Dream a little; sleep a little more!

By Sababa Anber

Do you ever feel that you cannot distinguish between dreams and reality? For those living with narcolepsy, the line between wakefulness and sleepiness is so blurry that one can look like they are perfectly awake, but their mind is far off on a vacation. My friend Elizabeth was diagnosed with a severe case of narcolepsy with cataplexy when she was in 6th grade. It crept up on her as she’d fall asleep at the ballet bar or in the middle of a friend’s party. It was painful for her to recognize that something her sisters assumed would be a passing personality quirk has proved itself to be a permanent burden in her life. Narcolepsy with cataplexy is a condition in which both sleep and wake states are disrupted.  Since becoming a narcoleptic, Elizabeth has never had a normal night’s sleep. It is not about her simply being tired. On a daily basis she copes with disrupted wakefulness and she will never sleep a night with normal sleep architecture. Elizabeth takes Xyrem, the most controlled substance in the U.S. that is only dispensed by one pharmacy in St Louis. It is deliberately manufactured to be short acting and foul tasting in order to discourage its abuse or use to harm someone. In fact, in drug circles it is known as the date rape drug, so she has to be extremely careful about keeping it safe and private. Xyrem knocks Elizabeth out, once at 11 pm, and then she wakes up, goes to the bathroom and takes it again around 2am, all of these just so that she can function normally; or at least hope to, like a regular person. Narcolepsy prevents Elizabeth from taking late night dance classes, having sleepovers, or reading for long hours (which she used to love to do). Plus, it can be an embarrassing disorder as well. People constantly take photos of her sleeping and laugh as she drifts off in class. Her teachers and friends sometimes question the legitimacy of the disorder. They sometimes won’t take it seriously– suggesting that she go to the nurse, or take a quick nap and then everything will be fine, frustrating her in her every step in life. She uses her functioning and awake time very carefully so that she can live the most normal life possible. She doesn’t, for example, drink alcohol (which is prohibited on her medication anyway). And she has restricted extracurricular pursuits. She spends most of her waking hours, which are very limited, studying, eating (meals are her main social life) or in class or at her job. She was in a dance group first semester which she resigned from in order to keep focused on her academics. In the past, she has fallen asleep during an exam and this resulted in the teacher having to create a substitute exam. On other occasions she has taken an exam while appearing awake and looking at the exam upon completion, it was evident that she was in a partial REM state and had written jibberish, and had to retake the exam. Lastly, an interesting part of having narcolepsy is that it comes with an incredible command over dreams. Narcoleptics have extremely vivid dreams and nightmares which are interesting to hear about. Every time I do not get sufficient sleep, I just remember that I am lucky to have the capability of sleeping normally when I want to. We must all appreciate our time awake and try to accomplish as much as possible. References: Elizabeth Sockwell, Class of 2020, Trinity College

“Can You See Me, Can You Hear Me?”

By Roxana Alvarez

Have you ever woken up not knowing where you are or who the people around you are? Lydia Velez-Herrera has. On Thursday during common hour, November 9th 2017, students and faculty were given the opportunity to hear Lydia Velez-Herrera, founder and president of “Lilly Sin Barreras”, discuss her experience as a traumatic brain injury survivor. According to Ghajar (2000), traumatic brain injury is one of the most common causes of death and disability (Ghajar, 2000). Carlson (2014) goes on to say that traumatic brain injury is a serious problem in which approximately 1.4 million people are treated and released from an emergency department, 270,000 people are hospitalized, and 52,000 people die from each year (Carlson, 2014). Translated in English, “Lilly Without Borders” is an organization that provides legal, informative, and personal support to those that have suffered from brain injury or those that experience cultural, language, or financial barriers. As Herrera’s presentation title “Can You See Me, Can You Hear Me” suggests, she and her organization are driven by the motto, “I Can See You, I Can You Hear You”, as they aim to provide resources to those who don’t have them or don’t know where to find them. During her talk, Lydia described how she was moved by her own experiences with TBI. Through them, she came to understand that sometimes all a person needs is an extended hand. At the age of forty-one, Lydia Herrera woke up and didn’t know where she was. During her talk, Lydia described how the members of her family became strangers to her. She became somewhat of an “adult child” and travelled to Puerto Rico to be with her mother who had to care for her. She expressed how, in Puerto Rico, she spent her time in eight hospital units, all contributing to her becoming overly medicated. During this time, Herrera felt as if she was constantly being watched. Her confusion with the disorder and, and with the way she felt she had to act, often led her to ask herself the question, “What’s happening?” She described that even the act of watching TV affected her negatively; she was easily overstimulated by the people and noises coming from the screen. As her emotional rollercoaster progressed, she was anchored by one quote that she repeated to herself constantly, “You can shake this.” Herrera was put in a position where she was made to understand many realities. At this time, judgement became an important quality in people to her. She claimed that when it comes down to it—intention is important. Perhaps she would be asked questions, (for example, “Do you speak Spanish?” or “Do you have a disorder?”) and that was okay—so long as the intention behind people’s words were not hurtful. As she progressed in her recovery, she also realized that it is important to not submit one’s self to his/her limitations (whether physical/mental/psychological/etc.). She met many people that pushed the idea, “I’ve always been this way” and, because of this, didn’t believe they could get better. She refused to hold on to this. On her search for healthcare providers, she learned that sometimes it takes people that are completely different from you to help you and that it’s important to be patient with, and stand up for, people with neurological disorders. Though Lydia’s TBI contributed to her struggling physically, socially, and emotionally, she expressed how, because of it, she grew stronger—especially in the fact that she never gave up on her own growth/improvement and refused to ever be anybody but herself. In having this experience, Lydia now aims to be a source of help and support to all of those in need—whether it be by providing them with information, legal help, or a general helping hand.

