Riva-Rocci showing off his new blood pressure cuff in 1896. Systolic and diastolic BP was not taken until 1905 (Courtesy of Bloodpressurehistory.com).
As a sports injury epidemiologist, I often look at, well, sports injuries. It is always interesting to look back and analyze the sports of yesteryear with the medical information we have now.
Comparing injuries of two players years apart that are similar but have completely different outcomes because of medical advancements, for example.
Harry Turner’s situation is unique because his death was described as a foregone conclusion after he sustained a spinal cord injury. For most, spinal cord injuries are not lethal, and so the assumption that Turner was a goner immediately is remarkable to me. The details don’t quite add up.
If you want to dissect this fascinating injury with me, keep reading. If that’s not your thing, I have some outstanding, injury-free articles here.
Harry Turner and the Hit
The details of the hit that injured Harry Turner are not particularly detailed. It appears that the NFL (that would be created in roughly seven years) had left all of its drones and cameras at home for this November 14, 1914, game.
The Canton Professionals were playing the Akron Indians in the Ohio League, a league that is considered the predecessor of the NFL.
“Canton Boy” Harry Turner was a 27-year-old center for the Professionals. He had apparently been playing professional ball in Canton for 12 years, since he was 15 years old.
The Actual Hit
In the first quarter of the game, Harry Turner attempted to block Akron’s fullback, Joe Collins, when he was sent through the line of scrimmage. In what was considered a clean and ordinary hit, Turner made contact with Collins via his head, not his shoulder.
On the one hand, players at that time were typically bareheaded. Shoulders were often preferred to the noggin due to no helmets and all. That being said, players were nuts in this era of football, and direct head hits are hardly out of the realm of possibility.
Turner was described as being conscious but paralyzed in all four limbs when he was carried off the field. And when they say carried, they mean carried. Typically, fellow players would carry the injured off the field, not unlike a sack of potatoes. And that’s if they didn’t just drag them off.
Could picking someone up and carrying them when they have a broken back and a spinal cord injury make it worse? Most definitely. Not off to a great start here.
Harry At The Hospital
Harry was brought to the Canton Hospital. It’s not clear how. Probably a very bouncy horse-drawn wagon with unpaved streets the way this team responded to medical emergencies.
We’ll dive into the hospital’s nitty-gritty details below, but for now, a summary Turner was found to have a broken back and a completely severed spinal cord. He would die the day after the game, on Monday, the 15th.
We know that Jack Cusack, the Canton’s manager, was present at Harry’s deathbed. Everyone’s preferred bedside hospice companion.
Harry’s Final Moments
According to Cusack, Turner’s last words were: “I know I must go, but I’m satisfied, for we beat Peggy Parratt.” Peggy Parratt was Harry’s arch nemesis and longtime rival.
Canton had beaten Akron 6-0 that night. All football players are cut from the same cloth; they can be facing anything, and their first thought is football.
Ohio Conference Devastated
The predecessor of the NFL, the Ohio Conference, was devastated by Harry Turner’s death. He was the first Ohio conference member to die. He was also one of the few football players to have ever died as a result of a spinal injury.
Spinal injuries that don’t kill players are rare, but they do happen. People dying on the field, next to the field, or after being on the field due to a heart attack are far more common. Someone dying as a result of a spinal injury? That combination is uncommon.
Which is why the assumption that Harry Turner was going to die after his spinal cord was scrambled is so odd.
Back to the Injury
Harry Turner attempted to tackle a player, leading with his head. He broke his back and had a spinal cord injury as a result. That checks out. Everything after that is bizarre.
It’s important to note that spinal injuries are bizarre in general. No two spinal cord injuries are alike, and they’re all incredibly serious. It’s impossible to predict what exact effect the injury will have in the long term. That being said, we have a pretty good idea.
1st of Many Questions
Harry was reported as having a broken back. Broken backs rarely damage the spinal cord, but if they did, it would probably be from a football injury.
A severed spinal cord typically creates quadriplegic paralysis, regardless of where it happens in the spine. Severed spines are particularly rare, but so are Harry Turner’s tackling capabilities.
However, spinal cord injuries that impact breathing, one of the few ways a spinal cord injury can be fatal, almost exclusively occur in the cervical spine. That is what most of us call the neck. A broken back would not likely impact breathing, but that is what Turner was diagnosed with.
Who says Harry died from breathing complications? No one yet. But as you’ll see, it’s a likely cause of death.
Question #2:
How did the doctors know that Harry broke his back and severed his spinal cord?
The Back
X-rays were invented in 1914, but they weren’t exactly widely available that early in the 20th century. But we will give the Canton hospital a break and assume they had one, and they x-rayed Turner’s back and saw the fracture.
