A few years ago, Dr. Neilank Jha, a Woodbridge-based physician, was playing a game of men’s league hockey when he absorbed an accidental hit to the head.
He was shaken by the blow, and it wasn’t long before it occurred to him he’d probably suffered a concussion. As much as he was enjoying the game, he knew what he should probably do — stop playing immediately and reassess his condition in the quiet of the dressing room. In an age of heightened awareness around head injuries, such common-sense tenets of self-preservation aren’t exactly brain surgery.
But Dr. Jha happens to be a brain surgeon. So perhaps it was a surprise that, for a long moment in the midst of that otherwise forgettable game of shinny, he tried to convince himself he could play on before he took himself out.
“I’m embarrassed to tell you this,” he was saying recently, “but I didn’t want to come off the ice. And I’m playing for a beer. Imagine what these guys are thinking when they’re playing for the Stanley Cup.”
If Dr. Jha can relate to the possibly self-destructive instincts of uber-competitive athletes, call it an occupational asset in a field that sees him cross paths with elite competitors and weekend warriors on a daily basis. But don’t misunderstand. As a man of medicine, he isn’t prone to minimizing the damage being done by what he calls an ongoing “epidemic” of concussions, the extent of which he understands better than most.
On many days he can be found at the private Weston Road clinic, Konkussion, where he tends to about 200 concussion cases a week. He’s also founder and editor-in-chief of first medical journal devoted exclusively to the current research on concussions. And later this month he will play host to an international conference that will bring to the GTA many of the world’s foremost experts in the field.
But even though Dr. Jha, 37, is devoting much of his life to concussions, he says it’s important to remember that most concussions, when treated intelligently, don’t turn out to be a matter of life and death.
“The thing is, you have certain groups going out there and creating hysteria (around brain injuries),” he said. “It is an epidemic. But at the end of the day, 80 per cent of people get better in a short frame of time. That gets overlooked very often.”
It gets overlooked because of the real and extreme cases of life-taking tragedy that have taken over the headlines and shaken the foundations of sports. High-profile injuries, billions in lawsuits, suicides linked to repetitive head trauma — the lot of it has led many to question whether pro sports, especially collision sports like football and hockey, will survive the gruesome emerging truths about their possible effects of the brains of the people who play them. Last year, Barack Obama, the U.S. president and an avid sports fan, said if he had a son he wouldn’t allow him to play football. Ditto LeBron James, the NBA star who was a force on the high-school gridiron, and NFL icons Mike Ditka, Adrian Peterson and Kurt Warner.
But Dr. Jha said he remains hopeful enough about the future of concussion care that he says he would allow his son, Akshay, to one day participate in a collision sport should Akshay, now 4 ½ months old, ever express such a passion.
“Knowing everything I know, I would say this: Absolutely I would allow it,” he said. “Because the benefits of health, fitness, discipline, character, team building outweigh, in my opinion, the risks. However, education is of paramount importance.”
Dr. Jha said he is optimistic in part because, thanks to the millions being poured into concussion research by everyone from the NFL to the U.S. Department of Defence, new discoveries for concussion diagnosis and treatment appear to be on the horizon. He said he sees a day — “we’re a couple of years away” — when there’ll be a blood test or a hand-held scanning device to diagnose a concussion. And there’ve been recent studies on a handful of therapies that have shown promise.
Still, Dr. Jha, who has a gift for talking sports and science with an infectious enthusiasm, says there’s an ongoing need for improved education at the youth-sports level.
“It’s the kids in our local neighbourhoods that don’t have the access to care immediately, to help them make the right decision. We know if you get a second injury before fully recovering from a first one — that is the real concern,” Dr. Jha said.
Dr. Jha’s Konkussion clinic is a compelling model in state-of-the-art care. For a fee of about $60, athletes get a baseline neurological test and a card with a telephone number they can call for around-the-clock advice should they suffer a concussion. Follow-up appointments are scheduled within 24 or 48 hours.
