I believe all media is instructive. I know we (adults and children) learn about health care when watching (reruns) of ER, Scrubs, or Grey’s Anatomy nearly as much as we do from the nightly news, Dr Oz, or our newspapers. And although entertainment may not feel instructive, I know it is. Media, from what’s online, to what’s on the television, to what’s on your phone, to what’s in your Xbox, informs and instructs. I don’t care how you cut it, I believe that every second of media produced has the potential to make change and educate. That’s why I’m so pleased to have heard some news. The husband pointed out that ESPN announced last week that Madden NFL 12, a hugely popular video game (5 million copies sold of the last edition alone), is about to have some new rules. And a new role.

It turns out, Coach Madden (a giant in football) is really putting money where his mouth is, working to educate and make change. EA Sports announced that their newest version of Madden NFL (12) will now incorporate new rules surrounding concussions and play. The game, coming out August 2011 (regardless of player lockout) will emulate the real game. When a player gets a concussion, they are not only out for the remainder of the game, the announcers will explain that the player was removed because of the seriousness of head injuries. The new video game will also block the ability for players/avatars to make helmet-to-helmet tackles, dangerous headfirst tackling, and hits to the heads of defenseless players.

I don’t play football and I don’t play video games, but I do know that:

Coach Madden is a smart guy. He understands that to change culture around football, particularly around concussions, we have to approach it from all angles. It can’t just be the NFL Rules Committee or the pediatricians, or the neurosurgeons standing up and demanding we take concussions seriously for the benefit of the players. We have to join our football fans where they learn most: the places they play. Madden NFL 12 may help ambassador the difficult concept of being out for the day after a serious injury to the head.

I’m ecstatic. Understanding the mechanisms of play that lead to concussions (helmet to helmet tackles or headfirst tackles for example) while also understanding the severity of concussions (2nd hits can be fatal), will save lives and ultimately improve childrens’ expectations. Understanding the big guys are out for the remainder of the game will translate to pee-wees and those high school guys getting out more easily. We’ve got aggressive laws to help guide coaches here in Washington state, but these protections are not universal. Starting with the most popular video game is just another layer in changing players’, parents’ and coaches’ understanding of the risks. When it comes to video games, I think kids really are tuned in…

Changing The Concussion Culture of Football:

Dr Rich Ellenbogen, a neurosurgeon here at Children’s is pretty happy about the rules, too. He should know about this stuff, he co-chairs and advises the NFL committee on head injuries and concussion and works to protect players. When I heard about this I knew I had to get his take. When I talked with him today, I spent the majority of the conversation nodding my head. “What we do in the NFL really trickles down,” he says, “What we do shapes what happens in pee-wee football and up.”

He told me a story of his experience with Coach Madden. In February, when Dr Ellenbogen was presenting to the NFL Rules Committee– a group of coaches, owners, and managers (read: NFL big-wigs) who make rules in football–he was advising then on the new strict sideline exams to help evaluate players at risk for or those who have sustained a concussion. He said, “I mean, Coach Madden was fired up about this! He’s a safety fanatic.” Dr Ellenbogen went on to say, “Coach Madden wants to universalize this, protocolize this. He wants to keep players safe.” But more, Dr Ellenbogen explained that Coach Madden really understands what he needs to do to accomplish change; he needs to change the culture around football and head injuries. When they discussed regulations for players, Dr Ellenbogen said that Madden urged that in addition to taking players out of the game and putting them on the sideline, they needed to go farther embracing Dr Ellenbogen’s recommendations. To improve management of players’ risks from concussions and head injuries and to protect their brains after concussion from all the sideline noise, lights and stimulation of the game, he wants them off the field entirely. Getting them off the bench will not only improve recovery, but send a clear message that there is no way to finagle your way back on the field. When you’re out, you’re out. That’s when it’s time to prioritize their brains.

Dr Ellenbogen reminded me that NFL players, like pee-wee football players, and HS football stars, are their own worst enemy. The players are the ones that want to shake off a head injury to get back in the game. We parents, we coaches, we pediatricians, we neurosurgeons, and it turns out, we video-game makers, are responsible for protecting them. Teaching then early and often to avoid head-to-head tackle and to rest their brains after insult and concussion is the way to preserve health, future play, and quite possibly, the game itself.

As I said, I don’t play video games and I don’t play football. That’s my disclaimer in all this; I don’t know entirely what I’m talking about here, when talking about video games. This Geek Dad (from Wired) knows better, possibly. He confronts one major limitation of all this progress: Is it possible you can “switch off” injuries while playing? Feel free to correct any errors you see in my grasp of video games. Never really liked to play video games (outside of a weekend obsession one weekend on a ski trip with the video game “Paperboy” circa 1984 and another stretch with Super Mario Brothers one summer circa 1986 at my cousin’s home). But I may take a look at this one, later this year.

I’ll talk more in upcoming posts about my take with how media can take responsibility for education without losing entertainment value. And I’m still committed to doing a series on concussions in young athletes. But Dr Ellenbogen got me thinking. He mentioned that 62% of soldiers return from war with either PTSD or traumatic brain injury. Good grief! And we know concussions are on the rise in sports. So, the Army is learning a bit from the NFL in concussion management, sharing experiences of how to manage and prevent serious head injuries and the devastating complications. Can the gaming world follow this collaboration? Is is possible Madden NFL 12 could lead the video game world in a positive direction?  Will war games start to incorporate the realities of devastating head injury? Will soldier begin to be removed for a week after being within 50 yards of a blast from an IED like they are in real life?

Telling the truth in entertainment can only help. And I sincerely believe, it won’t hurt. I’m not entirely naive, just entirely hopeful. When games, when entertainment, and when dramatic television simply tells the truth while concurrently telling the story, they can improve our lives and our health. Let me just say, “Atta Boy, Madden NFL 12.” Way to tackle a real problem. And thanks Dr Ellenbogen, for helping me understand.