For more information on Lydia or Lilly sin Barreras, call +1.8609668955 or e-mail lillysinbarreras@yahoo.com

References Carlson, N. R., & Carlson, N. R. (2014). Foundations of behavioral neuroscience. Harlow: Pearson Ghajar, J. (2000). Traumatic brain injury doi:https://doi.org/10.1016/S0140-6736

Disrupting the Baseline

Molly Fitzgibbon

Upon entering high school and signing up for a fall sport it was a requirement for all athletes to take the ImPACT test. It seemed very unimportant to me at the time and something I just wanted to complete so I could get out there on the field. Little did I know in a short few months this test would be a necessary and helpful tool in getting diagnosed with a concussion. One crisp fall day of my freshmen year, I was out practicing on the field with my teammates. A simple drill was being executed, but when running full speed with my head down I collided heads with one of my teammates and immediately fell to the ground. When trying to stand I felt nauseous, disoriented and my head was in much pain. After going in to see the trainer, I went to the South Shore Hospital and a CT scan was done. Everything looked normal on the CT scan but I was diagnosed with a concussion and told I could not finish out the season. After hearing this I was directed back to school to take the ImPACT test again, it was amazing how much the results differed from my baseline results in the late summer. The ImPACT test shows multiple aspects of neurocognitive function, including memory, attention, brain processing speed, reaction time, and post-concussion symptoms. Personally, it took me months to recover from the concussion, I struggled with headaches for quite some time. As I was recovering from the concussion, I took the ImPACT test multiple times to see if my score was returning back to the baseline, and sure enough as time passed it was evident that my brain began to heal and my scores inched closer and closer each time to back the level where it would normally function at. Throughout the rest of the season it was evidently noticeable that people treated my concussion very differently than if I had a sprained ankle. There was such a push to get back out there on the field when if I wasn’t ready I could have done more harm to my brain. Throughout my high school career, I watched people get multiple concussions and return back even when they had not been fully healed. Overall, by doing that these people seemed to struggle more with chronic headaches and long term effects of their repeated concussions. I am very thankful that my concussion was on the less severe end and I waited until my test results again matched those of the baseline so my brain was able to heal properly. References: http://www.nebsportsconcussion.org/impact/sports-related-concussion-testing-and-impact-testing-program.html

Are you seeing what I’m seeing?

