While hoping to be forgiven for the long delay, I do need to address the issue of Carlos Sainz’s return to competition after his accident in Sochi. Here’s my slant on the question.

Carlos’ accident was very violent; certainly it would be normal to expect at least some concussive symptoms (given that other physical injuries were ruled out). The short observation period followed by a quick release from the hospital were reassuring of course, but even concussed patients are not kept hospitalised (unless there’s another reason) just for these symptoms.

Once he (and the team) made clear that he wanted to race on Sunday, he had to be examined by both the circuit’s Chief Medical Officer and the FIA Medical Delegate. (Unfortunately, it would have been better to have had to have his accident in Austin, where the CMO is Dr. Steve Olvey, a world expert on concussion, especially in the motorsports environment.) This examination would include a thorough history, looking for subjective symptoms of concussion, as well as a detailed neurologic examination.

Carlos would also have had to re-take the ImPACT test, a computer-based neurocognitive battery specifically designed to detect concussion. All the drivers get tested pre-season (to supply baseline data); they are retested whenever concussion is suspected.

The ImPACT test consists of a number of subtests, each of which looks at a different aspect of brain function (visual memory, executive function, pattern recognition, etc). It’s crucial to note that the test starts with a review of SUBJECTIVE symptoms – a series of true false questions (“I slept well last night”, “I have a headache”).

My conclusion? I find it odd that Carlos failed to mention his dizziness pre-race to ANY MEDICAL STAFF AT THE CIRCUIT, including the CMO and the Medical Delegate, who unquestionably asked that specific question. And that he blabbed about it to the press almost immediately after alighting from his car. Let me repeat this: this kid denied symptoms to the people responsible for his care, got into his car, raced, then complained about not being well-taken care of.

HOW STUPID IS THAT?

One of the biggest problems with concussion is that many of its symptoms are subjective. That means they can be denied. As in all other walks of life, ultimate responsibility for one’s health and safety lie with oneself. If you’re stupid (or competitive, or just ignorant) enough to deny your symptoms when specifically asked by your doctor, you’d best have the maturity to deal with the consequences.

As much as the Medical Delegate’s lack of experience enrages me (and I can only assume that the Russian CMO was equally inexperienced, I give him a pass on this one. He was clearly dealing with a patient who was not mature (or honest) enough to respond accurately to the questions he was asked by his doctors.