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A concussion is a blow to the head resulting in alteration or loss of consciousness. The key features are transient confusion, disorientation or other inappropriate behavior associated with amnesia for seconds to minutes to occasionally hours. Concussion is graded; alteration in behavior without loss of consciousness with full recovery within 15 minutes is the most mild (Grade 1). Any actual loss of consciousness (from seconds to minutes) is automatically Grade 3.

What actually happens to the brain is debated -- some think it's an electrical short-circuit in the brain stem and others think there is a microscopic tearing of axons (the long connecting arm of neurons) caused by shaking of the brain. There is no absolute answer to this.

In 1997 the American Academy of Neurology set out guidelines for the care of athletes experiencing concussion. After a brief Grade 3 concussion (seconds), a player must abstain from all contact sports until he is asymptomatic for one week. Following a second Grade 3 concussion, the athlete should be withheld from play for a minimum of one asymptomatic month.

A single concussion of this magnitude rarely, if ever, results in permanent brain damage. However, each additional concussion raises the odds of more serious sequella (permanent effects). The effect is cumulative, especially if two injuries occur within a short time period.

I am no longer a football fan, having seen too many long-term injuries sustained in the pursuit of transient glory. I am unfamiliar with the details of Steve Young's recent and prior head injuries; however my friends tell me that he has had several prior concussions. If so, he should not be allowed to continue. This is obviously a strong opinion, not based upon unequivocal proof or personal neurologic knowledge of his injuries. But more and more medical literature is pointing to the devastating long-term effects of repeated sports-incurred concussions.

Ask Dr. Bob Dr. Robert Burton, who is a neurologist and novelist, answers health questions every Monday in Salon Health & Body. Please e-mail your queries to him at AskDrBob@ salon.com.

Macho heroics are great. Ignorance of the consequences of such heroism isn't.

I am infamous for having a short and volatile temper. I try to keep it under wraps, but it seems to leak out in minor explosions. I'm not so bad that I've physically hurt anyone, destroyed valuables or had outbursts at work, but I am often cranky and irritable and sometimes I just have to vent.

Is my anger a product of biology, environment or, as I suspect, both? My father had an awful temper and my family life was filled with constant fighting. But I've tried so hard to work through this, talk about it with my therapist and my partner, etc., and I still feel this sense of inner rage constantly roiling within me. I also have this sense of enormous guilt because I so desperately do not want to be like my father. Could there be something biological that is causing my anger? I have recently been diagnosed with sleep apnea (I'm going to have surgery this winter) -- could this be the cause? Am I doomed to be a cantankerous demon the rest of my life?

Knowing whether a trait is primarily biological or acquired is both of great interest and presently of little value. In the end, the learned behavior of early childhood also becomes biological in the way that all patterns become neuronal circuitry. The question remains: Is there a way to change the circuits? "Clockwork Orange"? Cognitive therapy? Prison and jails? Skinner boxes (named for psychologist B.F. Skinner, who pioneered the concept of reprogramming behavior). I have even heard of therapists who videotape a patient's session in the hope of embarrassing him into change. I'm sure the embarrassment is easy to come by, but the change?

There are two parts to anger, your response and whatever provokes it. If you've had great trouble controlling the rage, how about considering the most provocative circumstances, and considering what you can change in them. Or if you can't change the circumstances, can you change the interpretation?

Next page | The opposite of anger isn't calm, it's laughter