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Two Bucks County boys suffered concussions. One kept playing football. One didn't.

After the friends had walked off the football field, they gathered with their families not far from where the ambulance had been.

The boys are best friends. They are 16 years old, sophomores at New Hope-Solebury High School, and as fervid about football as boys can be. One day in late October, they stood next to each other on the sideline of the Bucks County school's playing field, having come to decisions about the sport that couldn't have been more different.

Nick Oszczakiewicz wore a windbreaker and a golf visor. As statistician for New Hope's varsity football team, he spends every game at head coach Jim DiTulio's side, logging the alignment and outcome of every offensive play on a white clipboard.

Nick used to play football, but he stopped in fourth grade after suffering a concussion. It was his second official concussion by then, though he may have sustained another when he was six years old that doctors did not diagnose. So his parents forbade him from playing football again, an order that he has come to accept intellectually if not emotionally.

"Of course, I miss it," he said. "But I know it's better that I'm not playing it."

Joe Gegeckas was the slope-shouldered one in pads and a blue-and-gold jersey, a linebacker on the team. Like Nick, Joe has sustained multiple concussions, the first when he was 13, from a hit that left him wobbled and dizzy and unable to stand on his own, that compelled his father to drive him 25 miles from a Pop Warner field in the Upper Perkiomen Valley to the emergency room at Doylestown Hospital.

New Hope's administrators make sure there's an ambulance parked next to the field at every home football game, just in case the EMTs have to rush an injured player to that same emergency room, and whenever Joe sees the ambulance, he says, it reminds him of that ride in his father's car, of why he had to step away from football — and of why he and his parents were willing to risk his return to it.

With concussions proving to be the most controversial health issue in America's most popular sport, families are making decisions shaped by forces as sharp as a parent's command or intangible as a ghost.

If one of these boys was your child, what would you do?

Weighty questions

Nick and Joe have known each other since kindergarten, and do not judge each other for their choices. Their families don't, either.

"We are not at odds with each other," said Nick's mother, Michele Oszczakiewicz. "We go out to eat together. Our decision wasn't for them, and their decision wasn't for us."

All of them — Nick and his parents, Michele and Jason Oszczakiewicz; Joe and his parents, Maryann and Rick Gegeckas — are aware of the evolving science about concussions and head injuries, the information that seems to increase by the hour and sometimes seems to conflict, the trends and shifts and shades of gray in public opinion about football's popularity and importance, about whether a teenaged boy should ever drop into a three-point stance and pile-drive an oncoming running back.

Football-related head injuries are so sensitive a topic that even though New Hope requires all its student-athletes to take an ImPACT baseline concussion test before participating in any sport, neither DiTulio nor athletic director Ernie Rehr would talk about head injuries for this story.

A poll conducted this year by the University of Massachusetts at Lowell showed that 48 percent of adults believe "tackle football is certainly or probably not safe" for high school students.

Enrique Aradillas, a neurologist who treats professional and amateur athletes at the Vincera Institute in South Philadelphia, describes a concussion as "a short-circuiting of the brain, neuron by neuron." In 85 percent of patients, he says, post-concussion symptoms will resolve themselves in two to three weeks. "If you repetitively have concussions, you're more likely to develop chronic symptoms."

Aradillas said he would tell a 15-year-old boy: "That's it — no more football for you." Not after his second or third concussion. After his first.

Ultimately, though, the reading and the knowledge and the open dialogue among parents and sons come down to some heavy questions: How do we balance the rational and the emotional in making this decision? How do we bridge the gap between This brings him joy and self-respect and This might get him seriously hurt? And how in the world can you know for sure?

Beginnings and endings

Elliot Teisler didn't like football. He had wrestled at Central Bucks High School East, and he was a Marine who had served two tours of duty in Iraq. He was married to Joe Gegeckas' older sister, Stasie. Elliot and Stasie Teisler made Joe an uncle when they had their son, Dominick, and Joe and his brother-in-law would go toe-to-toe in Star Wars Battlefront on PlayStation 2, and when they spent summer afternoons dueling with Airsoft water rifles in the Gegeckas' back yard, Joe learned to wear long pants because his brother-in-law always made sure to fire low so he wouldn't snipe the kid in the face from behind a stack of firewood. They were close, and they shared a lot, but they didn't share football.

"He was terrible," Joe said.