Dr. Charles Tator, the Toronto neurosurgeon who has been a pioneer in treating and understanding head injuries, lauded the approach in a recent interview.
“A few years ago it was almost impossible to get somebody knowledgeable to see a concussed patient in the first few weeks,” said Dr. Tator, who has referred patients to Dr. Jha and who is a member of the editorial board of Dr. Jha’s concussion journal. “So Dr. Jha has really innovated this rapid access, which is really a major asset . . . I think he’s the first one to be able to accomplish that.”
The gap in the system struck Dr. Jha in 2010, when his mother, Prema, suffered a concussion after falling down a set of stairs while shopping on Queen Street West. At the time Dr. Jha, who grew up playing hockey in Regina before moving to his ancestral India at age 12 to live for five years on an ashram, was the chief resident in neurosurgery at McMaster University. He came away unimpressed with what he called the “confusing” way his mother’s case was handled.
“It was a life-changing moment for me. The moment the CAT scan was normal, the neurosurgeon said, ‘Look, there’s nothing we can do. The CAT scan’s normal,’ ” Dr. Jha said. “But we know almost all CAT scans and MRIs are normal with a concussion . . . I also knew my parents came from India. My mother’s a hard-working nurse. Loves the job. She wanted to get back to work right away. But she couldn’t get back to work for four months because of cognitive issues, headaches and memory issues.
“I couldn’t understand why the emergency rooms didn’t have any information, why there were doctors — general practitioners and emergency medicine doctors — telling people that if the CAT scan is normal and you didn’t have a loss of consciousness, it’s not a concussion. We know those things are not true.”
It wasn’t long after that a life’s mission was born, and Dr. Jha has since come to see a possible ally in the ongoing search for solutions: The major sports leagues — the same ones that have often been criticized for their handling of the concussion conundrum.
“(The major sports leagues) have a huge responsibility, in my opinion, to educate the children at the grassroots level who are not following the protocols correctly,” Dr. Jha said. “Kids don’t want to listen to a boring doctor like me. They want to listen to a Sidney Crosby. They want to listen to a LeBron James. They want to listen to a Clayton Kershaw or a Ricky Fowler. Rather than attacking the professional sports leagues, they could be our greatest partners in educating the grassroots level.”
Later this month, when Dr. Jha welcomes many of the world’s top authorities on concussions to his conference — which will include dinner at the doctor’s Kleinberg home cooked by celebrity chef and friend Susur Lee — he’ll be among the undersigned of a white paper intended to set a new global standard for concussion management. That the conference’s list of attendees includes what Dr. Jha calls a “Hall of Fame” of concussion specialists — among them Dr. Robert Cantu, Dr. Julian Bailes and Dr. Tator — will lend heft to the document and to a sales pitch Dr. Jha plans to deliver to some of the world’s top concussion researchers.
His angle? That they work together.
“Right now groups around the world are competing to do research. We should not compete against each other. We need to collaborate with each other, but compete against the epidemic of concussion,” he said.
There’s money at stake, companies racing to develop a silver-bullet solution that could reap multi-millions. But Jha insists out he’s not motivated by finances. He says he doesn’t draw a dollar’s salary from Konkussion; that he makes a fine enough living in his day job as a brain and spine surgeon; that his formative time living a monastic existence in India, where he slept on the floor and owned two sets of clothes, taught him the inconsequence of material possessions. He said he still sleeps on the floor and drives a used red Dodge Challenger. What truly drives him, he said, is coming up with good answers to the questions of the day in his field.
“Will pro sports survive the concussion epidemic? My opinion is yes, they will,” Dr. Jha said. “But we’ve got to make adjustments . . . I’m not saying we haven’t done things incorrectly in the past. But what I am saying is we can change things and do things better together in the future.”
Indeed, it’s a work in progress, the blueprint to save sports. That there’s passionate optimism in its crafting is good news for everyone who desperately wants to keep playing.