Friday 19 October 2018

Neutral doctors the best cure for dirty tricks

Talking Point

Rob Kearney speaks with referee Nigel Owens while France’s Matthieu Jalibert receives medical treatment. Photo: Sportsfile
Rob Kearney speaks with referee Nigel Owens while France’s Matthieu Jalibert receives medical treatment. Photo: Sportsfile
Neil Francis

Neil Francis

I still have no clear recollection of leaving the Centre Hospitalier de Bretagne Sud other than the fact that I struggled with the sunshine in my eyes as soon as I left the hospital. I also asked for the music to be turned off in the car - it wasn't what Plastic Bertrand was singing, it was just that the noise aggravated my still-delicate disposition.

Two days in hospital with a serious concussion - even the walk to the car presented problems. The medical care had been excellent - the French nurses one more beautiful than the other (am I allowed to say that anymore?). The neurologist was fairly direct: "Take the whole summer off."

Jimmy Davidson comes to my room at the hotel a few hours later and informs me that I would be playing a few days later against the French Barbarians in La Rochelle. I had just played in two non-cap Test matches against France and this would be my fourth straight match in two weeks.

I had been selected, the team would be announced in the morning and I would train with the team in the morning. There was nothing wrong with me and I should just get out and play - shrug these things off. I wasn't in a position to argue and when Davidson left the room he was convinced that I would be playing that Saturday.

When I informed the medical team, they were aghast and could not believe what was happening. A quick and forceful meeting with the Ireland coach and my name was immediately withdrawn. This madness - well, it was Davidson's test of character for me!

I always had implicit faith and trust in all of the medical staff at the highest level in my time at international level.

Altruistic

The people charged with health have a huge responsibility to you and the duty of care to any player goes far beyond an altruistic and vocational interest. Your life is in their hands. For something as serious as concussion, you draw the line at the first warning sign. I had to have trust that the medics would do the right thing here.

Last Saturday was an ignominious day in the affairs of the game of rugby union. There can be no blurred lines when it comes to the safety of players, nor can there be any circumvention of concussion protocols or abuse of process.

Anybody who commits an action which taints the integrity of the protocols - there must be serious consequences. The role that medical people play in our game is sacrosanct - any corruption, dilution or unwarranted interference cannot be permitted.

A while ago I wrote a piece for the Sunday Independent outlining a situation where a player that I knew had been concussed six days previously and was passed fit to play on the following Saturday. The wigs were all over the place. "You cannot make an accusation against this club side's medical team alleging that they knew he was still suffering from concussion but allowed him to play anyway."

It happens! It happens now all the time in professional sport and if we the Press call it, we risk significant damages for calling the doctor's reputation into disrepute. That player played in the match and had a truly dreadful afternoon. He was not right.

This season during a play-off game in the NFL, Cam Newton, the Carolina Panthers quarterback, got smashed with a head shot and was down on the ground for a few minutes. As he went off the pitch, he fell over and had to be assisted to the touchline.

The NFL has an independent doctor (a neurologist) at every game. Newton, however, did not meet with the independent doctor, he instead met with the team doctor and sure enough was back out on the pitch to complete the game.

In my view, this was an abuse of process which put the quarterback's safety at risk. Last Saturday we had an abuse of process where safety of a player was not compromised but the damage to the integrity of the game was irreparable.

We all saw what happened and what didn't happen. Over the weekend there were four serious knee injuries sustained by players in the Championship. Ben Youngs damaged his knee and was hit while in possession - no HIA required.

Josh van der Flier had pretty much the same thing happen to him when he damaged his knee in contact - no HIA required. Antoine Jalibert and Antoine Dupont both hurt their knees against Ireland - Jalibert in contact and Dupont before contact. Neither player suffered a concussion or had cause to warrant a HIA. We know why!

It is part of the same feckless thinking that brought about the situation of the Harlequins v Leinster 'Bloodgate' incident. Our best place kicker is off the field, the only way we can get him back on is by way of a blood replacement. Hey ho, magic up a blood injury - it solves a problem.

In World Rugby's document on concussion, there are 11 signs of concussion where a player must be removed from the field - everything from loss of consciousness, ataxia, balance disturbance, convulsions to confusion. Dupont and Jalibert exhibited none of these symptoms and so you have to ask questions as why they were given HIAs when, patently, they weren't required.

The French have previous here, when they beat Wales last season in Paris and they won in the end on a scrummaging-fest. Uini Atonio, the extra-large but useless scrummager, received an unnecessary HIA which allowed the very strong and renowned scrummager Rabah Slimani back onto the field. Nobody died but Wales lost because Slimani made the difference in those last few scrums on the Welsh line.

When Antoine Dupont went down on Saturday, Paul Williams, the assistant referee, notified Nigel Owens: "I think he got a bump to the head." Owens stopped play and pointed to his own head to signify a head contact. There is confusion at this point.

Owens goes in for a closer look and states to the French doctor Phillipe Turbin and the French physio Bertrand Garet that the injury is in fact a knee injury.

"No HIA, just a knee injury," states Owens. Garet agrees with the Welshman and Dupont is taken hobbling from the field. Thomas Charabas, a French referee and a medical intern who is the fourth official, comes to the side-line and informs Owens that Dupont is to have a HIA.

Charabas informs Owens that this is the decision of the independent match doctor and consequently Owens does not follow through on any suspicions that he might have.

The independent match doctor is Gilles Garet, vice-chairman of the French rugby federation medical team and the father of Bertrand Garet, the French team physio, who is helping Dupont off the park.

I'll leave you to draw your own conclusions.

Footage

Garet senior was pitchside and has access to footage just like the TMO does and he can review and assess with the help of a TV assistant. Dupont was down long enough for Garet to reassess the situation several times. That re-assessment never happened. Was Garet in charge last season for the Welsh game?

Nobody's life was put in danger. Nobody was sent back out onto the park when they were not fit to rejoin the game.

What happened though was a fundamental abuse of process. Dr Wendy Chapman, the Harlequins team doctor, and Steph Brennan, the Harlequins physio, received heavy sanction for complicity in the 'Bloodgate' affair. We await Roger Marris and his committee's report through Alligin (UK) Ltd, a company charged with HIA review cases. On this one I will be holding my breath.

Lest we feel complacent on this matter. Dr Ger O'Connor and Dr John Ryan will be doing the Italian, Welsh and Scottish games at the Aviva. Both men's reputations and bona fides are beyond reproach but given the situation I think it is time to bring in a truly independent doctor from another nation - n'est-ce pas?

Irish Independent

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