Monday, November 2, 2009

Achilles Choice--II

In the Odyssey, Odysseus travels to Hades and meets the shades of great Greek heroes. In his encounter with Achilles, we hear Achilles' verdict on his own decision to choose a brief life of glory over a long life on earth. "I'd rather slave on earth for another man....than rule down here over all the breathless dead (Fitzgerald translation)." At what point does overcoming pain and injury become a journey to Hades for athletes?

People forget that Achilles died ignominiously shot by the coward Paris from behind. Pain and injury accompanies the physical demands and risks of success at sports. Overcoming them and competing and achieving reflects human spirit and courage. We praise an celebrate overcoming adversity in all aspects of life.

At one level playing sports involves a risk tradeoff  similar to other areas of life. People make decisions to devote energy to an activity because of satisfaction, achievement and goals. They give up other activities; they may fail and their efforts bear no fruit. They may succeed up to a point, and then give it up or pursue other activities. In many other areas of life the probabilities of succeeding at least at a professional level are much higher and the opportunities much greater. This accounts for the huge fall off in athletic participation as people grow older. But in America, college educations can be won with sports achievement and for a very few elect, they might have brief careers as professional players, but most of even the best will be finished by the age of 27.

The numbers of people actually affected by sports trauma narrows to a very very small band of people by the time most of them are 18 and to a miniscule by the time they are 23. Fewer than 400 play professional basketball; in the entire history of baseball there have been fewer than 17,000 players. But the way to get there is littered with injuries and cumulative traumas from repetition. An epidemic of knee injuries plagues youth soccer and basketball especially for young women. The body of a twenty-five year-old gymnist evinces the wear and tear of a 40 year old. Many high school and club players have struggled with pain, injury and damage. Most elite college athletes deal with some significant damage. We just don't know the long-term cumulative impact for most of these sports; linear clarity of impact upon their later health is not always clear. Doctors, however,  know enough to be able to warn athletes of the long-term impact of arthritis or debilitating injuries or repeated attempts to come back from injuries. At this point the role of doctors and parents becomes critical to ensure decisions to continue on are informed and made rather than simply taken for granted.

Unfortunately what modern sport gives athletes is glory, if they are good enough, and a long life full of debilitating injury. A recent NFL study suggests that football players who have suffered number of concussions potentially have a much higher chance of suffering early dementia. This data  meshes with compelling studies by the U. S. military of the cumulative impact of IED explosions on soldiers in Iraq. Proposed rules of engagement limit exposures to three and prohibit soldiers from returning to combat. Football and other sports have not reached such conclusions.

The cumulative impact on cognitive functioning differs in a profound way from the cumulative impact upon bodies. Individuals can adapt to physical injury and limits. Most people maintain their own character intact as they grapple with physical injury. But brain trauma from cumulative impacts erode the core personality and cognitive functions. The way the brain works changes, personality changes, people become shadows of themselves, they arrive at Achilles fate.

But athletes, especially young athletes, did not make a bargain with gods. They play for love, joy and accomplishment. They play for the experience of being with other  athletes. They play for their parents and coaches. A few play for dreams of being a professional. At some point, they grow into adults and make their own bargain with the game and their fate. But as youth, they depend upon others to protect them from the shades and shadow world that could await them. The more we learn, the more we need to be alert to protect the young athletes from the permanent injury to their soul that can await them.

What does it mean for people like me who enjoy and admire athletes and athletic competition? What does it mean to pay money and enjoy athletic contests that can be slowly sapping not just the body but the mind of the players? I have not been able to watch boxing for years. Over 28 percent of boxers suffer serious cognitive disability. I can remember the beauty and glory of Mohammed Ali. I recoil with physical and spiritual dismay when I see what his sport has done to his body and mind. We will not outlaw football; we will not find technical solutions to the mounting hidden epidemic. I honestly do not know how to react to this knowledge. How can I revel in the next explosive hit or block, knowing that each hit, each smash contributes to the loss of a mind?

Modern athletic glory is fleeting. Modern athletes are fungible marketing commodities. Even the greatest gain their momentary glory and their treasure, but they gain not eternal glory but a long life after the glory, a life of slow loss and suffering. This may be a deal for adults, but not for children.

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