Wednesday 21 November 2018

'If you have that suspicion, he's off and he stays off' - Barry O'Driscoll speaks to Paul Kimmage about concussion

Barry O'Driscoll won't back down in the fight against concussion, writes Paul Kimmage

Dr Barry O’Driscoll is urging World Rugby to change their protocols regarding concussion — “I’m annoyed at their meaningless statements, their platitudes,” he says
Dr Barry O’Driscoll is urging World Rugby to change their protocols regarding concussion — “I’m annoyed at their meaningless statements, their platitudes,” he says
Paul Kimmage

Paul Kimmage

Dr O'Driscoll, who is the uncle of Ireland and British and Irish Lions centre great Brian O'Driscoll, told BBC Breakfast News that he was particularly concerned for Wales wing George North, who suffered two heavy blows to the head in Friday's Six Nations loss to England - a recent report on the BBC website

Five O'Driscolls - Barry, Brian, Frank, John and Mick - have represented Ireland since the first rugby international against England in 1875: four are from the same family, three are medical doctors, two have played for the Lions and one, the original BOD, beat the All Blacks.

Meet Barry, he's the man they call 'uncle.'

We're in his car driving south towards the Manchester suburb of Wilmslow on a crisp Tuesday morning. "Wayne Rooney used to live there," he says, pointing to a huge brick pile on the left. "And that was (Nemanja) Vidic's house."

"You a United fan?" I inquire

"Since I was a boy," he replies. "They were playing at Maine Road when I went to see them first - used to share the ground with City."

We talk football for a while - his son, Gary, is the team doctor at Arsenal - but soon reach his home and his lovely wife, Beryl, who spoils us with coffee before abandoning us in the living room. "I've made some notes," he says, taking out a folder with some facts and figures on concussion. But I'm still trying to square his northern England accent with his roots.

"Do you have any idea how many times you've been referred to as Brian's uncle lately?" I inquire.

"I know," he smiles. "And I do put people right but I can't keep picking up the phone saying, 'You've got that wrong.'"

"Because you're not his uncle."

"No, Frank (Brian's father) is my cousin; Frank's dad and my dad were brothers."

"They were born in Cork?"

"Yes."

"Your dad was Florence?"

"Yes, a very common name in West Cork. It was a man's name down there - it wasn't over here (laughs) - but if you'd seen him he was no Florence. He was very strongly built and played hooker for Waterloo in Liverpool when he came over to do his degree. Then he took a job in Singapore and played a little out there."

"No, don't go there yet," I implore. "Stay with Cork and take it from the beginning."

The man who loved mosquitoes

William O'Driscoll did not believe in coincidence. A teacher and man of great foresight, he lived with his wife, Hannah, on a small farm in Mauletrahane near Skibbereen and firmly believed that we shape our own destinies. For his sons Florence, Paddy and Liam, that meant lessons in basic Latin and the rudiments of rugby football before they entered boarding school at Cistercian College in Roscrea.

Why Latin? Because they would need it to study medicine. Why rugby? Because he knew it was a game they would play.

Florence, or Florry as he was known, graduated from UCD and studied tropical medicine in Liverpool before beginning his working life in Singapore. "He loved the mosquito," Barry says "and thought they were the cleverest things. 'We'll never beat the mosquito,' he'd say. 'We'll make phenomenal drugs to destroy them but the mosquito will change.' And it has changed."

Florry spent several years in Asia, and married his sweetheart, Maureen, before returning to general practice in Manchester in 1935. Four years later, when Britain went to war, he joined the army medical corps and sent Maureen and their four kids back to Ireland.

"The army life suited him," Barry says. "He was a very disciplined man and it put him back into tropical medicine. He was in charge of the malaria campaign with the 8th army in the desert but thankfully got some leave or I'd never have been born."

Barry was born in 1941 and spent four years in Skerries before the family returned to Manchester at the end of the war. Florry had been rewarded with an OBE from King George but was lucky to have survived.

"The 8th army had defeated Rommel in the desert and were coming up through Italy when the jeep he was driving hit a landmine near Assisi. Dad was knocked unconscious and had a lot of head damage. Another Irish doctor who was with him in the jeep was killed."

