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Two Houston doctors will have authority to bench Super Bowl players with head injuries

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Dr. Jamie McCarthy, an emergency room physician at the Memorial Hermann Red Duke Trauma Institute, will be on the sidelines of the Super Bowl monitoring players for concussions, photographed Thursday, Feb. 2, 2017, in Houston.
Dr. Jamie McCarthy, an emergency room physician at the Memorial Hermann Red Duke Trauma Institute, will be on the sidelines of the Super Bowl monitoring players for concussions, photographed Thursday, Feb. 2, 2017, in Houston.Steve Gonzales/Houston Chronicle

The two most powerful men on the sidelines during the Super Bowl on Sunday might not be the ones calling plays.

Two Houston doctors will have the authority to stop play. Pull a player out of the game. Tell him he can't return.

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The physicians hope it doesn't come to that.

"I don't want to be seen or heard from during this game," said Dr. Arthur Day, a neurosurgeon at Memorial Hermann Mischer Neuroscience Institute. "I want to be completely in the background."

Day will stand on one team's sideline. On the other: Dr. Jamie McCarthy, an emergency room physician at the Memorial Hermann Red Duke Trauma Institute.

Each has been designated by the NFL as an "unaffiliated neurotrauma consultant." That means they'll be watching closely for high-speed collisions and potential head injuries and then, if they spot one, helping evaluate the player for a concussion.

They're a major part of the league's effort in recent years to crack down on repeat head injuries, which have led to debilitating disabilities and premature death in former players. Unlike other sideline doctors, Day and McCarthy don't answer to either team, freeing them of any perceived pressure to send an injured player back onto the field.

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"There is no objective way to test for concussions," said Jeff Miller, the NFL's executive vice president for health and safety initiatives, one of a slew of league officials who've descended on Houston this week. "As of today, it is a subjective test done by experts. Our thoughts were, adding an expert in concussions to work with the team medical staffs increases our capability in diagnosing the injury and treating the player."

For years, the NFL has been dogged by controversy for its handling of concussions and the effects on the brains of former players. Despite overwhelming medical consensus, the league only admitted to the connection last year.

Dr. Arthur Day, a professor of neurosurgery at UTHealth, helps to escort Kurtis Drummond (40) back to the locker room after an injury during the second quarter of an NFL game at NRG Stadium on Sunday, Nov. 1, 2015, in Houston.
Dr. Arthur Day, a professor of neurosurgery at UTHealth, helps to escort Kurtis Drummond (40) back to the locker room after an injury during the second quarter of an NFL game at NRG Stadium on Sunday, Nov. 1, 2015, in Houston.Karen Warren/Houston Chronicle

The league has implemented a series of rule changes and safety protocols in recent years aimed at reducing concussions and better caring for players who suffer one. The unaffiliated neurotrauma consultants were added to the sidelines three years ago: There are two at every game, one assigned to each team.

McCarthy and Day are part of a rotation of four Memorial Hermann physicians who fill that role at every Texans home game. One of them - they wouldn't say who - helped team doctors evaluate Texans quarterback Tom Savage after he took a hit to the head during the final regular season game last month, eventually concluding that he should not be allowed to return to the field.

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Fans might not have liked that decision, but the doctors' only responsibility is to ensuring player safety, said McCarthy, who also serves as chairman of emergency medicine at UTHealth's McGovern Medical School.

"What we really know is that you can't play hurt with a head injury," he said. "Sequential injuries are not just cumulative, but they are additive. So the next hit, things get worse."

The two unaffiliated doctors are not the only ones who can stop play and order a player be evaluated. That authority is shared with all of the sideline doctors, as well as referees and a pair of head-injury spotters who watch the game on video monitors.

If any of them notice a jarring hit or a player wobbling on his feet after a play, the athlete is taken off the field. The team doctors and neurotrauma consultants are first shown a series of video replays to help them understand how the player might have been injured. Then the physicians run the player through a series of standardized questions and physical tests.

The game doesn't stop during the evaluation, so the doctors must work quickly to make a determination and avoid sidelining a potentially healthy player. Fortunately, McCarthy and Day said, the team doctors and unaffiliated consultants usually are in agreement.

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It's the injured players who most frequently resist.

"It's tough for players to recognize, when they have a concussion especially, that you're not going to play as well," McCarthy said. "Your reaction time is slower. You're going to make mistakes. There are all kinds of reasons they shouldn't be back in the game."

It's a high-pressure gig, even during regular season games, said McCarthy, who spends his weekdays treating critically wounded patients in America's busiest trauma center at Memorial Hermann.

But the Super Bowl?

"Both Dr. Day and I have a little trepidation about if one of the quarterbacks go down and we've got to assess them," McCarthy said, referring to Brady of the New England Patriots and Ryan of the Atlanta Falcons, the league's top rated passers this season. "We're ready to make the call, but we'd both be thrilled if it doesn't come up."

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Most of the time, Day said, concussion assessments are "black and white." The trouble comes when it's not so clear, he said. When not every sideline doctor is on the same page.

When the biggest professional football game of the season is on the line and tens of millions of people are watching. Waiting.

"That's the pressure," Day said.

Both doctors are hoping for an injury-free game, unlikely considering the NFL recorded 167 player concussions in 256 regular season games this season.

The doctors have been directed to arrive at NRG Stadium four hours before kickoff Sunday and will be expected to hang around for a couple hours after.

Day hopes the most drama he faces will be parking his car.

"The less they need me," he said, "the better."

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Mike Hixenbaugh was an investigative reporter focused on exposing fraud and abuse in health care