NFL teams care about the well-being of their players when it suits them, and in the dying seconds of their season Saturday night, it didn’t suit the Pittsburgh Steelers.

On consecutive plays with less than five minutes left, as the Steelers faced a two-touchdown, fourth-quarter deficit against the Baltimore Ravens in the first round of the playoffs, quarterback Ben Roethlisberger and tight end Heath Miller trundled off the field, dazed after wicked hits to their heads. Roethlisberger stayed down after he took a sack and his head smashed against the cold turf. On the next snap, Miller caught a pass over the middle, charged up field and absorbed a violent, helmet-on-helmet blow from Ravens linebacker C.J. Mosely. Miller went momentarily limp, the ball falling from his grasp. An official sent him off the field, like a boxing referee saving a fighter from himself.

On the sideline, a trainer talked to Roethlisberger and inspected his neck and shoulders. Three plays later, less than five minutes of real time after his head met the hard ground, Roethlisberger returned. He lofted an interception into the end zone with his first pass. Once the Steelers got the ball back, Roethlisberger remained in the game. He fired a last-gasp pass over the middle  to Miller. The tight end sprinted forward and lost a fumble, something he had done five times in his 10-year career.

Should either player have returned? We don’t know. Jarring hits happen in football, and if all of them resulted in a player leaving the game, there wouldn’t be a sport. It would be foolish to play doctor from the couch, watching on television. Afterward, Roethlisberger said he experienced “just a little whiplash” in his neck. “I was just kind of laying down there and wanted to make sure I could feel everything.” 

We just know it looked bad. We don’t know if Roethlisberger and Miller suffered concussions.

The problem is, neither did the Steelers. The proper concussion protocol takes “at least” 15 to 20 minutes, said a doctor who has worked in the NFL and is now a Major League Baseball team’s medical director. Roethlisberger and Miller stayed sidelined for less than half that time  “too quick” to determine if they suffered a brain injury, the doctor said. The Steelers needed a miracle to win, and they rushed their franchise quarterback and starting tight end back to the field. Competitive desperation trumped best medical practices.

The NFL’s concussion assessment tool is a two-page, nine-section document that combines a visual diagnostic test with several cognitive tests to measure the player’s responsiveness. For example, players are given a sequence of three to six numbers and must correctly repeat them backwards. They also must complete a recall test in which they correctly repeat a list of five words in order. The recall test also contains a delayed recall section to be completed at the end of all sideline testing. On the worksheet, it clearly states there must be a minimum of a five-minute gap between the first test and the delayed recall test.

On commercials, in press releases and behind podiums, the NFL claims to value the safety of its players over all else. The league wants fans to believe it can make an inherently vicious sport safer. Put to the test, the Steelers proved the emptiness of those vows. The complexion of the human brain does not change in the playoffs, but apparently the NFL’s priorities do.

If the NFL is serious about player safety, it will take action against the Steelers for a clear violation of league-mandated concussion protocol. When one player endangers another with a dangerous hit, the league fines him. It likes to brag about the decrease in penalties this had led to. So what happens when superficial medical care endangers a player? The NFL needs to hold teams to the same standard it holds its players.

The end of the Steelers-Ravens slugfest cast the NFL’s on-field tension in stark relief. The drama of a heated rivalry, the ferocity of the Ravens and the intensity of Heinz Field delivered every reason we watch. The brutality of the end was everything frightening about the game. It became difficult to watch the short passes to receivers, who became targets for defensive backs and linebackers who, playing to keep the ball in front of them, could turn themselves into human rockets.

The NFL cannot legislate the physical danger out of football. Without the violence, there is no skill and grace. Without the scary blows, there is no football. It is embedded in the game.

But when the nature of the sport imperils a player, the team owes it to him to choose his health over the final score. The fourth quarter of a playoff game is a terrible time to lose your starting quarterback. But the importance of the game cannot make it okay to look the other way if a player’s brain may have just been scrambled.

Roethlisberger’s wooziness placed the Steelers in position to make a moral decision. They sent Roethlisberger, and then Miller, back to the field. The stakes revealed where the Steelers’ priorities lie. It made you wonder if there is something more worrisome embedded in the game. It made you wonder if you should look away.

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