I did not watch the Super Bowl this year. I could have, and there were a few moments when I was tempted to peek in, but I promised myself I would not, and I did not. In the interest of full disclosure I also cannot claim that abstaining was particularly difficult, because I had zero interest in either of the teams except to the extent that I hoped they might somehow both lose. Still, in a historical context my decision marked a turning point for me, and it is a choice I intend to continue going forward. As hard as it may be — and I suspect it will be a great deal more difficult than I imagine — I have decided to stop watching football at any level for the rest of my life.
In retrospect I am not surprised that I came to that decision, but I am surprised how quickly it took hold. As anyone even remotely aware of athletics knows, there is a serious problem with the game of football, which is that the game itself routinely if not inevitably maims the people who play it. For most of my life it was assumed that the physical damage from football was largely acute, occurring when a tendon ruptured or a bone snapped in two, and anyone who has watched football for any length of time has invariably seen players carted off as a result of such trauma. We now know, however, that there is a more insidious kind of damage which haunts players not only after their playing careers are over, but in some cases even while they are in what should be the prime of their life. This second class of injury may not become fully emergent until decades later, but there is now no question about where that damage comes from, and it comes from playing football. Otherwise healthy and fit — and in many cases extremely fit — human beings are disabled and even die, well before their time, for no other reason than having played the game.
That the first football game I chose to turn away from also happened to be the most celebrated annual event in American sports was not lost on me, but my decision was only incidentally symbolic. I could have watched the Super Bowl this year, then sworn off the game, but I decided I did not want to wait. Starting my football abstinence with the Super Bowl was indicative of my commitment, and I did not want to put off that commitment simply to satisfy my desire to be entertained for a few hours.
Abstaining from the Super Bowl was also not a specific indictment of the professional game. To be sure it is the National Football League which has been the focus of investigation into, and reporting on, long-term negative health effects for players, but the final straw that triggered my decision to stop watching football actually came from the college ranks. Specifically, only a few weeks into what would become my alma mater’s most improbably successful season on the gridiron, news broke that a former player at the University of Iowa — Tyler Sash — had died, in his hometown of Oskaloosa, Iowa, of what was believed to be an accidental drug overdose. Although there had been prior reports of odd behavior and scrapes with the law subsequent to Sash’s retirement from the NFL, nobody thought that his life would come to an end at the age of 27.
While there were certainly concerns that football might have contributed to Sash’s death in some way — perhaps because of chronic physical injuries sustained during his years on the field, and his subsequent need for painkillers — it was also clear that Tyler Sash had walked away from the game relatively unscathed. That assumption seemed to be borne out by findings a month or so later, when it was reported that Sash had died from a toxic mix of painkillers. Tragic, to be sure, but in a country overrun with opiate abuse, hardly an indictment of the game of football, which Sash himself clearly loved.
Not until after the end of the Hawkeye’s surprising season, however, was it learned that Tyler Sash not only had chronic traumatic encephalopathy (CTE) — a type of brain damage now closely associated with head injury, and particularly with concussion — but the development of the disease was shockingly advanced for someone so young:
The Times report says the severity of CTE in Sash’s brain was similar to the level found in the brain of former NFL hall-of-famer Junior Seau, who committed suicide in 2012 at age 43.
“With Tyler being so young, it’s very surprising to me,” linebacker A.J. Edds, who played at Iowa with Sash in 2008 and 2009, told The Register on Tuesday night. “But when you start looking back and connecting the dots, some of the symptoms and signs were there.
“It’s eye-opening. It tells you about the state and the standing of what football is continuing to do to guys, not just physically but mentally as well.”
The news of Sash’s post-mortem diagnosis broke at the end of January. Because CTE was already in the news at that time, and particularly because Sash played for a New York franchise in the NFL, the findings of his autopsy received national coverage. The news also occasioned deep reflection among several of the long-time beat reporters who cover Hawkeye sports, and their conflicted deliberations matched my own.
The NFL Conference Championships played out on Sunday, January 24th, 2016, only two days before Sash’s CTE was reported in the news. The Super Bowl was scheduled for two weeks later, on Sunday, February 7th. During that two-week period my already growing concerns about football as a sport, as entertainment, as a for-profit business, and as an agent of misery and death, coalesced into the only avenue of action available to me. I decided I would stop watching football, not simply as a means of avoiding what was happening to players at all levels of the sport, but as a means of effecting change, however incrementally.
