Concussion Inc. Read online

  So I have specific reasons for resisting the mawkish sentimentality of much of the Duerson media coverage. That coverage reflects the culture we inhabit. It is also perfectly appropriate for family and friends to be eager to keep his legacy positive. For my money, however, such a legacy must be tied to outcomes.

  One such outcome is an adjustment of the record created by Duerson’s work for the NFL retirement and disability board. I checked with Brian McCarthy, the National Football League’s communication director, and he told me that since the February 2007 inception of the 88 Plan, the joint labor-management disability claims committee has received 170 applications. All but 19 have been approved. Eight applications are pending. Eleven have been rejected.

  I am not sure how many of the 11 rejections came during Duerson’s tenure on the committee; I assume all or almost all. (An NFL Players Association spokesman did not respond to inquiries.) Out of respect for his sacrifice and in acknowledgment of what, in retrospect, was his diminished competence, these 11 files should be reopened and reconsidered at once.

  The same should be done for all non–88 Plan claims on which Duerson deliberated. I believe these would include the claims of ex–Minnesota Viking lineman Brent Boyd. (Boyd’s file began in 2000, pre–88 Plan, and may never have referred to that part of the disability benefits program; he claimed football-related mental illness, but I don’t believe that included dementia.)

  The NFL and NFLPA can litigate to death the question of Duerson’s disqualification. Or they can take the high road in at least this narrowly defined area, in return for considerable public good will. On the field, they’ve instituted replay review for the sake of getting the call right. Today, off the field, the lives of disabled NFL veterans and their families require nothing less.

  28 February 2011..........

  One truth revealed by the maudlin first round of reaction to the news that Duerson probably had severe brain damage from football concussions — something postmortem study will have to confirm — is that NFL players union contract negotiations do not, in the familiar idiom, simply pit greedy billionaires against greedy millionaires. Rather, they pit billionaires who know what they’re doing against millionaires who don’t have a clue.

  That’s the only logical conclusion I can draw from the fact that Duerson, while losing his Goliath post–NFL career food distribution business, plunging into personal bankruptcy, seeing his house seized by a bank, and getting arrested for beating his wife — all telltale signs of chronic traumatic encephalopathy — was being appointed by the Players Association as one of the trustees of a league fund, jointly administered by management and union, to compensate retired players with disability claims.

  Who needed a fox guarding the chicken coop when there was a hypermacho-enabling union more focused on the division of the NFL’s $9 billion revenue pie than on whether its members worked under conditions that would give them a reasonable expectation of living and functioning past age 50?

  No doubt Duerson had the best of intentions for his fellow athletes when he insisted, both on the NFL retirement board and in Senate commerce committee testimony, that ex–Minnesota Viking lineman Brent Boyd’s mental illness in his forties wasn’t proven to be football related. Duerson pointed out that his own father had Alzheimer’s disease in his late seventies or eighties, yet had never played football!

  But sincere or not, we now know more than just that Duerson’s argument was nuts. He was, too. Cognitively impaired. Of diminished capacity. Lacking responsible judgment. All from the very phenomenon about which he was instrumental in making administrative-legal rulings — a role for which, in retrospect, he was clearly incompetent.

  That’s why I say enough with the media’s Duerson pity party. If his friends and loved ones take comfort that his donated brain will contribute to public awareness of CTE, then by all means give them their soft landing.

  But the powers that be in the NFL and the NFLPA? Not so fast. Duerson was no hero. There were already dozens of confirmed cases of CTE, and undoubtedly hundreds of other unreported or ill-reported cases, by the time Duerson put a gun to his chest.

  If we’re really intent on honoring Dave Duerson, then let’s put some substance on his legacy. I have a three-point plan. We can call it the Double D Three-Point Stance.

  Reopen all rejected disability claims by retired players.Even as I write this, I’m sure lawyers are preparing new litigation arguing that the evidence of Duerson’s incompetence should invalidate the disability claim rejections. Instead of fighting a legal war of attrition over the inevitable, the league and the union should concede the morally obvious and order immediate “replay review” of these rejections.

  Double the 88 Plan’s outreach and benefits. The plan — named for Hall of Fame tight end John Mackey, who wore uniform No. 88 — grants up to $88,000 a year in reimbursement for the medical expenses of dementia victims. At Duerson’s funeral on Saturday in Chicago, his son Brock said the family would be setting up a foundation to aid players with mental illness. But hey, let’s cut out the middleman here. To date, the 88 Plan has distributed around $7 million. In the NFL and the NFLPA’s contract talks, let them take off the table enough crumbs from their $9 billion food fight to double the size of the disability fund endowment and benefits.

  Give fans and sponsors ownership of player care. This is the hardest one for me to talk about in specifics at this point. But nothing will get the league and the players union to take meaningful action until fans pull their heads out of their hero-worshipping butts and start taking responsibility for the human and societal costs of their entertainment. One possible idea: there is much promising research on the efficacy of Omega-3 supplements in reversing or at least slowing brain damage. Fan groups could raise money for distributing free supplies to NFL alumni and pressure beer companies, which tag “drink responsibly” bromides onto their wall-to-wall football telecast commercials, to pitch in, too.

