Linda Carroll and David Rosner are certainly journalists, and this tome very clearly illustrates that. Those looking for a detailed, technical exploration of the science behind traumatic brain injury, mild or otherwise, are advised to look elsewhere. What "The Concussion Crisis: Anatomy of a Silent Epidemic" presents to its readers is not so much an overview of the neuroscience involved in head injuries as an indictment of society, particularly how the pervasive "macho" culture leads to unnecessary tragedy and slow progress in diagnosis and treatment of the condition. That's not to say that the science is completely overlooked; it just takes a backseat to all the storytelling. Rather than inform you of what goes into diagnosing and treating concussions, including the various tools, techniques, and neurology, the authors go for the heart by describing the daily lives of those too ignorant of the reality of concussions to prevent them. Sometimes they learn too late to prevent any permanent damage, which is where the tragedy takes center stage--often as those in the know can only look on helplessly.
The majority of the book takes shape as accounts of those affected by concussions, and not just the immediate victims. The early chapters focus more on young athletes and display their general lack of knowledge regarding concussions as well as the environment that fosters such a lack of knowledge, created by coaches, teammates, the victims themselves, their parents, and even team physicians. These stories are written in the style of a news magazine unearthing a dark and disturbing underground culture where player safety is sacrificed in the name of the game, be it soccer, hockey, football, or others. Often times the afflicted are simply unaware of what a concussion is and whether they've sustained one; other times they underestimate their severity and potential long-lasting consequences. In several separate instances, a young athlete primed for success succumbs to multiple sustained head injuries, falling behind in both school and sport. Others, such as the case of Zackery Lystedt, are true tragedies resulting from a single vicious impact leaving them crippled for life. Lystedt becomes the namesake of the Zackery Lystedt Law, which aims to keep athletes safe by pulling them from a game after sustaining a head injury of any kind. In his own words, Zackery "just [wants to] make sure this doesn't happen to anyone else."
As the book progresses, the focus shifts to more ordinary people, those not even involved in sports. Carroll and Rosner try to communicate to the reader that it isn't simply the young and oblivious who can fall victim to the debilitating effects of brain injury. In one account, a young woman sustains what appears to be a minor bump on the head during a fender-bender. What she comes to realize is that she's sustained serious trauma to the brain, which affects her ability to perform the duties required of her job and causes her to "[find] herself losing her temper and screaming at people for the most minor of infractions." Lacking the knowledge to find therapy, her condition proceeds to deteriorate, resulting in a mind so disconnected that a messy house filled with sticky notes becomes her home due to her inability to remember to do simple tasks. Finally with the years, technology and knowledge advances, and she's able to find the therapy she so desperately needed long ago--but perhaps a little too late to completely restore her cognitive functions.
The rest of the book follows a similar pattern, bringing back a few recurring "characters" such as the scientists who study traumatic brain injury, the physicians who treat it, and the afflicted who seek to bring about change in the culture, be it the culture of boxing, professional football, or working Joes. Despite the inclusion of neurologists who made such pivotal discoveries and advanced the cause, only the fundamentals of the science itself sufficient to understand the basic storyline is included in the book. Those with no background in biology or medicine can easily follow the descriptions of various procedures and references to the brain and what it means when said brains contain unnatural bundles of protein following trauma to the head. While this is good for "getting the word out" so the layman can understand the severity of this "epidemic," as the authors put it, it leaves something to be desired for those who want to delve deeper. If anything, though, the book could surely encourage someone generally uninterested in concussions before to eagerly seek out other sources of information though; this, I think, is what the authors were aiming for. This isn't scientific literature; it's essentially a greatly extended piece of advocacy journalism. The cover alone indicates as much. It's not an image of a brain, showing areas typically damaged in mild traumatic brain injury or slides of tissue with characteristic markers of damage; it's a young athlete racked by the symptoms of post-concussion syndrome. This is meant to stimulate the heart into action more than the mind into deep analysis of facts.
As the focus is exposing widespread ignorance in a culture that downplays injuries as signs of weakness, there are many examples of real people finding themselves in tough situations dealing with head injuries themselves or watching everything unfold for someone else. There are many, many examples of this. The book is a relatively long read, with every chapter being a healthy chunk of 20-30 pages. Each chapter may cover just one person's story or several related accounts. Many of these stories unfold in a similar fashion, feature similar themes, and cover similar information. Often times reading the book I felt that the inclusion of so many stories was for the purpose of padding--and the writing style is full of typical journalistic embellishment. None of this is a bad thing exactly, but I do feel the book could have been significantly shorter and more easily digestible had a few of the accounts been cut. Once you've read a few stories of someone losing their hopes and dreams at the throes of traumatic brain injury, you get the point. Perhaps clearing out some of the padding would have left room for a more in-depth examination of the science involved, including a more comprehensive overview of the brain itself and why we should expect this organ to be so sensitive. The book makes it clear that concussions cause brain damage; but why is the damage so pervasive, so stubborn in its refusal to dissipate like so many other afflictions? Even a brief introduction to brain anatomy and function would have been helpful in linking everything together in the reader's general understanding of the issue. I don't mean to imply that there is no discussion of the science here; there's plenty to understand what's going on, but it could use a better foundation. As one with a basic knowledge of neuroscience myself, this was not an issue, but I can't speak for those who lack such knowledge.
It's missing the point to focus too much on these shortcomings, though. From those looking to peer into a world they may not be aware of to victims coping with the effects of concussions themselves, "The Concussion Crisis" is a generally rewarding and very informative read. If nothing else, the affected will come to know that their fight is not one they fight alone, and there exist those who understand and can help. The stories contained within serve the purpose of caution so that others may learn from mistakes already made. The reader, no matter their purpose, will also be made aware that the culture is changing, and the future grows ever brighter for those whose lives have been made so foggy and dark from a truly unfortunate and in no way "mild" injury.