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My Ben in is my heart, and he always will be - Peter Robinson

Fourth anniversary for Ulster rugby school player Ben Robinson who died from 'Second Impact' concussion injury

Four years ago this week, 14-year-old Carrickfergus Grammar schoolboy Ben Robinson died after collapsing during a rugby match. An inquest into Ben's death revealed that he had three separate brain injuries, probably all inflicted in that one game. Vincent Hogan spoke to Ben's father, Peter

Yesterday, Peter Robinson broke the habit of the graveyard. He went hiking up a Scottish mountain to mark the fourth anniversary of Ben's passing rather than stand, again, by that cold Ulster headstone.

The plot where his son's remains lie cannot offer the faintest balm to his pain. All it has ever done is bellow out at him about loss.

Karen, Ben's mum, still goes there twice a day. As Peter explains: "It's like she says, when Ben died, part of us died."

Somebody once put it another way, maybe a better way. They told them that if they put everybody in a huddle, that bit in the middle that couldn't be filled? That was Ben.

"It's surreal to think that it's four years now because if somebody said I got the phone-call yesterday, I'd believe them," Peter reveals. "It's still that raw.

"But I don't get a feel of him at the grave. At the end of the day, he's in my heart. I don't need to go anywhere. He's always with me."

Is it crass to talk of the death of a 14-year-old boy in terms of legacy or education?

Damn right it is if, almost three and a half years later, you are sat in your living-room watching a concussed and bloodied Frenchman all but hunted back into rugby action with a cattle-prod.

The TV images of Florian Fritz in Toulouse last May triggered widespread revulsion. But what did they say about the game of rugby as distinct from the irresponsibility of his coach?

Toulouse had a 10-minute window in which to decide upon what implications resuming play might have for Fritz's health.

Ten minutes in which to play God then.

Dr Barry O'Driscoll's dismay at rugby's use of the so-called 'concussion bin' is well documented. The uncle of Ireland's greatest player resigned from the IRB's medical advisory board in 2012 because of exasperation at a process he believes has "confused and trivialised concussion".

And Peter Robinson remembers watching Fritz appear to be cajoled back out of the Stade Ernest Wallon medical room that day and regarding it as "a kick in the teeth". He says that kind of spectacle "makes it seem that Ben's death has just been worthless!"

The records show that Ben Robinson died of something called 'Second Impact Syndrome'. In many ways, that information is in our possession only as a matter of chance.

If Peter and Karen hadn't discovered the existence of a video recording of their son's last rugby game (a pupil of the opposition school had been asked to make it for training purposes), Ben's death would have been signed off just as a freakish tragedy.

The process of finding the cause of their son's death exposed them to a climate, essentially, of denial.

"If we didn't have the video, we could not have proved anything," Peter reflects now.

"We found most of the evidence ourselves, and that was another kick in the teeth really. You've lost your son and then you are having to try to prove what actually happened that day.

"I made myself sick looking at the video. I don't know how many times I looked at it."

It would be two and a half years after the tragedy before the IRFU agreed, on their instigation, to a meeting with Peter and Karen.

And today, when Peter hears Dr Rod McLoughlin, the IRFU's Head of Medical Services, emphasise the extreme rarity of 'Second Impact Syndrome', it makes him uncomfortable.

Since Ben's death, he says there have been three more registered fatalities from SIS around the world.

"The thing is you don't hear about these," says Peter.

"You would think you would hear about a death in sport, but you don't."

Rugby, it should be said, has done a share of house-keeping.

It is certainly reasonable to believe that the shocking ignorance of concussion that cost a young life four years ago could not, logically, exist today.

The pathologist found that Ben Robinson had three separate brain injuries, probably all inflicted in the one game.

Video evidence showed him lying on the ground a minimum of three times that day and team-mates subsequently revealed that, at different junctures in the second half, he had admitted that (a) he could not remember the last tackle and (b) he did not know the score.

Yet, Ben Robinson kept on playing.

Four years on, awareness of concussion in rugby has never been higher, as perhaps evidenced by Jonathan Sexton being stood down for 12 weeks after his fourth concussive incident in a calendar year.