Emma England

One of the biggest questions in neuroscience stems from the question: what is perception? How do we know what we are seeing in the world is the same as what someone else is seeing? For example, the red we all have learned to describe, could it be maroon to someone else but they just learned to associate the maroon color with the word red? This is a million-dollar question that no one has answered, despite the technology we have. In the article “How Machine Learning is Helping us to Understand the Brain” by Daniel Bear, they bring up an interesting point about the metaphors we use to describe and understand the human brain. The author explains that many times, scientists study the bigger picture of the brain by using a “the systems approach”. For example, they study how large groups of communicating neurons lead to our perception of the world. Technology is expanding to the point that is not what is restricting us from understanding the brain. Alternately, he thinks that we should be taking an approach to the brain like an evolutionary biologist would and study the brain based on how it does something. Conversely, he states that we have been studying the brain as if we are seeking explanations for each aspect of what the brain does.  In my opinion, one of the biggest obstacles that we have yet to figure out is the line between sensing something and perceiving it. For example, in the visual system we know that the light source acts as the stimulus and this stimulus hits the back of the retina which then changes various cells turning this physical stimulus (the light wave) into a neural signal that the brain can then understand. The message will then be sent from the retina to the primary visual cortex via the optic nerve. The brain will then interpret this light and develop a figure based on many of the aspects of the stimulus. This is how we are perceiving the world. However, there is still a lot we do not know. We know the stimulus (the light), the pathway the light follows to transduce the stimulus into a neural signal (the cells in the retina), how the neural signal travels through the brain (the optic nerve), and then which areas of the brain the signal synapses in to increase the neural firing rate (the activity) in that area of the brain (V1; or the primary visual cortex). But we don’t really have any idea HOW these increased firing rates of neurons in a specialized portion of the brain allow us to perceive the world we just know that’s what it DOES. Essentially, this connects to the mind-body problem as well as the bind problem. The mind-body problem is the issue of how physical processes such as nerve impulses and sodium and potassium molecules flowing across membranes (the body part of the problem) become transformed into the richness of perceptual experience (the mind part of the problem)? Additionally, the binding problem focuses on how the different aspects of the world come together to lead to our sensation. I learned about these two different issues in sensations versus perception in the Perception class taught by Professor Grubb at Trinity. All in all, the article states that we need to start looking at how the functions and allows us to carry out every day activities and experience the world through a variety of senses. It is not saying that we need to disregard our previous techniques by identifying what each area does, but that in order to get a greater understanding of the brain as a whole we need to focus on the HOW question. Studying the brain using this approach will hopefully help us understand the brain more completely and allow u to answer the question of whether what we are seeing is the same as how other people see the world. Bear, Daniel. “How Machine Learning Is Helping Us to Understand the Brain.” Salon, Massive, 25 Nov. 2017, www.salon.com/2017/11/25/how-machine-learning-is-helping-us-to-understand-the-brain_partner/.

Advertisements: For You or Your Dopamine?

Anna Hackett

We all know the feeling, absolutely craving that gooey chocolate cake, that cheesy pizza, or that crisp salad even. You also probably know the feeling of seeing an advertisement for a restaurant with sizzling steak, steaming fries, and creamy ice cream. It turns out, marketing agents have a better idea as to what they’re doing than we may assume. You may already be somewhat familiar with the process of rewards and punishments in the brain. A pathway known as the mesolimbic dopamine pathway is the principle area of the brain associated with this phenomenon. Our brains are trained to learn what stimuli in the environment or actions we do lead to rewards, or good feelings. Food is no exception to this mechanism and we can thank dopamine for how we feel. We know that eating brings us happiness; we as well as our brains consider it a reward when we eat, thus dopamine is released. So, seeing food advertisements where the food is displayed as if it were right in front of you causes our brains to signal to us that we want what we are seeing and we want to complete this new goal to release dopamine. We associate seeing the food with eating and thus being happy. Advertising agencies are no fool to this process and thus know, the more they show you and the more frequently you’re exposed to their commercials, the more you’ll want their food. This same spark of craving can come from scrolling through social media. So many people, if you’re like me, follow food Instagram accounts or blogs that are dedicated to showing the delicious, mouth watering, food finds the poster has managed to get their hands on somewhere in the world. It may seem harmless scrolling though these accounts, but you’re actually causing your body to get feelings of hunger without realizing it. You may have noticed that after a few scrolls through one of these pages you start feeling like you’re ready for a snack. Whether or not you indulge in these feelings is an entirely other thing, but only those with willpowers stronger than mine will be able to resist these new cravings. So, next time you’re scrolling though one of these accounts, because realistically this post won’t make you stop, nor should it, try and see if you’re starting to get those munchies feelings you brain is trying to induce. References: Dooley, Roger. “Food Ads: How Brains Respond.” Neuromarketing, 29 Sept. 2014, www.neurosciencemarketing.com/blog/articles/food-craving.htm#. Banks, Amy. “The Dopamine Reward System: Friend or Foe?” Psychology Today, Sussex Publishers, 12 July 2015, www.psychologytoday.com/blog/wired-love/201507/the-dopamine-reward-system-friend-or-foe. Bergland, Christopher. “The Neurochemicals of Happiness.” Psychology Today, Sussex Publishers, 29 Nov. 2012, www.psychologytoday.com/blog/the-athletes-way/201211/the-neurochemicals-happiness. Romm, Cari. “What ‘Food Porn’ Does to the Brain.” The Atlantic, Atlantic Media Company, 20 Apr. 2015, www.theatlantic.com/health/archive/2015/04/what-food-porn-does-to-the-brain/390849/.