Football and Trampolines
Whether you are an ardent sports fan or only encounter news from the sporting world incidentally, you are probably aware of CTE as a recently discovered disease, and particularly so as it relates to players in the NFL. On more than one occasion in recent years, former players have actually committed suicide in a manner designed to preserve their brains for future study, and in those instances advanced CTE was subsequently diagnosed. Will obviously unsettling and extreme, such acts have advanced awareness of CTE as a danger, and more generally advanced the conversation about concussion and head trauma in athletics.
Subsequent to the news of Tyler Sash’s death, and to my decision to stop watching football in the future, I started saving links to articles about CTE as I chanced upon them. I did not do any sort of internet search on the subject, but rather allowed the internet and the cultural moment to deliver content to me by happenstance. Yet over the next two months I found myself almost inundated with new reports about CTE, particularly in the context of professional football. As the same time, however, my own thinking about CTE, and particularly about the long-term prognosis for football, moved more and more in the opposite direction, toward both the high school and college games.
Because of the money involved, the national platform, the marketing spectacle and the NFL’s deep cultural roots, there is no question that professional football will dominate the CTE conversation for the foreseeable future. I do not believe, however, that that is the level of play at which the ultimate disposition of the sport will be decided, for two critical reasons. First, professional football is the terminus of an athletic journey which begins in childhood, meaning parents are the first and most important gatekeepers in the football pipeline. Second, because the NFL is a for-profit business, it can avail itself of legal arguments which — as we all learned during Deflategate — have nothing to do with right or wrong or truth or facts, and everything to do with protecting the brand and the obscene amount of money that brand produces.
In my view, not only will football falter and ultimately fail as a sport because the supply of players will eventually be starved by parents who do not want their children turned into dementia patients (or worse), but it is in the ranks of the college game where collapse will first take place. Even momentarily tabling such a speculative outcome, however, it should be clear that any disruption in the college game — which effectively functions as the minor leagues for the NFL — would damage the NFL’s ability to put a compelling ‘product’ on the field. Without football factories like the University of Iowa and many others doing the training and winnowing of players, including playing twelve or more survival-of-the-fittest games each season, the NFL would have to implement and manage a similar developmental league, and that would probably exceed the financial and logistical reach of even its own considerable resources.
There is now no question that football as a sport causes CTE in at least some percentage of players, which is not to say that football is the only sport where that is or may be the case. Virtually any sport that involves a helmet is immediately suspect, and even games like soccer pose a real threat. Because of the rapidly evolving linkage which has been and continues to be demonstrated in the sport of football, however, economic and legal factors will continue to bear down on that sport with increasing intensity until the game may be simply be unable to survive. And yes, I understand that such prognosticating probably sounds loony to most of the people reading this post.
If you are old enough, however, you have already witnessed such a cultural transition regarding what used to be an almost ubiquitous piece of athletic equipment — the trampoline. And here I do not mean the modern, round, stretch-fabric trampoline, but the rectangular, industrial-grade gymnastics apparatus made of interwoven elastic straps, which was easily capable of launching people twenty or thirty feet into the air. As long as those people came right back down on the same spot they were fine, but if their trajectory was anything less than vertical they were suddenly at the mercy of the laws of physics, including the physical properties of whatever they landed on.
When I was a kid in the 1960’s, trampolines were everywhere. One company even made an insanely fun game called Space Ball, which two people played on a modified trampoline. Yet while almost everyone thought that trampolines were non-stop fun, there were two small but increasingly vocal groups who begged to differ. Those two groups were emergency room physicians and insurance adjusters, because as it turned out errant trampoline bounces actually happened with horrifying regularity. One minute everybody was happy, the next moment there were not only tears, but a trip to the hospital with a broken arm, leg, back or neck, at times leading to life-long paralysis.
As far as I know, no governmental body ever outlawed trampolines on the basis of safety, or even thought to do so. If that seems strange, remember that in the 1960’s you also could not purchase a truly protective bicycle helmet for yourself or anyone else, because they simply didn’t exist. Which is to say that back in the day, ignorance and the independence of the American spirit meant that your physical safety was entirely up to you, at least until someone proved that there was an obvious danger. But even then, as likely as not, no legislative enforcement would be undertaken.
Automobiles could have had airbags decades before they commonly became available, yet their eventual appearance in the marketplace was not mandated by law, it occurred because of a mix of cultural factors, including increased consumer interest in vehicular safety. In that same way, where trampolines were once commonplace, two converging safety-related factors rendered them virtually extinct in only a few years. Yes, if you were willing to pay exorbitant insurance costs you could still have one, but between that massive increase in costs and increased awareness about the dangers driving those costs, most people — and most schools, and most companies — decided to give up their trampolines, for good reason.
