Bob Crook walked into his daughter's room this past spring to check on her after she'd told him she was feeling ill earlier in the night.
He found Ellen, a then junior at Bellwood-Antis High School, with her head in her hands and tears running down her cheeks.
The three-sport athlete was dealing with her fifth concussion, just months after suffering her fourth - and most severe.
Mirror file photo
Ellen Crook was the Mountain League MVP for the Tyrone girls soccer team in 2012.
"All through March and April it was a problem just to study and do homework for her," Bob Crook said. "When we'd drive somewhere in the car, she'd have to cover her eyes, because on-coming lights would really bother her.
"She was never afraid when it came to her knee problems, but when it came to her head, she was scared."
After dealing with short-term memory loss, nausea, whiplash and constant headaches, Ellen made the decision to give up two of her sports - soccer and basketball - and pick up cross country for the first time once her senior year began.
"I didn't want to take anymore risks with my head," Ellen Crook said. "When I started getting memory loss, I started thinking about my future. When I had knee surgery, that didn't bother me. I just went through the rehab. The head injuries scared me, because that was my life I was dealing with."
Crook didn't just give up two sports she enjoyed playing. She stopped while playing at an elite level.
As a junior alone, Crook was named to the first team of the Altoona Mirror soccer all-star squad while compiling 15 goals and 12 assists despite missing seven games due to her fourth concussion. She was also named the Mountain League most valuable player.
Crook began basketball season in November with five steals and six points against rival Tyrone, but midway through the game she suffered a serious knee injury. It was the same leg in which Crook tore an ACL during her freshman year. This time, doctors removed all the meniscus from her knee, but it didn't stop her.
She returned to her point guard position in January.
"[Ellen] was our best defensive player," Bellwood-Antis girls basketball coach Jim Swaney said. "When she came back, we were playing our best basketball of the whole season."
Though she played just a month before suffering her fifth concussion, Crook did well enough to earn a position on the first-team squad of the Inter-County Conference all-star basketball team.
"She missed time in soccer but was still the league MVP. The same with basketball, but she was still all-conference," Bob Crook said. "She loved those sports and excelled at them, but was it worth risking her life?
"You can clear up immediately from a concussion, but if you look at some of these professional football players down the road, they really have problems."
Following her fifth concussion, Crook remained a part of the basketball team. Younger players filled in as Crook sat on the bench and supported her teammates. She was never ruled out for the season, and Bellwood-Antis made a deep run into the postseason - making the District 6 Class AA title game and the state playoffs.
"There were some people that said, 'when are you going to be back? It's just a bump on the head,'" Ellen Crook said. "Others were more understanding that life is more important than sports. It was hard, because I didn't want to sit out and let anyone down, but I couldn't go out and play."
Crook never played another minute of basketball. In fact, she didn't return for most of the high school track and field season.
When the District 6 championships began, Crook had run in only a few races and was nowhere to be found among the higher seeds in her event, the 800-meter run.
For the first half of the race, Crook lagged behind, but in the final turn something clicked and she flew past her competitors to win the district title. Once again, despite a shortened season, Crook was honored in the postseason, making the first team of the Altoona Mirror track and field all-star squad after being an honorable mention on the team a year before.
"Knowing her heart, I wasn't surprised she won at districts," Bob Crook said. "But I was surprised in that she wasn't in condition. She couldn't even jog long distances, but she just got that boost of energy that day, and I couldn't have been more happy and proud of her."
Crook sustained her first concussion during an indoor soccer camp at St. Francis University when she was in seventh grade, according to her father. The league was co-ed, and Crook took a hard hit and crashed into the bleachers.
"When she had that first one, the trainers laid her on a table and said she had a concussion," Bob Crook said. "There was no real gage that it was this degree or that degree. Now they look at how you deal with light sensitivity and severity of headaches."
Crook dealt with headaches, trouble with balance and eye sensitivity for about a week before symptoms seemed to clear up.