  While I was filing this piece, obsessed fans were already turning the page on Duerson and refocusing on the disgusting meat rack that is the NFL pre-draft combine coverage. (Where is Jesse Jackson when you really need him for an observation on how the big-time sports system is just like an antebellum plantation?)

  As millions pondered Cam Newton’s flexing pecs and stopwatch reading in the 40-yard dash, a report out of Canada said that former NFL and Canadian Football League defensive back Ricky Bell died 10 days ago at age 36. Both Bell’s girlfriend and his mother in South Carolina declined to comment on the cause of death.

  2 May 2011..........

  At a just-concluded press conference in Boston attended by Dave Duerson’s ex-wife and their four children, doctors affiliated with Boston University and Chris Nowinski’s Sports Legacy Institute announced that the postmortem study of the brain of Duerson, who committed suicide in February, confirms that he had chronic traumatic encephalopathy. He is one of dozens of recently deceased athletes, at least 13 of whom were National Football League players, shown to have had CTE.

  I asked the following question:

  Mr. Duerson served as a trustee on the NFL committee that reviews disability claims of retired players. A league spokesman told me that a total of 11 claims to the Mackey 88 Plan for dementia-related acute-care expenses have been rejected. There is some additional number of line-of-duty and disability benefits that have been rejected, and many of those also involve brain injuries — a subject that certainly weighed heavily on Mr. Duerson. In light of this new information confirming that he was himself of diminished mental capacity when he participated in these NFL Player Care deliberations, do you agree that there is a moral, if not also a legal, obligation to reopen the files of these rejected claims?

  Everyone should view Nowinski’s video on his CTE work, “Game Changers,”4 but there is a danger that the NFL’s activism in finding a cure for CTE and promoting sports safety reforms is way too little and way too late. That is why I a
sked the question.

  Robert Stern, co-director of the center, replied that his organization was not in the business of telling the NFL how to distribute disability benefits. He also said that the Duerson CTE finding could not be extrapolated to determine just when and how, or even whether, this player and fallen business tycoon came to incur “diminished mental capacity.”

  Though fair enough as far as the response went, this reticence to use the Duerson cautionary tale for more aggressive generic comment on the political landscape ahead may point to the limitations of the Sports Legacy Institute’s new million-dollar partnership with the NFL. In a related vein, I believe the question is not whether youth football coaches should be cutting back on contact in practices; it is whether youth football should exist at all.

  Further unfortunate fallout from the public progress on concussion reform is the schism between the Boston group and the West Virginia Brain Injury Research Institute headed by Drs. Julian Bailes and Bennet Omalu. The latter, now chief medical examiner of San Joaquin County, California, is the researcher who took the NFL head-on while more established voices — often doctors with league connections and other commercial conflicts of interest — were still equivocating in journal articles.

  A hint of the Boston–West Virginia turf war was evident yesterday after Boston University’s Dr. Robert Cantu correctly linked CTE to the phenomenon of “punch-drunk syndrome” in boxers, which was first isolated in 1928. Cantu went on to suggest, incorrectly, that CTE became widely recognized in the ’60s and ’70s. In fact, the pathology was neither named nor defined before Omalu came along in 2002. If there was widespread awareness of the scale of concussion syndrome in the immediate aftermath of football players such as Al Toon getting blasted into early retirement in the 1990s, then the NFL made sure it was a well-kept secret.5

  In any case, the point isn’t who gets credit for the discovery of CTE so much as who will pay the bill for the current generation of sports-generated broken lives. This exercise runs deeper than the NFL’s bottom line. Half-baked prospective solutions driven by an image-conscious, money-hungry corporation will not significantly arrest the CTE pandemic. And as writer Matt Chaney has noted, it is non-professionals and their families — along with the nation as a whole — who bear the brunt of the NFL lobby’s current campaign to shift responsibility to state legislatures by mandating new practices for cash-strapped school and other amateur athletic programs.

  A better idea: make commissioner Roger Goodell and his 32 owners cough up some realistic restitution for the brain-injury mill from which they profit so obscenely. A mere $20 million in research grants and $7 million in aid to retired players with dementia won’t cut it. That is the background of my question at the Duerson press conference.

  5 May 2011..........

  Alan Schwarz of the New York Times has taken the Dave Duerson story exactly where it needs to go: toward no-holds-barred examination of the NFL disability benefits system, which Duerson himself, with cruel irony, had helped administer and defend.

  Another question beginning to circle among retired players whose claims were denied during Duerson’s tenure is whether they can refile given his admitted impairment. Board votes are not disclosed to applicants or to the public.

  John Hogan, a lawyer for dozens of players in disability matters, said that he might request an audit by the United States Department of Labor to see how Duerson voted on claims.

