No Time To Butt Heads: Football, Brain Injury and Public Health – published in the Concord Monitor 9/15/2013
When Junior Seau retired from the the New England Patriots in 2010, he appeared to be in an enviable position. Extremely popular in his home community in the San Diego area, with all the fame and adulation that comes from being a long-time star NFL player, he was finally hanging up his cleats to enjoy retirement. He had made over $50 million in the 20 years he played for the Chargers, the Dolphins and the Pats.
Seau was widely considered one of the greatest linebackers to ever play the game. He was a likely shoo-in for the Pro Football Hall of Fame. He had no Super Bowl ring but he had been to 12 Pro Bowls.
As we all now know, Seau committed suicide in May 2012. He shot himself in the chest. He was 43 years old.
A recent article in GQ magazine chronicled the very tragic end of his life. Seau had been experiencing mood swings, insomnia, depression and forgetfulness. He had withdrawn from family and friends. He abused pills and alcohol. He made bad business decisions and he gambled away huge sums of money.
There was a weird possible suicide attempt in October 2010 after a very uncharacteristic domestic violence arrest. Seau drove his car off a 30 foot beachside cliff. He survived and claimed he had fallen asleep at the wheel.
His former teammate and friend, Aaron Taylor, described Seau at the end as like a beaten down man who had lost all his confidence. He struggled just to articulate his thoughts. It was like the old Junior had disappeared and been replaced by a shell.
After he died, scientists at the National Institute of Health who studied his brain found evidence of CTE – chronic traumatic encephalopathy, a degenerative neurological disease linked to concussions. Interestingly, during his 20 years of pro football, Seau never was diagnosed with a concussion. However, as early as the mid-90’s, he had complained of severe headaches, bouts of dizziness and insomnia.
Seau, through his family, was among the 4500 former NFL players who have tentatively settled a massive federal court lawsuit filed over head injuries sustained while playing football. The players had alleged that the NFL misled them over the long-term dangers of head injuries.
The settlement reached on August 29 provides $675 million to be paid out to former players who have suffered cognitive injuries. Payments to individual players will vary depending on the extent of their injuries. Another $75 million will go toward evaluation, monitoring and treatment of all retired NFL players, not just those in the lawsuit. An additional $10 million goes to unspecified research. Part of the deal is that the NFL makes no admission of fault or liability that plaintiffs’ injuries were caused by football.
The settlement is still pending final court approval. It is possible some former players could object or appeal. The settlement does not apply to college players. There is a separate court case about that.
I would say most commentators think this is a sweet deal for the NFL. For a league that brought in $9.5 billion in revenue last year, $765 million is a relatively low cost to pay considering that quite a few of its former employees are dead, dying, or living horribly damaged lives. Not to mention the harm that went on long before the lawsuit. No one knows how many former players have been adversely affected by brain injuries in the period before the medical world even had the diagnosis of CTE.
It is important to remember that for years the NFL took the public position that there was no substantive link between concussions suffered playing football and long-term brain damage. From 2003-2009, the Mild Traumatic Brain Injury Committee, a body set up by the NFL, wrote that no NFL player experienced chronic brain damage from concussions!
In the world of denial of responsibility, the NFL can hold its own, more than rivalling the behavior of the tobacco companies with cigarettes. The bottom line comes first and nothing the NFL has done challenges that assertion. The league has acknowledged nothing. However, it is paying out some money.
As we head into a new football season, many questions come to mind. What are the effects of multiple hits, even little hits, on the brain? How can CTE be minimized? How can practices be made safer? Can technology design a helmut that can reduce if not eliminate concussions?
One has to wonder what the NFL knows that it is not disclosing. Part of the settlement is that the NFL can maintain a veil of silence and non-disclosure about what its research has shown. I wonder if like the tobacco companies approach to public health, the NFL has a research treasure trove it is holding in abeyance.
There is a growing body of evidence which shows that repetitive trauma, football-related concussions, can cause permanent brain damage. Memory impairment, emotional instability, erratic behavior, depression, and problems with impulse control are all common symptoms. CTE appears to progress to full scale dementia.
As an almost lifelong fan, I take no pleasure in writing this. Still, I think the NFL should reverse course and err on the side of disclosure. Football-related brain trauma is a matter of public health.
Complicating the picture is the reluctance of players to disclose their concussions while they are playing. In a 2012 Sporting News poll, 56% of the NFL players who responded said they would hide symptoms of concussion to stay on the field. In a game defined by toughness, many players apparently feel that disclosure equals weakness. If they can play through, they will.
While it is a different context, it is a bit reminiscent of military veterans and PTSD. Future promotions and hope of advancement mitigate against disclosure of a PTSD problem. NFL players worry that disclosing concussions will put them out of the game and will shorten their football careers. Junior Seau is a perfect example. Given the punishing hits he gave and took, is it possible he had no concussions playing? And why was nothing ever diagnosed?
If you are the parent of a child playing football, I think it is perfectly legitimate to ask if the risks are worth it. Whether it is pee-wee football, Pop Warner, high school, college or the pros, we all, players and family and friends, should at least have full disclosure of the science in order to make informed decisions.