League of Denial: The NFL, Concussions and the Battle for Truth
Fainaru-Wada, M., & Fainaru, S., New York, NY: Crown Archetype (Random House LLC), 2013, 399 pages, $27.00 (hardcover), ISBN: 978-0-7704-3754-1, eISBN: 978-0-7704-3755-8.
For nearly a decade, the risk for, and actual incidence of, concussions and head injuries related to them has been a source of national discussion and dissension. The National Football League (NFL) studied the issue and, at first, concluded that insufficient evidence existed to call it a "problem." With the subsequent deaths of several relatively young retired NFL players, the autopsies of their brains, and the newly minted diagnosis chronic traumatic encephalopathy, we know the problem is real.
In this book, two investigative reporters from ESPN take a hard look at this health crisis. Beginning with early reports of isolated cases, the authors outline the road to today's realization that many, many professional athletes and, perhaps, equal or greater numbers of amateur athletes are at risk for traumatic brain injuries and that no amount of re-engineered, protective equipment can truly keep them safe. Although the book is harshly critical of the NFL and its early stance on football-related injuries, it does not spare selected members of the scientific and neurosciences community. At times, the book harkens back to the early public health crisis related to Big Tobacco and the long-term, devastating effects of smoking on the human pulmonary system and to some of the more recent discussions of steroid use in professional sports.
As a rabid football fan and a long-time neuroscience nurse, I have followed the public discussions and debates surrounding chronic traumatic encephalopathy for the past few years. These authors have written a masterful work that gives pause to much of what the football "public" believes is an acceptable part of the game. The narrative is thought-provoking and calls into question how healthcare professionals should or will respond to the growing evidence of football-engendered harm. This book is a must read.
Reviewed by V. Susan Carroll, MS RN-BC, Editor-in-Chief, Journal of Neuroscience Nursing.
ADHD Does Not Exist
Saul, R., New York, NY: HarperCollins, 2014, 312 pages, $25.99 (hardcover), ISBN: 978-0-06-226673-6).
Today, 11% of children and ~4% of adults in the United States are diagnosed with attention deficit hyperactivity disorder (ADHD); thousands of these individuals are prescribed stimulant medications. In this book, Dr. Richard Saul, a behavioral neurologist who is also board-certified in pediatrics, outlines his hypothesis that ADHD is not a single, all-encompassing disorder at all but, instead, that the symptoms of ADHD are the result of a wide spectrum of other, undiagnosed disorders that include vision problems, sleep disorders, substance abuse, learning disorders, and sensory processing disorders among others.
The book begins with a brief look back at the development of ADHD as a diagnosis, including the criteria included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (2013), and at the treatments for it. This introductory section outlines the monetary and lost productivity costs associated with the diagnosis as well. Each subsequent chapter addresses a particular set of signs and symptoms often identified as typical of ADHD. Chapters include a case history, a Big Point (a brief summary of salient definitions), clues to alternative diagnoses, and treatment plans. Dr. Saul often includes behavioral treatments and strategies rather than stimulant drugs in his treatment plans.
The book is targeted at nonhealthcare professional readers-patients, parents, teachers, and other care providers who struggle with the management of this diagnosis. Perhaps, most useful is the final chapter in which the author outlines ways to evaluate and manage symptoms. It also provides a different-less "medical treatment"-approach to caring for individuals with a variety of ADHD-like symptoms.
Reviewed by V. Susan Carroll, MS RN-BC, Editor-in-Chief, Journal of Neuroscience Nursing.