  “He had to exercise a high degree of care, skill, prudence, and diligence — the CTE findings, coupled with his suicide, certainly raise the question of whether he was capable of properly fulfilling those duties as is required in such an important undertaking,” Hogan said. “It therefore calls into question the possibility that some or all of the decisions he made when passing on disability claims are suspect, and perhaps invalid.”6

  I welcome Hogan’s assumption of a more aggressive stance than he articulated to me in the immediate aftermath of Duerson’s February suicide. Back then, while not hesitating to brand the entire NFL disability apparatus illegitimate, with or without the Duerson factor, Hogan had added that probing Duerson’s specific cases on the compensation board would be a tough road to hoe because of confidentiality laws and the possibility that he had actually cast his own votes in favor of retired players whose claims were rejected.

  NFL lawyer Douglas Ell reinforces this point to the Times: “He knew of no case where ‘if Dave’s vote were disregarded, the outcome would have been different.’”

  I think the league’s position is wrong. The disability committee is not tainted because of Duerson’s individual votes, but because of his overall participation. As one of the three NFL Players Association appointees, Duerson carried an expectation to deliberate and advocate on behalf of a constituency in need. To use a very loose analogy, if a lawyer is found to have provided inadequate representation to an accused criminal, the process is understood to be flawed and a rehearing required. Wargaming the final verdicts of the disability panel to determine whether they would have turned out the same anyway does not remove their procedural cloud.

  At Monday’s press conference in Boston, officials at the Center for the Study of Chronic Traumatic Encephalopathy (a partnership of Boston University and the Sports Legacy Institute, recently infused with a $1 million NFL grant) declined to go there. But even if the best-known faces of concussion reform are getting unhelpfully cautious in their rhetoric, the sports commentariat and the federal government have the means to take the Duerson narrative all the way home.

  11 May 2011..........

  A couple of different readers, with a couple of different viewpoints, have told me that my coverage of the announcement of Dave Duerson’s chronic traumatic encephalopathy maligned Boston University’s Dr. Robert Cantu by stating that he had vaguely backdated the definition and naming of the disease in a way that disrespects the work of Dr. Bennet Omalu.

  On this point, I think the critics are right and I was wrong, so let me correct the record here.

  After that, I’ll proceed to explain why I believe exposure of my error only deepens the suspicions that the sports medical establishment fell down on the job and that the National Football League was none too eager to see that a better job be done.

  What Cantu said in Boston a week ago Monday was that CTE was identified in boxers as “punch-drunk syndrome” in the 1920s, and “since the ’60s and especially the ’70s it has been known as chronic traumatic encephalopathy, with multiple case reports in the world’s clinical and neuropathological literature.”7

  That is accurate. Nor is there any reason to dispute this fuller chronology from the Sports Legacy Institute:

  The term “chronic traumatic encephalopathy” appears in the medical literature as early as 1969 and is now the preferred term. Through 2009, there were only 49 cases described in all medical literature since 1928, 39 of whom were boxers. Many thought this was a disease exclusive to boxers, although cases have been identified in a battered wife, an epileptic, two ­mentally challenged individuals with head-banging behavior, and an Australian circus performer who was also involved in what the medical report authors referred to as “dwarf-throwing.”8

  CTE remained under the radar when a Pittsburgh medical examiner named Bennet Omalu identified CTE in two former Pittsburgh Steelers who died in his jurisdiction in 2002 and 2005. He published his findings, drawing the attention of SLI co-founder Chris Nowinski, who worked with families to deliver three more cases that Dr. Omalu and others diagnosed with CTE, including SLI’s first case, former WWE wrestler Chris Benoit.

  What happened?

  In my several lengthy conversations with Dr. Omalu, he has taken credit for the term CTE; on one occasion, Omalu even reminded me that he had been the sole, and not merely a major contributory, coiner of it. To the extent that I ran with Omalu’s assertion, bad on me. If I’ve somehow misinterpreted what Omalu has been telling me (but I don’t think I
have), then double bad on me. (Omalu declined comment in an email this morning.)

  Now that that piece is out of the way — again, apologies to Cantu, Chris Nowinski’s SLI, and the Center for the Study of CTE for the implication that they were deflecting due credit to Omalu by fudging history — what does all this mean for the story of the national head-injury crisis in sports?

  The answer is that it is, if anything, even less flattering to the powers that be. Bennet Omalu didn’t discover CTE or even attach the most widely recognized handle to it. He was just the first to identify CTE in football players.

  CTE was wending its way through the medical literature throughout the 1970s in association not just with boxers, but with battered women and circus performers as well. Meanwhile, as concussions took a skyrocketing toll on football players over the next 30 years, no one made the connection.

  Remember Travis Williams, “The Road Runner,” a speedy running back who set kickoff return records as a rookie for the 1967 Super Bowl champion Green Bay Packers? He was finished way too early, battled depression, wound up penniless in a homeless shelter in Richmond, California, and died at 45. Of course, we can’t know if Williams had CTE, but his story is just one of dozens or scores or hundreds of similar ones prior to that day in 2002 when Omalu happened upon Mike Webster’s brain.

  All of which leads to another broad observation, about the folly of “peer-reviewed scientific literature.” This phrase, preferably uttered in hushed tones and on bended knee, is the talisman of the same priesthood that has failed a sports-mad nation in disseminating needed public health information. Peer review, in my opinion, is a pastiche of standards, honored as much in the breach as in the observance when convenient, and it comes embedded with its own set of social, professional, and commercial biases.