Percy Harvin walked calmly to the sideline last Saturday after absorbing a fierce hit in the first quarter of the Seattle Seahawks' divisional playoff game. When he realized the team's medical staff wanted to perform a concussion evaluation, however, Harvin seemed furious. The full test means at least eight minutes away from the sideline, according to NFL protocol, and usually leads to at least one missed series as well.
Harvin argued demonstratively as he walked toward the locker room, presumably insisting that he was not concussed. He gestured with both arms and his expression -- clearly visible because, per protocol, his helmet had been taken away -- made clear he did not want to go. He finally sprinted into the tunnel. Although he was cleared to return, another hit knocked him out for good in the second quarter.
The episode was a reminder of a hole in the protocol that is otherwise much more vigilant and effective than what the NFL previously relied on. In brief: What happens if the player, caught up in the emotion of a game and his judgment quite possibly impaired by a concussion, refuses to submit to a test?
Most players' instincts compel them to downplay injuries and do whatever necessary to stay in the game. They might not be aware they are displaying concussion symptoms, or perhaps they consider them too mild to render a trip to the locker room. (Indeed, many veteran players were allowed to plow through similar symptoms earlier in their careers.)
Current protocol places the responsibility for identifying symptoms on a team's medical staff. Compliance, however, rests solely with the players.
Recently, we've seen a few violations of that requirement. Green Bay Packers left tackle David Bakhtiari prematurely returned to a game, for one, and New Orleans Saints cornerback Keenan Lewis initially refused to leave the sideline. Harvin's theatrics weren't a violation, but were enough to make you think a physical confrontation between a player and a medical staffer is inevitable.
I realize the concussion protocol is a matter of collective bargaining, which by definition generates issues of liability. Whose fault is it if a concussed player gets onto the field? No one wants that responsibility, and I imagine this area of the protocol will have to be addressed more formally.
I don't see the logic or wisdom in holding players responsible for what happens when they are impaired, and hopefully it doesn't come to that. The big question is how to handle cases of emotional and potentially violent disagreement.
For the moment, the league's head, neck and spine committee is suggesting a player's position coach or another team official -- security directors are a logical possibility -- get involved when needed. A player might not listen to or respect a doctor telling him he needs to leave the field, but his position coach and/or a burly team security guard might be more persuasive.
This issue is just another example of how unique concussions are. There are no other injuries that carry specific, league-mandated protocol. A lack of pain and potentially impaired judgment make for a confusing situation to players at first. You would never consider a plan for keeping a player off the field if he might have, say, torn his ACL. The concussion issue requires it.