Clif CleavelandIf you care about football and the boys and men who play the game, I urge you to read “Concussion” by Jeanne Marie Laskas and watch last year’s movie with the same title. Both works raise disturbing questions about the National Football League and its efforts to suppress research into chronic traumatic encephalopathy (CTE).
Concerned by publicity of concussions in NFL players, the league had established a Mild Traumatic Brain Injury Committee in the 1990s. Chaired by a physician for the New York Jets, the committee regularly published papers that downplayed the association between football and neurological symptoms in retired players. The committee never referenced any autopsy studies of former NFL players.
In September 2002, Bennet Omalu, a highly trained pathologist in the Allegheny County Pennsylvania coroner’s office, conducted an autopsy on Mike Webster, the legendary center for the Pittsburgh Steelers. Following retirement from football in 1990, Webster’s behavior became progressively erratic. Omalu sought answers from a careful study of Webster’s brain, which appeared normal on initial examination.
After obtaining permission to conduct additional studies from Webster’s attorney, the doctor conducted careful microscopic studies on the brain, paying the expenses on his own. He found extensive tangles and protein deposits that altered the brain’s normal, delicate anatomy. He submitted the slides to distinguished colleagues in medical schools who verified his findings. “Chronic” traumatic encephalopathy was the term given to the new discovery.
Shortly after Omalu published his case report in the Journal of Neurosurgery, the chairman and other physicians on the NFL’s brain injury committee demanded a retraction of the paper. Thereafter, the committee and other spokespersons for the NFL used every opportunity to demean the character and professional qualifications of the Nigerian-born pathologist. Studies by other scientists were similarly attacked.
Omalu studied a second brain in June 2005, this from Terry Long, another Steelers veteran, who committed suicide after years of deteriorating behavior. The pathologist published a second paper documenting a second case of CTE the following year.
In 2006, the U.S. Fourth Circuit Court of Appeals ruled that Webster had suffered total and permanent disability due to injuries sustained in the NFL. The court ordered the league to pay $1.5 million to Webster’s wife and children.
Attacks against Omalu did not cease. When NFL hearings on CTE were held, he was excluded from speaking. Racism clearly played a role in sidelining Omalu. The NFL continued to deny a link between football and CTE.
Pathologists at other research institutions pursued investigations on brains from other former NFL players. In some instances, families requested the studies. In other cases, retired players who killed themselves requested the studies in notes they left behind. The number of documented CTE cases steadily grew. CTE also was detected in the brain of a college player who killed himself.
A steadily growing body of research documents much higher risks for Alzheimer’s disease, amyotrophic lateral sclerosis (Lou Gehrig’s Disease) and Parkinson’s in former NFL players compared to men of the same age who never played in the NFL. Studies predicted that one-third of retired NFL players would develop neurological disorders at substantially younger ages than normal.
A class-action lawsuit filed in 2011 initially involved 6,000 former NFL players who were seeking damages for persistent neurological problems. The NFL continued to deny a link between CTE and NFL participation. The suit was settled in September 2014 when the NFL pledged $675 million plus attorneys’ fees to retired players so afflicted. Further litigation raised the settlement to almost $1 billion for the 4,800 players who were part of the suit. Former players with at least moderate neurological symptoms would be eligible for compensation; families of players who died prior to 2006 were ineligible for any payment. Future players were also excluded. Several hundred players opted to pursue personal litigation.
Declining to cooperate with ongoing studies in university centers, the NFL pledged support for CTE research at the National Institutes of Health. In May this year, a congressional report strongly criticized six NFL officials for interference in the research by seeking to redirect funds away from an independent study at Boston University to a member of the NFL’s own brain injury committee. The NFL withdrew its financial support from the National Institutes of Health.
The book and movie for “Concussion” provide valuable insights into CTE and the gifted scientist who discovered it as well as rivalries in academic medicine, racism and the inner workings of the NFL. A picture emerges of a wealthy sports league that is more interested in profit than in the safety of its players. Anti-science, pro-profit attitudes of the NFL may well affect how football is conducted at all levels of the game. Player safety must be the top priority in carefully assessing and revising rules, equipment and protocols for evaluating and treating injured players.
Dr. Bennet Omalu, meanwhile, deserves a place in a Medical Hall of Fame whenever such an overdue structure is built. His work, which he courageously pursed despite unremitting attacks from the NFL, will save lives and prevent needless disabilities.
Contact Clif Cleaveland at ccleaveland@timesfreepress.com.