Today, the IRFU runs an extensive range of educational courses in its promotion of SAFE (Standard Approach to Field Emergencies) rugby and has distributed 30,000 concussion education wallet cards and posters to clubs and schools.

Its mandatory time-out rules for suspected or confirmed cases of concussion (21 days for an adult, 23 for an underage player) even exceed IRB guidelines.

And, in October of last year, Dr McLoughlin delivered an IRFU submission to an Oireachtas Joint Committee on Health and Children about concussion in sport.

Yet, not a single line of the SAFE literature references the reality that concussion can prove fatal. Why?

Peter Robinson's theory is that that message might just be too jarring for the parents of young players.

"Sometimes protecting the product gets in the way of protecting the player," he argues.

"I definitely think they're afraid that mums and dads will pick up on it and say 'God I didn't know concussion could be fatal. My wee Johnny's not going to play that!'."

On Newstalk recently, the worrying case of Ulster centre Luke Marshall came under a medical spotlight.

Dr John Chute, a GP who works as medical officer for Tralee Rugby Club, was asked what his position would be on a player who has now suffered five known concussions in less than two seasons.

Marshall's case is interesting. In early October, respected Sunday Independent journalist Brendan Fanning alluded to it in an article in which he suggested "it's the players who need educating".

At the time, Marshall's concussion count was four.

Fanning had read an interview with the player that, he felt, seemed to be trivialising the accumulation of red flags raised.

Marshall's response was a strongly worded letter to the newspaper, describing Fanning's article as "unfair and derogatory of me".

Since then, he has sustained a fifth concussion in training.

Dr Chute was unambiguous in his view of what should happen next.

"If he was a patient of mine, I would tell him immediately to stop playing," he said.

To do so would be to follow the reasoning of Professor Laura Balcer of New York University, who was quoted in the acclaimed US documentary 'Head Games: The Global Concussion Crisis', as saying that a tally of even three concussions in a sporting career should prompt thoughts of retirement.

There is a remarkable passage in Bernard Jackman's autobiography, 'Blue Blood', in which he admits to a conviction that he sustained "over 20 concussions" in the last three years of his professional rugby career.

Jackman suspects his susceptibility to concussion may have been triggered by a heavy hit in a 2004 Magners League game, a collision that left him with three weeks of migraine-like symptoms.

Towards the end of his career, Jackman privately dreaded live scrummaging sessions because of the "vicious" migraines they would trigger.

But to drop out would have been "a sign of weakness", he reckoned. A gesture that could also, potentially, have led to demotion.

He once admitted to this writer: "By the end, I'd say I could have been knocked out in a pillow fight."

But Jackman was of a generation that Brian O'Driscoll recently referred to as "guinea pigs" in the exploration of what the long-term implications of concussions might be.

"We don't yet know the downside to the escalating collisions," said O'Driscoll in a radio interview.

His uncle's view is that such case studies must leave bodies like the IRB and IRFU "very worried".

In America, the National Football League agreed a $765m deal to compensate thousands of retired players suffering from long-term effects of concussion.

A scientific paper published in '09 revealed that former NFL players were 19 times more likely to suffer from early onset Alzheimer's disease than the general public.

Last summer, a coroner's court in Dublin accepted that the death at 57 of former Lansdowne front-row Kenny Nuzum in 2013 was down to CTE, Chronic Trauma Encephalopathy. This is a degenerative brain condition brought about by repeated head trauma.

CTE needs no explaining in an American courtroom.

Nuzum, to be fair, played a game that wasn't medically policed with anything like the zeal of today. Sexton's standing down, however disappointing for Racing Metro or Ireland, is a reflection of broader enlightenment now. But perhaps of soaring worry too.

Up to 2014, he had only previously had a single concussion in his career. But a sickening collision with the mountainous French centre Mathieu Bastareaud in Paris last March provided what would be the first of four in a calendar year.

Sexton says that the symptoms have not been especially severe, but that the medics "just wanted to break the cycle for my own care and health". He has been frustrated at not playing, yet understands why it is best that such calls are not left with the player.