Your Mind AS Music

Thomas Hum-Hyder

On Thursday March 3rd, Prof. Dan Lloyd, the Brownell Professor of Philosophy presented the idea that everything in the brain is “as music,” contrasting the playful expression “brain on music.” He posited the internal functional dynamics of the brain resemble the dynamics of music. He began with the analogy of an app – phenomenologically, one can look at low level and high level understandings of how apps work. On the lower level, we know that the flow of electrons is involved with someone seeing the screen on their phone; similarly, one can realize that wires and circuits form the structure of the phone that houses the app. The middle level, the code of the program or the phone, connects the lower level to the higher level. This idea of finding the middle level of our understanding of behavior is where Prof. Lloyd’s research comes in. He believes that music can be distinguished from language through a measure of “zipf-y-ness” which goes along the idea that every modern speaking language, ancient language, un-interpreted language, and even programming language, have words that appear more frequently than others, and that the plot of the most occurring words appear as a power curve. Using fMRI data from the Institute of Living as well as from the national archives, Prof. Lloyd manipulated the data that allowed for a musical tone to play as the brain scan plays out. After listening to some sample scans, I was surprised to learn that it was rather easy to distinguish between the sounds of an fMRI scan from a healthy control from a schizophrenic patient. The idea that an untrained ear could actually hear the difference in the ways in which the brains of these individuals sounds suggests that music can provide the basis for the ways in which our brains work.

 

 

 

Head Games

Julianna Maisano

On Tuesday, February 16th, Trinity College held a “Concussion Awareness Day”, a day with a purpose to inform students not only about concussions, but the severe consequences one can endure in the long run. The evening, the film “Head Games” was played for the Trinity community, and a discussion was held after, led by Arleigha Cook ’16, Casey Cochran, retired UConn football player, Casey Cochran, and Deb Shulansky, JD, CBIS, from the Brain Injury Alliance of CT, as the panel.

“Head Games”, directed and produced by Steve James, focuses on the concussion crisis across the United States. The plot of the film is based off of former WWE Wrestler and All-Ivy Football Player, Christopher Nowinski’s book entitled, Head Games: Football’s Concussion Crisis. After being diagnosed with post-concussion syndrome, Nowinski was not only interested to learn more about his condition, he was eager to educate parents, coaches, and athletes about traumatic brain injuries such as concussions and their potential consequences. Nowinski conducted extensive research on the prevalence and documentation of concussions endured by athletes within the National Football League (NFL). As a concussion activist, Nowinski’s book and research enable investigations to be conducted and for the film to be produced.

The documentary, details the long-term consequence NFL players endure having suffered a concussion(s), the most prevalent being chronic traumatic encephalopathy (CTE), an incurable disease in which normal brain functions are compromised by an accumulation of proteins (Head Games: The People, 2016). The disease is so detrimental, that patients often experience anxiety and depression. In certain circumstances, the psychological and physical pain the patients endure is so severe, that the patients commit suicide. Throughout the film, former NFL, NHL, and college football players and their families are interviewed. The documentary emphasized that the concussions should be taken seriously no matter how mild the symptoms may appear, and that with proper care, caution, and the right information, we can limit the amount of concussions and long-term consequences that victims endure, but can not completely eliminate them.