Barry was 12 years old in 1953 when his brother, John - "an afterthought" - was born. They weren't pushed to follow their father into medicine but were educated at Stonyhurst, a Jesuit boarding school near Blackburn with a big rugby tradition, and it seemed a natural path.

Barry had just qualified and was playing full-back for Lancashire when he got what he describes as his "lucky break" with Ireland. "The county championships in England was huge back then and the only thing the selectors would watch," he says. "We used to have a warm-up game each year against Ulster and played on this lousy night in Ravenhill but for some reason everything went right for me.

"The Irish selectors were watching Ulster and came down to me afterwards: 'Your name is O'Driscoll . . . Have you any Irish qualifications?' I told them I was Irish born and got a final trial that year. Tommy (Kiernan) was Munster's full-back, so I wasn't going to make the Munster team, but I had a relative on my mother's side for Connacht."

In 1968, he was called up for the Five Nations Championship but spent the entire campaign, and the two that followed, watching from the bench. "In those days you had four subs: a scrum-half, a hooker, a utility forward and a utility back," he explains. "But for four years, none of the backs were injured."

In 1970, he finally wore green during the Tour to Argentina but the hosts were deemed as minnows and official caps were never awarded. His cousin, Frank, was also on that trip. "We had played trials together at Connacht," Barry says, "and I suppose at times it was between Frank and myself as to who would go on the bench.

"Frank was a gifted footballer. He had wonderful feet and was a dynamic little tackler and played wing and fly-half but I don't think he played full-back and I think that marginally swung it for me."

A year later, on January 30, 1971, Barry was selected in his usual position on the bench for the Five Nations opener against France at Lansdowne Road. His father had lost hope and travelled to Headingley to watch John in a schoolboy game but was sent sprinting to the pavilion to find a TV when the news hit from Dublin: 'Tom Kiernan had fractured his fibula just before half-time . . . Barry was on!'

He kicked two penalties in the 9-9 draw and experienced a thrill that has never left him: "It was indescribable really," he says. "I had been playing for 12 years and had finally worn the green shirt."

Florry travelled to Dublin for the game with England (a 9-6 defeat) and watched his son play at Murrayfield (a 17-5 win) and Cardiff (a 23-9 defeat). A year later, his son played on a team (the Northwest Counties) that beat the All Blacks.

"That was pretty much it for me," Barry says. "I was 31 years old and injured the next season and any attributes I had like speed were beginning to go. I was travelling over and back to Ireland and trying to build a practice and Dad was getting older so I finished."

He coached his club for a year, set up an Irish Exiles side, watched Gary play at Stonyhurst, and was slowly drawn to the corridors of power: Exiles rep at the IRFU; chairman of the IRFU Medical committee; Anti-Doping Commissioner at the IRB (now World rugby); World Cup Commissioner in Australia (2003), France (2007) and New Zealand (2011). "It was a big part of my life," he says, "and I enjoyed it."

But in the autumn of 2012, everything changed.

The man who wouldn't bend

I take smelling salts on the sideline. I insist to the medics that I'm good to go again. They run the protocol questions for suspected concussion.

'Where are you?'

'The Aviva."

'Who are you playing against?'

'France.'

'What's the score?'

Expecting the question, I've already looked at the scoreboard - knowing that if I nail it off quickly it will help me get back on.

'They've just got a try - it's thirteen all! Let me back on!'

- Brian O'Driscoll, 'The Test'

The interview has entered its second hour. Barry has reached for the folder and is guiding me through the story that has put his name in lights. It started in 2004 with a conference he attended in Zurich on concussion in sport. "Rugby weren't initially part of it," he says, "it was ice hockey and NFL and football. But we joined in 2004, and I was the IRB representative."

The rules were pretty clear back then. "When I first went to Zurich, anyone suspected of concussion in rugby was taken off the field and couldn't play for three weeks unless they were cleared by a neurologist or neurosurgeon. Then some research came through and showed that a six-day graded return was as good if you followed the steps religiously.

"The graded return was 24 hours of complete cognitive and physical rest and then you read and walk and trot. On the third day it becomes sports specific - the footballer kicks, the rugby player runs and passes. The next day is minor contact, the sixth day is full contact and on the seventh day you can play. But any sign, symptom or problem on any day and you go back to the day before.

