mauls and logs were home. All I could do was walk the fog-drenched streets of Verona and cry.

Youth sports force you to operate on several levels, especially if you’re a coach, as I am. The most superficial level exists in the platitudes we use to justify these sports: They build character. They teach teamwork. They provide life skills. They do, but so does a week spent building a cabin, and at the end of that you have a cabin to show for it. At the end of a hockey season you have a duffle full of stinky gear, a bottle of Gatorade, and a pin.

The next level consists of affection for the team. Andy’s hockey team this year was composed of genuinely good guys – not a blown-out ego or head case in the bunch. I like them. I root for them. I wish them well in life. But I wish my own son better.

The deepest and probably truest level is the selfish level: me and my own son, me through my own son, but mainly me. It’s not entirely exploitative; part of what defines family is the family against the world. Good on the family; bad on the non-family. It’s part survival and part identity-building. An entirely selfless family would probably not be much of a family. Youth sports facilitate that, sometimes in unattractive ways. So I don’t apologize for crying over my/my son’s misfortune. Sadness beats rancor or vindictiveness any day.

Yes; the game. Well, you know how it turned out. Andy’s team lost in overtime. Without meaning to exaggerate his skills, his team likely would have won had he played. A day, a tournament, a week, a month, a season tuned to maximize heartbreak delivered the final, least unexpected heartbreak of all.

We cried, shook hands, gathered up the jerseys, loaded the van, and drove back home in a cold, black, unremitting, totally unsurprising rain that later changed to snow.

March 9, 2013: The Concussed State

This is another concussion day. We are in Verona, Wis., for the state hockey championships. Andy is playing in the Bantam B tournament, basically a tournament for second-team (B-level) 13-to-15-year-olds (Bantams).

Andy played in his first-round game. Halfway through the second period he missed a check, fell over another player, and slid headfirst into the boards, in the corner to the right of the opponent's goal. He immediately removed himself from the game, banging his stick as he skated to the bench, and our hearts sank. He sat on the back bench and played no more that period. Occasionally coaches spoke with him, but made no move to insert him into the same.

Between periods I went to the locker room. His eyes were puffy from crying. He was agitated. He said his head hurt.

He did not play the rest of the game, complaining of a headache. Because he was worked up, we could not tell whether his head hurt because it hit the boards and he was re-concussed or because he was stressed, angry, scared, and crying.

"He's so afraid of going back to that place that when he gets hit, he pulls himself out right away," his coach told me after the game, and he's right. It's one of the big differences between concussions and other injuries. Stress, anger, and fear don't do much to a sprained ankle. You don't have to wait until someone stops crying to determine if their wrist is broken. People may favor a bum knee, but how do you favor a brain?

Meanwhile, back home, Molly says she feels better but still has headaches. Another non-symptom-free day for her.

It's 2 p.m. At three we've told Andy we will ask him how his head feels. If it hurts he won't play today – won't even suit up. Tomorrow we'll go through the same routine. If it continues he'll go back to the doctor on Monday.

The adventure continues.

March 4, 2013: My Concussed Family

Almost two months ago – the ominous date 1.13.13, for those who put stock in such things – my son sustained a concussion. I hesitate to say “was given a concussion” or “received a concussion” because that suggests something benevolent, and there is nothing benevolent about a concussion. I had entertained the idea at the time of writing a “concussion diary,” in part such behavior is expected of writers.

(This is unfair, obviously, since no one expects a painter to paint “concussion studies” when their child sustains a concussion, or a dancer to choreograph “The Concussion Dances,” or a songwriter to do The Concussion Album, or Mel Brooks to direct The History of Concussions Part I, or less logically, for an auto-body repairman to do “concussion dent removal.” But when something happens in the life of a writer, people expect the writer to write about it. I always gave writers more credit than to fall into that trap, and readers more respect than to force them to read writers’ attempts to extricate themselves from the trap.)

I didn’t write a concussion diary and my son got better, albeit excruciatingly slowly. He’s a hockey player, and was concussed via a shot to the chops delivered by a player who had already concussed one of my sons’ teammates (and cracked five of his teeth) and broken a collarbone of another teammate over a four-game series. Hockey is one of the strongest, darkest threads running through our family. Hockey, dance, church: Remove those threads and there’s not a lot left – meals, maybe, and the loose, sketchy plaid of a family laid on a loom of love.

