The hot topic in sports these days seems to be concussions, head injuries, and brain trauma. It’s definitely a big problem in football and boxing and it seems to have become a topic of discussion in high school sports as well. With the recent lawsuits from former NFL players suing the league based on the knowledge (or the lack of knowledge based on who you speak to) of head injuries, neurologists are becoming bigger “players” in this discussion.
Dr. Barry Jordan, chief medical officer of the New York State Athletic Commission and a team physician for USA Boxing, talks to BlackEnterprise.com and discusses his passion for sports and sports medicine, how the NFL is handling the concussion problem, and how the concussion issue is being discussed with more awareness these days.
BlackEnterprise.com: Congratulations on your recent promotion at Burke Rehabilitation Center in White Plains, NY. Why did you decide to pursue a career in the medical field?
Dr. Barry Jordan: Thank you. I wanted to pursue a career in the medical field for a variety of reasons—but the main reason, as it is for so many others, was to help people. Early on, I knew I wanted to pursue a field within the areas of math and science. I was always interested in how the brain works, and that led me to neurology. Then, as someone who is quite passionate about sports, I wanted to figure out a way to incorporate that into my career. I became particularly interested in traumatic brain injury through my involvement with sports like boxing and football.
In medical school, I first thought of the idea to merge my love of sports and sports medicine with my desire to be a neurologist. At the time, there weren’t any sports neurology programs—in fact, my medical school colleagues laughed at me for the idea!
However, I felt this type of study would be important for the medical field, and I eventually went on to complete the first sports neurology fellowship in the country at the Hospital for Special Surgery in New York City. Today, these types of programs are much more common—and I couldn’t be more excited for that.
As a neurologist, what advice would you give to people to have them avoid suffering from head injuries?
The most important advice would be to wear a helmet when riding a bicycle or participating in high-velocity sports such as skiing, rollerblading or horseback riding. And of course, it’s also important to wear a seatbelt while driving or riding in a car.
Although wearing a helmet may not necessarily prevent you from getting a concussion, they are important in preventing more serious types of brain injuries, including cerebral contusions, skull fractures, and intracranial hemorrhages.
As the chief medical officer of the New York State Athletic Commission, what is the main scope of your job and what pressures do you face in this role?
As the chief medical officer, I medically supervise all professional boxing within the state of New York. This includes training physicians to working ringside, screening boxers for medical eligibility before they can fight and overseeing the medical services provided to injured boxers.
Boxing is a dangerous sport and one of the major challenges is trying to make it as safe as possible. Although we’ll never be able to make it 100 percent safe, there are strategies that are useful in limiting potential brain injury among its participants.
In New York, we as medical professionals have the option to terminate a bout when it becomes medically necessary. Knowing when it’s the appropriate time to make this call can also be a challenging part of the job. Probably the toughest part is having to retire an athlete from the sport when it’s no longer medically safe for him or her to play–no matter how many years I’m in this field, that’s always difficult.
Outside of the obvious reasons of pending brain damage, why do you think that concussions are being more scrutinized in sports and do you feel that there was knowledge previously about the dangers being talked about today but never discussed years ago?
Concussion awareness has increased substantially over the last few years. Though they’ve always been a problem is sports, they often went unrecognized in the past. For example, the problems–including repetitive concussions and the long term consequences–have been well-known in boxing since the early 1900s, but there wasn’t much of a concern until it became a problem in tackle football, ice hockey and soccer.
How are you making a difference in the health field and what satisfaction do you get when helping others?
I’ve aimed to make a difference in the health field by being involved in, and helping to develop, the field of sports neurology for the past 30 years. My colleagues and I started the first sports neurology program in the country at the Hospital for Special Surgery and we went on to edit the first sports neurology textbook in 1989.
Today, it is much more common for physicians to become specialized in this field–there is now a sports neurology section under the American Academy of Neurology– and the field is receiving greater attention in the media and in circles outside of medicine.