"So, I came back with this from Zurich and we took it on and it was accepted by every sport in the world."

In 2008, he returned to Zurich again. "Everything we were learning - pretty well exclusively from the States - was bad news. There was no good news coming through about concussion in sport. The indications were that it could be a bigger risk in adolescents but four years later, what do rugby do? We bring in this five-minute rule and experiment with teenagers at the Junior World Cup in South Africa!"

Under the five-minute rule, or Pitch-Side Concussion Assessment (PSCA) as it is more formally known, any player who is suspected of having concussion has to be removed from the pitch for a five-minute assessment by the medical staff, who decide if he is fit to continue.

"Why was it introduced?" I ask.

"They reckoned, with a certain amount of justification," he says, "that doctors were under pressure from the coaches and that a lot of concussed players wouldn't admit to any symptoms and were staying on the field. And that was true. But we know that some of the symptoms may not arise for an hour, or even a day. And we know that if you exercise it will bring the symptoms on. So what use is a five-minute assessment in a dressing-room? What use is a player telling you the score or what his mother's name is? So I couldn't accept it."

In the autumn of 2012, a month after the new test had been introduced, O'Driscoll resigned in protest from the IRB. "I was on the doping panel, the disciplinary panel and the medical (committee) but you couldn't resign from one and not the other. And it wasn't a knee-jerk decision. I picked the brains of a lot people I value, and nobody said I was wrong."

Five months later, he watched Ireland play France in the Six Nations in Dublin and couldn't believe his eyes.

"You saw Brian going down?"

"Yeah."

"Where you there?"

"No, I watched it here on TV."

"And?"

"Well, the ironic thing about it was that the five-minute assessment wasn't in play - the Six Nations had spoken to me about it and turned it down. So I don't know why France didn't object because it was 13-all I think when he came back on?

"Yes it was."

"There were seven minutes to go and we had used all of our subs so the option wasn't there. But that's neither here not there because the point is that, in my view, he should never have gone back on."

"How difficult is it for doctors who love and work in sport to be doctors?"

"Very, very difficult. They've got coaches screaming at them 'Do a test! Do a test!' and every time there's a (George) Smith or an O'Driscoll (incident) the instructions are changed! After two years, they changed it back to the way it was during my tenure - any suspicion of concussion and the player is off and stays off. Great! We've won! But then they introduce a new category and change it again! Did you read the statement after the George North incident?"

"No," I reply.

"I have it here, somewhere . . ."

(He picks up his notes.)

"The World Rugby head injury protocol clearly states that a player should be immediately and permanently removed from the field of play where there are any visible symptoms or suspicion of a potential concussion.

"What on earth is that? Suspicion of a potential! Why are you doing the test?

"Surely it's because you've got a suspicion! And if you have that suspicion he's off and stays off. But now there's this new category that no other sport has ever used, or will ever use - suspicion of a potential! So we take the players off and do a ten-minute test! This is putting doctors at huge risk. They have no idea what they are meant to do."

He pauses for a moment and looks at me. The words have been firing from his mouth like a machine gun and he feels a need to explain himself. "I'm not getting emotional about it," he says. "I promise you, I'm level headed."

"You clearly are emotional," I observe.

"I'm annoyed about it," he says. "I'm annoyed at their meaningless statements, their platitudes. I've been vilified as a troublemaker and a guy on an ego trip and I'm upset that rugby people should say that about me. I didn't go looking for this. I didn't need it. I'm not in the ego-trip business. So I'm annoyed."

"Does what you've experienced have any bearing on your decision not to go to games any more?"

"That's a good question. I can't say, "Oh, if it wasn't for this I'd be there,' but it has definitely affected it."

"But ultimately you've done the right thing?"

"I've no doubt about that."

"And that's the bottom line?"

"Yeah, and nothing can change that but I don't know what the final outcome will be or how they can resolve this. I think they'll have to make some changes to the laws. I think parents are really worried about their kids playing the game."

"What would you say to those parents?"

"Well, I certainly wouldn't stop my grandkids from playing, because I think the advantages outweigh the disadvantages. But they've been given some very bad leadership at the elite level and that's got to stop. Because that's what's making everybody hesitate."

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