If he wasn't throwing up, he didn't have a concussion.
The first of David Piland's seven concussions wasn't diagnosed as a concussion at all. The Southlake, Texas native was in eighth grade, and saw stars after taking a big hit. Doctors on the sidelines took his helmet as a precaution, and Piland didn't put up much of a protest because his team was already nursing a big lead.
Then the second-stringers scored a touchdown.
Piland was the holder on special teams, so he managed to swipe his helmet and sprint on the field to fulfill his duties for the extra point.
"I didn't think anything of it, and then the doctor's yelling at me and telling me and my dad, I'm not supposed to go on the field," Piland said. "I didn't know any better. I was just doing what I was supposed to do."
Piland never vomited after the game, so no one associated with the team believed he'd suffered anything more than a spot on a defender's highlight reel.
"At that point, I didn't know what a concussion was," Piland said.
He didn't miss any practice the next week, despite the team enduring full-contact workouts several times. He played the next week. Another big hit ended his season and left no doubt about whether he'd suffered a concussion or not.
Piland went on to become Kevin Sumlin's quarterback at Houston in 2010. This season, he threw for 220 yards before his seventh concussion in a game against Temple on Sept. 7.
On Oct. 9, Piland announced that concussions had ended his football career.
He still hasn't vomited from a head injury.
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Concussions pose the biggest threat to football's long-term future. More and more research proves the human body was not meant to play football for the 20-30 years that Piland dreamed of doing. The recent PBS documentary and book by Steve Fainaru and Mark Fainaru-Wada, "League of Denial," shed light on the link between concussions and chronic traumatic encephalopathy (CTE), a degenerative brain disease that can produce short term memory loss, depression or suicide. Dr. Ann McKee, one of the nation's top researchers on the subject, found CTE in 45 of the 46 brains she examined, according to the Fainaru brothers.
Players who spent a decade playing professional football are most often the center of concussion controversy. Bigger, faster players naturally produce bigger hits with more force. Piland's case is one that proves the concussion problem can appear much sooner than the middle of an NFL career. CTE can only be definitively diagnosed after death, but it's something Piland has obvious concerns about.
"If I wasn't nervous about that kind of thing, then I obviously would have kept playing," Piland said. "A smoker's not going to say I'm not thinking about getting lung cancer."
The former Houston quarterback isn't alone in his home state. Texas running back Tre' Newton started the national championship game against Alabama at the end of the 2009 season, but concussions forced him to retire in 2010 with 781 career yards and nine touchdowns. Texas A&M receiver Ryan Swope is the school's all-time leader in receptions, but concussion issues caused him to slide to the sixth round of the 2013 NFL Draft. In July, the Arizona Cardinals placed Swope on the reserve/retired list, though he hasn't completely ruled out a return to football.
Reached by phone, both Swope and Newton declined to be interviewed for this story.
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Symptoms typically worsen with each concussion. For Piland, his latest concussion required two days in a hospital after the hit in the win over Temple. He doesn't remember flying home or anything about the game. He only remembers waking up in a hospital bed, where several friends and family visited him during his two days there. He has no memory of many of their visits. Many of the sympathetic texts or calls he received during the two days are hazy, too.
"You feel like you're a jerk when you can't remember people visiting you," he said.
For the next week, David's mother, Debra Piland took care of him at home while he lay in bed in a dark room. No reading was allowed, and he could only listen to the TV. His vision was blurred. Even getting up to go to the bathroom would bring about nausea.
Three weeks later, his current condition made his decision to retire even more difficult.
"I feel fine now. That's what's hard about the whole situation," Piland said. "If anyone on the team wanted to challenge me in anything, I would jump up and whoop 'em. I'd love to. It's not like a knee injury where you're hurt."
He's on track to graduate with a degree in business administration in December, but he'll chase a job in coaching before electing to use it. His knowledge of the offense Mike Leach popularized and has gained traction at Texas A&M and Texas Tech, along with West Virginia, can only help him.
No doctor said Piland had to quit, but each concussion became a more traumatic experience for his psyche and his brain. Several recommended he end his career. Continuing to play meant a high risk of early amnesia, headaches, migraines and continued short-term memory loss.
"Knowing all that, I just kind of came to a hard decision of how much of my life is worth another game," Piland said. "We know so little about these concussions and the effects of them, there could be a lot more severe problems psychologically. There could be depression, imbalances in your brain that throw off different things you do throughout your life."
Piland grew up with dreams of winning championships. Once he signed with Houston, he began the chase to break Case Keenum's record as a freshman. A lifelong NFL dream loomed, too.
"Those are things I've had to give up on," Piland said. "It's hard setting goals and not even getting to the finish line to see if you got close or seeing how you sized up to those goals. Instead, you just step off the track and you're not going to run anymore."
Maybe life would be different if Piland had waited longer than age five to start playing football. Some of his friends didn't play their first snap until sixth or seventh grade.
"They still have good ball skills," he said with a laugh.
Piland won't prevent his future kids from playing the game, but they won't be playing football at five.
"I have to start thinking about my future now," Piland said, "because I wasn't thinking about my future then."
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The connotation of a concussion is different now than it was when Piland was an eighth grader back in 2005. The effects of concussions decades later weren't taken with near as much seriousness. The case studies and evidence was minimal and far from the mainstream. More attention is paid now.
Today, it's ludicrous to think an eighth-grader could suffer a concussion, have it shrugged off and continue taking part in full-contact practice days later.
Back then, it was "just football."
When Piland suited up for practice, though, the symptoms were gone. Just like he does today, he felt fine.
His brain was not fine, and every concussion suffered makes another more likely.
Just a week after his first concussion, Piland suffered his second. It knocked him unconscious for about 15 seconds. He's watched it on tape countless times. His arms curl up. His body goes tense. Of course, he has no memory of the play. When he watches it, it could be anyone. It's not. It's him.
"It's a scary experience for a 14-15 year old kid," Piland said.
Back then, he didn't know the difference then between a broken arm and a concussion. Once he felt fine, he assumed the injury was behind him. The idea that hit could change the course of his life never even occurred to him.
By the end of his high school career, he had suffered five concussions. He's sure the real number is much higher. The second concussion at Houston will be his last as a football player, but even now, a bump on the head means a headache. Any other moderate blow to the head the rest of his life could mean an eighth concussion.
It all goes back to that one week in eighth grade.
"What really set me back was that second hit and not taking care of that first concussion," he said. "That's what gave me a lot of head trauma and future problems: not treating that first one correctly."
