I had already done this test with Dr. Petty once before. We did that to give him a baseline to work from should we ever find ourselves in the situation I was in now. In fact, the reason that NASCAR would mandate baseline ImPACT testing in 2014 was in no small part because of what I was about to go through now, in 2012.
Before that, doctors just eyeballed it. The idea was, Well, hey, this doctor knows this guy, so he’ll know if something’s wrong as soon as he sees him! But thankfully, that’s changed. Some racers had complained about talk of a NASCAR mandate for baseline testing—being “forced” to take an ImPACT test—but I can promise you that anyone who found themselves in my situation would’ve stopped complaining. IndyCar had already been doing baseline testing for a while, and now I knew how valuable that was. Because I had taken the test before my concussions, Dr. Petty had real data to use as a measuring stick. What was I capable of when I was healthy, and what was I capable of now? He took the results of my test on this day and compared them to the test I’d taken before either one of my big 2012 hits.
It wasn’t awful, but it wasn’t great, either. My memory was dragging in spots where it hadn’t before. So was my reaction time. Not a lot, but there was definitely a difference. Dr. Petty told me that just by looking at the comparison between those test scores he knew I had suffered a concussion. When that was added to my stories of what had happened at both Kansas and Talladega, there was no question that I had an issue that needed to be treated.
He called for a detailed MRI scan the next morning. The scan is used to find real, physical damage and uses a special method that can also sift through any damage done from previous injuries. Those scans looked good and also ruled out any other causes, such as tumors. The fact that I had suffered no amnesia on either side of either accident was also good news.
Wednesday, October 10, 2012
Dr. Petty says that the night before the MRI, he sat up going over the math problem in his head: my ImPACT scores + my personal recollection of both crashes + his personal observances of me. It was up to him to clear me to drive or tell me to sit. But even before the MRI came back normal on Wednesday, he’d already made his decision. He’d called Rick that morning. Then he and Rick met with Kelley, Steve, Amy, and others. They all called me into a room, sat me down, and told me that they didn’t believe I needed to be in my racecar at Charlotte that weekend.
When I describe it here, it sounds like an intervention, doesn’t it? But that’s not what it was. Amy had the best description of it. She called it an emotional support group. They explained to me that they weren’t forcing me to do something; instead they were telling me they were worried about me and that’s why they thought this was the best thing for me to do.
They were afraid of how I would react because I’m a racer, and they were right to be worried. As I’ve already told you, racers don’t get out of their racecars. In a dozen seasons at NASCAR’s top level I had never missed a start. My streak was up to 461 races. Now that was going to end.
I was shocked. We were still in the NASCAR Chase for the Championship. After my Talladega crash, we were no longer one of the favorites, but we were still fighting. Not only that, the Charlotte race weekend was scheduled to start the very next day, with qualifying on Thursday night. But when I looked around that room I realized that there wasn’t a single person in there who didn’t care about me. They also all depended on me to help them make their livings. So no one in there was ever going to make me miss a race unless they truly believed that it was the absolute right thing to do.
Though I don’t think I realized it at the time, I know now that deep down I was also a little relieved. My secret was out there. We had identified a problem. We were gonna fix it.
Rick and Steve went about finding a driver for my racecar for Charlotte, thankfully taking my suggestion and hiring my friend Regan Smith, a guy who needed a lucky break. Kelley and the folks at Hendrick Motorsports went about planning a press conference for the next day, when I would reveal to the world that I would be getting out of my car in the middle of the postseason not only because of a concussion suffered at Talladega but also because of a concussion suffered at Kansas that I had kept hidden.
Thursday, October 11, 2012
Charlotte Motor Speedway
I don’t remember being nervous about the press conference. Again, I think I was more relieved to get it out there and not have to pretend any longer, and I was also anxious to get on with whatever was next, to get healed up and get back into my racecar.
It was me, Steve, Rick, and Dr. Petty sitting at the front of the Charlotte Motor Speedway media center. The reaction to what we said, after the initial shock wore off that I was going to sit out two races, was overwhelmingly positive. The media wrote that I was open and honest, and they suggested that maybe I had helped start an important discussion in the garage about a very important topic that had always been an uncomfortable conversation. There was still that part of me that sat there and worried about being viewed as damaged goods by my fellow racers. On the microphone, live on national TV, I told everyone that I felt 100 percent and that sitting wasn’t what I wanted to do, but what I had been told to do, and I wasn’t going to argue with the doctors.
“I don’t have any plans of being here this weekend,” I said to the national media about the Charlotte race. “I think I’d be more of a distraction to the team and their efforts in the race. They’ve got a good opportunity to have a good run this weekend. And me staying away, to minimize that distraction, would help them out.”
The truth was, I had somewhere else I had to be. Dr. Petty, Amy, and myself, we had a doctor’s appointment. We were headed to Pittsburgh.