Immediately following the film, was a panel based discussion hosted by three individuals who have dealt with concussions first-hand. Alreigha Cook and Casey Cochran, former college athletes shared their reasons as to why they both decided to retire from their sports careers and the emotional toll that this not only took on them, but their families as well. While it was very difficult for Cook and Cochran to cease playing soccer and football, respectively, they were sure that their decisions were in the best interest of their health and well-being. Together Cook and Cochran, confirmed that things change a lot when one endures a concussion(s). Both experienced severe post-concussion symptoms such as anxiety and depression, that drastically impacted how the functioned, thought, and performed daily tasks. Cochran emphasized that players are hesitant to admit that they have received a concussion or are experiencing concussion like symptoms, as players are too invested in their game to give up and sit out. However, he notes that admitting to feeling dizzy, nauseous, or “not right” after a hard hit or bad fall, is one of the most important things an athlete can do. Deb Shulansky, a director of the Brain Injury Alliance of CT, noted times when her daughter experienced a concussion and expressed that treating concussions effectively involves adequate rest, patience, limited stimulating activities, and most importantly a strong support network that consists of family, friends, and doctors, all of which Cook and Cochran deemed were important and remain vital in their recovery process.

 

References

Head Games: The People. (2016). Retrieved from http://headgamesthefilm.com/about/the-people/

John DiFiori

Khaoula Ben Haj Frej

Despite all of the attention towards concussions and preventing them, athletes continue to experience blunt trauma to the head and return to the game, particularly in football, hockey, and soccer. If a change isn’t made, a decline in participation in such sports could occur, particularly as parents steer their children away from collision sports, out of fear of brain damage and concussions.

As a major focus of his presentation, Dr. DiFiori spoke about a “vulnerable window,” a time of Increased Cerebral Vulnerability (ICV), during which one should avoid a return to the collision sport or work, or else one may experience more long-term and drastic damage (Chloe et al., 2012). After a blow to the brain, there is an increased need for energy but a lesser supply, in the form of a decrease in cerebral blood flow, normalizing only after 7-10 days. Thus, one would assume that one should wait at least that amount of time before returning to the game, to allow for normalization.

When it comes to individual cases, the hard part isn’t determining if a concussion has occurred but more so whether or not someone can return to work yet. A concussion is not a catastrophic injury in the way that other brain injuries are, although it can result in loss of brain function, loss of consciousness, or amnesia (Chloe et al., 2012). However, a misdiagnosis (or unreported case) can lead to ignoring more dangerous brain damage. Among athletic trainers and trained personnel, SCAT3 is a standardized survey of questions meant to determine if a concussion has occurred. However, not all athletes will notice or report these symptoms and 40% will go on playing, putting themselves in danger for acerbating their damage. Those who have had a concussion in the past is more likely to have another, subsequent concussion with worse and more prolonged symptoms. Often, the second concussion occurs within 10 days, which is also how long it takes to normalize cerebral blood flow, as aforementioned. Multiple studies have been made on rat models to show the impact of concussion occurring multiple times within the vulnerable window, supporting the conclusion that repeated concussions do in fact have worse and worse impacts and a new disposition for more concussions.

So, how does one decide when someone is back to normal and ready to go back to the game? Computerized neurocognitive testing is the main way in which that’s determined. It’s not as good as had been hoped; it’s faster than a complete neuropsychological battery but isn’t very reliable in terms of consistency between studies. There are too many problems with it for it to the end-all be-all approach. For example, you can easily cheat on it, since all you have to do is put forth a smaller effort before your concussion and then you look normal when concussed. Secondly, the reaction time isn’t very accurate. Someone needs to come up with something better but for now, individualized, “best practice” involves rest for a period of time before slowly training them back to the level when they can return to their sport, in a 6 step-approach (not necessarily over the course of 6 days, especially in children), according to Dr. DiFiroi and Semple et al. (2014).

He showed a lot of clips of a player hitting his head multiple times in a game, only to keep going back to play. A week later he played again and was so concussed he was knocked unconscious. A potential helpful solution is metabolic, involving implementing something like a ketogenic diet, which is being studied here at Trinity labs, or glucose supplementation. When it comes down to it however, concussions are a common problem to which a solution has not entirely been found.

