Head games: Seeking consensus on concussion

Resurrecting a community game plan on baseline testing and head injury protocol could improve treatment, therapists say.

Four days completely gone.

“I didn’t know what happened to me,” Ethan McLeod said. “I thought I had COVID.”

Nope. Just a broken face — and a traumatic brain injury.

After he crashed while downhill skiing at Grand Targhee Resort in Alta on Jan. 9, 2022, McLeod, 27, was lifeflighted to Eastern Idaho Regional Medical Center in Idaho Falls. But no one knew who he was. He’d been skiing alone and left his ID in his car.

Friends finally tracked him down and alerted his parents in Boise, Idaho. A doctor offered to do the facial reconstruction surgery that McLeod needed, but he’d never done it before, McLeod said.

So McLeod was flown to the University of Utah Medical Center in Salt Lake City. That’s where he regained consciousness — a tube doing his breathing for him, his jaw wired shut — on Jan. 13, 2022. And that’s where he had the surgery to put his face back together.

The best he can figure more than a year later is that he hit a tree after skiing somewhat recklessly that day. Someone found him there, at the base of a tree. He thinks he’d been there for at least 15 minutes.

McLeod is one of the lucky ones.

According to the Centers for Dis-

By Mark Baker

ease Control and Prevention, about 1.5 million Americans sustain traumatic brain injuries annually and about 230,000 of them are hospitalized. Of those, about 50,000 people die each year from their injuries.

But not everyone who hits their head skiing or playing hockey or just falling down the stairs at home gets medical care. Many are not even sure what happened. They’ve simply sustained a concussion, which is a type of traumatic brain inury that happens when the head and brain move rapidly back and forth.

About 1.6 million to 3.8 million Americans sustain a sports- and recreation-related concussion annually, according to the CDC.

And when it comes to contact sports, dealing with concussions and concussion protocol and managing symptoms and treatment is an inexact science that continues to evolve, especially in a place as active as Jackson Hole.

From downhill skiing to ice hockey to mountain biking, not to mention youth and high school sports such as football and soccer, there’s no shortage of opportunities for the human skull to come in contact with the ground, the ice or another athlete.

But how do you lower the risk? Should kids not play contact sports?

Should a concussion signal an automatic end to a player’s season?

“The sport isn’t the problem,” said Hayden Hilke, owner of Peak Physical Therapy in Wilson. “It’s how we manage these incidents and these injuries.”

Hilke also runs Watershed Jackson, a nonprofit organization that aims to raise awareness regarding area athletes who have sustained spinal cord or traumatic brain injuries. He and other stakeholders thought they had a solution back in 2019 to lower the concussion rate and generally improve outcomes, by providing annual concussion baseline-testing and introducing a concussion management plan via medical providers, St. John’s Health, physical therapists and the Teton County School District, among others.

But then came the pandemic.

“We were just gaining momentum, and then the bottom fell out,” Hilke said.

In November 2019, Hilke spearheaded a concussion baseline screening night at Snow King Sports and Events Center, uniting medical providers, physical therapists, speech-language pathologists and St. John’s Health to build a community plan around concussion protocol.

Youth athletes from Jackson Youth Hockey and the Jackson Hole Ski and Snowboard Club, among others, received baseline tests that measure brain function, which can later help diagnose concussions through comparative testing.

A few months before that evening at Snow King a newly formed concussion support group met in a common area of St. John’s Health. Chris Smithwick, a speech-language pathologist with Teton Physical Therapy and Rehabilitation who would later choose the tests for that baseline screening night, and Oliver Goss, a St. John’s social worker, organized the group.

About eight people showed for that first monthly group in the spring of 2019, Smithwick said. But it lasted only around five months, he said, as attendance tapered.

“I’ve been asking myself, ‘Why did that happen?’” Smithwick said earlier this month.

Summer came and people got busy. It’s hard to push through summertime traffic to get to a late-afternoon meeting on the east side of Jackson. Maybe the meetings needed to be held more often?

Whatever it was, Smithwick and fellow Teton Physical Therapy therapist Margaret Blair put in countless volunteer hours developing the baseline testing program, said Lindsay Love, director of rehabilitation at