Imagine that you have finished dinner and have just sat down to watch the last half of the nightly news. Your 9-year-old son whom you have watched play soccer since he was 5 years old hands you a crumpled sheet of paper extracted from his backpack and asks, “Dad, can you sign this permission slip so I can play football?” Will you respond, “Sure, when is the first practice?”

Or will this be the jumping-off point for a dissertation on why you think football is a bad idea? Will you tell him that you are concerned that he will sustain a concussion, or two or three? Will you ask him why he would want a play a sport whose top level players are steroid pumped, inarticulate wife beaters? Or, will you tell him that the football culture tolerates the evils of hazing and fosters aggressive behavior?

Before we go any further, I must offer the disclaimer that I played high school football wearing a leather helmet. And that I played college football for 2 years until the handwriting on the locker room wall said, “Your skill level makes it very unlikely that you will ever get off the bench; maybe you should focus on lacrosse.” Which I did.

Although I had a few “stingers,” I never sustained any serious injuries other than a torn hamstring that still plagues me. My two concussions were unrelated to contact sports. As a team doctor for the local high school, I’m sure I sent several concussed players back onto the field. But in retrospect, I and most other physicians back then were working with a definition of concussion that was far too narrow. The most serious injuries I encountered as a game physician occurred during soccer matches.

I read the same headlines you do about what appear to be late effects in professional athletes of repeated blows to the head. I am repulsed by the off-field behavior of both collegiate and professional football players, and I continue to search unsuccessfully for admirable role models in the ranks of high-profile athletes.

Despite all the unseemly publicity, television revenues from professional football continue to surge unabated. However, I hear an undercurrent of discomfort with football from parents and some pediatricians: “Why would I allow my child to play a dangerous sport with despicable role models?” That’s a good question, and is the same one I asked you in the first line of this letter. I wouldn’t be surprised if some time in the not-too-distant future, the level of discomfort reaches a point that groups such as the American Academy of Pediatrics suggest that parents be strongly discouraged from allowing their children to play football.

I hope that this point is never reached because from my personal and professional experience, football can offer enough positives to make its risks acceptable – risks that are on a par with most activities that involve getting off the couch and physically interacting with peers and the environment. Football helped me to learn initiative (some might confuse this with aggression). It allowed me to enjoy the benefits of succeeding and failing as a member of a team. It exposed me to the value of careful preparation and meticulous attention to detail. One could argue that I could have acquired those insights and skills by participating in other activities, athletic or not. But for me it happened to be football. Were there downsides? Yes, because football was the only fall sport at my high school, it had the feel of an exclusive fraternity, a feeling that I have grown to dislike.

Would I sign my son’s permission slip to play football? Yes. Would I worry about him getting hurt? No more than I would when he played soccer and hockey. Because despite his dreams, we live in a town that isn’t football obsessed, and he isn’t going to have a 10-year career in professional sports. The risks of cumulative traumatic brain injury are too small to consider.

The bigger risk is that he might encounter a coach with a win-at-any-cost attitude and the moral character of a doorknob. But that can happen in any sport. Together he and I will continue to search for good role models in other avenues of life.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics including “How to Say No to Your Toddler.” To comment, e-mail him at pdnews@frontlinemedcom.com .

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