When his daughter was diagnosed with a concussion, it was a term familiar to Bob. He suffered four during his childhood.
"They always put a smelling salt under my nose and told me to get back out there," Bob Crook said. "But one time I wound up in the hospital for one I had in the 80s. I was throwing up so much, they had to put me in. But they didn't monitor me. I played flag football the next weekend."
Ellen has tried to tough it out as well.
After recovering from her ACL tear and two more concussions since the first one suffered at St. Francis, Crook was back on the soccer field for her junior year.
At first glance, soccer does not seem like a violent sport, but studies have shown soccer produces the second-most concussions of any sport, behind football. A girl is also twice as likely to suffer a concussion than a boy.
Those numbers caught up with Crook before long.
"She got kicked in the back of the head," Bob Crook said. "She knew something was wrong but kept playing. Later in the game, she headed a ball and she said it felt like an explosion in her head."
Crook missed five weeks of action.
"The first three I had were not too bad," Ellen Crook said. "I'd feel the symptoms for maybe a week or two, but the most recent soccer one really hit me. I still had some of the issues when I tried to come back and play basketball. I think it made me more prone to get another one."
Dr. John A. Baker, who runs the Concussion Management Center of Central Pa. at Nason Hospital, said trying to stay in games can lead to more serious problems.
"I've seen kids get hit, and they know something is wrong, but they still continue to play," Baker said. "Often that second or third blow is what really triggers the symptoms and makes the concussion more severe.
"Ten years ago, you had to be knocked out for it to be considered a concussion. Concussion management is much better now, but we still rely on the human element of kids telling us how they're feeling."
Baker said 95 percent of kids who suffer head trauma get better by three weeks but a concussion like Crook's fourth that caused her to miss five weeks put her more at risk.
"Longer than five weeks, we don't know if it is a cumulative effect or if the concussions are completely cleared up," Baker said. "The bigger issue is not the number of concussions but whether or not they were recovered from the original."
The breaking point for Crook came when she fought through her second serious knee injury and was a month into her basketball season.
"I got hit in a game against Williamsburg three different times," Ellen Crook said. "I was going to catch a ball, but it hit my forehead. I kept playing, but a girl threw a ball with one arm off my head and it took me awhile to recover. I kept playing and dove for a ball later and hit my head again."
This time Crook didn't keep playing. She watched the rest of the season.
"It was definitely frustrating, because that was the second district playoffs I had to sit out," Ellen Crook said. "The first one as a freshman because of my knee and last year because of my head. You put all the work in, and you get to where it counts and you don't get to prove anything."
Following her final basketball season, Crook was forced to re-evaluate what really did count.
After suffering a pair of concussions and having all the meniscus removed from one of her knees in a single school year, Crook sat down to talk with her parents, Bob and Monica.
"I told her everything was her decision," Bob Crook said. "She said she wasn't worried about her knee, but she was concerned about her concussions. She just didn't feel 100 percent about playing anymore, and both my wife and I were relieved when she came to her decision not to play contact sports anymore.
"As much as she loves both of those sports, it's not worth jeopardizing her future over them."
When Swaney learned of Crook's decision, he understood completely.
"My wish for Ellen is that she's happy and that she enjoys what she's doing," Swaney said. "The coach-point guard relationship is pretty special, and she certainly was a special player to me and always will be. She's as much of a part of the team now as she was last year.
"There's been a lot of work done on head trauma and how it can affect people. I think all the kids know the competitor she is and know if she could be out there, she would be."
Bellwood-Antis, in particular, has made a strong effort to increase concussion awareness among its athletic programs.
"We have made big strides with it," Swaney said. "One of the nice things that Bellwood does that I'm impressed with is that all the coaches must be certified in head trauma.
"Our staff does a great job. We're one of the schools that does testing before the year for every athlete. We follow it very closely. If there is head trauma, they take the test again. They are automatically out for five days if they don't get the same score."
