CONCORD, N.C. – Dale Earnhardt Jr. knew he had suffered a concussion in an August crash so jolting that other drivers tweeted about it immediately after the impact.
Earnhardt was too stubborn to see a doctor about it. He was too worried he would be yanked from his car, derailing his long-suffering Sprint Cup Championship hopes.
So he kept it a secret until a 25-car accident on the last lap Sunday at Talladega left him with a lingering headache.
NASCAR's most popular driver sought medical attention from a neurosurgeon, who found Earnhardt had indeed suffered two concussions in 6 weeks and could not be medically cleared to race. Earnhardt said Thursday he will sit out the next 2 weeks, at Charlotte and Kansas, ending his championship chances.
"I would love to race this weekend, and I feel perfectly normal and feel like I could compete if I were allowed to compete," Earnhardt said. "But I think that the basis of this whole deal is that I've had two concussions in the last (6) weeks, and you can't layer concussions. It gets extremely dangerous."
A decade ago, it was Earnhardt who helped spur changes in how NASCAR handled drivers showing signs of a concussion.
He self-diagnosed a concussion from an accident at California, but didn't tell anyone about it until revealing in an interview weeks later that he'd been having difficulty focusing and communicating with his crew chief. Within days of his admission, NASCAR strengthened its commitment to keeping drivers with concussions off the track.
NASCAR ruled that drivers unable to drive their car back to the garage after an accident had to make a mandatory trip to the infield care center. The attending physician could then refer a driver to a neurosurgeon for a CT scan or MRI if they suspected a concussion.
Clearance to race after suffering a concussion is not given until after a driver obtains a medical release.
"I think we've got a pretty good history of sending drivers to the care center and then also to a neurologist if we think there may be any cause to do so," said NASCAR senior vice president Steve O'Donnell, who added that only nine drivers from NASCAR's three national series have suffered concussions in the last 5 years.
Of course, Earnhardt proved Thursday that NASCAR isn't always in the know.
Earnhardt's first concussion this season came in an Aug. 29 wreck during a tire test at Kansas. His crash into the wall when his right front tire failed was so hard that Brad Keselowski immediately tweeted about it. Earnhardt was seen after the accident in the back of an ambulance, but was not treated in the infield care center and did not seek further examination elsewhere.
He attended a Washington Redskins exhibition game later that night, but admitted Thursday he knew he suffered a concussion.
"You know your body, and you know how your mind works, and I knew something was just not quite right," he said. "But I decided to just try to push through and work through it. I'd had concussions before and knew exactly kind of what I was dealing with."
Kansas Speedway president Pat Warren said Thursday the speedway was well-staffed with medical personnel for the August tire test, and that Earnhardt was assessed in the ambulance by a paramedic who has worked for 12 years at the track.
"She went up and assessed Dale with the questions they ask when they are worried about a head injury — he answered them all correctly," Warren said.
Warren said he also spoke to Earnhardt after he was back in the garage and already changed out of his firesuit, and the driver said he felt fine. The fire chief on staff at the track that day also asked Earnhardt in the garage the same set of questions intended to determine head injuries and checked for dilated pupils, Warren said.
Earnhardt said he regrets not seeing anyone about that concussion, but admitted to crew chief Steve Letarte what had happened and said he would not have raced at Atlanta the next weekend if he'd not felt well.
NASCAR concussion facts
Stat: Nine drivers from its three national series have suffered concussions in last 5 years.
When did current policy tak effect: 2003
What is the first step after injury: Driver taken via ambulance to infield care center for neurological exam.
Who decides when driver can return to track: NASCAR, based on neruosurgeon's apporval via note presented by driver.