Smith was taken off the pitch with a medic propping him up on both sides, his left leg giving way underneath him as he exited the arena, similar to a boxer no longer able to stand up straight after being punched into submission.
In boxing, the referee stops the fight to avoid further punishment to the pugilist’s brain. On Saturday, after five minutes of an examination – the highly controversial five-minute test in which a player is asked to stand up straight and answer basic questions to supposedly determine if he is concussed or not – Smith was allowed back onto the field. Nobody watching could have been in any doubt about Smith’s state, but his own words helped support the feeling – if not the certainty – that he was concussed and should not have been allowed back out there. “It [the collision] obviously affected me,” said Smith. “You saw me snake dancing off the field. I passed the [concussion] tests that were required within those five minutes and I got out there.”
Smith passed the tests because the tests are easy to pass, even when, minutes before, your legs are like jelly and your brain is away with the fairies. Smith had suffered a neurological injury and rugby, once again, had run the risk of serious harm coming to a player supposedly in their care, just as they had when Brian O’Driscoll was concussed and allowed back on to the field to play against France in the Six Nations.
The Smith incident merely supported the view that rugby is playing dangerously fast and loose with player safety. It prompted a former International Rugby Board medical committee member to send an e-mail on Tuesday to many of the game’s administrators – principally the International Rugby Board chief executive Brett Gosper – to voice his outrage at the way the Smith case was handled.
Barry O’Driscoll, uncle of Brian, is a former Irish international and for 15 years was on various IRB committees, including its medical committee. Last summer, O’Driscoll resigned from the IRB in protest against its introduction of the five-minute rule.
“Rugby is trivialising concussion,” he told me back in March, in response to the incident involving his nephew, who was clearly all over the place when leaving the field only to reappear soon after in a game of brutal physicality. At the time, American film-makers, who had come to the UK to do interviews for a documentary on head trauma in sport, particularly rugby, watched the O’Driscoll saga unfold with horror. One of them told me that rugby’s view on concussion is akin to giving a drunk the keys of his car just because he tells you he’s sober enough to drive home.
Barry O’Driscoll was one of those interviewed for the upcoming film. “They are sending these guys back on to the field and into the most brutal arena. It’s ferocious out there. The same player who 18 months ago was given a minimum of seven days’ recovery time is now given five minutes. There is no test that you can do in five minutes that will show that a player is not concussed. It is accepted the world over. We have all seen players who have appeared fine five minutes after a concussive injury then vomiting later in the night. To have this as acceptable in rugby, what kind of message are we sending out?”
The five-minute rule allows medics to remove a player from the action and test him for five minutes to see if he’s fit to continue. The player has to stand up straight without falling over and they are given a basic memory test.
“These questions should serve as a landmark for when you examine them six hours later to see if they’re getting worse or if they’re bleeding into their brain,” O’Driscoll, and many others, argue. “That’s why you ask them, not to see if they can go back on. They are already concussed at that point. You don’t need to ask questions to find that out. If six hours later their responses are worse than they were earlier you say ‘Wait a minute, this shouldn’t be the case, is this guy going to bleed?’ That’s why you ask the questions and so it has always been. But we’re going in the other direction now. We’re going from being stood down for three weeks to one week to five minutes with players who are showing exactly the same symptoms. The five-minute rule came out of the blue. I couldn’t be a part of it so I resigned from the IRB. It saddened me, but I couldn’t have my name attached to that decision.”
O’Driscoll has now written to the IRB, as well as other leading officials in the home unions including team doctors, to once again raise the alarm about concussion in the sport. “The latest episode of returning the concussed player to the field of play – Smith against the Lions – has highlighted the massive mistake the IRB have made and are continuing to make,” he writes. “There are many people who believe this legend [Smith] has been treated disgracefully – clearly unconscious and clearly unable to walk off the field, he was shunted back within minutes into an inferno.
“He was exposed to traumas to which he had little defence. ‘Rugby treats the welfare of the player as a priority’. I think not! The five-minute assessment of a player who has demonstrated distinct signs of concussion for 60 to 90 seconds, and usually longer, is totally discredited. There is no scientific, medical or rugby basis for the safety of this process.
“No sporting body in the world apart from the IRB have suggested that an athlete who has shown signs or symptoms of concussion can be cleared in five minutes. The IRB have refused to accept the significance of CTE, dementia, depression and suicide in NFL players with a history of concussion, as being in any way relevant to our game.”
CTE is chronic traumatic encephalopathy, a degenerative brain disease caused by repeated blows to the head. CTE manifests itself in memory loss and difficulties with concentration, mood swings, aggression and depression. In the worst cases it can lead to dementia. The NFL is currently experiencing a crisis with CTE being found in the brains of ex-American footballers. A Boston research group has examined up to 100 brains of former athletes who suffered these symptoms and the vast majority of them recorded levels of CTE.
Currently, about 4,000 ex-American footballers and about 2,000 spouses and family members of footballers have filed a class action law suit against the NFL. Their families allege that the NFL knew the dangers and did nothing about it.” Bob Cantu, the head of the Boston group – the so-called Boston Brain Bank – has said that rugby is ignoring the dangers of the disease and he has many supporters in that view, including O’Driscoll. “Just as the rest of the sporting world is increasing its protection of the concussed player, the IRB are heading in the other direction,” he wrote in that email to the game’s most powerful officials. As of yesterday evening, nobody in the IRB had responded to Barry O’Driscoll’s e-mail.