My Take on An American Obsession--Part 1
The post that has been jostling traumatically in my brain cells for the past month or so can finally be tackled. I have refrained, so far, from kicking this essay through the goalposts without first taking stock of how best to score points, and hoping to avoid being totally distracted by the boos of the crowd. This is about "An American Obsession.*" Football is the obsession.
At school, every expected written and oral report has been written and delivered on this topic, and my lips are now unsealed. I can write without anyone feeling tempted to parrot my words or see in them fighting words. I'll do exactly as we ask our students to do: examine the evidence and draw reasonable conclusions. I will especially try to avoid what some students did--make a logical case for a particular viewpoint, and then punt to the side at the last minute, refusing to name what any reasonable person would see as the logical followup to that logic, because it was not to their liking.
The article in Time that caught my attention told the story of Chad Stover, a 16-year-old high school football player who collapsed during the current football season on a playing field in Missouri. He had a catastrophic brain injury, and died days later without ever regaining consciousness.
The Time article did not go deeply into the matter of the brain injury called chronic traumatic encephalopathy. For information on that, I read the book League of Denial, which was published in 2013. The book was written by two brothers who are both journalists. The book appears to me to be a fine work of investigative journalism.
The title of the book League of Denial refers to the National Football League, and that organization's staunch and prolonged denial of any connection between brain injury from football and a host of debilitating conditions that surfaced in some (about a third) of professional football players when they reached their 40s and 50s. Besides enduring a great deal of pain from injuries to joints, vertabrae and muscles (and often suffering from poor coordination and difficulty walking), these retired players often spiraled downward in exhibitions of sharp personality changes, cognitive decline (speech and memory impairment), insomnia, and eventually, dementia. Some of them committed suicide.
Years ago, when the brains of boxers were examined during an autopsy, structures were discovered there that resembled the tau protein deposits found in Alzheimer's patients. It was informally called Boxer's dementia. More formally, the name is Dementia pugalistica. People who suffer from it are sometimes called Punch-drunk. Common agreement existed on what caused these structures to develop: repeated concussions and sub-concussive blows to the head. Boxing as a sport declined precipitously in popularity after the brain abnormalities were documented in 1973.
It was Mike Webster's autopsy that raised the alarm about similar brain injuries in football players, when Boxer's dementia-like structures were found in Webster's brain . The person who performed the autopsy was Bennet Omalou, an incredibly well-trained Nigerian-born neurosurgeon (this was only one of a number of medical specialties in which he was trained and certified).
Mike Webster was one of the greatest players of his time. He played for the Pittsburg Steelers. He died of "natural" causes at age 51, after having descended very far into misery and dementia. He was on a host of prescription drugs to manage his pain and allow him to sleep. He was homeless during much of the time in his later years, having left his family and squandered his wealth. When he was inducted into the Football Hall of Fame, his acceptance speech was a rambling disaster because he could simply not keep a thought in his head long enough to finish a sentence. Webster had come from a humble, hard-working family, and had worked very hard and behaved responsibly in his pre-retirement years.
Dr. Omalou reported that Mike Webster's brain initially looked healthy--not shriveled-up as is the case with the brain of an Alzhiemer's patient. Almost on a whim, however, Dr. Omalou decided to investigate further. When he did so, he found the telltale tau protein structures. They were distinctly different from the structures in an Alzheimer's patient's brain in that they were located in different areas of the brain. As I recall, they are in the fore-brain in the case of Alzheimer's. These were elsewhere. Dr. Omalou consulted with several other brain specialists, and they all concurred that what he had seen was something previously undiagnosed. They called it chronic traumatic encepalopathy or CTE.
Subsequently, the same conditions were documented in additional deceased professional football players. At one point, Dr. Ann Makee of Boston University had examined 21 such brains. Twenty of them had CTE. At another point, there were a total of 38, with 34 having CTE.
It's time for a caveat here. The survivors who gave permission for a football player's brain to be examined by a team looking for CTE were likely people who had noted symptoms that might have indicated brain injuries, or the players were known to have suffered concussions, so the samples were skewed to favor the discovery of CTE in the examined brains. On the other hand, it's likely that a host of CTE brains were never examined, for various reasons.
Several atypical cases, however, deepened the sense of urgency these CTE researchers felt regarding the dangers of brain injury in football players. CTE was discovered in a deceased college player in his early twenties, and then later in a high school football player. To discover extensive brain injury in such young players was very alarming. People who know how these things work realized that a young person's brain is even more susceptible to injury than an older person's because of the light weight of the brain and its greater tendency to bounce around inside the skull when a hard blow is delivered.
"Better helmets" is the rallying cry from football players and fans and high school students seeking desperately to find a way to preserve the game in the face of the damning evidence that the game is terribly dangerous for brain health. The trouble is that this has already been tried--but never successfully. At one time, Riddell, a helmet manufacturer, advertised their helmet to be sufficiently protective to insure 31% fewer brain injuries. They were forced to retract that claim after the Federal Trade Commission found no evidence that their helmets had any such protective capabilities. No other such claim has ever been defended.
In at least one macabre incident, a football player who committed suicide had carefully directed that upon his death his brain should be examined for CTE. He died of a self-inflicted gunshot to the chest--a move to preserve his brain intact, apparently.
The fact that CTE, like Alzheimer's, can only be definitively diagnosed posthumously is particularly distressing. The families of Mike Webster and Junior Seau (an NFL player who committed suicide) both felt betrayed and rejected by the husband and father who inexplicably became irresponsible and uncaring and volatile. They could not know that injuries they couldn't see were responsible for these tragic changes.