CHAPTER 3
BACK ON TRACK
Tuesday, October 16, 2012
Pittsburgh, Pennsylvania
When I stepped off the plane in Pittsburgh, I was stepping right into the center of the concussion world. This was ground zero for what had become the biggest controversy in sports: concussions and how they were affecting pro football players. It just so happened I was coming to town right when the fight between the NFL and its former players was getting pretty ugly, and as a result, a lot of the American public was really becoming aware of concussions for the first time.
It was a Pittsburgh Steeler, Pro Football Hall of Famer Mike Webster, who shook up the pro football world in 1999. He filed a disability claim that said his dementia had been caused by seventeen years of pounding to his head in the middle of the offensive line. He died on September 25, 2002—the exact same week that I’d gotten into so much hot water for confessing that I’d hidden my concussion earlier that season. It was a Pittsburgh-based medical examiner, Dr. Bennet Omalu, who did an examination of Webster’s brain and became the first to discover that football players suffered from chronic traumatic encephalopathy, devastating microscopic trauma done by constant, repetitive damage. It causes systems failures in the brain and body. A lot of times the pain and the uncertainty of it all ended up driving victims into becoming people they’d never been before. At the time, no sports fan had any idea what that was. Now, every football fan knows the term CTE.
They certainly knew it by 2012. In April of that year, former NFL player Ray Easterling committed suicide, and an examination showed he suffered from CTE. Barely one month later, Junior Seau, one of the most popular NFL players of the 1990s, shot himself in the chest at the age of forty-three. Why in the chest? So that his brain would be intact and could be studied like Webster’s.
The NFL was fighting to save its image, it was fighting with former players, and it was fighting with Dr. Omalu and others. That fight seemed to always come back to Pittsburgh. And now here I was, a racecar driver headed to see a doctor whose office was located, of all places, inside the Pittsburgh Steelers’ training facility.
I wasn’t sure how this was going to work. All I knew was that Dr. Jerry Petty had said this was where we had to go to receive the best diagnosis and treatment plan. He said, “You let Rick Hen
drick and your sister worry about the racing stuff. We’re going to see Micky” . . . and I didn’t argue with him.
Micky is Dr. Michael Collins, founding member of the University of Pittsburgh Medical Center’s Sports Medicine Concussion Program. He’s known around the world for his expertise on sports-related concussions. He gives lectures, he teaches doctors and athletic trainers how to diagnose and treat concussions, and he works with the Steelers, Pittsburgh Penguins, Major League Baseball teams, even Cirque de Soleil. Remember that ImPACT test Dr. Petty used to identify my injuries? Well, Micky cofounded ImPACT.
That day, when I shook hands with him for the first time, I had no idea how much he would mean to my life, as a doctor but also as a friend. Micky has this real disarming way about him. You have to figure he’s almost always the smartest guy in the room, right? On top of that, every conversation he has with a patient or a student is about the human brain, one of the most complicated, intimidating topics there is, period. And then, when he’s meeting with his patients, you know that most of them are scared to death. Probably all of them. I know I was.
When we arrived at Micky’s office, many patients were lined up. They were everything from professional athletes to kids who had been hurt playing youth sports to people who had been in car accidents on the street to construction workers who’d been hurt on the job. Looking around, in an instant, I learned two very important things. First, we were all in the same boat. We were all worried and confused and scared. Second, this Micky guy, he must be pretty dang good at what he does.
As soon as we sat down, he started handling me like a great crew chief would. We went over symptoms and how I was feeling, but I could tell he was already looking into me way deeper than that. He was evaluating me as a person. He immediately picked up on a couple of key pieces of my personality: that I can be a quiet guy and that I am also an information junkie. I can’t learn or read enough about whatever it is that I’m thinking about at the time. I’ve always been that way. I guess it’s me trying to keep up with my nonstop brain, trying to feed it. During the period of time when I’d kept my concussions to myself, I had been all over the internet, reading anything I could find, including all those stories about Mike Webster and Junior Seau and the others. I am also not the most patient person in the world. Stuff can’t happen fast enough for me. That goes for anything, but especially when it comes to me and my racecar.
Micky sensed all of that about me very quickly. He says that only a few minutes into our first conversation in that examination room, he knew that (1) I’d had two injuries in a short period of time, the second coming while I was still experiencing the effects of the first; (2) after all my personal research, I was convinced that those concussions had been layered, repetitive injuries, not unlike what had caused CTE in those football players; (3) I wanted to get this over with as soon as possible; and (4) I was nervous that this was all ultimately headed toward someone like him telling me that my racing career was over.
With all of that in mind, the first thing Micky did was to start educating me. It was Brain Science 101. I would compare it to my explaining how a racecar works to someone who thinks they know but doesn’t really know. He pulled out a sheet of paper, grabbed a pen, and sketched out a picture of a brain. He outlined for me how our brains operate.
