It’s been more than three months since a 17-year-old football player at La Jolla High School suffered a concussion during a game and he has not been back at school for a full day since then.

The student, who we’ll refer to as Blake – his family asked us not to use his name, citing privacy concerns – is receiving continuing treatment for a concussion and chronic migraines from head-on contact with another football player on Oct. 16.

Blake stayed in the game despite telling an assistant coach he was hurt, Blake’s father and the head coach of the La Jolla football team, Jason Carter, said. (That assistant coach, who was later suspended, disputes that account.)

Regardless, state athletic rules mandate training for all coaches to identify possible head injuries. Players have to be immediately removed from a game after any suspected concussion and they are only allowed back after a medical professional provides written clearance for them to return.

In this case, Blake had a head injury and kept playing — exactly the situation that state concussion rules are supposed to prevent. Why that happened is disputed. But what’s clear is that Blake’s injuries are serious. He’s supposed to have a parent with him at all times, and must refrain from all strenuous physical and cognitive activities, according to medical records shared with VOSD.

“Football was very important to (my son),” said Blake’s father. “Frankly, it was a large part of keeping him in school. And now that’s over. So it burns all the way around.”

A Blow to the Head

On Oct. 16, early in a junior varsity game against Point Loma High School, Blake took a blow to the head that left him dazed. According to Blake’s father, who was watching the game, his son was vomiting on the sidelines – indications he may have sustained a head injury.

Blake told assistant coach Steven Wachs that he wasn’t feeling well and asked if he could sit out. Carter said Wachs refused, then told Blake to “suck it up” and get back into the game.

Blake’s father said Wachs went further, telling his son, “I don’t have time for this crap.” When Blake re-entered the game, dizzy, he forgot his instructions and cost the team points. Wachs yelled at Blake after the play; Blake yelled back. When Blake stayed in the game, it was partly out of guilt for his mistake, his father said.

But Wachs has a much different version of how this played out. He said neither Blake nor anyone else ever told him the boy was injured. When he was trying to get his kickoff team together – the play Blake reportedly asked to sit out – he said it was business as usual.

“In all the chatter that was going on the sidelines, it was never communicated to me once that (Blake) was injured, I promise you,” Wachs said.

That’s where the stories diverge. But everyone agrees that Blake stayed on the field. He played offense, defense and special teams, absorbing more blows to the head as the game progressed.

Go to the Hospital

Blake’s father said that late in the game, a teammate looked at Blake’s eyes and sensed he needed help. The teammate told him to get out of the game immediately and see an athletic trainer.

The trainer assessed Blake for a concussion, then told his father to take him to the hospital.

His father said Blake now experiences a constant state of fogginess. He can’t read more than three lines at a time before a searing headache sets in. When he goes outside on a bright day, he has to sit in the car and cover his eyes for five minutes before he can do anything.

Blake hasn’t formally withdrawn from school, his dad said, but his grades for the semester won’t count. His football career – and probably his ability to play any contact sport – is over.

Wachs was suspended from coaching for two games, the remainder of the season.

The California Interscholastic Federation, the state body that governs high school sports, requires written clearance from a licensed health care provider before athletes return from a suspected head injury.

But Wachs said he wants to be very clear: He never made a call to keep Blake in the game.

“There was never a decision. I never made a decision to put him back in the game because he was never taken out,” he said.

Furthermore, Wachs said, if Blake had received a head injury before the kickoff, which was early in the game, he wouldn’t have been able to stay on the field and continue to play. The team runs a fast-tempo offense and throws a lot of passes; he wouldn’t have been able to make the quick decisions required of him if he suffered a serious head injury early on, Wachs said.

The way Wachs describes it, Carter is letting him take the fall for Blake’s injury. Wachs was merely an assistant coach on the junior varsity team, which had its own head coach. Carter – who heads the varsity team and oversees the entire football program – was in the stadium during the game, but wasn’t coaching.

Wachs said he hadn’t been with the team long, and that days before the injury occurred, he complained to other coaches that the team was allowing too much contact during practice by making the junior varsity team scrimmage against older, stronger varsity players.

In short, Wachs said he was singled out because he was the new guy who stepped out of line and tried to make the program safer.

Wachs said that he agreed to the suspension because he thought Carter’s job was at stake, and felt Carter had more to lose. Wachs said he had the impression that he was welcome to return to the team next year.

When I asked district spokesperson Ursula Kroemer about Wachs’ employment status with La Jolla High, she said it was the first she’d heard of the specifics of the situation, and that Wachs was still listed as active in the district system. That could be because of a lag in the system and didn’t necessarily mean he would be retained as a coach, she said.

What is clear is that neither Wachs, an athletic trainer who was present on the sidelines, nor the other coaches stepped in until Blake came out on his own accord late in the game. By then, the boy was badly injured.

