A game in desperate need of some answers

IF THERE is one thing I have learned over the last six years dealing with neurologists as they grapple with a complex and changing case of my own, it is that nothing is simple in their world. Or rarely.

- BRENDAN GALLAGHER

They are well capable of interpreting exactly the same brain MRI image and symptoms very differently and offering varying diagnosis. Consensus is elusive.

As one told me: “What we can see (with an MRI) is not always what you get (symptoms) and what you get is not always what we can see.” i.e. one set of MRI scans can strongly indicate brain deficit or damage, but you won’t necessarily be presenting those symptoms but, conversely, you can have textbook symptoms, but the MRI scan does not back it up.

Another neurologist informed me that in many ways the brain remains a mystery and that medical science has only got a name for probably 5 percent of brain conditions and malfunctions. The other 95 percent are real, often life-changing, and even life-threatening, but they aren’t yet properly identified and understood.

And, finally, I also recall possibly the most noted brain surgeon of them all – the brilliant Henry Marsh – writing how he didn’t relish viewing an MRI of his own brain in his early 70s. It would undoubtedly be shrunken, misshapen, and almost certainly scarred – even though it is manifestly still working because he remains one of the most lucid talkers and eloquent writers on the planet.

All this is by way of preamble and as rugby enters the doomsday scenario it has long feared – the start of litigation between a group of the 200-plus former players and the RFU and WRU seeking compensation over brain damage and associated neurological issues allegedly incurred as a result of their playing rugby. Who knows how this will pan out but let’s try and identify the key areas.