By Ken Reed
Matt Chaney, a former football player and coach, periodically writes a blog about the dangers of football. He recently posted a long, sometimes-rambling, but wide-ranging and compelling blog entry entitled, “The Medical and Monetary Case Against Public Football.” Here are some highlights from his post:
Daniel S. Goldberg, JD and PhD, an expert in public medicine, commented on football’s communications strategy for NFLConcussionLitigation.com:
This strategy is known as the ‘manufacture of doubt.’ It involves the mobilization of an enormous amount of resources all devoted to creating doubt regarding both the probability of the harm in question occurring and the magnitude of that harm if it were to occur. By creating doubt in the policy arena, industry can argue that given the uncertainty, regulation is unwise pending the development of further facts.
[T]his is a particularly poor standard for public health policy because of the undeniable fact that epidemiologic evidence is always uncertain. That uncertainty inheres in the field itself because determining epidemiologic causation is one of the more difficult tasks we face. If we waited for knock-down drag-out proof that a given exposure caused a given health problem, we would barely implement any public health policies at all.
Dr. Bennet Omalu, sport neuropathologist:
“My advice is caution—first, do no harm. I have a son who is 3 years old. I would never let him play football. Period. That’s my son, and based on what I know, I should not be fooling around with my son’s brain.”
Chris Nowinski, co-founder of The Sports Legacy Institute, which focuses on brain injuries in sports:
“Personally, if I had a 6-year-old out there playing football I would be freaked out and I think rightfully so because you’re playing Russian roulette with their futures … I think we are putting the health of the game ahead of the health of the players … It’s important that research accelerates. But no matter what level of evidence people claim there is or isn’t, I think everybody agrees today that it’s not a good idea to hit a child in the head hundreds of times.”
Ann McKee, neuropathologist:
“We’ve never seen this disease [CTE] in a person who didn’t have substantial dramatic exposure [to head impacts]. You’ll notice that none of my critics are ever neuropathologists because neuropathologists know what you find in people’s brains even if they live to be 100. This is very abnormal. The fact that we’ve seen it with people who are head bangers speaks to the fact this is a traumatic disease.”
Stefan Fatsis, sports journalist:
There is no uncertainty that the disease discovered in the brain of former Steelers lineman Mike Webster and subsequently found in the brains of more than 40 other NFL players was caused by repetitive head trauma. There is no scientific doubt whatsoever. None. There is also no doubt that the disease found in those brains can lead to depression, memory loss, irritability, and other symptoms. And there is only one possible source for the trauma that caused the disease: playing football. Everything else is secondary—how the players’ symptoms were manifested, how their lives ended, whether they took steroids, why they got sick and other players didn’t. But those secondary issues are becoming a smokescreen—readers and listeners and commentators, myself included, are allowing them to confuse the conversation.
A central discovery by neuropathologists Bennet Omalu and Ann McKee is the high concentration of what are known as tau-immunoreactive neurofibrillary tangles in particular areas of the brain. The amount of neurofibrillary tangles found in the brains of the autopsied NFL players is, the doctor I spoke with said, 10 standard deviations above the mean. Before Mike Webster, that level of concentration of neurofibrillary tangles had been observed only in the brains of boxers. It had never been seen in any other context. That there are now more than 40 former NFL players in which that amount of tangles has been found, he said, is ‘off the charts.’
Neuropathology is the study of diseases of the nervous system. Neuropathologists examine brain tissue and form diagnoses based on what they see. Neurologists aren’t trained to do that. Neurosurgeons aren’t trained to do that. And yet many of the people who have been commenting on the findings of [sport neuropathologists] Omalu and McKee—in the Frontline documentary, in the book, and in the media in recent days; people who have been disputing their findings, or calling them preliminary or inconclusive—aren’t neuropathologists. One of the people questioning the conclusion that there is a direct correlation between football and brain disease is on the exercise science faculty at his university. Give him or any of those other non-pathologist doctors a slide of damaged brain and they wouldn’t be able to analyze it. Oh, by the way, the NFL’s reconstituted Head, Neck and Spine Committee includes neurologists, neurosurgeons, and neuropsychologists—but no neuropathologists. Which you might say could make easier for the committee to conclude that more study is needed before we have definitive proof.
Dr. Paul Butler, a retired physician:
“We have a moral imperative to at last begin the process of ending this game. The literature is clear. This is a dangerous game for children to be playing. A game that uses the head as a battering ram is not a smart game to allow a youngster to play. Our brain is really who we are… In this society, in this time, if your brain has been altered, you have been fundamentally altered.”
— Ken Reed, Sports Policy Director, League of Fans
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