CIF mandates all coaches take a football-specific course on how to handle possible concussions. And besides, Wachs isn’t just a coach. He’s a chiropractor who specializes in treating sports injuries.

A constellation of safeguards was in place to protect Blake from this exact type of injury. All of them failed.

Carter’s Take

Neither La Jolla High School’s athletic director Paula Conway nor Vice Principal William Hawthorne would talk to me. Both referred me eventually to the school’s principal. But Carter did speak with me.

After Coach Carter was hired as head coach before the 2013 season, he got to work rebuilding the team’s offense, shifting to a fast-tempo strategy that relies on its pass attack. Carter’s experience playing college ball for Texas A&M, then in the pros for the Carolina Panthers and Minnesota Vikings, energized the La Jolla football program.

On Dec. 10, when I first contacted him, I told Carter that a concerned parent had told VOSD that a LJHS player continued playing in a game after showing signs of concussion, and was then injured worse.

“(The parent) must have been talking about a different program,” Carter said. “He wasn’t talking about my kids, because nothing like that ever happened. My coaches know what to do if they suspect a concussion. If I ever heard that a coach put a kid back in the game, I’d fire him on the spot.”

As a coach, balancing intensity and competitiveness with the need for safety is a matter of understanding your players, Carter said.

The team has only had one concussion in two years he’s been a coach, he said at the time.

But a day later, after I approached him with more details of the incident, Carter confirmed that Blake had been injured.

He said he had been referring to the varsity team when he’d said no one had been injured in the way I described. Blake was on the junior varsity team. Carter was present at the junior varsity game on Oct. 16, but didn’t see Blake get injured.

About the call to keep Blake in the game, Carter said Blake informed the coach he wasn’t feeling right but he didn’t specify: “In Wachs’ defense, (Blake) never said he had a head injury. He didn’t say anything about a concussion.”

I verified Blake’s diagnosis with the Neurology Center of Southern California, where he is a patient. His father gave the clinic permission to speak with Voice of San Diego.

Relying solely on someone who has sustained a head injury to recognize and report a concussion is asking a lot.

According to a study by the Institute of Medicine and the National Research Council, most concussions don’t result in loss of consciousness; players may not recognize the injuries. And if they do, football’s play-through-pain ethos may keep them from reporting them.

Despite previously insisting that he would fire a coach on the spot, Carter decided to suspend Wachs instead of firing him because it was an immediate solution.

In that same conversation, when I asked how Blake was doing, Carter said, “He’s good. I saw him at school today. He was out on the field, catching passes.”

Only Blake wasn’t OK. His dad said Blake had stopped by the school after hours, and snapped a few balls to his friend, but that he wasn’t working out or exercising.

Neither La Jolla High nor San Diego Unified has offered much clarity on how the school responded to the injury, or steps it plans to take to prevent further injuries. Chuck Podhorsky, the LJHS principal, didn’t confirm or deny anything. He said only that “we are conducting a thorough review of the processes for evaluating athletes who may be injured during the course of a game to make sure appropriate steps were followed and that assessments of possible injuries are completed in a timely fashion.”

Carter said the parent who told VOSD about Blake’s injury should have taken any concerns to him personally. Carter called the parent a “coward” for speaking to the media.

“Kids now believe in themselves, they didn’t before I got here. Now they’re going to class. Now they’re winning games,” Carter said.

Policing Football

Even now, Blake’s family is loyal to the team. His father says the school and team have been incredibly supportive of his son.

Carter and other coaches call the house to check up on Blake, his father said. Teachers and school staff are doing what they can to get Blake back on his feet academically. He believes Carter and the school took swift and serious action once they knew the details of what happened.

But, he said, he doesn’t want this to happen to another kid.

“It would be dishonest to say that there’s not anger there. Particularly in the youth setting, there should be no question when a kid complains that something is not right – especially someone like (Blake), who never complains – the coach should do whatever he can to immediately remedy the situation,” Blake’s father said.

His worry for his son and loyalty to the team encapsulates the public’s ambivalence toward football.

Even with mounting evidence that the sport poses both immediate and long-term risks, and can muddle an athlete’s brain years after the final whistle sounds, football’s mix of brutality and grace captures regional pride, young manhood, school spirit.

In recent years, CIF has implemented rules aimed at making football safer for high school athletes. In 2015, a new law will take effect that limits full contact to two practices a week. Players who suffer concussions will also have to go through a return-to-play protocol that lasts at least a week.

Only time and research will tell whether rules and precautions can stem the bulk of serious injuries that result from football, said Howard Taras, a pediatrician and a professor at UCSD. Taras contracts with school districts, including San Diego Unified, and advises them on health and safety policies.

“I think the story on football’s safety is not quite fully told, just yet,” he said

“We may have to add more rules, and try to make the game safer,” Taras said. “But we have to wonder, as we add more rules, whether there’s a safe way of playing football without changing the game entirely.”

After all, there were already numerous safeguards already in place the day Blake was injured.