Elliot Teisler was 21 on April 17, 2010, the day that he was riding in a jeep that, as it trundled along a canal near Camp Lejeune in Jacksonville, N.C., flipped. He drowned in the canal. Joe was just 9, his nephew Dominick wasn't even 2. Throughout the funeral, a week later at Covenant Church in Doylestown, Joe and Dominick stayed in the nursery, playing with toy horses and action figures. Nick stayed with them.

"I could take his mind off the death at that point, hanging around in there," Nick said of his friend.

That fall, Joe began his first season of tackle football. Nick began his last.

"I don't even remember most of it"

Stretched out on his family's living room couch one night last summer, Joe was asked to describe what led to his first concussion — the one that happened during a Pop Warner game in Upper Perkiomen on Sept. 13, 2013, when he was in seventh grade and just beginning to recognize why he loved, and maybe why he needed, football.

He curled his lips into a smile and slowly nodded his head with relish, and the first thing that he mentioned was the number of tackles he had in the game: 19.

"You get to hit people," he said.

They get to hit you back, too. One of them did, as Joe was getting up after a play.

"I wasn't going to say anything," he said, but after the game, one of his friends and teammates, Mike Duncan, told Maryann Gegeckas, Joey's hurt. I saw it in his eyes. When she turned to look for Joe, she saw him wander toward a wooded area, for no apparent reason. Joe said he was fine, but when his father and another parent accompanied him to the bathroom, Joe emerged with his arms draped over them, so woozy that he had trouble walking to the car. Rick Gegeckas loaded his son in the back seat — Mike Duncan rode with them to make sure Joe didn't pass out — and drove to Doylestown Hospital.

On Oct. 25, a neurologist at the hospital cleared Joe to resume playing football. On Oct. 28, as he was goofing around with friends in a hallway at New Hope-Solebury Middle School, Joe stepped in a small puddle of water, slipped, and fell, breaking the radial bone in his arm and slamming his head against the floor. Two weeks later, according to his parents and best friend, his behavior began to change.

"It wasn't a small change," Nick said.

He grew nasty, more defiant, toward his father and mother.

"I thought, 'OK, it's hormones,'" Maryann Gegeckas said. "Then his math grade started to go down."

Already following an independent education program because of a learning disability in which he exhibits symptoms of dysgraphia — difficulty in written expression — Joe found he couldn't look at his classroom smart board without either bringing on a headache or lapsing into a gauzy stupor.

"So," he said, "I'd just put my head down."

His mother took him back to the neurologist — "I didn't think about his head because I was so worried about his arm," she said — and the doctor recommended that Joe stay home from school for a week. For weeks thereafter, he did little but sit in his room in the dark, and it took months of vestibular rehabilitation therapy — exercises, such as standing on one foot, designed to treat dizziness — before he felt normal again.

"I don't even remember most of it," Joe said.

For his mother, that was it. Growing up in Northeast Philadelphia, she had been a cheerleader, and one of her uncles was the legendary Philadelphia Catholic League gridiron coach John Quinn, and all four of her brothers had played the sport and still followed it closely, but that was it: As far as she was concerned, Joe's football career was finished.

When Joe was in eighth grade and the high school began emailing prospective players and their parents about tryouts, his mother ignored every message, including one that provided the details of a mandatory meeting for anyone interested in joining the team. Joe demanded that she take him to the meeting. She refused. Joe called her the worst mom in the world, then asked his father to take him, which he did. It's just a meeting, Rick Gegeckas said. His wife stayed home.

The next day, her phone rang. It was Michele Oszczakiewicz. You're letting Joe play? No, Maryann said, she was not. She was angry, and she didn't understand why, after a year without football, after two concussions and the problems they had wrought, Joe was so desperate to play again.

Unwinnable fight

The roots of the Ozs' decision to have Nick give up football — everyone calls the Oszczakiewicz family "the Ozs," even the Ozs themselves — dated to May 18, 2007. Nick fell off a scooter that afternoon and ended up in Doylestown Hospital that night with a lump on the right side of his head, having vomited once. To this day, Michele Oszczakiewicz wonders why the word concussion appeared nowhere in the five pages of medical records generated by Nick's visit to the emergency room.