As regards football the analogy should be clear. As if routinely splintered bones, shredded ligaments, ruptured spleens, lacerated kidneys and the occasional practice-field death weren’t already enough, there is now no question that the sport of football — as a direct consequence of blows to the head which are inherent in the game — causes CTE, which is an acronym for a long medical term that is synonymous with brain damage. Take a human brain, bounce it around on a football field long enough, and at some point you will induce CTE.
How many blows to the head are safe? Nobody knows, but the weight of medical evidence strongly suggests that the answer is, as you might expect, none. All blows to the head have the potential of causing CTE, and more blows to the head make the likelihood of developing CTE exponentially worse. Most bounces on a trampoline were safe, too, but because nobody could come up with a reliable way to prevent an occasional bad bounce from leading to catastrophic damage, the trampoline eventually had to go. I now believe the same economic and cultural factors which led to the demise of the trampoline will inevitably lead to the end of football.
CTE and Legal Exposure
While the question of legal liability is already being contested in the professional ranks, given the NFL’s small number of teams relative to the college game, its closely held and concentrated power structure, its legal standing as a corporation, and its long-standing demonstrated willingness to do anything to protect its profits, I believe the professional game is actually least likely to suffer a near-term downturn because of concerns about CTE. Much more likely, in my view, is that growing safety concerns and attendant legal liabilities will bear down on the college game, which is played at more than 650 schools across the United States, including schools in states where the legal landscape will inevitably be more favorable to litigation.
Even assuming that such suits are sincere and on the merits — as opposed to cynical attempts to extort money by bottom-feeding members of the legal profession — the mere threat of legal exposure, or increased insurance costs to compensate for same, may be sufficient to cause some schools to terminate football, just as many colleges removed trampolines. In fact, I don’t see any way for a school to avoid at least the potential for legal liability other than abandoning football altogether, because head trauma is quite literally part of the sport. While it has long been known that football was physically violent, the discovery of, and subsequent ability to, diagnose CTE — albeit currently only on autopsy — radically changes the prior legal calculus.
About a decade ago I actually stopped watching professional football for a few years because the NFL was aggressively marketing physical violence as part of the game. Acts that would have landed the perpetrator in jail in any other context were celebrated, and all the more so if they “laid someone out” or “rang his bell” or “put him to sleep”. While the NFL did ultimately start paying lip service to player safety prior to the discovery of CTE, and I did eventually drift back to watching the professional game, there has never been any question that the game of football is antithetical to good health, particularly over time. Even in high school severe injuries are commonplace on every team, to say nothing of the magnitude of injuries which are suffered at higher levels of play because the athletes are bigger, stringer and faster.
Yet even taking all of that into account, CTE is fundamentally different. In Iowa City you can’t just stagger across the street from Kinnick Stadium to the University of Iowa Hospitals and Clinics and have them diagnose your CTE. And even if CTE could be diagnosed while you were alive, there is no treatment, and I don’t believe there will ever be a treatment for CTE. Unlike a ruptured Achilles or a torn ACL or even a severe case of rhabdomyolysis, CTE is something you should avoid at all cost. Yet as we now also know, and as every Hawkeye fan learned from Tyler Sash, CTE can manifest at a much earlier age than previously believed.
The Growing Toll
During the two-week period after Tyler Sash’s CTE diagnosis was released, but before I decided to skip the Super Bowl and stop watching football for good, I ran across a story which had been published in early January. That story was about a young man named Michael Keck, who never played professional football, and who only played two years in college:
All told he spent 16 years on the gridiron, 16 years of using his body like a battering ram, 16 years of boom.
When he died two years ago, at 25, those 16 years left his brain brittle and deformed, pockmarked with the clumps of protein characteristic of chronic traumatic encephalopathy. The disease, researchers reported Monday, was the worst they had ever seen in someone so young.
“It was quite widespread,” Ann McKee, co-author on a study of Keck’s brain in the journal JAMA Neurology, told NBC News. (The study does not name Keck, but he has been identified by news outlets.)
If you want to fully understand why I won’t be watching football for the rest of my life, you should read the entire article about Michael Keck. Because when you’re done you will be faced with the same dilemma I faced after Tyler Sash’s post-mortem CTE diagnosis, which is that something I enjoyed watching as entertainment — as a mere diversion in my own life — was crippling and even killing the people I was rooting for and against. Not injuring them acutely as a result of random chance, or some deranged act on the part of another player, but as an inevitable byproduct of the game itself.
