The Invisible Injury: How Concussions Affect Student Lives

by Samantha Hussey | 10/6/17 1:45am

by Amanda Swinhart / The Dartmouth

This article was featured in the 2017 Homecoming Issue.

With Homecoming reuniting students and alumni in celebration of the Big Green, it is easy to get caught up in the traditional sports events, overlooking sidelined athletes. Injuries — of the “muscles and the brain,” as the “Alma Mater” puts it — are inevitable. Awareness and prevention of concussions in high-impact sports have received much attention in recent years. Despite this fact, concussions that student-athletes in any sport suffer are still overlooked or mistreated. These “invisible injuries,” with lengthy recovery times and impacts on one’s social life and academics, are still downplayed at Dartmouth.

While the College provides resources for students who experience concussions and similar catastrophic injuries, many find that their injuries still somewhat negatively impact their academics, athletics and social lives. Stephanie Everett ’19, a former women’s varsity soccer goalie, sustained one concussion during her senior year in high school and two concussions during training in her first two years at Dartmouth.

“I am probably worse today than I was the day [my latest concussion] happened — it’s been 13 months,” Everett said. “[The healing process] is different for everyone, and obviously because it’s my third [concussion] in two years that’s definitely not helpful. It’s not like a broken leg where it’s six weeks [recovery] and you’re fine. You just have to wait and see.”

In terms of academics, Everett found that while she could maintain her grades while concussed, it was almost impossible to raise them.

“At first, it would take me a while to read anything because I could only read for 20 minutes at a time, and now I try to power through it,” she said. “It’s harder for me to concentrate, so I’ll sit and look at my computer, and unless I feel a looming deadline, I can’t get myself to do anything.”

Everett recalled times during class when she could not remember what she wanted to say or when she had difficulties forming sentences.

Jennifer West ’20, a member of the figure skating team, also had problems focusing after sustaining two non-sports related concussions.

“I do think having a concussion does make it harder to go about my academic life at Dartmouth,” West said. “Specifically, concussions really have an impact on my ability to focus. I found that readings that would usually take me a half an hour would take me two hours after my concussion.”

West’s two concussions occurred within the past year: She suffered one during First-Year Trips and the other, which she is currently recovering from, in a serious biking accident this past summer. Now, West requires frequent breaks while studying to recenter herself because she finds it very easy to lose attention while doing normal tasks.

Despite this, West has found her professors to be understanding of her situation and are more than willing to provide her with additional assistance if she asks for it.

“That being said, sometimes it’s hard because I think the things that really affect me the most are things such as [an] inability to focus, inability to complete work … things, for example, a note-taker can’t help with,” she said.

Everett, too, has found that, even with accommodations, it can be hard to keep up with the College’s fast-paced 10-week terms.

“It’s tough because everything moves so fast here,” Everett said. “For the fall term, I had extra time on midterms, which was really helpful for writing essays, but besides that I haven’t really gotten any special treatment: I just have to deal with it. It’s an invisible injury, and I don’t complain about it so everyone forgets about it.”

Jonathan Lichtenstein, director of pediatric neuropsychological services at Dartmouth-Hitchcock Medical Center and a Dartmouth team physician, said that the “push through it” mentality that so many Dartmouth students have can be detrimental to an individual’s recovery.

“While the brain is recovering, it’s losing a lot of its resources,” he said. “If you don’t allow the brain to spontaneously heal and instead you spend four hours reading or writing that paper or doing that science lab … the brain doesn’t heal, and it actually takes you longer to get better.”

West said that while she didn’t feel any external pressure to get better or heal any faster, she did face a lot of internal pressure because she wasn’t healing as quickly as she had hoped to, especially taking on new commitments this fall.

“I think that it’s hard because at Dartmouth, a lot of us put these burdens on ourselves, and we feel as if we have to overload ourselves,” West said.

Unease with “taking it easy” can also affect students’ social lives. West said that her concussions have contributed to feelings of isolation on campus from both the larger Dartmouth community and her smaller groups of friends, noting the major role that Greek organizations play on campus.