Concussion Awareness

Jonah Meltzer

The talk given by Dr. DiFiori was both eye opening, with regards to the research and techniques being used in modern sports medicine, and informative in terms of how these techniques are actively applied to the athletes around the NCAA. While most of his talk centered around repetitive concussive brain injury (r-CBI), I found the bits about traumatic brain injury (TBI) the most interesting. In regards to TBI, Dr. DiFiori spoke about how these r-CBI sustained by the UCLA athletes become more and more serious when they are left untreated, which can largely be due to players not reporting their injuries or coaches not wanting to take their best players out of the game. The result of multiple untreated or mistreated CBI can lead to a progressive degeneration of neurons and the brain injury known as CTE. The intersection of CTE and Dr. DiFiori’s work has manifested itself in a project on TBI spearheaded by the NCAA and the DOD that is looking to explore the effects of TBI and CBI in relation to conditions such as CTE. The DOD has taken an interest in these head trauma studies because of the similar concussive and traumatic injuries that soldiers see during combat. The larger problem with active duty soldiers is that they cannot be treated as readily for these injuries as an athlete can be on the field. Therefore, it is more likely that an active duty member of the military will sustain repeated traumas within a short period of time, traumas that are more likely to go untreated. Furthermore, it has been shown that repeated head injuries, sustained within days of one another, can be far more impactful than single traumas sustained in a similar time frame (Weil, 2014). This causes further problems for veterans because of the overlapping symptomology of post-traumatic stress disorder (PTSD) and CTE. The symptoms manifested by the two disorders have a striking similarity and often lead to a misdiagnosis, and as a result, mistreatment. When the symptoms of either disorder are manifested clinicians tend to treat for CTE first because it is a biologically occurring disorder that can be mediated with drug therapies, however, PTSD is cognitive and can be left untreated as a result of being more difficult to treat. Through the discovery of novel information with regards to CTE through studies conducted by researchers such as Dr. DiFiroi the two disorders are becoming more accessible to diagnose and treat individually, making for quicker and more complete rehabilitation of veterans.

DiFiori Talk

Georgia Mergner

Dr. DiFiori presented to us a series of studies regarding repetitive mild traumatic brain injury in mice animal models and the presence of proteins released from sheared microtubules such as tau and beta amyloid. The presence of these proteins and their relation to chronic traumatic encephalopathy found in contact sports athletes, and neurodegenerative diseases such as dementia and Alzheimer’s, give rise to many questions about preventative measures and treatment. How can we protect contact sport athletes from developing CTE? Is there any way to repair the damage done from a mild traumatic brain injury, and prevent further injury from being more damaging then the first?

Dr. DiFiori’s focus on the “vulnerable window” could be the start to answering at least some of these questions. From his research on animal models studies and implementing his findings in his patient care protocol of the football players at UCLA, Dr. DiFiori and his colleagues have found that there is a window of time where re-injury could be the most damaging, if a player returns to play too soon. This is due to the window of time it takes for regular metabolic function to return to the brain. As we have learned from Brain and Behavior, the brain accounts for the use of about 25% of the body’s metabolic function. As Dr. DiFiori mentioned, a return of cerebral blood flow of normal glucose and glutamate levels takes roughly 7-10 days. With that in mind, in most of the animal model studies mentioned in the presentation, there was a peak at 3-5 days where another closed-headed injury caused heightened symptoms and increased damage to the brain; whereas a repeated injury at 7 days after the initial injury reported that histological and cognitive symptoms were no more severe than the initial injury.

This finding should be enough to pull athletes off the field at even the suspicion of brain injury. Coaches, athletic trainers and team physicians should be mindful that at collegiate and professional level, athletes are extremely competitive and less likely to report symptoms if it means staying in the game. Although 7-10 days in an athlete’s career or season may seem like forever, the risks of permanent brain damage in their later lifetime will keep them sidelined from much more. An interesting point made by Dr. DiFiori reminded me of something I had recently seen online. Besides the fact that concussions themselves should never go ignored or unreported, he mentioned that concussions could be the gateway to discovering more severe brain and spinal injuries. Recently, I watched the Tuft’s men’s lacrosse team’s documentary on their road to the national championship of their 2015 season. Their program is one of the best in the country, having won the NCAA National Championship for Division III back to back the past two years. This past season, the Jumbos’ leading scorer and returning All-American attackmen was knocked unconscious with what was believed to be a pretty high-grade concussion. After some complaining of numbness in the fingers and toes and careful observation by the athletic trainer, some testing was done and Chris Schoenhut was diagnosed with spinal stenosis. A blow to the lower back on the field could cause irreversible damage. Though his athletic career as a Jumbo has now been cut short, Chris’ future quality of life has been preserved because of this discovery. All because a trainer and a coach did not allow him to return to play after a suspected concussion and gave him the appropriate medical care he needed. As I was listening to Dr. DiFiori present, it reminded me of this discovery, and the incredible importance and responsibility that medical professionals have, at any level, to give their patients the best care possible – even if that means pulling them off the field for an extra 7-10 days.