It’s OK To Err On The Side Of Caution

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After Will Power missed the opening round of the Verizon IndyCar Series season reportedly due to a concussion; it was revealed on Wednesday that it was actually due to an inner ear infection. As expected, there were a few that took to social media to blame IndyCar for misdiagnosing Power.

I’m not trying to stir the pot by saying that it was the overwhelming sentiment, because it wasn’t. I think most rational fans agreed that while unfortunate, it was best to err on the side of caution. Still there were enough malcontents that I saw trashing IndyCar, that I felt the need to comment.

Although some have accused me of being a cheerleader for anything that is IndyCar, I certainly don’t feel that’s the case. There are countless examples I could give for when I’ve criticized the series quite heavily for some of their decisions, but this isn’t one of them.

To be honest, I’ve never had a concussion. Nor have I ever had an inner ear infection. But I know people that have had both and neither sounds enjoyable. I don’t even have that much experience being nauseous. But I do know that this past December on Christmas night, I suddenly became so violently ill that I was actually hoping someone would come in and shoot me to put me out of my misery. It was the first time I had thrown up since 1992, but I made up for lost time throughout that entire night. It certainly made for a not so Merry Christmas.

What I most recall as I was laying there at my mother’s house, was wondering how in the world I could even ride in a car to go back to Nashville the next day. I couldn’t even drag myself into the kitchen. If Will Power even felt half as bad as I did, there was no way in the world he could drive a race car around those turns at speed and experience the g-forces that would be exerted onto his body. Even if he tried, he would not only endanger himself but those around him.

Apparently, that’s how bad he felt because Power and Tim Cindric both have said; concussion or not, there was no way Power was racing that day.

As far as misdiagnosing him, I don’t have a problem with that either. As advanced and experienced as IndyCar’s medical team is, there is just so much they can do while at the track. Power had to go through eight hours of rigorous testing later this week, before it was determined that he was not concussed. No one on the IndyCar medical team even knew Power had any problems whatsoever, until Sunday morning.

Dr. Terry Trammell, who has been treating IndyCar drivers so long that I don’t remember when he wasn’t, examined Power Sunday morning and was forced to make a quick decision based on the patient he saw in front of him. Although Power’s practice crash on Friday was not considered what is normally hard enough to cause a concussion, it had been hard enough to cause a sore neck and a headache by Friday night. Then Power was suddenly nauseous and dizzy as he climbed out of the car Saturday after putting his car on the pole.

Dr. Trammell has saved the lives of more than one of our racing heroes over the years. His surgical skills have also allowed drivers to regain the use of their limbs when they were originally considered certain candidates for amputation. His skills, abilities and his reputation as a physician are unquestioned in the paddock. I find it ironic that a few clowns on social media would call Trammell’s judgment into question, when the drivers trust him with their very lives.

There are a few things that I just don’t mess around with, due to the risk/reward associated with them – lightning in the area, faulty brakes on my car and the possibility of sustaining a concussion. Those are three things that I think it is wise to err on the side of caution. To do otherwise is simply not worth it, whether you are twenty-one or seventy-one. The potential for disaster with those three things far outweigh the benefits of messing around with any of them.

Those of us that are football fans have probably learned more about concussions in the past five to seven years, than all the previous years combined. The side-effects appear to have long-reaching effects, well after the initial symptoms wear off. But Power was believed to be in the initial stages of a concussion, when cognitive thinking can be heavily impaired and confusion is common. If I were a driver, I think I would insist that my fellow competitors be fully aware of their surroundings at all times.

It’s a shame that Will Power begins this season in a points deficit to the rest of the field. It makes things interesting for fans; but it creates a hardship for Power, his team and his sponsors. But if that’s the worst thing that came out of this past weekend, that’s small in comparison to what could have happened by allowing a possibly concussed driver to climb into a car and race wheel-to-wheel for two hours. Maybe a Will Power with a concussion could have gotten away with it, but would it have been worth the risk?

Dr. Trammell and IndyCar had to make an informed decision in a very short amount of time. Given the amount of information they had to work with, I think they made the right call – regardless of the opinions of a few cretins on social media. Again, their numbers were few, but it didn’t take seeing many to get me riled up over this.

