USING THE HEAD
WHEN Donncha O’Callaghan and John Fogarty were in cahoots you knew there was trouble ahead. On one occasion the two famously got hold of a pantomime costume of a horse and were grazing on the famous Thomond Park sod when the rest of the Munster squad reported for training. Fogarty found himself at the rear end of that arrangement and recently has been down on his luck once more.
O’Callaghan’s practical jokes are legendary at this stage, but in those early days when everyone in the Munster squad was fair game, Fogarty was his chief lieutenant and more than willing to play along. A good-humoured, happy-go-lucky guy, the proud son of Tipperary went on to play professionally for Connacht, captain the Ireland A side, win a Heineken cup medal with Leinster and fulfill a lifetime ambition when he came on in the latter stages of Ireland’s test against New Zealand in New Plymouth last June to win his first cap. Things could not have been better, or so we thought.
Within five months of his career highlight, Fogarty was forced to announce his retirement two weeks ago. On the same day, another Leinster front rower, Ronan McCormack, and Scottish international, Thom Evans, also announced their careers had come to a premature end.
Professional rugby has become such a collision sport that very few players get the opportunity to call time at their own discretion. More often than not injury is the deciding factor.
Fogarty’s story is both shocking and revealing. He was a smiler, always in good form and universally popular. That is why it was a shock to read his candid revelations in a Sunday newspaper on November 7 last that he now regularly suffers blinding headaches and mood swings that are having a major impact on his day-to-day life. There are times when he doesn’t want to leave the house and has to spend the day in bed in a darkened room. He admits to slipping into periods of depression. There is something seriously wrong. Nothing could be further from his normal demeanour.
All of this has been brought about by continual incidents of concussion. Fogarty claims to have suffered at least seven or eight over the course of the last year alone. His story is bolstered by confirmation that his fellow Leinster and Irish hooker Bernard Jackman has also suffered similar difficulties and goes into great detail on his battle with concussion in his recent autobiography Blue Blood.
Should parents be racing to withdraw their kids from underage rugby in schools and clubs around the country, fearing the game has become too dangerous? The answer to that is no, I don’t think so. The professional game is a completely different animal to its amateur cousin.
Medical care for professional players in this country is second to none but in relation to concussion it would now appear the players are being less than truthful in their dealings with their medical advisers. As a consequence they are placing themselves in great danger. The effectiveness or otherwise of the cognitive test which dictates whether or not a player is cleared to play after revealing signs of concussion is being called into question.
In some respects players were more protected, especially from themselves, in the amateur era when any suspicion of concussion automatically led to a mandatory three-week break from the game. Former Highfield hooker Kevin Lynch’s story is instructive from that point of view.
In 1990, Lynch took a bang to the head in a Munster senior cup game against UCC but left the field five minutes later faking a shoulder injury. The medics on duty that day were not happy as they felt he was concussed.
Trouble was, Highfield were due to play Young Munster in the biggest game in the club’s history the following Saturday. Against medical advice and because he fully appreciated the importance of the game to his club, Lynch insisted he was fine and was togged out in the dressing room 30 minutes before kick off, ready to put his body on the line. A former Leinster player from his days with Wanderers, he was an excellent lineout operator and knew his presence was crucial.
However the medical officer on duty, who also happened to be at the game the previous week in the Mardyke, approached the referee and declared Lynch unfit to start. Standing on the bank at Musgrave Park that day as an interested spectator, I can still recall the consternation among the Highfield faithful when news of his withdrawal hit the terraces.
Twenty years on and with the benefit of hindsight, Lynch accepts he was concussed, that he concealed headaches in the week of the Young Munster game and the medics acted in his best interests. Put another way, he would not want one of his sons to play in similar circumstances today.
The problem seems to be that the modern day professional player is too aware of how to hide the symptoms of concussion and is being granted an out because they are being economic with the truth when undertaking cognitive tests at the outset of the season.
Bernard Jackman, who admits to some 20 concussions alone over the last three years, describes the issues surrounding the condition as a time-bomb ready to explode. He accepts personal responsibility in that he never admitted the fact to the Leinster management or medical team and when the incidents occurred, bought himself time on the field to regain his faculties. It is easy to go to ground, holding some other part of your anatomy while trying to recover your senses. The bottom line is that some players do not want to miss matches due to a combination of financial or selection issues. You don’t give a rival for your position the opportunity of keeping you out of the team.
Last season, against England at Twickenham, Brian O’Driscoll took a knock to the head from the knee of Paul O’Connell. It happened directly in line with where I was doing commentary for RTÉ radio. The pictures on television did not fully reveal the fact that he made two attempts to get up off the ground but stumbled on both occasions. I immediately said not only would he have to be taken off — which he was — but that there was no way he could play against Scotland the following week, even if a Triple Crown was at stake. I couldn’t believe it when he led Ireland out seven days later. I worry for him at times.
The cognitive test, in lay man’s language, is a series of questions and reactions over a 20-minute period that a player suspected of concussion must complete. The results are then compared with a similar test all players undertake at the outset of the season. Your percentage deterioration from your early season score determines whether or not you are fit to play. Both Jackman and Fogarty admitted there is no incentive to score highly in the pre-season test. That is a serious mistake, a point highlighted by the results on repeated cases of concussion in the NFL in America which are now coming to light. Rugby players had better take note.
The attitude towards concussion in American football has changed dramatically over the last three years. This season the NFL has produced a poster for dressing rooms across the league which bluntly alerts players to the long-term effects of concussions, using words like “depression” and “the early onset of dementia”. It carries the warning that repeated concussions “can change your life and your family’s life forever”.
The poster covers four specific areas — concussion facts, symptoms, why a player should report his symptoms to the team medics, and advice as to what he should do if he thinks he’s had a concussion. It doesn’t make for pretty reading and it should be taken on board by the IRFU and put in every dressing room in the country.
The kernel of the problem, as alluded to by Fogarty and Jackman, is that concussion as an injury is not taken seriously enough by the players. In addition, players are not working closely enough with medical advisers who, in my experience in rugby, will always do what is right for the player.
John Fogarty has contributed much to the game all levels. Perhaps the IRFU and the player’s representative body IRUPA should now use him in an ambassadorial role to preach the dangers of concealing concussion. I’m sure the IRB medical personnel will observe the candid views of the two hookers with great interest and act accordingly.
As to the game itself, professionalism has resulted in players today being bigger, faster and stronger than ever before. As a consequence, the collisions are massive and the incidence of shoulder and knee injuries is huge. However bad they seem at the time, they can be repaired.
As for parents, who must have been horrified reading the revelations of Fogarty and Jackman and are worrying about their kids’ involvement in the sport, I would say the amateur game now is cleaner and safer than it was when I played. Schools players are bigger now as a result of greater exposure to weights but there is nothing to suggest that the game at that level is more dangerous. As with everything in life, a little bit of common sense goes a long way. Fogarty and Jackman would accept that now.
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