In the fall of 1990, Pittsburgh Steelers coach Chuck Noll was informed that because of a concussion, his starting quarterback, Bubby Brister, should not play that week in an upcoming game against the Dallas Cowboys.
Since Bubby appeared perfectly normal, Coach Noll forcefully challenged the decision and announced he wanted objective criteria, not nonevidenced-based guidelines, to determine timing in return to play.
With this directive, Dr. Mark Lovell and I developed the evidence-based ImPACT neurocognitive test, which accurately assesses memory, cognition and brain processing speed. It has become the standard of care at all levels of contact sports for baseline and post-concussion testing before returning to play. More than 20 million athletes and accident victims have now been evaluated with this instrument — thanks to Coach Noll.
In September 2000, several years before the test was generally accepted, I introduced Dr. Lovell and his associate, Dr. Michael Collins, to Dr. Freddie Fu. Dr. Fu immediately grasped the significance of the innovative work and virtually on the spot recruited and subsequently hired both amazingly talented neuropsychologists into the department of orthopedics. His incredible vision resulted in the first concussion prevention and evaluation program to be embedded in a sports medicine clinic, one now acknowledged internationally.
It is said giant oaks from small acorns grow. Since Dr. Fu, who died Sept. 24 at age 70, planted the seed for the UPMC Sports Medicine Concussion Program, more than 10,000 patients with concussions from sports-related and other traumatic accidents are evaluated annually by six full-time neuropsychologists and a staff of 30 faculty in the program, the largest in the country.
With support also from the Chuck Noll Foundation for Brain Injury Research, initiated by Art Rooney in honor of Coach Noll, more than 400 peer-reviewed scientific papers have been published, and hundreds of scientific presentations and fellowships in sports medicine have been given.
Although Dr. Fu’s contributions are enumerable, few recognize his impact on the prevention and management of brain injuries from sports. It was his vision to enjoin in one facility all the right neurological experts and then provide the resources for optimal rehabilitation, not just for knees, but also for injured brains.
The initiation and founding of the UPMC Sports Medicine Concussion Program is a legacy that will continue to live long beyond the sad passing of a dear friend and colleague and one of the most creative, energetic, industrious and visionary physicians in the history of sports medicine.
Joseph C. Maroon, M.D., is a clinical professor in the Department of Neurosurgery and the Heindl Scholar in Neuroscience at the University of Pittsburgh Medical Center, a neurosurgical consultant to the Pittsburgh Steelers, and chairman of the Scientific Advisory Board for the Chuck Noll Foundation for Brain Injury Research.