I side with IndyCar on this one. They made the right decision. It really is better to err on the side of caution in this case.

George Phillips

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15 Responses to “It’s OK To Err On The Side Of Caution”

  1. Ron Ford Says:

    I have been diagnosed as having a hangover and will not be allowed to comment today. Hopefully I can return for Phoenix.

  2. Surprised that he is receiving criticism. He obviously knew the driver could not race and made the right decision. If it turned out to be something other than a concussion, he still diagnosed a problem that should and did keep the driver out for health reasons.

    He probably saved his life. Imagine those g-forces with a sick inner ear.

  3. Thanks for not suggesting what some did when Dale Earnhardt Jr missed races with a concussion. Those who said that Regan Smith should be able to run races and earn points as Dale Jr should be checked themselvs for a concussion! Some things are more important. If Will can go out and win all the remaining races of the year, it won’t matter anyways!

  4. DZ-groundedeffects Says:

    Interesting to me that this was even an issue for consideration.

    I would never in a thousand years second-guess Dr. Trammell and his staff. I don’t think he ever stated that it was a misdiagnosis, only that his symptoms were consistent with those following the concussion protocol, yet the ear accelerometer data (the most objective data to use) was inconsistent with that diagnosis, but decided to keep him out anyway.

    Regardless, it was the right move and Dr. Trammell has been a true godsend for Indycar and racing as a sport. He is a giant among others in this sport.

  5. I just don’t get the criticism that’s out there regarding this. When a person is symptomatic, he’s symptomatic, and if those symptoms point at a concussion among other things, it’s entirely reasonable and in fact keeping in line with the other factors – including the crash – to diagnose a concussion.

    And at the same time, Power wasn’t symptomatic at first. *That* is why he got back in the car. So for the other element out there who’s chiding Indycar for supposedly not following – or in some cases not even having a concussion protocol – they need to consider *that*.

    A diagnosis based on symptoms plus external factors – such as the wreck in this case – is often put out there as a testable hypothesis, not as a definitive conclusion. This is one of the things people miss about the actual process of medical caregiving. It’s why Power went for more tests later. And it’s completely keeping in line with standard differential diagnoses as I understand them (admittedly as a layman, but still, it’s something that can be grasped as a concept, even though few of us are trained like doctors). People need to realize that the initial diagnoses was not meant to 1. Eliminate from consideration any other causes, and 2. Be the final word on the matter. And at the same time, the diagnosis does not happen until the symptoms manifest.

    I really don’t get why people are sounding off negatively about this. I just don’t. It’s like the critics expect 1. Injuries and symptoms to just be apparent immediately, full force, upon the first examination, and 2. Medical caregivers to be clairvoyant when problems are not found. That’s just not the way things work.

  6. Ah, Internet Armchair Doctors, right up there with the Commandos. They have their 5 minute GoogleMD license, which certainly trumps Dr. Trammel’s decades of experience! I’m equally sure that if Will had raced and wrecked they would have been screaming just as loudly about how could IndyCar have let him race.

    Jackwagons.

    Disclaimer: I’m a former EMT and currently work in the Diagnostic Imaging field as a technologist administering tests. There’s a reason why there’s a concussion protocol. It’s very hard to diagnose. As was reported, it took hours of testing at one of the premier facilities in the country to positively ascertain that it was not a concussion.

    They made the right call.

  7. I have read several stories that say the Power himself made the call that he would not race and that Tim Cindric agreed. Accepting that that is true, no other decisions made by anybody else are directly relevant.
    What I find interesting is that the team put Servia in the car (which I liked) rather than withdrawing the car which would at least have given Power half points for finishing last plus his one point for the pole. It will be interesting to see if he makes a strong enough run at the title for that to be a deciding factor in the chanpionship.

  8. ecurie415 Says:

    There’s a great chapter in the Denis Jenkinson classic, “The Racing Driver”, where Jenkinson talks about why the inner ear is far more important for a driver than hand-eye coordination. The short version is that the inner ear gives a driver “feel” for what the car is doing underneath him, versus hand-eye coordination, which is actually less important. Michael Schumacher is the greatest F1 driver of all time, at least statistically, but he was a mid-field performer on standardized hand-eye coordination tests given to F1 drivers. Car control comes more from the inner ear than the eye.

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