If you have spent any time around football players and football coaches and football culture, you know that players learn at a very young age — and are often actively taught — that they must sacrifice their bodies in order to be successful. To an ordinary person such advice sounds crazy for the simple reason that it is crazy by every normal standard, but that’s the game of football. It is, inherently, about physical collisions and the physical trauma that inevitably results.
Until only a few months ago, however, despite full awareness of that mentality, it was still possible for me to rationalize the pain and suffering that football represented by limiting my conception of that trauma solely to the physical sphere. And here, in fact, modern medicine actually aided in that selfish conceit. If I sprained my ankle I am confident that I would hobble around in agony for weeks if not months, but I’m not a football player. Football players, we learn, are a special breed who can have their knees entirely destroyed — ACL, MCL, PCL and LCL, all torn from their moorings or ripped in two — only to have all of that damage surgically repaired so they can subject their bodies to even more gridiron trauma in the future. You don’t even have to go looking for players who have lost an ACL or MCL or patellar tendon more than once, only to rehab like a boss and come back for more — albeit after an agonizing year of daily off-camera physical therapy. And yet that is itself an improvement over how things used to be, back in the day when such reconstructive options did not exist, and crippled players were simply discarded.
By the time each football season comes to a close every player is hurting physically, but there are steps those players can take — often at their own behest — to at least minimize the pain or the potential for further injury. Yet while physical trauma has always been acknowledged (though also minimized, often to the detriment of players), any mental toll from playing football was widely believed, in the literal sense of a convenient fantasy, to be entirely a question of cognition. If you had trouble thinking the game it was not because you had a concussion-related brain disease, but because your mind wasn’t right, or you didn’t crave success, or your willpower was weak. Though there has long been evidence that repeated head trauma causes mental problems for athletes — hence being ‘punch drunk‘ in boxing — it was more expedient for fans, coaches, the media and even football players themselves to ignore such linkage and blame the mind, as opposed to the brain, for everything from performance lapses to personality changes. Even players who were clearly concussed were simply told to ‘shake it off’ or ‘walk it off’ or ‘get back in the game’ — or they kept themselves in the game for fear that coming out would be seen as mentally weak or cowardly, or give another player their precious playing time.
Again, CTE changes all that. There is no more pretending, ever, that blows to the head can be overcome simply through strength of character or mental resolve. The brain — the most important organ in the entire human body, if not also the most fragile — is now not only part of the injury conversation, it has revealed itself to be vulnerable to irreversible and long-term trauma simply as a byproduct of playing football. And that in turn exposes the inherent insanity of the sport when that correlation is translated back into football-speak. Because however crazy it sounds to tell a human being to sacrifice their body for a game, it is positively sadistic to suggest that someone should sacrifice the functioning of their mind.
That is, I think, a big reason why more and more football players at all levels are simply walking away from the game. It’s one thing to know you’re going to go under the knife three or eight or sixteen times in your career, and another altogether to know that no knife can fix the CTE in your brain. Again, in only a couple of months I ran across multiple stories of players giving up on what was for many of them a life-long love of the game, and for some even the promise of riches:
On Wednesday, [A.J.] Tarpley, 23, announced that he’s retiring after just one season because of concussions.
“The only thing comforting about not knowing this play would be the last of my career, is knowing that I never took a second for granted,” he wrote on Instagram. “After months of introspection, I am retiring from football. I suffered the third and fourth concussions of my career this past season and I am walking away from the game I love to preserve my future health.
Tarpley was preceded in the news by twenty-four-year old linebacker Chris Borland, who also walked away from the pros after one year:
San Francisco 49ers linebacker Chris Borland, one of the NFL’s top rookies this past season, told “Outside the Lines” on Monday that he is retiring because of concerns about the long-term effects of repetitive head trauma.
Borland, 24, said he notified the 49ers on Friday. He said he made his decision after consulting with family members, concussion researchers, friends and current and former teammates, as well as studying what is known about the relationship between football and neurodegenerative disease.
“I just honestly want to do what’s best for my health,” Borland told “Outside the Lines.” “From what I’ve researched and what I’ve experienced, I don’t think it’s worth the risk.”
Only a few weeks ago seven-year vet Husain Abdullah also called it quits:
Chiefs safety Husain Abdullah announced his NFL retirement this morning after seven NFL seasons, becoming just the latest in a string of players calling it quits while still effective, and yet another one citing his health as a reason to hang it up.