"We've been doing the certification for coaches for two years," Bellwood-Antis athletic director John Hayes said. "We re-do it every year. Every coach has to participate and go through the course. The goal is to be as understanding with the injury, concern and ramifications as possible."
Swaney understands why a parent may be wary about letting their child participate in high school sports but said the school is always looking out for every student-athlete.
"I know at Bellwood we take it very seriously," Swaney said. "I think everyone looks out for the welfare of athletes. For parents, they need to know the school district has their kids first and foremost on their minds. There is always going to be risk, but we're trying to minimize that risk as much as we can."
Baker said parents can also help prevent their children from suffering a more serious concussion.
"It's common for a kid to get hit in the head and be stunned," Baker said. "If mom or dad is in the stands and see their child who is usually a good passer, but they are struggling or that maybe they are moving slower, that could be a sign.
"It's often not until they get hit again that trainers get involved. Any indication or any possible thought that they may have a concussion, and it should be your obligation to take them out. It's not popular, because of the stressing of getting the win and not letting teammates down, but it's the best thing we have right now."
When Crook made the decision to end her soccer and basketball career, she knew there would be a huge void in her life when school started back up this fall.
That was when she was approached by Bellwood-Antis cross country coach Julie Roseborough.
"When she was having trouble with her concussions, and she and her dad talked about the dangers of another concussion, I talked to her about coming out for cross country," Roseborough said. "I told her it would be a good sport for her to remain competitive but stay safe, rather than abandon sports altogether until track in the spring."
Because she had played soccer in the fall her entire life, Crook never ran cross country before her senior year. Her track events included the 800-meter run, but 3.1 miles per race was a big step up.
"I figured she would be good, because she's athletic," Roseborough said. "But I wasn't sure how good she could be. When you become a distance runner, sometimes it takes some time to get your endurance up and learn how to run. But it didn't take her long at all, and she's ended up being excellent."
In her first official high school cross country meet, Crook finished eighth out of 163 runners and second in her classification at the Big Valley Invitational. She won the Inter-County Conference championship by more than 2 minutes over her closest competition last week and won the Blair/Huntingdon meet on Monday.
"It's definitely cool," Crook said. "In soccer conditioning, you are always running, so I was prepared in that regard, but it's been nice being decent."
Decent doesn't seem like a fair way to describe Crook's season. She will be one of the favorites entering the District 6 Class A championships this Saturday in Sidman.
"I think she has a very good chance of qualifying for the state cross country meet," Roseborough said. "I don't want to put pressure on her by putting certain expectations on her, but if she runs the way she's been running all season, she has a great chance."
Crook hasn't had a chance to see her former soccer team play a game this season due to her cross country schedule, but she's hoping she will be able to take in some basketball games this winter.
"I don't like to bother kids in the fall," Swaney said. "But I would like to see Ellen this year regardless of what her involvement might be. I know the other kids respect her an awful lot. It would be nice if she's around, but I know she'll do what is right. Ellen is a kid who has her priorities straight."
Crook received a final assurance that her classmates did not resent her for the time she missed on the court and field when she was named Bellwood's homecoming queen on Sept. 13.
"That was a cool experience and an honor that my peers gave me," Ellen Crook said. "It showed they were happy for me and liked me enough even with everything I missed. It showed I didn't let my teammates down. It was definitely a cool moment in my life."
Though offers from several Division II and Division III schools to play soccer are now no longer a possibility, Crook has begun to draw interest as a collegiate cross country runner. Ellen's sister, Emily, who attends Duquesne and plays soccer, already plays a sport at the collegiate level.
"I honestly like to think everything happens for a reason," Crook said. "It's hard to know I'm never going to play contact sports again, but running is my thing now, and that happened because of what happened in the other sports.
"Everything that happens is meant to happen, and I wouldn't change anything for that reason. I'm going to be just fine."