Having started with flag football at age 5, he played tackle until a Pop Warner game on a cold morning when he was 9. He and Joe could pass for brothers nowadays — both 5-foot-9 and growing, converting baby fat to muscle, with the same tawny, wavy hair — but Nick was a butterball then. He played on the offensive line, and a kid on the other team plowed him over, knocking him backward, his head thudding against the frozen ground.

This time, there was no doubt he had been concussed. Into fifth grade — in part because of another concussion he sustained later, when he banged his head against a school desk — he experienced persistent headaches. When he read, the words on the page or screen would blur and separate. His father and mother limited Nick's use of any computers or video games. They made sure he kept his music low, as a relaxant. He got glasses to correct the vision problem. The headaches eventually subsided. His vision returned.

Nevertheless, his parents had seen enough. His father had given up playing football and soccer in high school after undergoing two knee surgeries. ("I said, 'I want to walk when I get older,'" Jason Oszczakiewicz recalled.) Michele Oszczakiewicz hadn't been crazy about having the oldest of her three sons play football anyway. Nick wanted to pick it back up someday, but as he matured, he recognized that this was a fight he was never going to win.

So he pitched and played third base for New Hope's junior varsity baseball team as a freshman, and hopes to graduate to varsity in the spring. As for keeping the football team's stats, he figures that it's better to be standing on the sideline than standing behind the fence, although he sometimes overhears the snickers from his peers, and he is certain, based on the chop-busting, that some of them consider him soft.

"They know how I feel, how my mom feels," Nick said. "I'm Concussion Boy."

He has one friend who never calls him that.

Choices and reasons

In March 2015, Maryann Gegeckas got a phone call from Jeff Petzak, a special-education teacher at the middle school. Her son Joe had written an essay for class, Petzak told her, and you should read it, if he will let you.

When I was in third grade my brother died. It was my brother in law, but … he treated me like he loved me, and we spent time with each other. We would always play airsoft guns and xbox together. … So now if someone asks me about him I just say he was my brother. We were as close as we could be without being blood.

She asked Joe if she could read his essay. He said no.

That was the first year I played football. If I didn't play football I would have been much more depressed and sad than I was. I guess it just let me take my mind off things for an hour and a half on Saturdays. I just loved it. It was so fun. Now thinking back, I would have been a different person if I hadn't stepped on the field. … It really helped with the pain of my loss. I probably would have had a harder time if I didn't play football. But more recently I got a few brain injuries and I didn't know if I could or should play anymore.

She logged into his Google Classroom page on her iPad — "Like only a mom would do," she said — and read the essay anyway.

Then I thought about it. What would Elliot do? I told myself that he would take a year off and think about his options. So I took a year off and considered my options. I decided I'd keep playing football.

After she finished reading, she began to cry. When Joe's father arrived home from work, he read the essay, and he wiped his eyes. He asked his wife if she could print a copy for him.

When I'm out on the field I feel like he's still there with me. But the first sign of injury I'm done.

"That's basically what changed my mind," Maryann Gegeckas said. "I said, 'OK, I'm going to let him do it.'"

"Still working through it"

New Hope went 9-2 and qualified for the district playoffs, and the Lions' 42-14 victory over Delaware County Christian in their final home game that day in October was an easy win in a season loaded with them. Nick scribbled on his clipboard and, when the action waned, made small talk on the sideline with Joe and some other players. Maryann Gegeckas sat with Michele and Jason Oszczakiewicz in the stands. Rick Gegeckas, as he does every home game, worked on the chain crew.

Joe got in for a few plays on special teams and at fullback, throwing a clearing block on a touchdown run, before taking over at middle linebacker in the fourth quarter, once the outcome was all but assured. He was on the field for all nine plays of Delco Christian's last possession, and when the game ended, he said, "I literally had six tackles on that drive." And yes, six was exactly the number of tackles he had.

You get to hit people.

"We're still working through it," Rick Gegeckas said. "Joe is very passionate about football, and in my opinion, you can't steal someone's passion. You have to let him pursue it. If he wanted to give it up, that's up to him. If he wanted to play, it's up to him."

"If he's going to do it, I hope that he does it well," Nick said, "and that he doesn't get injured again."

The two friends walked off the football field that night, and when they and their parents met to chat about the game, another player's father approached them and said, "Good game, Nick," as he slapped him on the back.

The father's words were teasing. Nick's face was stone.

Of course, I miss it.