Abdullah, who was a UFA but surely would have found work, made the announcement on his Instagram.
“Sitting for five weeks last year after suffering the fifth concussion of my career,” he wrote, “I had a lot to contemplate. My goals moving forward are to be of benefit to my family, my community, my country and hopefully the world. Having a sound mind will be vital in accomplishing these goals.”
Then again, given all the news about older players and the struggles they’ve faced, which is getting much more attention precisely because of awareness of CTE and the havoc it wreaks, maybe those retirements aren’t so surprising. Former QB Joe Montana seems to be one of the lucky ones so far, though his body is still breaking down. Two other former quarterbacks, however — Frank Gifford and Kenny Stabler — weren’t so lucky, and although both of them died of natural causes, it was clear that they also suffered from the effects of CTE:
[Stabler] died of colon cancer in July at age 69, and his family donated his brain and spinal cord to Boston University’s CTE Center; Stabler was among the players who had sued the NFL over the occupational hazard that is head trauma.
The results surprised no football player or fan who followed the case of Frank Gifford, or knew of the suicides of Junior Seau and Andre Waters and Dave Duerson, or read about the accidental pain-medication overdose of Tyler Sash, who died with CTE at age 27 despite appearing in only 27 regular-season and postseason NFL games, and never as a starter.
Over the past decade or so the NFL sanitized its violent image while settling lingering and looming legal issues related to physical injury, yet the league still vehemently disavowed any connection between concussion and CTE. As such, rules changes were made not so much to protect every player, but to protect star players, and in particular the star quarterbacks that make the league the success that it is. Given that the Denver Broncos won this year’s Super Bowl with a geriatric QB who would have been bludgeoned senseless in the first five minutes of the game twenty years ago, those rules are obviously a success as far as they go, and that’s a positive step compared with how things used to be, but those rules do not prevent head trauma.
The NFL’s mania for protecting QB’s doesn’t extend to all players, or even to QB’s in all instances, again because of the nature of the game. Once you step out of the pocket and start running, no matter who you are, your noggin is exposed because it’s right there on top of your shoulders. Although the head slap — which used to be legal, and was routinely employed up and down the line of scrimmage on both sides of the ball — was outlawed way back in 1977, by their very nature positions such as running back and fullback and linebacker and safety experience equivalent blows to the head on almost every play. Even linemen routinely find their helmets bashing into a helmet on the other side of the line of scrimmage, merely as a byproduct of play, which may be why D’Brickashaw Ferguson recently announced his retirement from the Jets’ offensive line after missing only one snap in the previous ten years.
And yet, to illustrate how quickly things are changing even for the NFL as a result of growing awareness of CTE and the danger of concussion, consider first these words from uber-tool Roger Goodell, the commissioner of the NFL, just before this year’s Super Bowl:
“From my standpoint, I played football for nine years through high school and I wouldn’t give up a single day of that,” he said. “If I had a son, I’d love to have him play the game of football because of the values you get. There’s risk in life. There’s risk in sitting on the couch.”
As you might imagine, some of the families of NFL players who suffered from CTE did not take too kindly to Goodell’s invalidation of their pain, including the family of Dave Duerson:
Tregg Duerson was among those who took offense. His father, who played for the Bears for seven of his 11 NFL seasons, committed suicide in 2011 at 50 and was posthumously diagnosed with chronic traumatic encephalopathy (CTE).
“Comparing the CTE risk that NFL players face with an apparently inherent risk in sitting on the couch is an insult to the men affected by CTE,” Duerson said in a statement Sunday morning. “These men and their families deserve better. The commissioner and the owners should be displaying empathy, not insensitively minimizing the severity of long-term brain damage.”
Apparently unable to resist playing to type, one of the NFL’s more colorful owners recently followed up on Goodell’s couch trip with his own variation on the same theme:
Indianapolis Colts owner Jim Irsay told the Sports Business Journal that players understand they are taking a risk playing football, but said much is not known about side effects of participating in the sport, comparing it to the varying side effects one might experience from taking aspirin.
That sage chemical analogy not only comes from the man who wasted the early years of Andrew Luck’s career, but a man who was arrested in 2014 for driving while impaired, at which time the police discovered $29K in cash in his car, and a laundry bag containing numerous bottles of prescription drugs. Yet despite systematically downplaying the risks inherent in the game, and perpetually denying the long-term negative effects of repeated head trauma, only a few weeks ago the growing weight of medical evidence finally compelled an NFL official to acknowledge, for the first time, that there was a link not simply between concussion and CTE, but between football and CTE:
The NFL’s top health and safety officer acknowledged Monday there is a link between football-related head trauma and chronic traumatic encephalopathy, or CTE, the first time a senior league official has conceded football’s connection to the devastating brain disease.
