Concussion Repercussions: Watching Texas Longhorns QB David Ash

After basking in the lukewarm, flickering afterglow of Texas' win against an out-manned KSU squad, my mind turned to a very specific question - had Texas broken NCAA concussion protocol in permitting David Ash to return to play two weeks after his brain injury against BYU?

Turns out the answer is no - because there is no NCAA concussion protocol.

As this illuminating article from Deadspin illustrates, the NCAA has devolved pretty much all responsiblity for creating, executing and making decisions around a concussion protocol framework to its member institutions. There's probably another way to interpret this decision besides a cowardly attempt by this feckless organization to absolve itself of legal culpability, but I'm gonna go ahead and call that one like I see it.

With a blatant and wholly in-character failure to lead from the NCAA on this issue, it's up to the schools to make decisions on how badly athletes have been injured and when it's safe for them to take the field.

As the Deadspin article relates, there have been some instances over the last couple of seasons where schools' decision-making here could charitably be described as 'aggressive:

In 2012, UConn QB Chandler Whitmer had suffered a head injury against Louisville. A week later, he started against Cincinnati and took a hit that slammed the back of his helmet into the turf. Announcers praised UConn's justifiable caution in removing him from the game at that point, only to have him return ONE SNAP LATER and swiftly get his helmet dashed to the ground again. He required assistance to make it to the sideline.

FSU's E.J. Manuel took a shot to the head against Florida, returned to the game after a brief examination and had his absence described by coach Jimbo Fisher as an 'abdominal injury'. USC receiver Robert Woods missed just a single play against Utah after a helmet-to-helmet shot that had him stumbling towards the sidelines.

A direct quote from the article on perhaps its scariest example:

Arizona quarterback Matt Scott puked on the field after getting hit in the head, leading ESPN announcers Matt Millen and Joe Tessitore to plead on the air for him to be taken out. But Scott stayed in, getting pulled only after that series was complete. In the Wildcats' next game, Scott suffered another concussion. After taking a week off, the quarterback returned to action and was shown barfing on the sidelines against Utah.

If you'd been operating under the idea that college athletes were playing under the aegis of a robust, centrally administrated and strictly enforced set of protocols around concussion safety - they ain't. BC has opined on this topic over the past few seasons, highlighting various aspects of the player safety debate while also calling out the fundamental uncertainty that still exists on such a vital issue. The impact of brain trauma has already hit close to home for the Longhorn family, as Texas running back Tre Newton was forced to hang up his cleats after repeated head injuries.

Now, it's hitting home again with David Ash. In the absence of a nationwide protocol, we're left to look solely at Texas' own protocols and procedures to understand what happened between BYU and KSU. Likewise, Texas alone bears the responsibility for what will happen from here.

What We Know

David Ash suffered a concussion against BYU.

Ash missed next week's game against Ole Miss, and in fact wasn't even present at the stadium.

Ash is a tough kid with a ton of heart who takes his leadership responsibility of this team very seriously, and would do anything in his power to take the field.

Ash was in fact medically cleared by UT's physicians, according to a protocol that is not publicly known.

Ash returned against Kansas State and, after taking several solid but largely unremarkable impacts, was unable to complete a full half of football before getting sidelined with a serious headache.

What We Think We Know

We think that Ash's concussion, and post-concussion symptoms, were severe enough that it was judged best that he miss the home game against Ole Miss. Insider-y talk all over the Longhorn Interwebs has ranged from "Ash has felt terrible and hasn't been sleeping" - which makes the concussion issue sound pretty bad - to "Ash was pretty much fine and the shoulder was always the bigger issue." We're facing uncertainty here, but my instinct is to believe that he was indeed advised by doctors to miss Ole Miss for concussion symptoms severe enough to be aggravated by light and loud noise.

Which doesn't sound like a minor concussion.

What's Unclear

Right now, a hell of a lot.

We don't know what specific protocols are employed by the University of Texas physicians to certify a player's post-concussion fitness for a return to duty. We don't know how much those protocols rely on objective, science-based evaluations of physiological baselines and cognitive function versus subjective symptom reporting from the athlete himself. (If there's anyone reading this with specific knowledge of exactly what those protocols are for UT, please share).

There was more unconfirmed insidery whispering that Ash was trying to game the concussion tests as early as Ole Miss week, but that's vapor without a stronger confirmation.

Most importantly, we don't know what David's health at this present moment. There's been no confirmation that Ash suffered a second, distinct concussion or whether he was still suffering from the initial concussion and simply had its effects re-aggravated by one or more run-of-the-mill hits. And, given HIPPA, we're quite unlikely to get a full and official accounting.

The bottom line is that we don't know, for a dead-solid certainty, that David Ash was under undue risk of further trauma by playing against KSU. The question before us, then, is about proper conduct in the face of uncertainty.

The Face of Uncertainty

I feel confident to assert that there was uncertainty around Ash's fitness to play on Saturday. Medical science's imperfect understanding of the diagnosis and effects of brain trauma and the obvious outcome of re-injury seem to argue strongly against the idea that anyone could say with rock-solid, 100% certainty that Ash was good to go against K-State.

In the face of such uncertainty, the decisions of leaders must be evaluated. I am in no way asserting that Mack Brown is a monster who knowingly pressured David Ash to return to action in the face of clear evidence that Ash was unwell as of Saturday night. Nor am I automatically whitewashing any decision made by Mack based on the chimera of a self-abnegating, high-character, "it's all about the kids" mindset.

By the same token, I certainly don't believe that Bellmont outright seeded false information the existence of a medical clearance, and I'm not accusing them of floating stories that played up the shoulder and played down the head over the last couple of weeks. But the second part wouldn't exactly stun me, either.

You can stop short accusing someone of active malfeasance in a specific instance while still letting them know that you no longer trust them as far as you can throw them. And if we're high enough up on the radar for one of John Bianco's flunkies to have printed this out for him, I hope it's crystal-clear that everyone associated with Bellmont has lost every last ounce of my trust and goodwill thanks to their robust history of naked self-interest, transparent spin and out-and-out falsehood. The fact Texas' leadership no longer deserves implicit trust on such fundamental issues is tragic, but it's a situation they've brought entirely upon themselves.

We're 19 days away from the season's obvious watershed line against OU. For Mack, who shows every indication of still fighting tooth and nail to linger on as Texas' head coach, the temptation to play Ash will be obvious. And, given Ash's re-injury despite medical clearance this week, there can be no true 'certainty' prior to the game that he's not at heightened risk of serious or even life-altering damage by playing. It will be a judgement call.

As fans, we're also in a state of unfortunate uncertainty around just how fully we can trust Mack and Bellmont to be the paragons of wisdom and prudence and forthrightness that they project themselves to be. In the face of that kind of uncertainty, every fan has to make their own decision on how to react.

I've made mine. If I can do anything that actually matters this season, it's to do a small part to ensure a long, happy and healthy future for a great person like David Ash. I'll never have 100% knowledge of his medical fitness at any point during this season. But I also believe that UT's medical folks cleared him too early this time - not out of willfull malfeasance, but because NO ONE can or will have 100% certain knowledge when or if he's fit to go again for quite some time. It'll be a decision made in the face of uncertainty, and I'd like to introduce this into Mack's decision calculus:

Should David play against OU or any other opponent this season and suffer yet another concussion, I'll have no choice but to believe that Mack weighed uncertain evidence and let self-interest outweigh caution. And I'll use every public forum available to me for as long as I'm around to make sure that decision is stamped front and center on the Mack Brown Legacy.