Tuesday, December 29, 2015

Concussion - the story of real courage standing up to the industry of the NFL

“Concussion” is a very good and disturbing movie about Dr. Bennett  Omalu, the pathologist who discovered the brain damage caused by playing football. His story of courage, honesty, and persistence is inspiring. This is a very human story about very human people caught in this difficult truth about football.  Oscar nominations for the movie and for Will Smith should be forthcoming.

Short version – football damages the brains of its players.  Not too complicated.  The human brain was never developed over millions of years of evolution to be jarred up against the inside of the skull over and over and over and over again in a game that football players practice and play for years and for decades. 

Is it just the big concussions where a player loses consciousness the problem? No. The bigger problem is the countless sub-concussions that come from every block, every tackle, every bounce of the head off the turf, pretty much every play that every player plays.  That’s the problem.  Blocking and tackling, or, the game itself.

The movie is about the scientist who discovered the brain damage to one of the game’s greatest players  - Mike Webster of the famous Pittsburgh Steelers multi-Super Bowl victory team.  Hall of Famer.  Center.  Block block block block block block …
How does it work?  Apparently what happens during sub-concussions is that a protein known as tau forms around blood vessels in the brain, tau is released into the brain after an event (each and every block or tackle during a game, or during practice, etc.), then more of that protein is released the next time, and more, and more.  The blood vessels become more and more impaired and constricted by the protein and eventually the brain becomes deformed, brittle, dramatically impaired.  The result is CTE, Chronic Traumatic Encephalopathy.  (See the symptoms and tragic human results later in this post)

So, as I have written often, I simply do not enjoy watching football anymore because all I see is brain damage.  I was a big fan back in the Mike Webster days.  Not anymore.

What to do?  I think football will just fade away.  As Will Smith, star of the movie, said in an interview on the Charlie Rose show, his son played football in high school, and Will Smith was completely unaware of this danger to his son.  I believe parents will refuse to allow their sons to play football as they come to understand the consequences.  I believe others will be like me (and Will Smith and the director, Peter Landsman, who played high school and college football) and we will simply stop watching simply because it is not fun to watch people inflict brain damage upon each other.

This is a strangely American problem because football is such a representation of the American notion of “Manhood” – being tough, strong, impervious to pain, courageous, playing hurt, hyper aggressive, punishing, bulling, pushing, conquering, dominating  - all tests of and proofs of “Manhood.”  In many ways football is a representation of the mind set of military warriors, and we all admire the military and their mindset.  They protect us and we are grateful.  But football actually is not war, and the brain injuries last a lifetime and progress to greater and greater damage as ex-players age.

Maybe it’s time to come up with some new ideas about what it is to be a man, what real courage is all about, valuing thought and feeling as well as action and will, valuing mastery but not domination.  Actually, basketball was invented as an alternative to the savagery of football by Dr. James Naismith over 100 years ago. We could watch that instead?

See the movie - if you dare. But you may start to wonder how you can enjoy watching men do so much harm to each other.  I know we have parts of ourselves who a enthralled by watching gladiators fighting to the death, or Christians being fed to the lions, in the Roman Coliseum, but is that who we want to be today?

The film dramatizes the tragic effects of CTE on players.  For your reference, the Mayo Clinic lists these symptoms of CTE:
"Symptoms of CTE are like those of other conditions that involve progressive loss of function or structure of nerve cells (neurodegenerative diseases…
Signs and symptoms of CTE usually begin eight to 10 years after repetitive mild traumatic brain injury. These include:
·         Difficulty thinking (cognitive impairment)
·         Impulsive behavior
·         Depression or apathy
·         Short-term memory loss
·         Difficulty planning and carrying out tasks (executive function)
·         Emotional instability
·         Substance abuse
·         Suicidal thoughts or behavior
Over time, memory and executive function may become worse, and other signs and symptoms may develop, including:
·         Irritability
·         Aggression
·         Speech and language difficulties
·         Motor impairment, such as difficulty walking, tremor, loss of muscle movement, weakness or rigidity
·         Trouble swallowing (dysphagia)
·         Vision and focusing problems
·         Trouble with sense of smell (olfactory abnormalities)
·         Dementia
Researchers use the following stages to describe the progression of CTE symptoms:
·         Stage I. Headache, loss of attention and concentration
·         Stage II. Depression, explosivity and short-term memory loss
·         Stage III. Decision-making (executive) dysfunction and cognitive impairment
·         Stage IV. Dementia, word-finding difficulty and aggression
They have also created four stages to describe the process of damage to brain tissue.
CTE causes ongoing pathological changes that once are started, continue to have an effect for years or decades after the original traumatic brain injury or after an individual retires from a sport. Symptoms progress throughout an individual's life.
CTE progresses in two patterns. In younger people, it may begin with behavior and mood changes, whereas in older people, it may begin with cognitive problems that progress and may lead to dementia. It's not known whether there are two different disease processes or if the process changes over time."
It makes me wonder about the endless stories of hyper-aggressive behavior of football players like Ray Rice and O.J. Simpson.  Not to excuse their behavior, but do they suffer from CTE?  I would like brain autopsies on them when they finally pass.  I wonder…