The admission came during a roundtable discussion on concussions convened by the U.S. House of Representatives’ Committee on Energy and Commerce. Jeff Miller, the NFL’s senior vice president for health and safety, was asked by Rep. Jan Schakowsky, D-Ill., if the link between football and neurodegenerative diseases such as CTE has been established.
“The answer to that question is certainly yes,” Miller said.
Those hoping for a similar change from Roger Goodell or the league’s marketing weasels, however, remain predictably disappointed. In fact, after hiring former White House press secretary Joe Lockhart to spearhead an aggressive new public relations effort, the NFL had its ass handed to it by the New York Times after the Times ran a story exposing the ways in which the NFL intentionally undermined its own concussion research. You can see the NFL’s reply here, and the NYT’s response to the NFL here, but the important point is that the NFL itself poisoned key research about the relationship between concussion and consequent brain damage, including CTE.
CTE and Big Data
While the sudden evolution of the NFL’s views on concussion and CTE betrays the speed with which medical questions are finally being answered, it should be clear from all of the above that the NFL has absolutely no incentive to lead the research charge, and every incentive to deny and delay. And again, because professional football is nothing but another self-interested industry, albeit one which necessarily maims its employees as a matter of due course, it’s unlikely that the NFL will do anything about head trauma other than the absolute minimum required to remain profitable.
By contrast, however, that is not only decidedly not the case with the college game, college football is played in an environment in which questions such as the relationship between concussion and CTE are welcomed and pursued with scientific rigor. Again, at the University of Iowa the football stadium is quite literally across the street from a cutting-edge university medical facility, to say nothing of the university proper, and all of its various departments. That in turn raises questions not only about additional medical research that needs to be done, but about other research which might prove useful in identifying problems associated with sports-related head trauma. And it is on that latter point, I think, that researchers will eventually uncover a powder keg of incriminating data that effectively makes football incompatible with higher education.
Currently, the battle over concussion and CTE is being waged on a purely medical front. Blows to the head beget concussions, which in some individuals triggers CTE. More blows is worse, fewer blows is better, but overall the question remains one of basic physiology. Yet the anecdotal evidence is also overwhelming that the earliest evidence of CTE may not be physiological, but behavioral, including everything from mental health problems to run-ins with law enforcement to suicide or accidental death.
I do not know if anyone is currently doing research along the following lines, but if they aren’t it’s only a matter of time, probably measured in months rather than years. Because if there’s one similarity between mental health diagnoses and run-ins with the law it’s that those events are almost always documented. Meaning all someone is going to have to do to determine if football as a sport produces mental health problems or criminal behavior down the line, is gather the medical and legal data for a given population, then compare that information to the documented sporting history of the individuals in that population. If it turns out that playing football in college, high school or even junior high produces a statistically greater likelihood of mental health problems or criminal behavior, my guess is that that correlation is going to be clearly apparent when compared with individuals who never played the game.
As you can imagine, if such a correlation was ever made, football would be finished, and not just on college campuses. Yet it is precisely at colleges and universities that we are most likely to see researchers step up and do the necessary number crunching, because that way lies academic advancement. Prove a statistically significant correlation between blows to the head on the football field and trouble later in life — or perhaps even during the player’s career — and you’re going to make a splash.
Sure, all kinds of cockroaches will come out to dispute the findings, and more research will need to be done, but if it holds up — as the correlation between smoking and cancer held up, and the correlation between asbestos and lung disease held up — then the legal gloves are going to come off. At that point, as happened with the trampoline, it will no longer be economically viable to play the game even if the players swear they’re happy to assume all future risk in exchange for compensation or playing time in the present.
But that’s only the beginning of the potential problems for those who hope, for whatever reason, that football will survive. Because as soon as any research shows such a correlation, that’s going to unleash an almost unimaginable deluge of lawsuits from former players who believe, or hope others will believe, that they are victims of the sport. And since many if not most of those litigants will have been introduced to football in their youth, it’s not hard to imagine that they may have a claim as non-professionals. Particularly if it can be shown that there was or should have been some awareness of the potential dangers on the part of coaches and administrators, whether in college, high school, junior high or even in the Pee-Wee leagues.
