We finally live in a world of widespread concussion awareness, and for that 17-year-old Abby Cahalan will give thanks on Thursday.
She learned about postconcussion syndrome the hard way — one pounding headache and dizzy spell at a time — and has spent the past four years redefining herself as an athlete and as a determined young woman bent on overcoming a debilitating physical obstacle that could have derailed her athletic dreams.
That's why there wasn't a dry eye on the Dulaney High girls cross country team when the senior qualified for this year's Class 4A state championship race, and why there really are times when finishing in the middle of the pack is as good as gold.
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If this were simply a story about a very promising youth soccer player who wouldn't give up on sports after suffering multiple concussions, it would be story enough for an uplifting Thankgiving week after-school special. But it is so much more than that.
It's about a kid who had trouble walking a single lap around the Dulaney track when she joined the team, but who still stood up at a Capitol Hill news conference four years ago to testify about the ravages of traumatic brain injury among youth athletes.
It's about a family that never gave up looking for answers when the headaches wouldn't go away and other concussion-related symptoms also made it difficult for Cahalan to focus in the classroom.
Perhaps most poignant, in a world where there are far more headlines about adolescent bullying than altruistic behavior, it's about a pair of track coaches and a group of young athletes who made sure there would be no loneliness for one fledgling long-distance runner.
By all accounts, Abby Cahalan was a very promising youth soccer and lacrosse player with a competitive streak that might have been her sneakiest opponent.
When she got knocked down, she kept getting up and going back out there, unaware that her brain was keeping count and the effects of the repeated concussions would eventually count her out of contact sports for good.
"We aren't clear on how many, to be exact, just because when I would get one I would keep playing through it,'' she said. "We were missing signs and symptoms that are so prevalent now. I came home with a headache, it went away the next day, I kept on playing. I think I had around five, and each additional concussion just added to the snowball effect."
Joyce and Jack Cahalan had no idea. They had brought up three young athletes. Abby's twin sister, Lauren, is a gymnast headed to Towson University next year. Her older brother, Joey, plays college soccer at Loyola. The occasional childhood bruise or bloody nose was just business as usual. Only relatively recently has it become clear how dangerous a series of seemingly mild concussions can be.
"The time frame is important, because this is when concussion awareness was still evolving,'' Joyce said. "For her age, the term concussion could be a little misleading because they were probably hits that jarred her brain and a lot of times it was disguised as a bloody nose, so the focus was on the nosebleed rather than what was behind the nosebleed."
It took a particularly nasty shot to the face and forehead with a weighted soccer ball to change everything.
Cahalan was playing a hybrid soccer game called futsal with her youth team in February 2008 when a defender moved out of the way and she could not react in time to a sharp pass. Of course, she shook it off and went back into the game, but this time, the symptoms didn't subside. The Cahalans embarked on what would be a long quest to figure out why she suffered flu-like symptoms after even light physical activity and suddenly had serious trouble with something as seemingly unrelated as reading comprehension.
It wasn't until they got an appointment with nationally known brain trauma expert Dr. Kevin Crutchfield at Sinai Hospital that they got their answer.
"Probably for the first three years, we were trying to put the pieces together,'' Cahalan said. "We went to multiple different places. No one could tell us why the symptoms were still there. ... Back then, they wouldn't even look at kids under 15 for concussions because they didn't think they were important enough or prevalent enough, but he took us in as a fit-in appointment, took a look at me and told me I had postconcussion syndrome. And that was a wonderful thing to hear."
Well, sort of. She finally had an explanation, but there would be no more contact sports — ever. The risk of a serious concussion with more consequences was just too great.
"I remember sitting in his office when he told me I couldn't play soccer anymore, and I was crying, and I remember him telling me I could run cross country,'' Cahalan said, "and I remember thinking, 'I don't want to run. Who wants to run?'"
Dr. Crutchfield looks back at that time and is as impressed as anyone at the way Cahalan accepted that challenge, but he is not surprised.