It was just one moment in time — a single impact and an athletic career ended. Everything else for so many other people involved seemed to end, too. “The Crash Reel” (2013) — directed by the renowned Academy Award-nominated British filmmaker Lucy Walker — is a stirring documentary about the traumatic head injury of Kevin Pearce, an elite snowboarder who was in serious contention for the gold medal at the 2010 Vancouver Winter Olympics. The film is rumored to be on the Academy of Motion Pictures Oscars' short list of best documentaries.
Indeed, it should be mandatory viewing for neurointensivists and neurologists involved with neurorehabilitation for this among other reasons: Injuries among snowboarders are more frequent (two- to three-times higher) than in skiers, and improper landing from high amplitude jumps is the most common mechanism for injury. Indeed, 13 percent of all face and head injuries occur in elite World Cup snowboarders, according to a study published in a special section last month in the British Journal of Sports Medicine for the Winter Olympics.
This is a film about the impact of that injury, not only on the athlete, but on their families and loved ones, as well.
The film opens with scenes of snowboarders pushing the limits of their capabilities. Sponsored and fueled by energy drinks and harboring characteristic cockiness, they become airborne at high velocity and high amplitude.
The scene then shifts to Park City, UT, just 49 days before the 2010 Vancouver Winter Olympics. Pearce is about to start his practice session, explaining that a half-pipe 22-foot wall gives more “air time” and provides “more tricks.” He adds: “People are going to be blown away with what they are going to see.”
Pearce tries out a new “cab double cork” — a double back flip with a twist. But in a dramatic turn of events, Pearce's snowboard does not make contact with the landing zone. His extended body lands face first. He is left comatose.
The camera close-up reveals an orbital hematoma. Bystanders tell us that he had to be intubated and was observed to be “shaking.” Another witness tells us that Pearce's left eye had a “blown pupil.” He is helicoptered out into the neurointensive care unit, where he stays for 26 days. The family is asked whether they will grant permission for a ventriculostomy. We get a glimpse of his MRI scan, which shows multiple severe white matter shearing brain lesions.
The film offers a unique window into the long-term — subtle, but severe —effects of traumatic head injury, particularly in young people who physically look almost the same as before, but who are, in fact, forever changed. We see Pearce recovering in small increments, but never completely. He takes antidepressants and two antiepileptic drugs and struggles with memory and attention deficits. He has episodes of confusion, impulsivity, and what he calls “sensory overload.” There are tearful moments where it all seems too much to him and his family. He undergoes surgery to correct his double vision and is left to wear corrective glasses.
And, still, Pearce wants to go back to his sport. Indeed, “The Crash Reel” depicts the continuous drive of Pearce and other injured snowboarders to rebound to their original athletic prowess, and their frustrations when they discover they cannot do so. The film does not hold back, emphasizing that these accidents can be fatal. We learn about Sarah Burke, a professional freestyle skier, who died after a traumatic head injury at the same half-pipe where Kevin sustained his fall.
The tremendous duress Pearce's parents (and brothers) experience is obvious and is represented well. They feel understandable guilt that they could not stop their son from engaging in a high-risk sport, and now face a son who is not willing to give it up — even after his injury. Pearce's father says that someone has e-mailed him that “you need to be prepared for the Kevin who comes back not to be the same Kevin.”
Many of the involved physicians try to discourage Pearce from going back to snowboarding, telling him “you actually could die.” One physician compares Kevin's brain with that of another brain-injured athlete, warning him of more potential serious injury to come. Referring to the MRI of an NFL running back, he says, “Your brain looks so much better than this guy's.”
The fear factor does not seem to faze these athletes. Pearce, however, does eventually “see the light,” but only after it becomes clear he is unable to do even the simplest snowboarding turns.
There is a lot of discussion currently in competitive sports circles about preventing traumatic injury and developing better protective gear. But for a sport like snowboarding — which is focused solely on developing new tricks and pushing limits — there are still many unknowns. Are the goggles, which improve peripheral vision but reduce frontal skull protection, too big? Will the helmets be able to properly absorb the extreme forces and torque of the increasingly evolving and dangerous new tricks? Should sports associations and committees mandate their use?
There are no answers to these serious concerns about where this elite sport is going — or more importantly, what to do with a major handicap after a severe head injury with years of recovery and still no good insight. Pearce's mother had the most important thing to say: “I was so surprised they do see people with a second one [traumatic brain injury] and a third one... I thought if someone had one, why would they put themselves in a situation where they might have another one? “
“The Crash Reel” confronts all these questions — genuinely and compassionately. It is an astounding documentary.
Dr. Wijdicks is professor of neurology at Mayo Clinic in Rochester, MN.
•. Major DH, Steenstrup SE, Bere T, et al. Injury rate and injury pattern among elite World Cup snowboarders: a 6-year cohort study. Br J Sports Med. 2014; 48:18–22.
•. Wijdicks CA, Rosenbach BS, Flanagan TR, et al. Injuries in elite and recreational snowboarders. Br J Sports Med. 2014; 48: 11–17.