Tech + Health

11.13.13

Can NASCAR Driver Trevor Bayne Race Safely With Multiple Sclerosis?

Trevor Bayne deserves praise for pushing ahead with his life and NASCAR career after his MS diagnosis. It seems fair, however, to ask whether he’s putting himself and others in danger.

Trevor Bayne, the 22-year-old NASCAR driver who announced Tuesday that he has multiple sclerosis, joins National Hockey League goalie Josh Harding  as an active athlete with MS carrying on with his life and career.

We have not been told what symptoms Bayne and Harding have; surely maintaining their privacy is appropriate. But their illnesses and their courageous decision to live their lives emphatically and without interruption does raise a set of interesting questions. For example, should a race-car driver with a neurologic condition really be allowed to drive 200 miles an hour with a pack of other drivers, all of whom depend on his steady hand for their own safety?

MS, a chronic often progressive neurologic condition of uncertain cause, was well characterized clinically in the 19th century, including an understanding of what went wrong with the nerves in the brain and spinal cord. Nerves throughout the body normally are sheathed by myelin, which improves the speed and accuracy of the information traveling the neural network. In MS, the amount and quality of myelin is abnormal, replaced by “sclerotic” plaques, the hallmark of the disease. This loss of usable myelin results in poor nerve-to-nerve coordination, resulting is a slightly haywire main dashboard. Patients experience a wide array of symptoms, ranging from visual problems to poor coordination and clumsiness to numbness and pain, in addition to fatigue and depression.

Professional sports has a singularly unheroic and uninspiring precedent for treating those with a medical problem. When Magic Johnson initially was diagnosed with HIV in 1993, he wanted to resume playing basketball. He was physically well enough to compete, but some players in the NBA worried he might, in the heat of the game, spread the infection to them after a cut or a scrape. Eventually the NBA came up with an approach to allow him to continue, but he opted to retire, probably demoralized by his peers’ stigmatization of his condition.

The pinched response of NBA players was repeated a few years later when Olympic diver Greg Louganis announced that he, too, was HIV positive. With the news, focus was placed not on his health or his courage but rather on a long-ago event where he had cut himself on the diving board. What if, people said, he had spread HIV to other divers? Wouldn’t that be awful?

It may be that Bayne has been seen by a team of neurologists who have cleared him as fit for service. I hope he is.

Of course, MS is not a contagious illness. And certainly everyone with MS or any neurologic condition should do what they enjoy. Harding should tend goal and Ann Romney, diagnosed with the condition years ago, should continue to ride her horses.

But driving is different. Like infectious diseases, it has a public health dimension. Several other neurologic conditions are accepted as risky to the public, at least as far as driving a car is concerned. People with seizure disorders are not allowed to drive until a certain seizure-free period has passed. Many have gone through the miserable experience of determining that their aging parents no longer should be behind the wheel, owing to poor eyesight or wandering judgment. And the United States operates a fierce stop-and-frisk for anyone trying to drink and drive.

It seems fair, therefore, if graceless and ill-timed, to ask whether a race-car driver should be sitting behind the wheel and relying on reflexes that require perfect if not inhumanly fine function. The risk to others on the racetrack, surely, is decidedly greater than that presented by the HIV infection of Johnson or Louganis. One mistake could injure not just the racer but his competitors, as well.

Still, car racing tends to be seen as a tough sport. Courage in the face of senseless, self-imposed danger is the coin the realm. Drivers are supposed to suck it up, and, Duke Wayne-style, push forward. That attitude extends to fans,  a few of whom are killed or maimed each year by flying car parts after a collision. Indeed, in a report 10 years ago, the Charlotte Observer found that 22 people, including two to three spectators, were killed by the sport annually

It may be that Bayne has been seen by a team of neurologists who have cleared him as fit for service. I hope he is. He deserves respect and applause for coming forward with his condition. I also hope, though, that in our ongoing celebration of his bravery we do not overlook the facts about car racing, a sport in which fierce individuals are bound to each other more closely than members of any team as they accept a large, collective danger. The only reaction worse than the embarrassing debacle that greeted Magic Johnson’s first HIV-positive steps would be an equally intense but much more dangerous decision to ignore the risk that Trevor Bayne may be assuming.