Thursday night’s game between the Cincinnati Bengals and the Miami Dolphins is a worst-case scenario situation as Tua Tagovailoa was knocked out of the game with a vicious hit that produced a traumatic brain injury requiring the young quarterback to be stabilized and transported to a tier one trauma facility at the University of Cincinnati. Since then, an onslaught of vitriol, outrage, and “I told you so’s” have been launched at the Dolphins considering their perceived lack of diligence for the safety of their own player. First let me say that player safety is paramount and comes before all things game related. I, like all of you, was extremely saddened to see Tua lying supine on the turf displaying the “fencing response” with his fingers that often occurs when there is an injury to the cerebellum. I immediately said prayers for Tua and his family as his health was and still is my primary concern. I could care less who won the game at that point, I just wanted Tua to be okay. Thankfully Tua was discharged later that night and was able to travel back with his teammates and was seen laughing, joking around, and walking under his own power with his teammates back at the stadium before departing for Miami. In my opinion it was an unnecessarily violent hit that did not have to occur, but I will get into more of that aspect later.
What I cannot abide is all these sports journalists and social media personalities suddenly becoming medical professionals and presenting details of how the Dolphins must have skipped over the concussion protocol without having any evidence to back up these assumptions they are asserting. Let me be clear, I am not defense counsel for the Miami Dolphins. I am merely advocating that patience be demonstrated in allowing the investigation to play out and letting scientific facts drive the narrative as opposed to people who know nothing and assume everything while giving final opinions as if the matter is concluded. There will be plenty of time to bash the Dolphins and suggest punishments if they are guilty of what everyone is alleging. Just like they were penalized after the Matt Moore situation in the playoffs against the Steelers. The Dolphins will deserve it if they have done what everyone is convinced, they did, but someone must state there is a possibility that they did everything by the book and Tua still would have ended up getting his head smashed on Thursday night. I even heard one analyst present Stephen Ross serving a suspension for tampering with Tom Brady as evidence that the Dolphins did not follow the concussion protocol when the two things could not be more unrelated.
Many of you may not know but my first career and all of my academic training was as a medical professional. Writing and creating is a professional hobby for me that I have no classical training in. However, in the medical field I do. I was a double science major pre-med student at the University of Miami who got into UM’s medical school before deciding to go into the entertainment space much to the disappointment of my parents and family because medicine is the exclusive career of choice in my family. I interned at two of the largest hospitals in Miami-Dade County for six years and did a neurological rotation at Ryder Trauma Center under my personal mentor, who is a foremost neurologist in Miami that most of you probably know by name. Speaking as someone who has seen and helped to treat people with traumatic brain injuries, I can tell you that it is never a good idea to try and diagnose anything, let alone a brain injury by watching on a TV or from the stands. So many deficits or conditions present with the same symptoms that as a medical professional you have to be diligent and conduct a physical examination and/or run diagnostic tests to confirm a diagnosis and rule out all others. Doctors do not have the luxury of jumping to conclusions. They must be confident in their diagnosis. Saying “I know what a concussion looks like because I had one before and I have had back injuries before and never lost control of my legs” simply is not acceptable as a medical evaluation.
If you walked into your doctor’s office and they diagnosed you based on a social media video of you that they saw without evaluating you themselves, fire them immediately. Yet this is all that I am seeing happening on television and social media. Medically untrained pundits using the eye test to give their diagnosis and to make matters worse, they are presenting it as if it is an absolute fact. Physically compressed nerves that run through the brachial or lumbar plexus, also known as “Stingers,” to most athletes, can also cause you to lose gross motor control of your extremities and fine motor control of your digits. When Tua got hit late by Matt Milano on Sunday against the Bills, I like everyone else was concerned and looked at it as a potential brain injury likely to be a concussion. But I had no way of being sure of that without doing an assessment myself. When Tua came out after the game and gave his explanation I can understand the inherent skepticism. Tua is not a medically trained professional and his answers on the details were not clear. However, the more I listened to him the more I realized that he may have been describing a back stinger. The prospect of him getting a back stinger on the quarterback sneak when Buffalo folded Tua up like a Futon and then banging his back on the ground after the dirty late hit by Milano opened a world of medical diagnostic possibilities. A compressed nerve in your lumbar region, depending on which nerve it is, can absolutely produce the lack of motor control Tua exhibited when he fell and stumbled multiple times. When nerves are compressed, the communication between the brain and the muscles that it controls are essentially temporarily short-circuited for lack of a better description. It is an odd phenomenon to experience because your brain feels fine, but your body does not, and your extremities often don’t perform efficiently to your brain’s commands like they are supposed to or like you are used to. Which makes the sensation hard to describe when people ask you about it.
