In the early days, anybody leaving the field for concussion was regarded as something less than manly.
Football players the world over resisted the idea that concussion caused any kind of permanent injury, so there was no way in hell a little head knock was going to make them walk off.
The battle began most prominently in the NFL, the League of Denial.
A trainer grabbed quarterback Jake Plummer after a solid knock early on and asked him how many fingers he was holding up. "One," said Plummer, extending his middle finger.
And so we go.
The middle finger has made its way, metaphorically speaking, to the NRL. The game is still having a hell of a time getting its head around concussion and what to do.
And getting smarter isn't always beneficial.
On Tuesday morning, the NRL's dirty little secret - that players are disguising concussion under pressure from clubs - will be a key part of a discussion when the newly formed Australian Athletes Alliance (AAA) concussion working group meets in Melbourne to discuss athlete welfare.
Rugby League Players Association chief executive Ian Prendergast will represent NRL players. He goes in to the meeting with their full support, aware some privately admit there is pressure from clubs to stay in the game after serious head knocks.
It is a long road ahead. Progress is being made.
The formation of the AAA group, to be announced Tuesday, will apply further pressure.
The overall theme of Tuesday's meeting will be to ensure the brain injuries are being respected based on the potential risk they expose to players.
"Respect" is the key noun. It suggests something more than lip service.
The NRL has a strong head-injury policy. But there is enough wiggle room on the edges for abuse, which players privately admit is occurring.
Masking concussion is a common sight in the NRL. A player goes into a tackle and collects a swinging arm or a solid hip or stray elbow and comes out of it something less than when he went in.
The culture to play on exists an it is privately encouraged by some clubs.
It is why we see players who are only partially concussed put an arm to their shoulder, suggesting a busted wing is why they are moving a little slowly.
It's certainly not the white stars floating through their brain. The loud whistle playing, in stereo, in their ears.
After years of research, we know where a small concussion leads; protein deposits on the brain that lead to depression, violence and too often suicide.
The AAA believes players need to be better educated and cared for. It believes there have been accelerating advancements in assessment, management, reportage and research of concussion injuries.
From that, it believes, there needs to be more independence and transparency from its governing bodies to keep it up to date.
Many athletes have spoken privately to their players' associations about the culture of denial within clubs to properly treat head injuries, the main one being the efforts to disguise concussion and play on.
To do any less would be soft. Not putting in for the team.
Along with that, the same diligence to treating concussion is rarely applied at training where, although contact is less sustained, players still get concussed.
It is important to understand concussion is not classified only as a player being knocked unconscious but also sustaining a head knock that temporarily affects his judgment, eyesight, hearing and balance.
The difficulty of enforcing tighter controls is clubs are quick to exploit it the other way.
It goes too far the other way when clubs exploit the interchange rule.
Some clubs have had as many as 15 player changes this season. Given they are allowed eight legal interchanges, it suggests as many as seven head-injury assessments are added to this.
And given just four players are available on the bench, it shows some have returned to the field, prompting the question: were they really injured at all?
The NRL and the clubs applaud such figures, highlighting them as an example the system is working. It is not.
Clubs are using the head-injury assessment as a chance to take off a tiring player, rest him for the 10 minutes or so it takes to undergo the test, and then send him back on to the field when he passes. It does not cost them an interchange.
While not ideal, it is a necessary byproduct of a strong head-injury assessment program. The concern is the conversation in the shadows, something the AAA will shine a light on soon.