Whither Football?

What we now know, from reading Schwarz, is that retired N.F.L. players are five to nineteen times as likely as the general population to have received a dementia-related diagnosis; that the helmet-manufacturing industry is overseen by a volunteer consortium funded largely by helmet manufacturers; and that Lou Gehrig may not actually have had the disease that bears his name but suffered from concussion-related trauma instead. (Since 1960, fourteen N.F.L. players have had a diagnosis of amyotrophic lateral sclerosis, which is about twelve more than you would expect from a random population sample.) In the manner of Elisabeth Kübler-Ross, Dr. Maroon has delineated four stages in the N.F.L.’s reaction to the reality of brain damage: active resistance and passive resistance, shifting to passive acceptance and, finally, in the past few months, active acceptance. “What we’re seeing now is that major cultural shift, and I think Alan took a lot of barbs, and a lot of hits, initially, for his observations,” Maroon said.

Can football find a way to avoid these kinds of injuries?

[Dr. Omalu] put the first slide from the new set under his microscope and looked in.

“What is this?” he said out loud. “Geez. Gee! What is this?”

Brown and red splotches. All over the place. Large accumulations of tau proteins. Tau was kind of like sludge, clogging up the works, killing cells in regions responsible for mood, emotions, and executive functioning.

This was why Mike Webster [former NFL football player] was crazy.

Omalu showed the slides to Wecht and to scientists at the University of Pittsburgh. Everyone agreed: This was a disease, or a form of it, that no one had ever seen before. Omalu wondered what to call it. He wanted a good acronym. Eventually, he came up with CTE, chronic traumatic encephalopathy. He wrote a paper detailing his findings. He titled it “Chronic Traumatic Encephalopathy in a National Football League Player” and put it in an envelope and sent it to the prestigious peer-reviewed journal Neurosurgery. He thought NFL doctors would be pleased when they read it. He really did. He thought they would welcome a finding as important as this: scientific evidence that the kind of repeated blows to the head sustained in football could cause severe, debilitating brain damage. He thought they could use his research to try and fix the problem.

“I was naive,” he says now. “There are times I wish I never looked at Mike Webster’s brain. It has dragged me into worldly affairs I do not want to be associated with. Human meanness, wickedness, and selfishness. People trying to cover up, to control how information is released. I started this not knowing I was walking into a minefield. That is my only regret.”

It doesn't look like helmets can get to the point where they can really guard against concussions (as per the articles I've linked to above).

“Here we have a multibillion-dollar industry. Where does their responsibility begin? Say you’re a kid and you sign up to play football. You realize you can blow out your knee, you can even break your neck and become paralyzed. Those are all known risks. But you don’t sign up to become a brain-damaged young adult. The NFL should be leading the world in figuring this out, acknowledging the risk. They should be thanking us for bringing them this research. Where does their responsibility begin?

“Look, there was a seminal study published by the University of Oklahoma two years ago. They put accelerometers, which measure acceleration, in the helmets of University of Oklahoma players. And they documented the g-force. So we know the g-force for a football player being knocked out is about sixty to ninety g’s. To compare, a fighter pilot will pass out at five or six g’s, but that’s over a long period of time. These football g-forces are just a few milliseconds, very brief—boom! And they found that in the open field, the dramatic cases of a receiver getting blindsided is about one hundred g’s. It knocks them out. Very dramatic, everybody sees it. But the linemen? They were actually getting twenty to thirty g’s on every play. Because they start out and they bang heads. Every play.

“Helmets are not the answer. The brain has a certain amount of play inside the skull. It’s buoyed up in the cerebral spinal fluid. It sits in this fluid, floats. When the head suddenly stops, the brain continues, reverberates back. So when I hit, boom, my skull stops, but my brain continues forward for about a centimeter. Boom, boom, it reverberates back. So you could have padding that’s a foot thick. It’s not going to change the acceleration/deceleration phenomenon. And a lot of these injuries are rotational. The fibers get torn with rotation. You’ve got a face mask that’s like a fulcrum sitting out here: You get hit, your head swings around. That’s when a lot of these fibers are sheared—by rotation. A helmet can’t ever prevent that.

“And have you seen helmets lately? In the old days of football, you had this leather cap to protect your ears. That was it. You’d never put your head in the game. You’d be knocked out after the first play! Even in the ’60s, the helmet was a light shell. The modern helmet is like a weapon.

“So I told the NFL, I said, ‘Why don’t you take the head out of the game? Just take it out of the game! Let the linemen start from a squatting position instead of getting down for head-to-head. Have them stand up like they do on pass protection. So there’s not this obligatory head contact.’

“Nothing. They had nothing to say. Who am I? I’m only a guy who has concussed hundreds of rats in the lab, a player for ten years, and a sideline doctor for twenty years. What do I know? Some stupid neurosurgeon.

“Instead of answering anything we bring to them, the NFL is ducking and shooting arrows at us. Criticizing us. Saying our work is a bunch of bunk. They have only attacked us.”

Do you (general "you") think that the head can realistically be taken out of the game of football?

I think part of what's coming out is that they don't really know the risks. They know about the small chance of death on the field, and the large chance of bodily injury (a blown-out knee, a broken wrist, whatever.)

But the dementia stuff is really just emerging, and that's a whole other thing to sign up for.

(By the way, the above GQ article was posted by a friend on FB and I thought it was new, but it's actually from October 2009. The NFL has made some strides since then.)

Dementia, though?

I can think of guys who seemed a bit slow and foggy.

But not going outright crazy and killing themselves.

Schwarz may not have been out to get football, but he was clearly less emotionally invested in it than most of his predecessors and peers, who had helped build the sport into the de-facto national pastime with romantic coverage of heroic sacrifice. He was not a fan. “I’d been pitching this to reporters for years,” Nowinski told me, of the head-injury problem in general. “People in football told me, point blank, ‘I don’t want to lose my access.’ It literally took a baseball writer who did not care about losing his access, and didn’t want the access, to football.”

Schwarz’s math background came in handy, too, as he batted away the statistical objections about the unknown incidence of C.T.E. from skeptical doctors. And Schwarz had the backing of a news organization that did not see itself as having any symbiotic ties to the game’s economic engine. (ESPN, which drives the national conversation on sports, invests more than a billion dollars a year in football broadcasting.) “There’s certainly been a lot of tension between Alan and the N.F.L., and the N.F.L. and our editors,” Jolly said. “Their communications people made it clear that they were not happy with the reporting. Some of their folks were pretty brusque and not particularly eager to work with Alan.”