In the front row of Memorial Stadium's wheelchair section, Adrian Regier could feel and hear the crowd's sudden roar — a sure sign his beloved Cornhuskers had scored again.
Adrian's dad, Ron, played the role of personal play-by-play announcer for his blind and severely disabled son, leaning toward his ear to describe how the Husker running back had plowed into the end zone.
You wouldn't know it to look at Adrian Regier today, but there was a time when he knew what it felt like to run with a football under his arm, to plunge recklessly into the line.
He once played for the eight-man team at Madrid Wheatland High School in southwestern Nebraska.
But that was before the evening in September 1997 when a simple blow to the head left him with a catastrophic brain injury, stealing his life's promise and thrusting his parents into the roles of around-the-clock caregivers.
Adrian Regier had become a victim of second-impact syndrome, the rare but sometimes all-too-real outcome when a concussion is ignored or not properly treated. It's the kind of injury that makes heightened focus on concussion prevention and treatment long overdue.
“These kids today need a stronger vision of what can happen if they don't step out when they get a concussion — even a slight concussion,'' Ron Regier said as he massaged his son's stiffened limbs. “This is what it looks like if you don't heed that warning.''
Second-impact syndrome can occur when a person 21 or younger suffers a second blow to the head after a previous concussion has not fully or properly healed. The second blow does not even need to be a severe one.
Blood rushes to the brain, which begins to swell uncontrollably, pressure critically building within the skull. The result is almost always death or devastating, disabling injuries.
The syndrome is indeed rare, with fewer than 100 cases documented in medical literature. The National Center for Catastrophic Sport Injury Research, however, has recorded 172 catastrophic brain injuries in American football since 1984, including many cases consistent with the syndrome.
Nebraska has seen its share. Advocates for the brain-injured can count at least nine young football players who have suffered severe brain injuries since 1995. Several of the injuries followed earlier concussions.
“I was a gladiator — I didn't think I could be touched,'' Brady Beran said, recalling his attitude toward head trauma as a football player at Lincoln East High School.
That was before the second-impact injury that nearly killed him in 2004, leaving him with lasting disabilities.
For reasons not entirely clear, catastrophic injuries such as those to Adrian Regier and Brady Beran produced little change in the culture surrounding football and concussions or the treatment of such injuries.
It took the more recent cases of high-profile National Football League veterans linked to an equally rare dementia-causing disease for the world to take notice of the dangers of repeated concussions.
Now concussion awareness is rising at all levels of football. Laws in Nebraska, Iowa and many other states aim to keep youth athletes off the field after a concussion, until they've been cleared by a doctor. And neurocognitive testing designed to reveal whether the brain has healed has often become a standard part of recovery.
Critical to proper concussion management, experts say, is recognizing the seriousness of head trauma in the first place. Young athletes must understand the dangers of trying to play through a head injury.
Said Lincoln athletic trainer Dave Schultz: “Unfortunately, these kids who go out and play with symptoms don't realize how close to the edge they get.''
When Adrian Regier suffered a concussion early in the 1997 season, it didn't seem a huge deal. After all, he had suffered as many as five the previous season.
Not much was known then about how serious a concussion was or how long it took to heal.
“Let the pain be your guide,'' the doctor had told Adrian's family after one brain injury.
Free of headaches, the 17-year-old was back on the field two weeks later. He was blocking on a punt return when he was felled by a seemingly minor hit to the head.
He was flown to Lincoln and plunged into an ice bath in an attempt to reduce his brain's swelling. He spent three months in a coma.
Regier became one of the first documented survivors of a second-impact injury. But the results were devastating. The three-sport athlete, trumpet player and good student was left a quadriplegic, trapped in a rigid body.
Today, Regier, 33, communicates with his parents mostly by blinking his eyes or sticking out his tongue. It's not known exactly how aware Regier is of his surroundings.
But cognitively, he knows what happened to him, his parents say, and he doesn't want to see it happen to any more football players.
“People need to know how long it takes a brain to heal,'' said his mother, Lorie Regier. “It might be two or three weeks, or maybe they shouldn't play again. People need to understand the risks.''
In September 2004, Brady Beran didn't tell anyone about the concussion he apparently had suffered in the first half of Lincoln East's game against archrival Lincoln Southeast. But the signs were there.
A friend thought something was wrong when Beran didn't give a high-five after the friend made a kick. When another friend gave him a pat on the head at halftime, Beran told him, “Don't do that. I'm tired.''
But the hard-nosed Beran went out to play the second half as if nothing were wrong. After taking a helmet-to-helmet hit on a kickoff, he walked to the sideline and sat on the bench. Then he collapsed.
Later that night, doctors removed part of his skull to relieve the swelling in his brain, a treatment that had become common in the years since Regier's injury. It may have saved Beran's life.
Beran emerged from a five-week coma unable to walk, talk or feed himself. He was reading at a kindergarten level.
Only through years of grueling physical therapy was he able to put his life back together.
He eventually graduated from high school and then the University of Nebraska-Lincoln. Last year he married a woman he met at his church. He credits the prayers of others for his recovery.
Today he still walks with a limp and needs special prism glasses to keep from seeing double, but that doesn't stop Beran, 26, from working as an activities aide at an assisted-living facility in Lincoln.
Two years ago, Beran joined with the Regier family in lobbying for passage in the Nebraska Legislature of the Concussion Awareness Act, the state's concussion law.
Both families are heartened to see how far concussion care has come.
Beran still often speaks to groups about his experience, and his message to young football players is a simple one.
If you have a concussion or you think your teammate has a concussion, let the coach know. No football game, no matter how big, is worth the risk.
Scientists cautious about link to disease
A recent PBS documentary on football and concussions could leave the impression that the sport faces an epidemic of chronic traumatic encephalopathy, a serious degenerative brain disease.
“I'm really wondering, on some level, if every single football player doesn't have this,'' a Boston University researcher says in “League of Denial.''
Many experts, however, say such speculation runs far ahead of the current scientific consensus on CTE.
Some 90 deceased football players have been found to have suffered from CTE, a disease causing dementia that has long been linked to boxers. But that's out of millions who have played competitive football, including thousands as professionals.
“There certainly seems to be a correlation with repeated head trauma (and CTE), but there's a missing link in all of this,'' Dr. Brian Hainline, the NCAA's chief medical officer and point man on concussions, told The World-Herald.
Most of the brains of football players found to have CTE were studied because the men had died after exhibiting symptoms of the disease. That selectivity makes it impossible to determine the true frequency of the disease among football players, Hainline and others say.
“The research is seriously flawed,'' said Dennis Molfese, director of the University of Nebraska-Lincoln's Center for Brain, Biology and Behavior. “The question is 'If you went out and took a random collection of brains (of football players), would you find something similar?' ”
An international panel of concussion experts last year concluded that it's still only speculative that repeated concussions cause CTE. Just the sheer number of people who have played football for years without showing signs of CTE suggests that it takes something besides head trauma — perhaps a genetic disposition — to bring on the disease, Hainline said.
“That head trauma may not be enough,'' Hainline said. “Maybe it's head trauma and something else — and it may be just something else.''