Photo: Courtesy of USL

Understanding an event depends on where you sit and what you see.

The television camera at Goodman Stadium for Bethlehem Steel FC’s matches sits at midfield halfway up the empty East side stands, directly across from all live seats available to observers.

On Sunday, June 5, I was sitting in a camera-high, west side seat when Bethlehem left back Mark McKenzie took a clearance to the head and then went down immediately, an apparent drop from playing to prone. For alarmed observers on the fan side of the field, the player’s own head blocked a clear detailed view. As McKenzie’s teammates surrounded him and medical staff rushed onto the field to treat him, many observers views’ — including my own — were obscured by the gathering.

Later, we never saw, let alone heard, the instruction to McKenzie of, “Take a knee.” Those observing live get one bite at the apple, referees and spectators alike.

Faisal Al-Amin’s view

Dr. Faisal Al-Amin, Bethlehem’s team doctor and a former soccer player for Canada’s Carleton University, saw differently from the sideline. He saw both the ball’s angle of strike and point of contact with the head, he told PSP in a telephone interview. All those who have responsibility for in-game player safety know the criticality of direct event observation. Dr. Al-Amin and the Steel’s trainer Yaseen Khan both had it.

They hurried to address the player’s needs, launching the system to diagnose blows to the head. They assessed headache, neck pain, balance, memory, and cognitive function. “Where does it hurt?” Al-Amin recalled asking McKenzie. “Do you feel pressure? What’s your name? What happened? Where are you? What have you been doing?” The player answered perfectly.

They also questioned aggressively for concussion symptoms such as dizziness, light-headedness, and unsure balance — “aggressively because 17-year-olds are more vulnerable than fully matured adults,” Al-Amin said. Such symptoms often delay their appearance. For the soccer player turned physician who questioned a proud, competitive athlete making his first professional start, first assurance did not suffice. The questions were repeated insistently as the McKenzie recovered, arose, and made his way to the sidelines. He only complained of contact-sided facial numbness.

As we all saw, the player was waved back on. Already, Bethlehem head coach Brendan Burke had been advised to prepare to send in a substitute to replace McKenzie.

“These are my players, and I know them well,” Al-Amin told PSP.

As Bethlehem staff continued to observe the teenager closely, McKenzie began running slower, triggering Dr. Al-Amin’s decision.

“Take a knee,” McKenzie was told, an instruction all coaches have given to prevent medically foolish bravery.

The player went from standing through kneeling to flat in one continuous motion, with no discernable pause. The player subsequently came back to his knees, raising an arm.

The bench-encouraged ref saw, ran, and waved. Trainer and doctor again hustled, raised up their player, and, never removing his waist-supporting arm, Dr. Al-Amin angled him toward the sidelines and then briskly to the locker room.

The follow-up

Once in the locker room, the questions resumed, Al-Amin said. For the first time the player said he was experiencing dizziness, triggering the neuro checks described above.

Once any concussion symptom shows up, neuro-check protocol begins. It repeats every 20 minutes until “symptoms free” occurs. By the end of the rain-delayed game, it did. After a final, different assessment, focus shifted to recovery.

In Chester, the player retook a computer test, Al-Amin said. He first took it during preseason, establishing a baseline for this assessment. The retest showed no change, and continued thus for the next few days.

For soccer, controlled exercise must produce no symptoms for four days before the candidate may resume play. Team procedures follow these rules. Coach Burke said on Wednesday the player had practiced, but not fully.

Mark McKenzie traveled to Charlotte and subbed on for Derrick Jones after the 90th minute. Steel fans — and others — breathed a sigh of relief.