Watching my son play hockey is one of the joys of my life. I harbor no illusions about his modest skills. There will be no NHL hockey for him, no college hockey, very probably no high-school hockey. Every game he plays is a gift, and to not have him heal from his ephemeral injury and to have him miss game after game was like watching other people celebrate Christmas and not being allowed to go downstairs.

The redemption story, the finding in every loss a gain to match, is this: He got better. He returned to the ice, a different player in a different role but a player nonetheless.

I remember the redemption story today because several hours ago my daughter was diagnosed with a concussion.

Molly is 16, and a dancer. Not a dance-to-wear-the-costume dancer, not a contest dancer living in that made-up (in more ways than one) alternate universe, but a serious student of dance, of Balanchine and Baryshnikov and the Bolshoi. She was rehearsing a piece – with her best friend, ironically – that required them to enter from different directions with their heads down, like the entrance of the mushrooms to the “Oriental Dance” in Fantasia. They bumped heads. Molly got a headache.

When we came to get her at the dance studio after the hockey games she was sitting on the floor with her dance teacher, Tori, sorting out costumes for an upcoming performance. She looked absolutely, utterly normal.

"I think she's fine," Tori said.

"I just have a little headache," Molly said.

The headache didn’t go away for two days. When the physician’s assistant shined a light in her eyes Molly turned pale, felt dizzy, and had to lie down.

The PA didn’t even bother conducting the concussion test. “She has a concussion,” she concluded quickly. “Bring her back when she feels better and we can do a test.”

So here we are again, delivered accidentally, descending like a box-office bomb into the odd, floating otherworld of the concussion family. Let me try to explain what this world is like.

First, let me give you my concept of a concussion. It’s like your brain getting kicked in the shin, only it has more insidious side effects because it’s your brain and not your shin. You can probably focus in school after getting kicked in the shin. Daylight doesn’t make your shin hurt or your stomach ache or your hands and feet tingle or your head fog over. When you’ve been kicked in the shin there’s very little variance in how your shin feels. Your shin hurts like that guy’s shin hurts, and that guy’s and that guy’s and so on. Assuming you’ve all been kicked in the shin about the same way, the pain in your shins will go away at about the same rate – and if you went to a doctor, they would be able to tell you when your shin would stop hurting. That’s not the case with a concussion.

The reason I stick with the kicked-in-the-shin analogy despite these vast differences is because if you’ve been kicked in the shin solid and hard, it takes a surprising length of time for the pain to vanish. For months afterward you can press on your shin where you were kicked and feel the pain. You’re not incapacitated; you’re inconvenienced. But until the pain goes away you’re not completely healed.

That’s how it is with a concussion, only you are largely incapacitated for a big part of that healing process. Andy had four and a half weeks of forced inactivity. Molly’s sentence is nearly a week, and counting.

Forced inactivity, if the doctors had their way, would involve sitting in a darkened room with no TV or iPod or cell phone or computer or music or books or homework or noises or smells or stimulation of any sort.

(I wonder whether that embargo on stimulation would include thinking, because if I had no access to external stimulation I guarantee I would come up with some cracking internal stimulation. I’d be writing songs and stories and screenplays and books and blogs – and concussion diaries – in my head until I fell asleep. If I was a doctor, and serious about healing someone with a concussion, I’d recommend what my doctor recommended when I had bronchitis: boring movies. I’d think 15 minutes of Heaven’s Gate would flatline anyone’s brain.)

The lack of tangible progress during this healing process is maddening. You can’t peel off the bandage and see how the wound is closing up, or watch the bruise go away, or see range of motion return, or even watch the progress on weekly X-rays. And if the symptoms are ephemeral, as they were with my concussion children, this inchoate process becomes vaguer. My kids had to fish around in their brains for a headache – something they had never had to do before – and if they found one their day was shot, since healing is measured in symptom-free days.

Because it just takes one symptom to shoot a day, progress is measured in minutes and hours. A symptom-free minute has to build on another and another, and then the hours have to make a day, and the days a week; one headache resets the clock.

Negotiating a day with a concussion patient is like watching them run a 24-hour egg-and-spoon race. They’re wobbly but still in the race step after step and minute after minute, and you’re on the sideline cheering them on, louder and more enthusiastically with each step because this is going to be the race – This is going to be the symptom-free day! This is going to be the beginning of the end! -- but then they drop the egg two steps from the finish line and have to start over. Nothing has been accomplished. It’s just another concussion day.