56 | New Scientist | 15 February 2020
The back pages Q&A
Our knowledge of brain injury and the
long-term effects of concussion has
changed dramatically in recent years,
says Elizabeth Sandel, particularly
when it comes to children’s sportsSo, what do you do?
I specialise in physical medicine and
rehabilitation (PM&R or physiatry), a young
specialty with only about 10,000 practitioners
in the US. We treat people of all ages with
disabling conditions such as arthritis, brain
injuries, chronic pain, congenital conditions,
muscle and nerve conditions.You’ve just written a book about
concussion. Why?
Films and other media depict concussion as a brief
jolt to the head. Victims who don’t die “see stars”,
but they quickly recover. These portrayals convey
the message that concussion is a trivial matter
without lasting consequences. But that is far from
the truth – concussion is an injury to the brain.What kind of impacts can cause problems?
It could be a fall or a sports injury. But it doesn’t
have to be a blow to the head: a combination of
acceleration-deceleration and rotational forces can
cause a concussion. Some parts of the brain are
very susceptible to stretching by these forces.
So, for example, in a high-speed motor vehicle crash,
a seat-belted person may sustain a concussion
without any direct impact to the head.Can concussion have long-term effects?
Some people develop a chronic condition called
post-concussive syndrome, especially if they don’t
receive education and targeted treatments. Typical
symptoms include headaches, depression and
memory problems. Early diagnosis and treatment
of associated conditions such as post-traumatic
stress disorder and insomnia lead to the best
outcomes, along with non-opioid treatment of pain
and individualised exercise programmes. Repetitive
concussions are associated with more problems,
including neurodegenerative conditions.“ Films depict
concussion
as a brief jolt
to the head
without lasting
consequences.
But that is far
from the truth”
SUSAN FREUNDLICH. PEACOCK PUZZLE COURTESY OF LIBERTY PUZZLESIs brain injury more serious in children than
in adults?
Our brains are not fully developed until our mid to
late-20s, and there is some evidence that brain
injuries in young people may set them up for health
problems later in life. In my opinion, children
should not be subjected to repeat concussions
and we should find safer ways for them to get
exercise. However, this is a complicated area of
investigation that has not yet produced definitive
answers. I hope people will read my book so they
can draw their own conclusions.What’s the most interesting thing you are
working on right now?
The neuroscience of consciousness and
neurotheology – the study of the brain and religion –
are areas of research that excite me.Were you good at science at school?
I preferred biology and physics, possibly because
my chemistry teacher joked about having to repeat
explanations so the girls would understand.If you could have a conversation with any
scientist, living or dead, who would it be?
Sabina Strich, a pioneer in the study of brain injury,
who died in 2015. She studied the microscopic
damage that I explain in my book. I’d like to talk with
her about the distinction between the mind and
brain, and her life in Munich and later in England,
after her family fled the Nazis.Do you have an unexpected hobby, and if
so, please will you tell us about it?
A beautiful and challenging jigsaw puzzle offers
a distraction from the world and life’s stresses.
I also play the piano.What’s the best thing you’ve read or seen in
the past 12 months?
Greta Thunberg is mobilising the rest of us to pay
attention to climate science. She exemplifies the
kind of activism that is necessary now.OK, one last thing: tell us something that will
blow our minds.
The human brain’s current configuration may only
be about 40,000 years old. That greater capacity for
thinking and creating has had helpful and harmful
results. I’ve always been an optimist, but unless we
figure out how to manage the darker side of our
psyches, we will destroy the planet. ❚Elizabeth Sandel is a professor of physical
medicine and rehabilitation at the University of
California, Davis. Her new book is Shaken Brain:
The science, care, and treatment of concussion
(Harvard University Press)