(To be continued)
*The September 20, 2014 Time carried a cover article with this phrase in the subtitle.
At school, every expected written and oral report has been written and delivered on this topic, and my lips are now unsealed. I can write without anyone feeling tempted to parrot my words or see in them fighting words. I'll do exactly as we ask our students to do: examine the evidence and draw reasonable conclusions. I will especially try to avoid what some students did--make a logical case for a particular viewpoint, and then punt to the side at the last minute, refusing to name what any reasonable person would see as the logical followup to that logic, because it was not to their liking.
The article in Time that caught my attention told the story of Chad Stover, a 16-year-old high school football player who collapsed during the current football season on a playing field in Missouri. He had a catastrophic brain injury, and died days later without ever regaining consciousness.
The Time article did not go deeply into the matter of the brain injury called chronic traumatic encephalopathy. For information on that, I read the book League of Denial, which was published in 2013. The book was written by two brothers who are both journalists. The book appears to me to be a fine work of investigative journalism.
The title of the book League of Denial refers to the National Football League, and that organization's staunch and prolonged denial of any connection between brain injury from football and a host of debilitating conditions that surfaced in some (about a third) of professional football players when they reached their 40s and 50s. Besides enduring a great deal of pain from injuries to joints, vertabrae and muscles (and often suffering from poor coordination and difficulty walking), these retired players often spiraled downward in exhibitions of sharp personality changes, cognitive decline (speech and memory impairment), insomnia, and eventually, dementia. Some of them committed suicide.
Years ago, when the brains of boxers were examined during an autopsy, structures were discovered there that resembled the tau protein deposits found in Alzheimer's patients. It was informally called Boxer's dementia. More formally, the name is Dementia pugalistica. People who suffer from it are sometimes called Punch-drunk. Common agreement existed on what caused these structures to develop: repeated concussions and sub-concussive blows to the head. Boxing as a sport declined precipitously in popularity after the brain abnormalities were documented in 1973.
It was Mike Webster's autopsy that raised the alarm about similar brain injuries in football players, when Boxer's dementia-like structures were found in Webster's brain . The person who performed the autopsy was Bennet Omalou, an incredibly well-trained Nigerian-born neurosurgeon (this was only one of a number of medical specialties in which he was trained and certified).
Mike Webster was one of the greatest players of his time. He played for the Pittsburg Steelers. He died of "natural" causes at age 51, after having descended very far into misery and dementia. He was on a host of prescription drugs to manage his pain and allow him to sleep. He was homeless during much of the time in his later years, having left his family and squandered his wealth. When he was inducted into the Football Hall of Fame, his acceptance speech was a rambling disaster because he could simply not keep a thought in his head long enough to finish a sentence. Webster had come from a humble, hard-working family, and had worked very hard and behaved responsibly in his pre-retirement years.
Dr. Omalou reported that Mike Webster's brain initially looked healthy--not shriveled-up as is the case with the brain of an Alzhiemer's patient. Almost on a whim, however, Dr. Omalou decided to investigate further. When he did so, he found the telltale tau protein structures. They were distinctly different from the structures in an Alzheimer's patient's brain in that they were located in different areas of the brain. As I recall, they are in the fore-brain in the case of Alzheimer's. These were elsewhere. Dr. Omalou consulted with several other brain specialists, and they all concurred that what he had seen was something previously undiagnosed. They called it chronic traumatic encepalopathy or CTE.
Subsequently, the same conditions were documented in additional deceased professional football players. At one point, Dr. Ann Makee of Boston University had examined 21 such brains. Twenty of them had CTE. At another point, there were a total of 38, with 34 having CTE.
It's time for a caveat here. The survivors who gave permission for a football player's brain to be examined by a team looking for CTE were likely people who had noted symptoms that might have indicated brain injuries, or the players were known to have suffered concussions, so the samples were skewed to favor the discovery of CTE in the examined brains. On the other hand, it's likely that a host of CTE brains were never examined, for various reasons.
Several atypical cases, however, deepened the sense of urgency these CTE researchers felt regarding the dangers of brain injury in football players. CTE was discovered in a deceased college player in his early twenties, and then later in a high school football player. To discover extensive brain injury in such young players was very alarming. People who know how these things work realized that a young person's brain is even more susceptible to injury than an older person's because of the light weight of the brain and its greater tendency to bounce around inside the skull when a hard blow is delivered.
"Better helmets" is the rallying cry from football players and fans and high school students seeking desperately to find a way to preserve the game in the face of the damning evidence that the game is terribly dangerous for brain health. The trouble is that this has already been tried--but never successfully. At one time, Riddell, a helmet manufacturer, advertised their helmet to be sufficiently protective to insure 31% fewer brain injuries. They were forced to retract that claim after the Federal Trade Commission found no evidence that their helmets had any such protective capabilities. No other such claim has ever been defended.
In at least one macabre incident, a football player who committed suicide had carefully directed that upon his death his brain should be examined for CTE. He died of a self-inflicted gunshot to the chest--a move to preserve his brain intact, apparently.
The fact that CTE, like Alzheimer's, can only be definitively diagnosed posthumously is particularly distressing. The families of Mike Webster and Junior Seau (an NFL player who committed suicide) both felt betrayed and rejected by the husband and father who inexplicably became irresponsible and uncaring and volatile. They could not know that injuries they couldn't see were responsible for these tragic changes.
(To be continued)
*The September 20, 2014 Time carried a cover article with this phrase in the subtitle.
posted by Mrs. I (Miriam Iwashige) at
8:56 PM
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