Scott Ramsay receives his PhD in nursing from UBC this week, with his focus on concussions in youth. And, on some level, he was one of his own case studies.
Ramsay, 32, was a bruising, stay-at-home defenceman in the WHL for four seasons, a 6-foot-2, 218 pounder who split time between the Chilliwack Bruins, Seattle Thunderbirds and Medicine Hat Tigers.
The Abbotsford product was regarded highly enough that he was a free-agent invite by the Anaheim Ducks for the 2010 Young Stars tournament in Penticton.
He had to retire from the game after the 2010-11 season, the victim of five concussions. He was 19 years old.
He received a concussion during a fight with Tayler Jordan of the Canucks at Young Stars on Sept. 15, 2010, the back of his head hitting the ice as the bout came to an end. He played his first WHL game that season with Thunderbirds on Nov. 15, against the Vancouver Giants at the Pacific Coliseum, cleared by doctors and told that he was fine to play.
“My mom came down after the game and she said, ‘You need to go tell your trainer right now that you’re not OK, because I just watched you play a full game and you look like a skeleton of yourself,’” Ramsay recalled. “And she was right. I would look up and the score clock was spinning. It was horrific.”
He went to school after hockey, studied nursing and wound up with a job at B.C. Children’s Hospital. He was based in the emergency room as part of his training and “and we kept getting these kids who would get concussions and they had no education and that had me thinking, ‘What’s going on here?’”
He eventually moved to the outpatient neurology clinic there, where they treat more complex concussion situations, with patients who are usually six months past their initial diagnosis.
“I remember this one kid so vividly. Sunglasses on, not able to leave his room, blinds drawn, pitch black,” Ramsay said. “All I could think about was when I had my post-concussion syndrome. I’d be sitting on the couch, my sunglasses on, not able to do anything. It was just so debilitating.”
That brings us back around to his dissertation. He looked at just under 23,000 cases across the province of children and youth (ages 5-18) who were diagnosed with concussions in 2016-17. He said that just under 20 per cent had a timely followup visit with a doctor — defined by Ramsay as a followup within the first month of their injury — and just over 75 per cent had “no followup at all.”
“That’s not a small sample size. We’re not talking 50 kids. We’re talking 10s of 1,000s of kids,” said Ramsay. “On descriptive statistics alone, it’s pretty mind boggling to think that so many kids are affected just in B.C. alone.”
His study found that if you were from a lower socioeconomic status, you were less likely to have that timely followup.
“It speaks to something about the system in general. It says that these kids are seen and then left to their own devices if they don’t have a good family physician or someone to advocate for them,” Ramsay said. “I see it and I work in it every day and it frustrates me.
“I spend major parts of my day doing primary care and trying to find people family doctors.”
Ramsay’s study also found that if you had a delayed followup or no follow up your odds of having persistent post concussion symptoms “were basically double.”
“That’s telling us that there’s a way to prevent these symptoms from occurring in this population and we’re doing nothing about it,” he explained. “As someone who has lived it and tried to advocate for it at multiple levels, it’s disappointing. I spend a lot of time giving people insights into education and what resources are available and what steps to take. I’m hoping that my next stepping-stone in my career can allow me to do more for this population.”
He believes that much of this is tied to how society still views a concussion as an “invisible injury,” unlike when someone has a cast or needs to use crutches.
He also says that “sports is the obvious one, but I can’t tell you how much I deal outside of sports as well. Because people aren’t trying to get back to a sport, there’s even less resources available.”
“In other areas of health care, the research is really great,” Ramsay continued. “In concussions, there’s a lot of simple care and research that we don’t do that could enhance people’s lives. From a disciplinary perspective and being a nurse, I think I see things differently than other health care providers. I’m going to try to help those populations that are marginalized and don’t have access to care or understudied.”
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