Yet even that won’t be the end of it, because there may be even more information hiding in whatever data is already available. For example, when adjusted for the economics of different teams, school districts or colleges, do football players from wealthier communities show less trauma, perhaps as a result of having better equipment, including particularly the latest helmets? Or perhaps players from poor communities or disadvantaged families tend to have more problems indicative of head trauma because the game simply represents their best chance at escaping poverty.
Even if data proves that is not already the case, as concerns about brain trauma grow, and more and more parents prohibit their kids from playing football, it’s almost a given that football will become like the armed services, which are often the best available option for kids who come from families with limited means. That in turn will further concentrate the negative effects of brain injury from football in a population with the least available resources to deal with those problems. And of course that is already the case with the armed forces, where far too many of the those who have suffered from TBI or developed CTE as a result of IED’s live at or below the poverty line.
Again, all head trauma is bad, whether it happens on the battlefield, the gridiron, a soccer pitch or a basketball court, and that correlation is spurring conversations if not outright changes in other sports. Just as football teams are pulling back on contact during practices, soccer at the youth level is now recommending that headers not be permitted during practice in order to cut down on blows to the head. At the same time, the sport of BMX was left reeling in early February following the suicide of the legendary Dave Mirra in Greenville, North Carolina, in a tragedy which mirrored the deaths of Dave Duerson and Junior Seau in the NFL. (It is not yet known whether Mirra’s brain was affected by CTE.)
Football and Profit
In any other context it might take considerable time for a few researchers around the country to gather the necessary data, check various hypotheses and publish results, but here again the fact that colleges and universities are intimately involved in the football pipeline suggests otherwise. At the professional level, yes, the pros will not only attempt to slow-walk research and control the dissemination of results, but at the college level there is a convergence of favorable motives, if not vehemently so.
The reason for that is that on many college campuses across the country, there already exist faculty, staff and even students who are sick of routinely subsidizing what is effectively entertainment at the expense of the academic mission of those schools. If it suddenly seems possible that the primary driver of those subsidies — the football program on campus — might be dislodged from academia because it is inherently injurious to the students who play that game, it may be quite easy to recruit people at various schools and in various disciplines so as to expedite that research.
Again, it’s going to be hard to kill football at the professional level because there’s just too much money to be made turning a few human beings here and there into basket cases, particularly when the worst damage doesn’t usually show up until years after they’ve been shown the door. In high school it’s also going to be hard to let go of the game because of the local traditions and history, which often reach back into families for generations. At the collegiate level, however, where there is at least a pretense of intellectual curiosity on most campuses, it’s going to be a lot harder to stop people from asking questions — meaning people who aren’t simply concerned parents, but fully qualified and credentialed professionals in their own right. Professionals whose institutions also have the exact resources necessary for investigating those issues, including a football team. (Although powerful athletic boosters at any level are notorious for breaking rules and even laws, at state-funded schools the football team and athletic department may even be obligated to help conduct such research.)
In this, again, there are obvious parallels to toxic for-profit pursuits like smoking or working with asbestos, and there is no reason to believe that the people who profit from football — whether economically or otherwise — are going to give up those profits without a protracted and even dirty fight. There is one way in which football is markedly different from those toxic pursuits, however, and that’s the fact that most of the profits derived from player injuries are indirect.
While we can liken people who were hurt by asbestos or tobacco to football players who are injured by concussive blows to the head, neither working with asbestos nor smoking was ever a source of entertainment for others, meaning there was no third-party constituency which was heavily invested in the perpetuation of those pursuits. Nobody ever groused about asbestos being taken off the market because they got their kicks watching other people develop lung disease, and the same goes for smoking. With football, however, the vast majority of people who love the game — and who back that love up by spending billions of dollars on everything from tickets to cable packages to merchandise, do not actually play the game, they simply watch.
Taking everything we’ve discussed so far into account, then, it should be clear that the question of whether football will survive or not has already been answered. Given the connection between CTE and concussion, and the fact that concussions are an inevitable byproduct of the game, football is finished, yet that is not actually news. For decades now — and I do not say this is an original thought, even as I came to it myself — it has been clear that if football did not already exist, and someone proposed it as a school-sponsored activity at any age, that person would be run out of town.