Our brains are made up of billions of neurons that constantly process information and send out the signals that tell our bodies how to function and how to feel, physically and emotionally. Those neurons are connected by trillions of synapses, operating like a pipe or a fire hose, sending information like water up and down the line. We tend to think of it as this kind of mystical process, but it’s actually pretty practical. It’s amazing, but it ain’t magic. It’s physical and chemical. Brain activity is powered by electrical charges, sparked by the right combinations of positively and negatively charged chemicals, stuff like potassium and calcium—things we’ve all heard of. They keep information moving like a wave through those synapses and between those neurons and sending whatever it needs to on down the line through the rest of our body, reminding every organ and system how to do their jobs and waiting to help find solutions if any of those organs and systems run into problems.
All of that is happening within your brain, a three-pound organ that’s basically the same consistency as a firm block of Jell-O. It seems very fragile when I describe it that way, and it is. So are all those cells doing all that communicating, especially those long, hose-like synapses. Our brains float along inside our skulls day and night, protected by cerebrospinal fluid and three layers of protective tissue called the meninges. Most of the time, that’s enough to prevent injuries to your most important organ, even as fragile as it is. You’re good.
Unless you hit a wall at 185 mph.
When our bodies experience giant collisions—really any big change in speed, like the deceleration of a racecar when it hits something—the brain can be jarred so hard against the inside of our skulls that there isn’t much those layers of protection can do about it. Even if it doesn’t hit anything, the shaking alone can be damaging. People hear the word concussion and they think about hits and impacts, but the roots of the word actually mean “to shake violently.”
The brain is just like any other organ. It gets bruised. It bleeds. It swells. But even if none of that happens, those tiny little synapses can still get stretched, bent, or snapped, and the communication lines in your brain are interrupted. In other words, your body’s information hose is stepped on. It gets holes and creases in it. The stuff that’s supposed to stay out gets in, and the stuff that’s supposed to be sent out gets stuck. The whole physical and chemical process is changed and, naturally, it stops working as well as it used to.
That’s what Micky explained to me that day. That whole process, before and after injury. Then he explained that word—injury—and how it is never as simple as, “Well, patient, you have a concussion, so we’re going to do this now . . .” because it’s not a one-size-fits-all prognosis or treatment. He said something to me that day that I have remembered ever since and that I have repeated to anyone who will listen. He said, “Every concussion is like a snowflake. No two are alike.” It makes sense when you really think about it. No two brains are alike; that’s why no two people are alike, and that’s why no two concussions are alike. Micky likes to say that there are about thirty different types of knee injuries, so why in the world would people assume that all brain injuries are the same?
And though no two concussions are exactly alike, that day he explained to me that they generally fall into six different types of brain injuries.
There’s a cognitive/fatigue concussion, when patients experience a lag in their ability to concentrate. They get easily distracted, it’s hard for them to retain information, and they get worn out way quicker as the day goes on.
There are ocular concussions, when your eyes can become disconnected, each eye kind of off doing its own thing, and you struggle trying to track something visually.
Post-traumatic migraine concussions are marked by headaches that just won’t go away, often paired with becoming super sensitive to light and noise along with constant feelings of nausea.
Cervical concussions are injuries suffered farther down the neck and spine, also leading to constant migraines. When he told me about this one, I thought about all the racecar drivers I knew that I now figured had long suffered from these.
The description of anxiety/mood concussions felt familiar too. It’s when the injured suddenly has a hard time turning off their thoughts and are constantly dogged by being stressed and worried all the time.
Finally, he said, he believed I was suffering from the sixth concussion type, known as a vestibular concussion. He said I had “decompensated my vestibular system.” In other words, I had damaged the functioning ability of that system. The vestibular system is the balance center of your brain. That’s where our minds interpret motion, stabilize our vision when we’re moving, and coordinate the movements of
our head and eyes. You know, pretty much everything you need to be a racecar driver.
He also explained that those six types are not mutually exclusive. You could suffer one type but the symptoms it causes could cross over into the symptoms of another type. Different sections of the brain control different types of thoughts and activities. If you suffered an injury to an area of the brain that works closely with another area, then both areas could be affected. The lines between concussions aren’t black and white. Gray matter comes with a lot of gray areas.
I wanted to freak out. Deep down, I was. My feelings about the situation didn’t improve when he explained to me that my spin at Talladega hadn’t simply reaggravated the concussion from Kansas. This was a whole new injury. The Kansas hit was head-on, blunt-force to the front corner of my brain as it smacked the front of my skull. The Talladega accident had been a spin, like a centrifuge you see astronauts and fighter pilots training in, and it had whirled the back of my brain up against the back half of my skull. Micky said that I would have suffered the concussion at Talladega regardless, but that the first hit and the untreated injury I’d kept to myself had made me vulnerable. It made the second hit six weeks later much worse than it likely would’ve been on its own. Even more, my anxiety over it all—that self-inflicted stress I experienced between Kansas and Talladega, and in the days between Talladega and this appointment—had made things worse too. In the past, that connection wouldn’t have been made. But now, Micky said, there was real evidence that anxiety accelerated injuries and symptoms.
Racing to the Finish Page 5
