It's fall. The air is brisk, edged with winter. Streets are checkered with yellow and orange leaves.

And each week, beneath Friday night lights, parents and students across America gather in bleachers and stands overlooking a grassy field of play. The excitement is palatable.

However, behind the patina of school spirit and the intensity of the weekly football contests is a reality that often goes unspoken.

For all of the approbation heaped on those young high school athletes (1.2 million suit up annually) there is risk. How could there not be? Football is a hard contact sport. The uniform includes multiple pads and a polycarbonate alloy helmet designed to protect the head. There's risk to still developing knees, ankles, shoulders and spinal cords, the most insidious being a concussion, often a stealth injury, chronically underreported and one that can have life-altering implications for young players.

Football has the highest rate of concussions in high school sports.

A concussion occurs when a player is hit hard enough to slam the brain into the skull. Players may refer to it as getting your bell rung. When pressed to describe their symptoms more specifically, they say they feel dizzy and may have impaired vision and experience nausea and headaches. Depending on the severity of the concussion, these symptoms can be followed by lethargy, sleepiness, irritability, loss of concentration and even a drop in schoolwork performance.

According to a New York Times report, when players are asked if they have ever had the above symptoms during a game (without using the word concussion), almost 50 percent answer in the affirmative. When asked if they reported their symptoms to their coach, most say no. Why? Because these young athletes adhere to the warrior code, they take pride in playing through pain, in being there for the team, in making the sacrifice. They suck it up and carry on.

A study conducted between 2005 and 2008 found that 41 percent of concussed athletes in 100 high schools across America returned to play too soon.

Of course, a banged up knee or ankle is immediately discernible; however, a concussion is not, unless the player understands the full import of what has happened. Usually the symptoms will pass, often within minutes. The headache will lessen, fuzzy vision will clear, and the player will assume all is well and insist on staying in the game.

The problem is that the brain has sustained a trauma that will take time to heal. Players who are concussed should automatically be benched and evaluated by a certified athletic trainer or team physician. Otherwise, if the concussion is allowed to go unevaluated and the player returns to the field, the consequences can be tragic. What is in play is a phenomenon called second impact syndrome. If a second trauma to the head is sustained, even one considered inconsequential, when taken in the aggregate, the results can be serious and potentially life threatening. Physiologically, a concussion can be a ticking time bomb.

There is a subtext to high school football that is rarely debated and a set of assumptions we all take for granted. Nevertheless, the question begged is this: Is high school football too dangerous for our young people? Adolescents are still growing and developing. Irreparable damage can be done not only to their brains but to their bones and joints. It is one thing to watch grown men play football, a sport that involves an unparalleled level of violence. It is another to support and encourage young people to do the same.

Is it unimaginable to think of high school in the fall without football games and pep rallies and homecoming? Without players wearing big-numbered jerseys in the hallway, absent Friday night excitement as the school readies to crush the Crusaders? The answer is an all-but-certain yes. This ritual is far too deeply imbedded in our culture.

But there's another reality that too often slips under the radar, and that's of the athlete standing on the sideline, leaning on crutches, his leg in a knee brace, his season over. Or the young player who lied about his second or third concussion and now can't concentrate well enough to finish his math assignments.

So, what's the answer? Athletes who play contact sports, include soccer and basketball, must be counseled repeatedly, with all seriousness, to self-report an injury to the head that results in any of the symptoms mentioned. To play on, despite dizziness or impaired vision or a headache, to adhere to the play-through-pain code, is to make a sacrifice for the team that can have tragic and unintended consequences.

Chris Honoré's reviews appear weekly in Revels.

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