Junior year, Melissa is voted team captain. But her game is off, and her grades drop. She fails tests and gets the first D of her life. She loses her car in parking lots. Once, on the way to class, she looks for the third floor of a two-story building. Another morning, she leans back in the shower and closes her eyes to let the water cascade down her face. She falls over. She never used to cry but finds herself weeping at McDonald's commercials. She's impatient, even nasty, when she doesn't mean to be. Her family notices her personality changes. Her younger brother says, She's such a bitch.
There's a day during senior year when Melissa realizes she can't see out of her left eye, although her vision soon returns. She's scared but doesn't want to say anything. Is she supposed to tell the world she can't find her classrooms? Melissa starts to wonder if she has a brain tumor.
During halftime of a game, it happens again -- she's zoning in and out, her eyes blurry. The familiar rush has become her enemy. Her adrenaline-fueled heart still pushes her to play, but now, as the blood rushes through her skull, her head pounds with pain. Her hands find her knees. She vomits, again and again.
Her boyfriend, Joe, waits outside the bathroom. "Enough is enough," he says. He tells Melissa's coach, too. That week, Melissa's grandmother drives her to see Jill Brooks, a clinical neuropsychologist at Robert Wood Johnson Medical School in New Brunswick, N.J. She stays for six hours.
"Is light bothering you?" Brooks asks. "Have you noticed changes in your personality?"
For the first time in two years, someone has noticed that Melissa has a range of postconcussion symptoms. She's not out of her mind, she doesn't have a brain tumor. But she does have brain damage.
A neurologist hands Melissa a paper filled with squiggles from an electroencephalogram. The left side of her brain is abnormal and probably has been since that sophomore-year concussion. She realizes that most of what she thought she knew about concussions was wrong. They often don't appear on CT scans or MRIs. You don't even need to be knocked out to get one. But if you return to play before the brain heals from the initial trauma, every subsequent blow adds to its injury. Melissa's head was like an egg that scrambled without ever cracking.
She tells her family, and her father sobs, wishing he'd done more. She redshirts but will never play competitive soccer again. She accepts note-taking help from classmates and attends extra study sessions to deal with her short-term memory problems. Working with Brooks, she develops methods to associate words with pictures -- new ways of retaining information.
Most important, Melissa learns that she is not alone. In sports played by both women and men, women sustain more concussions. The girls' concussion rate in high school soccer is 68 percent higher than for boys. And it's nearly triple the boys' rate in high school basketball, according to research by scientists at Ohio State, Nationwide Children's Hospital in Columbus, Ohio, and the NCAA. Other studies reveal similar differences between softball and baseball, in college sports as well as high school. Yet researchers, including Brooks, find that female athletes get less information than males about concussions from all sources, including coaches, trainers and the media. Generally, women athletes don't consider concussions a serious phenomenon.