The Spinal Cord
Now the back diagnosis is feasible based on x-rays. But the spinal cord is not. An x-ray can’t detect the spinal cord itself, and the creation of the MRI was way, way after Turner’s death.
It doesn’t exactly take rocket science to figure out someone likely has a spinal cord injury when they’re paralyzed, but they wouldn’t be able to narrow down any specifics like whether or not the cord was severed.
The only way they would know is if they determined that in an autopsy. It seems like the diagnosis was given prior to the death, but that’s another missing detail.
The Biggest Question
How did Harry Turner die from his injury? He has a broken back; he has a spinal cord injury of some kind. Fine, but how did things get deadly? Particularly, how did it happen so fast?
People with spinal cord injuries are 2-5 times more likely to die prematurely than their peers with happy spines.
Back in Turner’s day, there was an 80% mortality rate associated with spinal cord injuries, which explains his peers assumption of death. It’s just hard to grasp that it was ever that bad.
Common Killers
Infections were and still are risky business for people with spinal cord injuries. They were just (more) deadly back in the day. People prior to WWII typically died within weeks of an injury from infection.
Peeing problems were the biggest infection culprits; incontinence, or urine retention, was often an unexpected killer. Medical professionals didn’t have a clear idea of how that all tied together in the 1910s, so bladder infections would happen all the time and spread to the kidney. But it takes time to develop a UTI. Not say 12 hours.
Bedsores were also common at that time; regular turning wasn’t a thing. These bedsores would turn into huge, life-threatening infections. But again, that takes time.
Pneumonia is also a big issue (over time). The lungs are weaker; there’s less air coming in and out, and it’s harder to clear things out with a cough.
The Most Likely Killers
In a recent study, roughly 8.2% of people who are quadriplegic die within the first year. In another study, if you survived making it to the hospital, only 16% of 341 people died within 3 and 24 hours after the injury.
Obviously, it’s hard to nail down just how many people die within 12ish hours (particularly in the 1910s), but in the study, the majority of people died 24 hours or later, with the majority passing after one week or more. Those who did pass within 3 to 24 hours often had a compounding injury like a head injury, which seems quite possible here.
Turner didn’t pass in the typical time period from an infection, so his injury is already different from the majority. Not that it proves his football friends wrong; they assumed he would die, just not so soon. The opposite of a gotcha moment.
Likeliest Killers:
High Blood Pressure:
This is a big one. It comes from Autonomic dysreflexia (AD), which in English means the Autonomic nervous system is on the fritz. This condition can make a person 300 to 400 times more likely to develop a stroke.
It’s not a common killer, but in the 1910s, when little could be done about lowering blood pressure, it was likely a much more dangerous condition.
Temperature regulation can also be faulty with AD, and a person can pass from hypothermia.
Blood Clots:
Blood clots are very common in spinal cord injury patients. It often takes time to develop and is usually life-threatening weeks, months, or years after the initial injury.
A blood clot could form very quickly due to the injury, pass through the body, and be lethal in this short period of time. It’s not likely, though.
Impaired Breathing:
The muscles that control the breathing process may be impacted by paralysis. If the spinal cord is damaged in the neck region, paralysis can inhibit breathing entirely. A lower spinal cord injury (like a broken back) is more likely to create weakened muscles that allow infections like pneumonia.
The only thing is that people experiencing breathing problems struggle to speak as well. Harry Turner appeared to have a long, complex sentence as his parting words. This would likely rule out this cause of death.
Head Injury:
Head injuries are dangerous on their own. A study did find that patients with head injuries and spinal cord injuries are more likely to pass. This could be because of brain bleeds and the formation of clots that could lead to a stroke. It’s not totally clear why these two injuries together are more lethal.
So what happened to Harry Turner?
No one can be sure. It seems as though there was some misdiagnosis (broken back vs. broken neck) or an exaggeration of things like Harry’s ability to speak.
A spinal cord injury can get worse with time. The cord can swell, for example, which can create further damage. Which would explain how Turner’s breathing problems got worse with time, but it doesn’t explain his parting words.
Most Likely Scenario
Most likely, Harry Turner either had a traumatic brain injury that would have caused his death independent of the spinal injury or he would have passed from Autonomic nervous system issues.
He may have had a spike in blood pressure that caused a stroke or had temperature regulation problems that caused hypothermia.
If I had to pick, it would be a stroke from high blood pressure. It would leave him lucid and be a relatively pain-free way to go, allowing him to speak clearly at the end.
Thanks for taking this injury deep-dive with me. It was certainly bizarre. Rest in peace, Harry Turner!