“Not being able to go out and being sensitive to noise and light makes it really hard,” she said. “It also can be frustrating because a lot of people don’t realize that concussions change your mood, so it’s been hard to talk to people and go about my daily life when I think they can tell I’m not the same person I was a couple months ago.”

Similarly, Everett found that because of her concussion, she struggled to meet the demands of her social life and responsibilities.

“I was president of my sorority [this past summer], so I had to go to 85 percent of events as part of my job,” Everett said.

With sorority events six times a week, Everett found fulfilling her job difficult because she often had headaches throughout the night.

Everett also said that her relationship with her teammates and coaches changed when she was forced to prioritize her health.

“I had to quit soccer because I realized I was going on nine months [of recovery time] and never wanted to risk this happening a fourth time,” Everett said. “I lost pretty much everyone on the team. We will still say ‘hi’ and get a meal sometimes, but I think with sports teams, it’s really hard for them to hang out with people who aren’t on their team.”

When analyzing the effects of concussions, it is also important to acknowledge those students who are more susceptible to these injuries.

“It does seem that … women have more concussions than men,” said William Storo ’88, a pediatrician at Dartmouth-Hitchcock Concord and concussion specialist.

“Some people feel women are much more willing to report [their concussion] and be honest with their symptoms,” Storo said.

Lichtenstein felt similarly, saying, that female athletes tend to take longer to recover than males. He said that this difference could possibly be due to biological differences, but a more likely answer is that women are more willing to report their symptoms and men underreport.

Both Everett and West find it fairly common that student-athletes will either not report their suspected concussion or will return to play before they are completely healed.

“Two of my teammates have gotten concussed and didn’t tell anyone, but I knew about it so it was frustrating to see them get better in like two weeks while still playing,” Everett said.

There could also be pressure to play before fully recovering from a concussion or a majory injury, which increases the chances of suffering another injury that could have dire consequences.

“There’s a hypothesis that if somebody has a concussion and then they return to play in the next day or two when their brain is in this very, very vulnerable state and they take another blow that can be very minor, it may cause a vascular disruption in the brain, major bleeding and a catastrophic outcome,” Lichtenstein said.

While few sports have developed concrete responses and policy changes to practice and game protocol in response to the increased trend of concussions in youth, the Dartmouth football program has chosen to respond more aggressively. Football head coach Buddy Teevens ’79, explains that his commitment to concussion awareness and prevention extends beyond the football field.

“A lot of my guys are engineers, doctors, venture capital people, entrepreneurs — very, very successful individuals,” he said. “I tell my players that they use their minds way longer than they use their body, so let’s protect your mind.”

In 2010, Dartmouth football made a radical move by announcing it would hold no-contact practices and team up with the Thayer School of Engineering at Dartmouth to create a mobile virtual player to practice with instead. In 2015, a prototype robot was created. Since the implementation of these policies and the use of the robotic practice dummy, the football team has seen a decrease in injuries and missed tackles.

“The push has been to reduce the opportunities for contact in practice without depriving our guys from the opportunity to improve their skill sets in the game,” Teevens said.

While Dartmouth is making strides in concussion prevention for football, a sport known for its resulting concussions, feelings are mixed on whether the College is doing enough for all its student-athletes.

Lichtenstein said that there is conflicting research about whether there are long term effects of sustaining a concussion.

“The long-term effects are one of those things [that scientists] are really trying to wrap our heads around,” Lichtenstein said. “I think we have a less complete understanding and definition of that than we do of the short-term [effects].”

West said that the school is doing the best it can, but she believes that overall, there are certain things that the school can’t provide a solution for. She does, however, find it frustrating that as a member of a club sport, she doesn’t have access to the same recovery resources as a varsity student-athlete does.

Though, as a former varsity athlete, Everett believes the College’s athletic department could still provide more support for those injured.

“I’ve spent more time concussed at Dartmouth than I have healed,” Everett said. “I don’t know how [Dartmouth] would [address the issue], but I think it needs to be a bigger deal.”

Correction Appended (Oct. 6, 2017):

A previous version of the Oct. 6, 2017 article "The Invisible Injury: How Concussions Affect Student Lives" incorrectly stated the timeline of Everett's injuries. This article has been corrected to reflect this change.