IRFU Medical Officer Eanna Falvey was widely lauded last November for refusing to allow Brian O'Driscoll to continue after sustaining a heavy hit in Ireland's game with New Zealand. O'Driscoll argued vigorously to be left on, yet has since admitted that, on returning to the dressing-room, one of his first acts was apparently to ask for tomato ketchup.

He has, he concedes, no recollection of this.

O'Driscoll himself tweeted praise of Falvey's decision, admitting subsequently: "I don't know whether it's a macho nature. . . but you see it in players. That's the default. 'I'm perfect!'

"A player is going to always want to stay part of it and not decide to take himself off the field. They're going to want to hang in there and tough it out."

Trouble is, when professionals "tough it out", schoolboy rugby players are entitled to confusion.

All about them today are posters reciting the policy "If in doubt, sit them out."

Yet, size seems to be everything in their world now too. Go on the IRFU website and there are Strength and Conditioning guidelines for players from the age of 12 up, allied to the best of advice on nutrition.

This is sensible on the one hand, yet it is also an implicit concession to the gradual super-sizing of young players. And that worship of size has begun seeping down from the professional game to grassroots.

For the two years before his death, Ben Robinson followed one such programme.

Peter says bluntly: "I think the gym-bunny culture has kicked in with rugby and people are picked for their size rather than their actual ability with the ball.

"When you think that a person's brain isn't fully formed until 24, we're creating havoc here.

"I'm all for rugby, but I think the professional era has created a monster. My big concern is the schools and the grassroots, because it's copycat behaviour.

"Anything we see on TV is being done at schools level, and the support structure, especially medically, is not there.

"When you think about it, it's about child protection at that level. If you took Ben's situation into a classroom and he'd been knocked down three times, a teacher would have stepped in and protected him.

"But because you're wearing a rugby kit, it's like 'Ah, that's just part of the game!'

"I'm not talking about wrapping kids up in cotton wool. My idea is go and play it as hard as you want but, as soon as something goes wrong, you take them off.

"When you think of some of the top schools in Belfast now, they're more or less semi-pro, feeder clubs for Ulster. That's all very well but these kids' brains are not fully formed and that's why they're in a high-risk group.

"It's like somebody driving an articulated truck without a licence.

"It's just the size of these kids now. If they get it wrong it can be with terrible results for them."

Peter believes that all teachers and coaches involved in any contact sport should undergo mandatory training in concussion.

He also suggests that, in pre-season, an information pack should be sent out to parents and pupils, raising awareness of concussion.

In his view, the authorities have had to be "dragged kicking and screaming" towards purposeful recognition of the dangers.

Shockingly, shortly after the inquest into Ben's death, the IRFU sent a coach to his school to talk about Strength and Conditioning without a single reference being made to concussion, something Karen described as "incredibly insulting, sickening, humiliating."

Yet initiatives have been sprouting up in the most unlikely places.

After reading of Ben's case, a group of Transition Year students in Cashel Community School produced a project called "Without Your Brain You Have No Game", winning bronze at last year's Young Social Innovator Awards. Part of the project involved creating a digital animation on the condition.

For Peter Robinson, the Cashel project has been far more comforting than much of what he regards as the medical "arrogance" encountered in his campaigning since 2011.

When researching Ben's death, he depended almost exclusively on American reports and findings. Concussion here seemed some kind of dark secret, that no-one had much appetite for exploring.

They made a few banners for the anniversary - one reading "Concussion-Recognise-Remove in memory of Benjamin Robinson" - and had pictures taken with them in Northern Ireland and Scotland that will go up on Facebook.

Some of Ben's organs were donated and on Wednesday of last week Peter got a letter from one of the recipients, a sufferer of Cystic Fibrosis whose life has since been transformed.

The letter was beautiful and moving, yet Peter could not subdue a faintly grudging thought.

"As great as it was as a parent to read how this chap is living a new life, you just want Ben to have his own lungs back and be living his own life and telling me what he is going to do," he says.

"Maybe that sounds selfish, I don't know. . ."

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