Football could learn from Tomlin's choice

Ryan Clark believes the organs that could be affected were already removed after the last time — when they took his spleen and gallbladder — he lost 30 pounds and nearly died. He has worked out in the altitude since then without problem. Doctors cleared him this time, too, without guarantees.

And the Steelers had already devised a plan of in-game IVs and other measures to make sure it all didn't happen to Clark again the next time they played in Denver.

That's what made it all the more amazing this week when Pittsburgh coach Mike Tomlin told Clark he wouldn't be playing Sunday against Tim Tebow and the Broncos in the playoffs.

"I informed him that I'm not going to allow him to play," Tomlin said. "For obvious reasons."

Obvious? Some people are calling Tomlin's decision a "no brainer." The problem is, in football — and in some other sports, too — they don't always use their brains. They bash them into mush instead. It is done by culture, by code.

Tomlin did not do the obvious here, benching Clark in a playoff game to avoid a longshot risk of another attack related to his sickle cell trait. Tomlin did what he should have done, but what hardly anyone else would have done.

Tomlin is a hero. And while everyone will be watching Tebow on Sunday, the most intriguing player there will be in street clothes, standing on the sideline.

Medical issues will keep Steelers safety Ryan Clark on the sideline Sunday.

Mark J. Rebilas

This could be the start of something that changes a mentality, a dangerous culture that hurts NFL players, college players, high school and Pop Warner players.

Tough guys play through injury — for the team. Warriors play. We've all been taught that. I still stand by it, too. But there has to be some sort of limit or balance, and that's never going to be easy to find.

"When a man tells you his reasoning for not letting you play is because if that was his son, he wouldn't want him out there, it shows you he cares about you more than just as a football player, that you're not just an asset to a football team," Clark told reporters. "He understands you have a family and people that depend on you."

A day before Tomlin benched his leading tackler, San Diego Chargers offensive lineman Kris Dielman, who missed 10 games this season with a concussion, said he would be willing to risk future health for the chance to win a Super Bowl. He is married and has kids. Early in the season, he took a big hit, then continued to play with an undiagnosed concussion.

"It looks like I'm drunk," he said after looking back at the play. "Deal with it. That's how I got here, doing stupid (stuff) on the football field. It got me 10 years in, so I'm all right with that."

See? He looked drunk on the field, but no one pulled him out or told him he was done. Not his teammates. Not his coaches. Maybe he should have done it himself, if he was clear-headed enough to know.

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And a few weeks ago, Cleveland's Colt McCoy took a huge hit and continued to play with an undiagnosed concussion, as the claim was there were no symptoms. One bit of overlooked evidence: He took a huge hit to the head.

For all the concussion-related disasters chronicled lately by former NFL players, and even after some tough hit-to-the-head rules rushed into place by NFL commissioner Roger Goodell, the simple truth is that the psyche, the culture, still hasn't changed enough.

The hope was that all the horror stories of ex-players would scare the daylights out of current players, like when they show fourth graders pictures of the black lungs of a person who died of lung cancer. Is this what you want?

It is working to some level in the NFL, but the culture is too entrenched. Tomlin is bucking it.

"If he's in any more increased danger than any of the other 21 men on the field during the course of a game, then we're going to err on the side of caution," Tomlin said. "We're looking at all our data and all our variables in this equation. We came to the simple determination that he is at more risk, so we're not going to play him. It's that simple."

Sickle cell trait is a greatly underdiagnosed problem in sports. Its effects apparently can be triggered by high altitude. According to the Orlando Sentinel, it has been linked to 17 sudden deaths among athletes since 2000. Last year, following a suit from the family of a Rice cornerback who died suddenly during practice, the NCAA began mandatory testing for the trait.

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When Clark played a game in Denver's altitude in 2005, he didn't feel right and was later diagnosed with a bruised spleen. When he played there in 2007, according to several reports, he wasn't feeling bad until after the game. But the altitude, according to the New York Times, was causing a reaction in his blood that attacked his spleen.

They had to take him off the charter flight before it took off. He was overwhelmed with pain on one side and eventually had the spleen and gallbladder removed in separate surgeries.

Since then, he has sat out two games in Denver, one in preseason. But the Steelers had him work out in Denver to see how he would react. He was fine. And the team devised an elaborate plan to take care of him during any future games in Denver.

But with everything looking good, and with the playoffs starting, Clark said doctors told him they couldn't guarantee nothing would happen.

So Tomlin — in what Clark described as a short, one-sided conversation — told him he was out.

Are you watching, youth coaches? Coaches at all levels? It's a big game for Tomlin, too, and his leading tackler and safety would almost surely not have a problem.

Football isn't worth the chance. Maybe Clark's kids can thank Tomlin someday for understanding that something is bigger.