So here I was, enjoying a nice autumn Saturday, waiting for some college football to start, and I decided to catch up on some New Yorker articles.  Scanning the table of contents of the Oct. 19th issue, I see Malcolm Gladwell.  “This should be intersting,” I think to myself.

The title was “Offensive Play,” but it’s the subtitle that really gives the summary of this article: “How different are dogfighting and football?”

My initial reaction was filled with anti-elitism.  Here is Malcolm Gladwell, a skinny, nerdy, Canadian-with-British-parents, former runner comparing grown men to dogs, and dismissing an extremely popular sport as morally repugnant.

After reading the article, I still have a fundamental issue with the extent to which this comparison is made, but I left it with a serious bad feeling about football.

The meat of the article covers some relatively new findings about chronic traumatic encephalopathy (C.T.E.), which Gladwell describes as “a progressive neurological disorder found in people who have suffered some kind of brain trauma.”

C.T.E. has many of the same manifestations as Alzheimer’s: it begins with behavioral and personality changes, followed by disinhibition and irritability, before moving on to dementia. And C.T.E. appears later in life as well, because it takes a long time for the initial trauma to give rise to nerve-cell breakdown and death. But C.T.E. isn’t the result of an endogenous disease. It’s the result of injury.

It was well known that boxers suffered from C.T.E., but its prevalence in football players is only now being understood, and the initial data looks really bad:

[Ann] McKee says that she will need to see at least fifty cases before she can draw any firm conclusions. In the meantime, late last month the University of Michigan’s Institute for Social Research released the findings of an N.F.L.-funded phone survey of just over a thousand randomly selected retired N.F.L. players—all of whom had played in the league for at least three seasons. Self-reported studies are notoriously unreliable instruments, but, even so, the results were alarming. Of those players who were older than fifty, 6.1 per cent reported that they had received a diagnosis of “dementia, Alzheimer’s disease, or other memory-related disease.” That’s five times higher than the national average for that age group. For players between the ages of thirty and forty-nine, the reported rate was nineteen times the national average. [...]

“A long time ago, someone suggested that the [C.T.E. rate] in boxers was twenty per cent,” McKee told me. “I think it’s probably higher than that among boxers, and I also suspect that it’s going to end up being higher than that among football players as well. Why? Because every brain I’ve seen has this. To get this number in a sample this small is really unusual, and the findings are so far out of the norm. I only can say that because I have looked at thousands of brains for a long time. This isn’t something that you just see. I did the same exact thing for all the individuals from the Framingham heart study. We study them until they die. I run these exact same proteins, make these same slides—and we never see this.”

This is a very real problem with very real consequences.  Many ex-players have serious issues after their careers, and most of the evidence to date shows that this is not necessarily concussion-related, either.  It’s just cumulative head trauma, which means a real solution is very hard to come by:

“People love technological solutions,” Nowinski went on. “When I give speeches, the first question is always: ‘What about these new helmets I hear about?’ What most people don’t realize is that we are decades, if not forever, from having a helmet that would fix the problem. I mean, you have two men running into each other at full speed and you think a little bit of plastic and padding could absorb that 150 gs of force?” [...]

“Let’s assume that Dr. Omalu and the others are right,” Ira Casson, who co-chairs an N.F.L. committee on brain injury, said. “What should we be doing differently? We asked Dr. McKee this when she came down. And she was honest, and said, ‘I don’t know how to answer that.’ No one has any suggestions—assuming that you aren’t saying no more football, because, let’s be honest, that’s not going to happen.” [...]

“We certainly know from boxers that the incidence of C.T.E. is related to the length of your career,” he went on. “So if you want to apply that to football—and I’m not saying it does apply—then you’d have to let people play six years and then stop. If it comes to that, maybe we’ll have to think about that. On the other hand, nobody’s willing to do this in boxing. Why would a boxer at the height of his career, six or seven years in, stop fighting, just when he’s making million-dollar paydays?” [...]

Casson is right. There is nothing else to be done, not so long as fans stand and cheer. We are in love with football players, with their courage and grit, and nothing else—neither considerations of science nor those of morality—can compete with the destructive power of that love.

So now, even though I won’t go as far as Gladwell does with his dogfighting analogy, my weekend is ruined.  Every time I see someone take a big hit, every time the linemen crash in to each other, I’ll be thinking of this:

“There is something wrong with this group as a cohort,” Omalu says. “They forget things. They have slurred speech. I have had an N.F.L. player come up to me at a funeral and tell me he can’t find his way home. I have wives who call me and say, ‘My husband was a very good man. Now he drinks all the time. I don’t know why his behavior changed.’ I have wives call me and say, ‘My husband was a nice guy. Now he’s getting abusive.’ I had someone call me and say, ‘My husband went back to law school after football and became a lawyer. Now he can’t do his job. People are suing him.’ ”

One good thing (relatively) that I can take away from this is that I now know never to encourage anyone to pursue a career in football (i.e. my future kids).  In fact, I’m going to throw up some serious barriers to any participation in football, period.  Here’s McKee talking about an eighteen-year-old kid, and his levels of tau, which is a protein buildup in the brain that is an indicator of C.T.E.:

She pulled out a large photographic blowup of a brain-tissue sample. “This is a kid. I’m not allowed to talk about how he died. He was a good student. This is his brain. He’s eighteen years old. He played football. He’d been playing football for a couple of years.” She pointed to a series of dark spots on the image, where the stain had marked the presence of something abnormal. “He’s got all this tau. This is frontal and this is insular. Very close to insular. Those same vulnerable regions.” This was a teen-ager, and already his brain showed the kind of decay that is usually associated with old age. “This is completely inappropriate,” she said. “You don’t see tau like this in an eighteen-year-old. You don’t see tau like this in a fifty-year-old.”McKee is a longtime football fan. She is from Wisconsin. She had two statuettes of Brett Favre, the former Green Bay Packers quarterback, on her bookshelf. On the wall was a picture of a robust young man. It was McKee’s son—nineteen years old, six feet three. If he had a chance to join the N.F.L., I asked her, what would she advise him? “I’d say, ‘Don’t. Not if you want to have a life after football.’ ”

Tags: C.T.E., dogfighting, football

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