To laugh ... or to cry? There is no middle course here, no way of dodging the utter failure of soccer’s response to the concussion crisis. No way to ignore the inadequacy of the protocol, no way to pretend you haven’t noticed the pathetic hesitancy of referees when confronted with head injuries.
To laugh at the lengthy learnedness of the protocol and the timid dithering of the referees? Or to cry in despair at a sport so smitten with its own image that it can’t even realize that it has a serious, potentially tragic, human problem to deal with.
FIFA and the IFAB are the problem here. Caught up in the inertia and the ineptitude of those two supposedly ruling bodies are the referees, involved where it matters -- at the human level -- and called upon to give public respectability to shoddy cynicism.
As the referees have no strong representative body, they are never heard from. They are content to go meekly to the slaughter. They deserve some sympathy -- but not too much. Going meekly becomes, far too often, going enthusiastically.
That is what we are seeing with concussions. We saw it on Saturday during the MLS game between San Jose and Los Angeles. In the 62nd minute San Jose forward Cordell Cato positioned himself to get under a high ball in the LA penalty area. Clement Diop, the LA goalkeeper raced out of his goal and, arms flailing, jumped into Cato from behind, flattening him and not getting within a mile of the ball. Cato stayed down, holding his head.
At this point, the referee -- who was well positioned to see everything -- had two reasons for halting play: one, Diop’s challenge was illegal and dangerous, a clear foul and therefore a penalty kick to San Jose; and two, the protocol calls for a referee to halt play immediately there is a head injury.
This referee allowed play to continue for 30 seconds before strolling over to Cato and calling for help from the sideline. Those who follow MLS will hardly be surprised to learn that the unobservant referee was Allen Chapman.
But suppose Chapman had done his duty, had blown his whistle as soon as Cato went down, and urgently called on the medics. Would they, in turn, have done their job? Experts I have consulted (a referee and an ex-referee) tell me that the minimum time to complete a meaningful protocol assessment is 6 minutes. I have never seen an assessment, on the field, last as long as six-minutes.
My observations are borne out by a recent study published in the prestigious Journal of the American Medical Association (JAMA) that analyzed head injuries during the 2014 World Cup. The stats are interesting right from the start, because of the number of such incidents. There were 67 players showing two recognizable signs of concussion. So, in a World Cup of 64 games, we got an average of one potentially serious head injury per game -- a stat that ought to worry FIFA. But apparently not.
The damning conclusion of the study to which I am referring is this: “In the 2014 World Cup, we found that players received no, or very cursory, assessment for a concussion after sustaining a collision and showing concerning physical signs for a concussion.”
Of course, this is not news. It has been blatantly obvious for years now that head injuries are not of great interest to FIFA. What the study does do is to add academic authority and statistical proof to that charge. This sort of thing:
FIFA’s protocol “says that players showing any signs of concussion should be immediately withdrawn from play and assessed by sideline health-care officials.”
Yet the study found that of the 67 players who showed two or more signs of concussion, 11 players received no assessment and returned to play immediately. Another 42 immediately returned to play after an on-field assessment by another player, referee, or health-care worker. Only three were removed from the game. Among the 22 players with three or more concussion signs, 19 returned to play during the same game after an average assessment of 84 seconds.
Another point to notice about this study, is that it is not official. Not capital “O” Official, that is. It was not conducted by, or at the request of FIFA. An independent group of Canadian researchers has come up with unwelcome news for FIFA.
Back in January I pointed out that FIFA’s concussion protocol was being honored more in the breach than in the observance. I had not, at that point, seen a player removed from a game after receiving a head injury. But I had seen several incidents in which an obviously shaken player had been quickly sent back into the action.
So we now have proof that my random personal observations reflect a much wider truth: the protocol is being ignored, even in FIFA’s showcase tournament. FIFA’s vaunted protocol is not being taken seriously, and FIFA does not care. The protocol is a joke. A sick joke. So we should laugh, then?
Sick jokes provoke sick laughter, fake laughter that covers some form of shame. The shame here, the shame that FIFA and IFAB should feel, is the shame of refusing to own up, to admit that soccer has a problem that needs to be faced up to.
The protocol seemed like a start -- indeed it could still be that, but only if we can be sure that FIFA itself believes in it. The evidence so far suggests that FIFA hasn’t given the matter much thought.
In practical terms, the fatal fault with the protocol is that it calls for a team to withdraw a player from the game for maybe six minutes, while he undergoes the tests. So the team is required to play with 10 men during that period -- even though the player involved committed no offense, may in fact have been the victim of a foul.
An outrageously unfair scenario that pretty much ensures either that the protocol will be ignored altogether, or that, when it is used, it will be hurried. A third, and most worrying, consequence entails the degradation of the whole protocol procedure -- it becomes a sham which is doing next to nothing to protect players from concussions.
How much thought can FIFA/IFAB have given this if they fail to understand that, if you’ve come up with a procedure that compels a team to play six or more minutes with only 10 men, you had better allow a temporary substitute during that period. If you do not, your procedure will surely fall on stony ground.
Is it beyond FIFA’s thinking ability to create a temporary “medical substitute” who will not be counted as one of a team’s three permissible subs? This has already been suggested to FIFA by FIFPro, the international pro players union. FIFA has yet to be heard from.
U.S. Soccer is again in the forefront here. Having been the first (to my knowledge) organization to ban heading for younger players, it also allows the use of temporary substitutes in its Development Academy.
The use of temporary subs, I would say, constitutes a rule change, for which FIFA approval is necessary. Even on this issue, FIFA remains quiet. But is it possible to imagine FIFA nixing a rule change designed to protect players from concussions -- and, in particular, designed to ensure that FIFA’s own protocol is honored?
Actually, I suppose it is possible to imagine that, such is the obtuseness that FIFA is displaying on this issue (I have long since given up hope of anything worthwhile originating at IFAB). But FIFA cannot maintain a silence much longer. It surely must be receiving legal advice letting it know that this is a high-risk situation for soccer, particularly if it is not seen to be taking steps -- much bigger steps than so far taken -- to protect its players from the far from funny consequences of head injuries.
So, no laughter at the hopeless bumbling of FIFA and IFAB. And, for the moment, no tears. No bemoaning the lack of resolve at FIFA. With the evidence we now have of the frightening damage that can be done to a player’s life by concussion, can there possibly be any excuse now for not taking head injuries seriously? Maybe, after all, there is a middle way, between the laughter and the tears. There is always hope.