The hit came quickly and on the opposite side of the field from the home grandstands, on a foggy November evening.
Sequim High quarterback Drew Rickerson knew he'd been hit hard, and his teammates knew, and by the time he was stumbling around the sidelines, shooting water over his shoulder instead of into his mouth and getting up from the bench to ask coaches if he could sit down, his mother Jean suspected her 16-year-old son wasn't all there.
"I knew something was up," Jean Rickerson says. "(But) I didn't want to be the mother who sits on the bench."
The sophomore quarterback, doctors know now in hindsight, suffered a concussion, defined by the National Institute of Neurological Disorders and Stroke as a short loss of normal brain function in response to a head injury.
Had she known all about concussions and the repercussions of hits to Drew's head, Jean Rickerson might have been quicker to demand her son get taken immediately to a hospital.
The scary thing, she says six months later, is that it didn't seem like anyone around knew the impact her son's concussion had on his brain or what to do next.
Eventually Drew did make it to the emergency room.
The time span from the hit to the hospital, all told, was two and a-half hours.
"That timetable could have been deadly for him," Jean says.
The incident and the resulting complications - Drew experienced numbness, loss of reflexes and sapped energy - led Jean Rickerson to ask Dr. Stanley Herring, professor of neurosurgery at the University of Washington Medicine Sports and Spine Center, to lead a workshop on concussions in Sequim this Saturday.
Herring has been the team physician for the Seattle Seahawks since 1997 and a consultant for the San Francisco Giants since 1994.
Jean Rickerson says she hopes the information will help parents, coaches and the players themselves become experts about concussions and know exactly when they occur.
The goal, she says, is to help those hurt know how to seek medical care, what's important to watch for with possible concussions, when hurt athletes can/should return to play and how to avoid more serious complications.
The event features the premier of "Help! My Bell Just Rang," a video featuring players from Sequim, Port Angeles and Chimacum. That video includes interviews with Adrien Gault, the Sequim High football player whose multiple concussions sent him into seizures and a coma in September 2006.
of the injury
The mysteries surrounding concussions are multifold. The most common type of brain injury sustained in sports, according to the Brain Injury Association of America, they generally do not involve a loss of consciousness. People can sustain a concussion even if they do not hit their head; an indirect blow elsewhere on the body can transmit an "impulsive" force to the head and cause a concussion to the brain.
The problem can come from a single blow to the head, sometimes causing massive headaches. Or, as in Drew's case, the headaches can appear three weeks after the blow.
Scarier still, multiple concussions can have cumulative and long-lasting life changes, such as epilepsy.
Concussions can lead to a hematoma, or bleeding in the brain that collects and clots, forming a bump that pushes on the brain. A hematoma may not be apparent for a day or even as long as several weeks and can be life-threatening.
That Friday night, Drew had a computerized tomography (CT) scan showing no significant, permanent brain damage. But by Monday morning he still was unresponsive, still dazed.
"He couldn't read, he couldn't watch TV, he couldn't concentrate on anything," Jean says. "(At that point), I'm frantic."
By Wednesday, Drew had no reflexes on his right side and was numb in the extremities.
At that point, the family rushed Drew to Harborview for more tests that showed no structural damage but - as another quirk of the injury - concussions rarely show up on magnetic resonance imaging (MRI) and CT scans.
Drew spent the next two weeks out of school, then spent the next two months going part-time with much of his studying at home. The concussion had sapped much of his energy and affected all but his mathematics skills (which, not uncommon to concussion sufferers, can remain sharp).
It wasn't until March, exactly a day before baseball season started, that Drew felt well enough to play and got the OK from doctors.
A new, safer law
Washington now has what many sports injury advocates say is the nation's toughest high school return-to-play law for concussions.
Gov. Chris Gregoire signed a House bill into the Zackery Lystedt law on May 14. The law prohibits athletes younger than 18 and suspected of sustaining a concussion from returning to play without approval from a licensed health care provider. (Lystedt is a 16-year-old in Maple Valley. He suffered a life-threatening brain injury in 2006 after he returned to play football following a concussion. His major injury came a week before Gault's and the two were in Harborview at the same time.)
The law already was gaining steam in the Legislature before Jean Rickerson heard of it, but she become such a supporter that she visited Olympia to witness the announcement.
"I was thrilled when I found out about the law," she says.
The law also mandates that school districts work with the Washington Interscholastic Activities Association - the governing body for high school interscholastic sports in Washington state - to develop policies educating coaches about concussions.
One of the major problems with figuring out if a player has sustained a concussion, Rickerson says, is that the person who has sustained the injury isn't in his or her right mind anymore.
"Asking someone who's had a brain injury if they're OK isn't a reliable source," Jean Rickerson says.
Instead, she says, coaches, teammates and parents need to be able to read the signs and symptoms of a player they suspect has received a concussion - appears confused, dazed or stunned; unsure of the game, score or opponent; answers questions slowly; has loss of memory either before or after the hit; loss of consciousness, etc.
Players who can realize their own symptoms - headache, nausea, dizziness or balance problems, double vision, sensitivity to light or noise, sluggish or groggy feeling, confusion - can help diagnose their own problem.
"What floors me is the lack of information most of us have," Rickerson says. "I was part of the problem."
According to the Washington State Athletic Trainers Association, as many as 64 percent of Washington state high schools do not have access to a certified trainer.
Herring, professor of neurosurgery, told the Seattle Times in November, "If you want to ask me what the booster clubs should spend money on ... (it's) a certified athletic trainer to cover the sporting events. Money well spent."
Reach Michael Dashiell at firstname.lastname@example.org.
Concussion, The Invisible Injury
What: A community workshop featuring Dr. Stanley Herring, professor of neurosurgery at the University of Washington Medicine Sports and Spine Center at Harborview Medical Center
When: 1-3 p.m. Saturday, June 13
Where: Sequim High School auditorium, 601 N. Sequim Ave.
Includes: Raffle for three sets of two tickets each to Mariner games
Contact: Dave Ditlefsen at 582-3600 or Jean Rickerson at 452-6765