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Drew Tate keeps passing concussion tests, but his comments are cause for concern

Drew Tate passed concussion tests, but his comments leave questions.

There are plenty of opinions out there on what happened with Stampeders' quarterback Drew Tate in Sunday's win over Saskatchewan, but they diverge along one crucial line: if you think being cleared by the league's concussion protocol is sufficient for a player to return to a game. Tate's post-halftime comments to TSN following a hit to the head of "I don't remember the first half," awoke plenty of concern, as did his post-game comments of "I just got my bell rung" and his reaffirmation that he didn't remember the first half, but Calgary coach/general manager John Hufnagel said Monday Tate was subjected to concussion tests after the hit, at halftime and passed them all (and Tate now says that wasn't what he was talking about, but admits to "fuzziness"). League officials looked into this Monday and were satisfied with the Stampeders' handling of it, and thinking their actions are sufficient and Tate wasn't concussed isn't indefensible. However, there's a growing school of thought on concussions, endorsed by some of the leading authorities, that these tests alone may not catch every concussion. For those of us who subscribe to that way of thinking, and also believe it's far better to sit a player who may be healthy than play a potentially-concussed one, there are still concerns about how the Tate situation was handled.

First, it's worth pointing out again that this isn't a one-sided issue. (It's also notable that the NFL has similar issues here, which was shown Sunday as well.)  The CFL's concussion protocol isn't bad, and the tests it uses are well-respected. This was apparently played by the book, and by those rules, Tate wasn't concussed, so his 363-yard performance in the wake of his grandmother's death is seen by some as more inspiring than foolhardy. Under the existing rules, this is fine. Here's what league director of communications Jamie Dykstra told me via e-mail Monday:

We are also advised by the Stampeders that following his post game comments, they asked Drew about the first half and he remembered numerous plays. The bottom line is Drew has been symptom-free each of the three times he was tested: at halftime, post game and the morning after the game.

Is there a possibility that concussions are missed by these tests, though? According to Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University (the group that's been at the forefront of finding CTE in the brains of former NFL and CFL players), absolutely. In his recent book, Concussions And Our Kids, Cantu shared an interesting story about former NFL quarterback David Woodley:

"The Steelers asked [Woodley] to take a then-experimental test to measure his cognitive function—his thinking. The test would later become known as ImPACT. Woodley agreed and scored well—solidly in the average range. Based on the result, the Steelers wanted Woodley to play. He wasn't sure he was ready. He still wasn't feeling himself. 'You may say I'm fine. I know I'm not fine. I'm taking longer to figure out things than I would normally.' Woodley sat out again. The next week, the Steelers tested Woodley and his scores were much higher. Off the charts. In fact, his IQ was 138, genius level. So Woodley had been right. He had been impaired. With no baseline test, which few teams were using at the time, his scores appeared normal.

Cantu also included another story about former NFL and CFL legend Doug Flutie and how he hid concussions to keep playing. Here's what Flutie told The Boston Globe about that in 2011:

"As a professional, I had at least three different concussions where I know I had memory loss," Flutie said Wednesday at a concussion-awareness event in his hometown of Natick.

"There was one in particular I remember when I was with San Diego and we were playing Kansas City. I got hit hard, and I played the next game, but I wasn't the same quarterback for the rest of the year. I had eight interceptions in the next three games. You think your reaction time is still good, but it's not, it's different."

Flutie said that towards end of his career, the NFL had testing in place to evaluate recovery from concussions, but he avoided it. He admitted he likely would have failed those tests.

"I intentionally blew off the testing so I could get back on the field," Flutie said. "I was really playing with fire."

The specifics of the Woodley and Flutie situations are a little different than the Tate case, and testing's improved since those days, but Cantu also notes that athletes can still manipulate their test results (in particular, by scoring below their capabilities on a baseline test, as Peyton Manning once confessed to before later claiming he was joking). The larger point is that tests are not infallible, though. Does that mean everyone who's ever hit in the head should be held out? Probably not (that might be an ideal safety solution, but it's never going to happen). What's interesting is that the answer may come from another controversial sports issue: drug testing.

For a long while, drug testing operated the same way league concussion policies do today; using only a clear, analytical pass/fail system. The problem is that this didn't catch the vast majority of cheaters. What's interesting is that if you look at a lot of the athletes who have been linked to performance-enhancing drugs, many have been caught through investigations, receipts, testimony and the like, not purely failing a drug test. As Sports Illustrated's David Epstein wrote recently, even the best drug tests don't catch everything, and the Marion Jones case in particular shows that more than just pure testing can be needed:

[A]nother implication of the USADA report is that drug testing is not the only weapon in today's anti-doping battle.

"Marion Jones had more than 160 tests during her career, none of them positive," says David Howman, director general of WADA. "[For] Balco we realized we had to get evidence from other means, so we worked closely with the federal investigators."

That realization led WADA to partner with Interpol in 2008. Today WADA has its own chief investigative officer—a former U.S. federal agent—and last year published guidelines for national anti-doping bodies that want to collaborate with law enforcement and customs "to take advantage of the investigative powers of those public authorities, including search and seizure, surveillance and compulsion of testimony under penalties of perjury," the guidelines read.

That's not to call for the CFL to start hiring investigative officers. The approach is notable, though; WADA (the World Anti-Doping Agency) and USADA (the U.S. Anti-Doping Agency) have realized that the tests don't always get everyone, so they're exploring other methods as well. The CFL situations we've seen this year are similar: Kevin Glenn passed tests but complained of a headache (often a concussion symptom), the Bombers played Buck Pierce after he passed tests following a head hit but pulled him when he developed a headache and thought of starting him again soon after before he failed another test and Tate passed tests but appeared to exhibit many symptoms often linked with concussions (situational unawareness, memory loss, "bell rung" comment, and even perhaps the intense emotions he showed afterwards, although those have a non-concussion explanation as well given his grandmother's passing). Moreover, if his memory was fine and he was never concussed, why in the world would he say he couldn't remember the first half and he got his "bell rung"?

From this corner, the optimal situation would be for teams to recognize that tests won't catch everything and hold players out when they exhibit any signs linked to concussions, regardless of how they do on the tests. Players could also admit that they shouldn't be playing if they notice anything that may be concussion-related. However, given teams' focus on winning now and players' focus on toughing it out for their team, it's not surprising that this hasn't happened. Again, by the existing rules, the Stampeders and the league don't appear to have done anything wrong, and those who believe passing a test's good enough aren't necessarily wrong either; it's an opinion, and it has the advantage of drawing a hard and clear line that's universally applicable. For some of us, though, questions will linger even after a passed test when other factors suggests something may be up.

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