This has really allowed me to make a difference and to help athletes at all levels–from kids playing Pop Warner football to college athletes to professionals. By serving as an adviser for various sports organizations, for example, I’ve been able to help make games safer and to reduce head injuries in players. On the more legislative side, I’ve served as an adviser for a variety of issues, such as, for example, assisting in the implementation of New York state concussion laws for scholastic athletes.
It has alw
ays been my hope to try and make contact collision sports as safe as possible and minimize the risk of brain and spinal cord injuries. It’s extremely gratifying to be able to help these players and advocate for safer sports for all athletes.As a team physician for USA Boxing, how do you respond to boxers who, despite advice given them that would be a detriment for them, sometimes refuse to follow advice or just don’t listen and want to continue in a way that would be harmful to them?
As a physician caring for boxers, the health and safety of the boxer is paramount. If we determine he or she is experiencing untoward consequences from a particular bout or from simply having been fighting for years, it’s encouraged that they not continue. If you, as a physician, suspend a boxer, he or she is not allowed to box. Thankfully, the boxer usually does follow our advice.
Naturally, they may be upset, so I try to show them in a concrete way what we’re talking about. I’ll explain how this particular test was this way at one point and now it looks different, so they can see the evidence of neurological deterioration.
What is your stance on how the NFL is now handling concussions?
I believe the NFL is doing a good job. The rule changes the league has implemented have been particularly important. For example, changing where the kick-off occurs has undoubtedly reduced the number of concussions. Also, having unaffiliated neuro trauma consultants on the sidelines to assist the team physicians has made an impact on recognizing, documenting and managing concussions.
What’s also great is that the NFL has come forward to fund programs in various parts of the country that look at the long-term effects in players who’ve had numerous concussions over the course of their career.
Though not affiliated with the NFL, here at Burke Rehabilitation Center, we are currently launching a program called RACE–Retired Athletes Cognitive Evaluation–which will provide retired amateur and professional athletes from any sport (including football, boxing, soccer and lacrosse) with a comprehensive neurological examination as well as diagnosis and appropriate treatment. This is important because recent studies have speculated that Chronic Traumatic Encephalopathy (CTE) and other neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease may be associated with repetitive concussive or sub-concussive blows to the head.
President Obama just hosted a Healthy Kids and Safe Sports Concussion Summit at the White House. How important is it to get the word out to kids at an early age and what steps do you feel must be taken to save kids from concussions and other brain related mishaps?
I was honored to be invited and to attend the summit at the White House. Having discussions at events like this highlights and brings continued attention to the importance of keeping kids safe while playing sports.
Getting the word out to kids, in particular, is extremely important. To start, we need to get a better idea of what the magnitude of the problem is, so we need better surveillance and epidemiology.
I think it’s also important that we level the playing field, so to speak, because there are disparities between different areas in the country in terms of access to athletic trainers. Inner city schools very often don’t have the same resources as affluent communities with larger budgets–and having athletic trainers is integral in recognizing and documenting concussions in student-athletes.
There also needs to be increased and continued education about the signs and symptoms of concussion. Along those same lines, having proper supervision of kids at a young age in order to prevent unnecessary trauma to the brain, such as heading the ball and excessive contact during football practices, is also important.
What is the most enjoyable part of your job?
For me, the most enjoyable part of the job is being able to help others and work towards preventing brain injuries in athletes at all levels of play. If a patient has sustained a severe brain injury, it’s a great feeling to be able to see them recover and reintegrate back into society. When they come back to visit or even when I’m out and run into someone and they say, “I was your patient!,†it’s just a remarkable feeling.
Along with helping patients on a daily basis, it’s been gratifying to have had the opportunity to work with some of the most talented athletes from all over the world and to be able to provide them with important medical care. Working with the US Olympic committee in the 1995 Pan-American games in Argentina was phenomenal. It was hard work, but it was extremely rewarding. One instance that comes to mind was with the cycling team. During a race, one rider fell and the whole team basically fell over him. They came into the clinic and we were all trying to take care of them and treat any injuries. Then, the team went back out there the next day and won the gold medal–now that’s what makes working in sports exciting.