Opinion

The legitimate concerns about Hillary’s concussion

Karl Rove created a stir with his recent suggestion that former Secretary of State Hillary Rodham Clinton may have suffered traumatic brain injury in December 2012.

Speaking at a conference in California, he noted, “Thirty days in the hospital? And when she reappears, she’s wearing glasses that are only for people who have traumatic brain injury? We need to know what’s up with that.”

Let’s ignore the media hyperventilating and look at what Rove actually suggested.

According to the National Institute of Neurological Disorders and Stroke, traumatic brain injury, or TBI, “occurs when a sudden trauma causes damage to the brain.”

Clinton reportedly “fainted, fell and banged her head,” as The Daily Beast put it, suffering a subdural hematoma, or a hemorrhage between her brain and skull.

While surgery is sometimes needed in such cases, Clinton was “treated with blood thinners on Monday at a New York hospital to help dissolve a blood clot in her head,” CNN reported.

What is the prognosis after TBI?

“Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the individual,” says the NINDS.

And following TBI, “common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste and smell), communication (expression and understanding).”

In other words, Rove raises legitimate concerns: Such disabilities would be of great concern in a potential commander in chief.

Rove didn’t have it quite right on Clinton’s eyeglasses: She has Fresnel prism glasses, used to correct double vision, but not only for TBI cases.

Still, according to the Neuro-Optometric Rehabilitation Association, “It is not uncommon for a visual field loss to occur as a result of a CVA or traumatic brain injury.”

Indeed, over a third of TBI patients have visual field defects.

If Clinton suffered vision loss after her injury, could she have also suffered other disabilities — specifically in the areas of cognition or communication?

That’s what Rove is questioning. Not accusing, but wanting assurance that Clinton’s mental facilities are up to the job she’ll presumably be seeking come 2016.

Is it beyond the pale to question Clinton’s injury and long-term effects?

Well, countless media outlets had no problem questioning John McCain’s health and age when he was running for president. Or Bob Dole’s when he was running.

Clinton didn’t just bump her head. Her husband said last week that her injury was “a terrible concussion that required six months of very serious work to get over.”

That is indeed a long recovery — much longer than the State Department suggested at the time.

Where else have we heard about the long-term effects of concussions? In NFL players, there is justified concern about the consequences of concussions.

Clinical depression and cognitive impairment are three to five times more likely in players who suffered concussions. Ask Broadway Joe: Namath has blamed some of his own health issues on on-field concussions.

President Obama is sufficiently concerned about youth sports concussions that he is hosting a summit to address the issue.

Last year he told The New Republic, “‘I’m a big football fan, but I have to tell you if I had a son, I’d have to think long and hard before I let him play football.”

How does he feel about a hypothetical sister named Hillary, who already suffered “a terrible concussion,” succeeding him in the Oval Office?

Rove raises legitimate concerns.

Will the media, in the interests of disclosure and transparency, make sure Clinton’s injury and potential long-term consequences are disclosed and analyzed? Or will they ignore the story, blame the messenger and adopt Clinton’s response, “What difference does it make?”?

Brian C. Joondeph, MD, MPS, is a Denver-based physician.