Alan Quinlan: We have every right to be worried for Jonathan Sexton's welfare
Published 26/01/2016 | 02:30
If Johnny Sexton was my brother or son, I'd be worried for him. Very worried. Four concussions in 2014, another scare at the World Cup, before he got that smack on the jaw last Saturday.
It all adds up. And if he was still playing in France, where the Ligue Nationale de Rugby (LNR) have the powers to take away a player's licence, there would be every chance the authorities would stand him down.
Yet the risk of a few months out of the game - or to take it to a more extreme level, an enforced retirement - is nothing compared to risking your health.
I'm not trying to be a scaremonger here. Far from it. If Johnny is cleared by a doctor to play against Wales on Sunday week, then that's good enough for me because no doctor worth their salt would send an injured player out into the fray with the words, 'We'll take the chance'.
So why am I worried?
So much of it stems from a story I read four years ago in the 'New York Times' about an American footballer, Ray Easterling.
Having suffered from chronic traumatic encephalopathy (CTE) - a degenerative brain disease caused by frequent knocks to the head - Easterling's life had deteriorated alarmingly in the years that followed his career in the NFL.
Only ten years after retiring, depression and dementia kicked in and he had to deal with both illnesses for over a couple of decades before, in 2012, he ended his life with a gunshot to the head. He was 62.
His story isn't a solitary one. Subsequent research has highlighted how common CTE is among former players; how a higher proportion of NFL players suffered from Alzheimer's disease compared to the general population; how in situations where concussion wasn't treated seriously, players' lives suffered - and in a number of cases like Easterling's - ended in tragedy.
Hence my concern. And yet, there is a distinct difference between American football in the 1970s, when Easterling was playing, and rugby union in 2016.
And the difference is this. Back then, Easterling was sent back onto the pitch when he was concussed. Now, Johnny Sexton is kept off the park as a precaution, even when he has cleared a Head Injury Assessment test.
Justifying his decision last Saturday, Leo Cullen yesterday said: "We've lost a player this year to retirement, Kevin McLaughlin (as a result of concussion), so we're ultra cautious. It's important that everyone is really aware of that fact. Player welfare is really important to us.
"If there's any little bit of doubt [we won't risk a player]. I know there was a bit of hysteria around this but he's being managed as best as possible."
He certainly is.
And therein lies the difference between then and now, between how Easterling was treated in the 1970s and how Sexton is being looked after today.
Leo Cullen, and Leinster's, attitude has sent out a really positive message to everyone in the game, because effectively they are saying, 'We know this is a world-class player on our hands and we know we have a better chance of winning the game if he is on the field. But this issue is a serious one. A man's health matters more than a result.'
* * * * *
I remember the call like it was yesterday. It was a Monday afternoon. A couple of days earlier I had been commentating on Ireland's match against Australia when Conor Murray had been removed from the play for a Head Injury Assessment at a crucial stage of the game. At the time I made it clear that it was the right call, that Conor's health had to come first.
Listening to the commentary, Peter Robinson made contact with me via Twitter. When we spoke, we spent over an hour talking about Benjamin, his son, a promising young rugby player who took three blows to the head during a game in 2011 and played on each time.
Towards the end of that match, he collapsed. Two days later he died. Had he come off after the first head injury, he would still be alive.
So when I think about players suffering from head injuries now, I think about Benjamin Robinson and err on the side of caution.
Again, I stress, I don't want to scare people. All any of us want is for the dangers to be more widely known.
We want Sexton lining up for Ireland against Wales because we know Ireland will have a better chance of winning if that is the case. But we also want him - and every rugby player - safe.
Of course that isn't easy. Rugby is a contact sport. The modern-day player is fitter and more powerful than the player from yesteryear. Coaches have drilled into teams the importance of getting off their defensive line quicker. The change in the substitution laws means that, for 80 minutes, the game is played at a much faster tempo than ever before.
And on the back of that there is less space on the pitch than ever before. There are more collisions and more concussions. Yet don't tell me that concussion is a new thing in rugby.
It isn't. It was there when I played and was there before I was around. The difference now is the issue is in the spotlight - and people are not just aware of the problem but are dealing with it.
Were people as aware six years ago?
There is no way they were. When I was growing up, the answer to every medical problem on the pitch from a hamstring to a head injury was a squeeze of the magic sponge.
Medical education has improved since then. These days players are no longer viewed as weak if they walk off the field with a head injury. They are regarded as intelligent men making the smart decision.
And there is no doubt in my mind that intelligent decisions will be taken around Sexton too. If there are dangers, he won't play against Wales or France or anyone until the dangers clear.
Sexton is a tough, abrasive, physical guy. He is a smart man, too. He knows the risks yet he also knows that if a doctor clears him to play, it is because he is fine. So should he retire, as has been suggested?
No. But should he see a neurosurgeon and receive regular medical advice? Yes.
And is he in safe hands under Cullen and the IRFU's care?
I've no doubt he is. Rugby, I'm convinced, has finally got its head around concussion.