If the NFL truly wanted its teams to show America they take concussion awareness seriously, then the marquee Bears-49ers "Monday Night Football'' game would pit backup Jason Campbell vs. backup Colin Kaepernick.
That would be a quarterback matchup only Jon Gruden could love — but the right thing for both teams after starters Jay Cutler and Alex Smith couldn't finish their respective games Sunday because of concussions.
It was reckless when the Redskins played Robert Griffin III seven days after a severe blow to the head caused temporary memory loss. It would be no less risky for the Bears or the 49ers to start a quarterback so soon after suffering a concussion.
Want to make a statement about concussion safety? Take the decision out of the hands of teams and players. Institute an NFL rule requiring any player who cannot finish one game because of a concussion to sit out the next game as a precaution. Stop talking about how much the league cares about brain injuries and then letting teams treat them like sprained ankles.
Passing a battery of NFL tests could return Cutler by midweek, but too many unknowns remain for anyone to feel too comfortable. The concussion Cutler suffered Sunday from the hit by Texans linebacker Tim Dobbins was at least the fourth of his career — with news archives suggesting it was his sixth. Regardless, the potential cumulative effect cannot be ignored for someone with Cutler's history — not with the 49ers defense lurking.
"It does concern me a little bit that these guys are being returned too quickly,'' said Dr. Jeffrey Mjaanes, a concussion expert and sports medicine physician at Midwest Orthopaedics at Rush. "I'm sure (Cutler) feels immense pressure to get back out there as soon as possible, but the best thing he can do for his brain is to be honest about his symptoms and not return until he's feeling 100 percent.''
When Bears team President Ted Phillips thoughtfully discussed "changing the culture'' during a concussion-awareness program conducted jointly by the U.S. Army and the Bears before Sunday's game, this was precisely what he meant. And this is an opportunity to start. But to hope for any cultural change, everybody needs to quit being naive about football players telling the truth about injuries. They don't.
Understandably, Cutler waved off team doctors and nobody administered a sideline concussion test during a five-minute lull because he wanted to display toughness. Regrettably, Cutler took seven more snaps. Each one represented a threat for a second hit to the head that "can be devastating'' for concussed athletes, Mjaanes said.
On the next play, Cutler delivered a blow at the end of a run. Two plays later, he showed poor judgment in forcing an interception. But the most questionable decision was Cutler being on the field at all without thorough medical examination — even if the NFL determined Monday the Bears properly handled the injury.
"We'll never put a guy at risk,'' Lovie Smith said. "No game is that important.''
Smith insisted Cutler presented no concussion symptoms until halftime. But isn't reflexively putting one's hands on his helmet after getting pummeled symptomatic of a player with a serious head injury?
"It was very concerning,'' Mjaanes said. "My hope was after what happened in 2010 (with Cutler's concussion against the Giants) people would have learned their lesson and been more aggressive (treating him). I want to be fair. I don't know when his symptoms developed.''
Now an independent neurological consultant must clear Cutler, but how reliable are the league's tests? Former Bears linebacker Hunter Hillenmeyer, forced to retire after a fifth concussion, cast some doubt.
"The baseline testing is not perfect,'' Hillenmeyer said.
He described a process that requires players to show no symptoms at rest before showing the same asymptomatic signs after full exertion. But just like every hamstring heals differently, so does every brain. Therein lies the mystery, the danger and the reason to spare Cutler the 41/2-hour flight to California — the sky is no place for concussion patients either.
"You can find doctors who say a player should wait months after a concussion or doctors who say once a player is asymptomatic he is good to go,'' Hillenmeyer said. "Truth is, when it comes to long-term effects, nobody really knows — not the Bears' trainers and not the Bears' doctors, and certainly not Jay. To me, that presents a situation where doing anything other than erring on the side of caution would be unforgivably irresponsible.''
Smith maintained Monday at Halas Hall that the Bears always will err on the side of caution regarding concussions. Monday night in San Francisco gives the organization a chance to prove it to a national TV audience.