Now we have all of these internet doctors diagnosing a concussion because they simply are not aware of other conditions that can produce a similar wobbliness and loss of gross motor function. They have ruled out a back stinger and concluded with the eye test from 1,000 miles away that Tua was concussed on Sunday because they do not even know what a back stinger is. I can assure you that there are many other conditions that can cause Cataplexy or loss of gross motor control including but not limited to shock, panic, internal bleeding, low blood sugar, laughing too hard, hyperventilation, heat exhaustion, brain hemorrhage, various stingers or pinched nerves, Cerebral Palsy, Muscular Dystrophy, Parkinson’s, Tourette Syndrome, Tonic-Clonic seizures, and sexually induced orgasms. With that said, I am not diagnosing Tua with a back stinger or any of these other medical conditions. It would be irresponsible of me to do so and frankly it is not within my purview. What I am saying is, let us defer to the medical professionals who actually evaluated Tua on this and see what tests were run and if the protocols were actually followed. It has to be stated that Tua was evaluated by an independent board certified neurologist who specializes in brain injuries and had no affiliation to the Dolphins. As a former medical professional myself, I find it hard to believe that an independent neurologist would risk his medical license just to get Tua back into a 3rd regular season football game. However, crazier things have happened, so I will await the conclusion of the NFLPA’s investigation and I recommend that everyone else does the same.
Now let me address the physicality of Thursday night’s game. I am not accusing the Bengals of being a dirty team, but they certainly made some dirty plays on Thursday night. The Dolphins are seen as one of the best up and coming teams in the NFL, but they do not overpower teams. They run by you with elite speed. As a result of them being seen as a “finesse” speed team, other teams are going to try to test their toughness. They are going to start with trying to rough up our star players. If they can’t beat you straight up, they try to beat you up. That is how the game goes. Unfortunately, that typically begins and ends with trying to bang up the quarterback. The QB1 trigger man is the field general and king of the offense. Historically, if you knock that guy out of the fight, the rest of the army loses morale and battlefield effectiveness.
By the letter of the law Josh Tupou’s hit was not dirty because it was not a penalty, but it was unnecessarily violent. Slamming Tua into the ground head first was unnecessary. Tupou already had Tua in his grasp and wrapped up. There was no need to roll and slam with such ferocity to complete the sack and tackle for loss. Nevertheless, that is my opinion. To me it fit a pattern of the Bengals trying to bully the Dolphins all night and unfortunately there was finally a play with dire consequences. There are some parts of the game that are unavoidable and cannot be legislated out of the game, but slamming a guy like Tupou did and hitting a quarterback so late while they are in a vulnerable defenseless position after throwing a pass like Matt Milano did is not “football” and does not need to be in the game. Tua was almost robbed of his health and potentially his career and NFL fans were robbed of a good game that was shaping up to be a shootout because of an unnecessarily violent body slam that was more wrestling than football and the promising season of the Dolphins is now in question.
Tua Tagovailoa came into Thursday’s game questionable to play because of a back and ankle injury and a few plays before he got knocked out of the game there was a play where the Bengals went after his injured ankle. Tua ended up hyperextended backwards and fell back onto his tangled legs that were twisted like a pretzel. I gasped when that play happened and felt that Tagovailoa and the Dolphins were lucky that he was not injured on the play. The referee correctly threw the flag for unnecessary roughness. Not to mention that the Bengals also body slammed other Dolphins players that they were flagged for and additionally got away with a close late hit call on the sideline when Teddy B was hit as he was going out of bounds. There were too many flags on personal fouls for unnecessary roughness against the Bengals where it seemed like this was a definite strategy of theirs coming into the game. I give all players the benefit of doubt that they aren’t trying to end anyone’s career, but when you make it a habit of always going a bit above and beyond to “leave a little bit extra on a guy” or to rough him up late to “make him feel your presence,” you run the risk of seriously injuring your opponent and that is the feature of what happened to Tua Thursday night that no one is talking about enough. Get well soon Tua. We are all rooting for your speedy recovery.
