HBO Presents "The Crash Reel": Examining The Enormous Impact Of Traumatic Brain Injury (TBI)

Traumatic Brain Injury (TBI) is a public health problem.  We hear about it a lot in relation to the members of our Armed Forces.  In fact, TBI has been "one of the signature injuries of troops in Afghanistan and Iraq".  There has also been much discussion in the media (and here on Pop Health) about the impact of TBI on National Football League (NFL) players.

On July 15, 2013 HBO premiered an incredible documentary called "The Crash Reel".  This film follows U.S. snowboarder Kevin Pearce as he rises through the ranks of the sport, dominates international competition in the run-up to the 2010 Olympics, survives a horrific training accident in Park City, Utah and launches a come-back to his life (and possibly) the sport he loves so much.

The documentary does an amazing job of examining both macro and micro public health issues as they relate to TBI.

Society:

During a poignant interview, Kevin's Dad says "we were all to blame" [for Kevin's injury].  The spectators, the families, the sponsors....he believes they all have a role in injury prevention and athlete safety. He asks why the halfpipe walls keep getting higher and higher (increasing speed, height, and risk of the tricks).

Risk culture and the role of spectators and sponsors in perpetuating this culture is called out in "Wrecks Over Reason", an article running in the August 5, 2013 issue of Sports Illustrated (SI).  Referencing the "X Games" specifically, athletes acknowledge that the audience is hoping to see crashes.  The author Austin Murphy writes, "Indeed, many of the events-at the X Games in particular and in the extreme sports world in general-seem designed to ensure a modicum of carnage.  That's what people are tuning in to see".  

Family and Friends:

Kevin's close-knit family is a big part of the documentary.  We hear them recount how they learned of his accident and through pictures and video, we see them assume the role of caretakers.  It is clear that TBI can have an enormous impact on a person's entire family.  His brother Adam quits his job to help Kevin through his rehabilitation.  His mother is by his side for almost every appointment.  His roommate helps to counter his memory loss by helping with organization and medication.

Having almost lost him and with their lives heavily impacted during his recovery, their fear is understandable when Kevin talks about getting back to snowboarding.   Although his physicians and family constantly reinforce the danger that a second head injury could bring (i.e., it could be fatal), Kevin is determined to return to the sport.  

Kevin:

The accident was caught on video and is horrific to watch. All things considered, Kevin makes a pretty amazing recovery.  He spends 3 months in the hospital and then participates in ongoing rehabilitation to address the lingering effects of his injury: double vision, impulse control problems, memory loss, and depression.  He wrestles with accepting that his injury is life-long and will forever change the trajectory of his life and career.

According to the Centers for Disease Control and Prevention (CDC), at least 1.7 million TBIs occur every year, either as an isolated injury or along with other injuries.  The costs of these injuries are huge- not just in terms of medical costs, but in terms of lost productivity for that individual (and their friends/family that serve as caretakers).  While it is important to focus on helmet use and other individual-level interventions, I applaud the tone of this documentary and the SI article above.  I hope they ignite a discussion of society-level (and sports-level) interventions for traumatic brain injury.