Those who know me well know I love to watch documentaries. As a speech therapist, I watch documentaries through a different lens. While most viewers focus on performance, leadership, and grit, I pay close attention to how brain injury, cognition, and communication are portrayed. In part 1 of my discussion of The Gambler and His Cowboys, I discussed 1) the role of communication from the coaches and the impact different styles had on success and 2) dementia.
In this blog, I will discuss concussion and also the role of communication from quarterbacks as it was discussed in the documentary.
Voice, Leadership, and Ability
In The Gambler and His Cowboys, Troy Aikman describes himself as being “not a real vocal guy.” Aikman’s subdued nature becomes a liability when he suffers a knee injury during the 4th quarter of an important game against the undefeated Washington Redskins. The timing was terrible. However, backup quarterback Steve Beuerlein’s ability to “rile up the team” comes in clutch, along with a poetic pass to Michael Irvin, which leads to a narrow 24-21 Cowboy victory.
Coach Jimmy Johnson’s respect for Beuerlein gains steam following the win, and he starts Beuerlein in the subsequent 4 games, all of which they win. The string of victories places the Cowboys in the playoffs for the first time in years. By this time, Aikman’s injury has healed, and he is ready to play. But Johnson choses Beuerlein over Aikman. While Beuerlein has clearly proven his athletic ability, it leads one to wonder how much Beuerlein’s strong motivational skills played in that decision.
Ultimately, Aikman reclaims the starting position and between the two quarterbacks, the Cowboys lose the playoffs that season.
Concussion: More Than a “Bell Ringer”
The documentary does an important job pushing back against the outdated idea that concussions are minor or temporary. In the field of speech language pathology, we know that a concussion is a mild traumatic brain injury (mTBI)—and “mild” refers to the initial injury, not the impact it can have on daily life.
In the documentary, Troy Aikman recalls an incredibly tough playoff game against the 49ers. (Steve Young described it as the most brutal game he’d ever played.) During what seemed to be a run-of-the-mill play, Aikman’s knee was hit by a helmet. Aikman only remembers “a scuffle”, and on the sidelines after, he asked a player who’d been out for 6 weeks why he wasn’t in uniform. This was a huge red flag, and the teammate got a trainer to examine Aikman. Aikman was taken to the hospital where he kept asking the same questions about the game: “What was the score? How did I play?” An assistant at the bedside grew so weary of the repetitious inquiries that he wrote the answers on a legal pad in front of Aikman. The confusion and short-term amnesia are consistent with concussion (also now referred to as mTBI).
Despite the hospitalization, Aikman was starting quarterback in the Superbowl just one week later. Aikman admits of his playing time, “It was obvious after about 4 or 5 plays, something was off.” Emmitt Smith recalled, “Troy would call plays . . . but . . . with glassy eyes . . .”
Aikman: “At that time in the league, people were just starting to pay attention to the long-term ramifications of concussions. Nobody ever suggested that maybe I shouldn’t play. Clearly, I just could not get things going.” Within the first few minutes, Aikman threw an interception. Coach Johnson, looking back, says, “Troy . . . was not sharp.” At intermission, the Bills led 13-6.
Now, back to that discussion on oral communication and its importance in sports: at halftime, Jimmy Johnson gave one heck of a speech. The Cowboys emerged with renewed fight . . . and strategy. Because Troy was not at his best, they capitalized on the strengths of superstar Emmitt Smith and called 6 straight running plays. For the defense’s part, they relentlessly sacked Buffalo Bills quarterback Jim Kelly. The Cowboys won the Superbowl, 30-13.
But the MVP award did not go to the typical player (quarterback); it went to Emmitt Smith.
It is clear that Aikman’s cognitive state had a huge impact on his ability to make quick decisions, process information, and organize and recall plays. Instances such as Aikman’s performance in this Superbowl Championship and the results of many other players’ concussions have led to evolving concussion protocols in sports.
How concussion shows up in communication
Patterns of concussion manifest in a variety of ways:
-
Slowed processing speed
-
Difficulty finding words under pressure
-
Reduced attention and mental stamina
-
Emotional regulation challenges
-
Increased frustration during high-demand conversations
These are classic post-concussion symptoms that often go unrecognized, especially in cultures that value toughness and resilience.
From a therapy standpoint, what’s striking is how often individuals continue to push through symptoms. Troy Aikman playing in the Superbowl a week after a mild traumatic brain injury is a classic example. Such actions pose a risk for immediate and long-term recovery.
Repeated Head Injury and Dementia Risk
While the documentary does not touch on the long-term consequences of repeated head trauma, it’s important that I note the risks here. While dementia is not inevitable after concussion, repetitive brain injuries significantly increase risk, especially when recovery time is inadequate.
Dementia-related changes reflected in the film
From a speech-language perspective, dementia affects:
-
Short-term memory and new learning
-
Word retrieval and naming
-
Organization of thoughts
-
Judgment and decision-making
-
Social communication and pragmatics
When Aikman describes changes in thinking and memory, these moments mirror what families often report in the early stages of cognitive decline. I am not suggesting that Aikman will develop premature dementia; but he and every other athlete who’ve had repeated head trauma are more predisposed to early onset. I highly recommend the documentary Requiem for a Running Back, which includes commentary by Frank Gifford’s son, Cody Gifford, after Frank was diagnosed post-mortem with Chronic Traumatic Encephalopathy (CTE).
What’s powerful—and heartbreaking—is seeing how these changes affect identity. Communication is deeply tied to who we are. When it falters, relationships, confidence, and leadership roles can shift dramatically.
Why This Matters in Speech Therapy
Speech-language pathologists are uniquely trained to treat the invisible consequences of brain injury. While physical recovery may be visible, communication and cognitive changes are often missed—or dismissed.
This documentary helps normalize conversations around:
-
The long-term impact of concussion
-
The need for early intervention
-
Redefining strength as seeking care
In clinical practice, we see that early speech therapy after concussion can:
-
Improve attention and memory strategies
-
Support word-finding and processing speed
-
Reduce cognitive fatigue
-
Help individuals return to work and leadership roles safely
For individuals at risk of dementia, therapy focuses on maximizing function, preserving independence, and supporting meaningful communication for as long as possible.
A Cultural Shift Toward Brain Health
One of the most important takeaways from The Gambler and His Cowboys is the growing acknowledgment that brain health matters. High-performance environments are beginning to recognize that ignoring neurological symptoms doesn’t build champions—it shortens careers and impacts lives.
As a speech therapist, I see this documentary as an opportunity:
-
To educate the public about concussion, oral communication, and dementia
-
To validate the experiences of those living with brain injury
-
To encourage earlier referrals to speech therapy
-
To reframe communication support as performance optimization, not weakness
Final Thoughts
The Gambler and His Cowboys doesn’t just tell a story about sport—it also has an undercurrent of the importance of brain health, communication, and how both interact to affect performance. From a speech therapy perspective, it reinforces what clinicians have long known: how we think, speak, and connect matters on and off the field.
If conversations like these lead even one person to seek evaluation after a concussion or cognitive change, the impact extends far beyond the screen.
If you or someone you know in the Utah County area are in need of cognitive therapy for dementia or head injury, let’s talk. Live Well Speech Therapy specializes in cognitive impairments in adults. Most speech language pathologists are not specialized in treating concussions; we are!
We accept private pay and most insurances. You can reach us via phone call or text at (801) 420-4083 or e-mail us at jackie@livewspeechtherapy.com.