Concerns about child safety have never been higher, both in terms of mental and physical injury, yet with regard to football we still encourage healthy young human beings to slam into each other at full speed — if not also to train intensively in order to become bigger, faster and stronger, so those collisions are even more damaging. (For the record, no, it does not matter how you teach children to crash into each other, because there is no way to prevent the brain from slamming against the inside of the skull during sudden deceleration.) What we are still dealing with, however, even in the aftermath of medical documentation of CTE, is very much like what happened with smoking after the linkage between smoking and negative health effects was clearly established.
Long before that time people referred to cigarettes as ‘coffin nails’, so there was clearly awareness that cigarettes were not good for you, yet the lack of hard science allowed the tobacco industry to profitably peddle its addictive lie. Even after the negative health effects of smoking were established, however, not only did people keep smoking — as might be expected given the addictive nature of tobacco — but the industry kept on promoting its lawful products by any and every means available, including advertising at children. Still, today, you can legally sell tobacco products which have serious documented health risks, and there is no prohibition against smoking yourself — which is pretty crazy when you think about how much all of those lung ailments and hospitalizations cost everyone, to say nothing of the human toll.
Again, however, the difference with football is that it is not a drug, or at least not a chemical addiction. It is, instead, pure entertainment — or, more broadly, a state of mind, and the profits from that state of mind are going to dry up unless it can be preserved. Intruding on the football fan’s happy place more and more, however, and thus disrupting that cultural high, is the undeniable realization that football is as potentially dangerous as tobacco or asbestos — and even more so given that otherwise vital football players can be struck dead on almost any play, simply as a result of stepping on the field.
The Fantasy of Football
Football at all levels is quintessentially American, for all that says about America. Though not everyone participates, partakes or even approves, football is part of our collective cultural DNA, and there is simply no mechanism known to mankind, including a cultural revolution, which can stop that kind of historical momentum in its tracks. Even though the vast majority of people do not play football, they are deeply invested in the games, in the teams, in reading about the sport, in watching highlights on TV, in playing fantasy football, and of course in wagering on every conceivable aspect.
Because of the weight of history — the memories, the lore — football persists even as it is clearly hostile to every other trend in society. We not only do not want people hurting each other, we particularly do not want such behavior to be state-sanctioned or for-profit. And yet where we would be aghast at the idea of heading over to the local highway to watch young, healthy athletes participate in sponsored car wrecks, we think nothing of heading off to a stadium or flipping on the telly to watch the functional equivalent. Why?
The answer, of course, is that what we witness on TV or even on the field right in front of us is not real. We could attempt to explain that further by delving into the empathy gap and other aspects of psychology, but we don’t need to head down that road. The simple truth is that if most fans were fully aware of the physical violence that occurs on a football field during every play, those fans would at least think twice about their own enjoyment of the sport. Which brings us back to my own decision to stop watching football, because even before I learned about the deaths of Tyler Sash or Michael Keck, I found myself struggling to keep the veil of innocence in place while watching games. And that was particularly true when a game was halted by what I would have previously considered a routine or relatively minor injury.
When I was a kid, and through most of my life, football injuries were just another opportunity for the TV network to cut away for a lucrative commercial, and for me to hit the fridge. One minute a player was down, the next minute or two featured dancing bagels or bubbling beer, then play resumed whether I made it back in time or not. Over the past couple of years or so, however, particularly as ‘player safety’ became the new marketing mantra of both the NFL and its sycophantic media partners, broadcasters have been forced to take a much more concerned tack, not only somberly intoning that a player has been injured — because they can no longer instantly and euphemistically diagnose players as ‘shaken up’ — but showing the attending medical personnel in a concerned way. The problem with that, of course, is that doing so only reminds any viewers of conscience that football is an entertainment product in which the performers are routinely hurt.
Over the past year or two, when an on-field injury occurred, the reality of that moment intruded on the fantasy of abstracted military conquest that was playing out in my head. One moment I would be ardently rooting for something that others were ardently rooting against, which had no intrinsic meaning other than the spectacle itself, then the next minute the game was unmasked as nothing more than violent theater. Injuries, even those having nothing to do with blows to the head, became real to me, and I felt complicit in that reality.
Yet even in those moments when trainers now rush onto the field at the first sign of trouble, instead of waiting as they used to for players to stagger to the sidelines, I also know that the flurry of attention and concern I am seeing is simply a new act to help absolve me of that complicity. Specifically, I noticed during a number of last year’s professional and college games, that some of the staff attending to fallen players were on the field only for show. They would run out, kneel down, immediately recognize that the player simply needed a moment to recover, and yet they would stay down in order to mime the concern that the people in the stands — and particularly the cameras — now demanded.
As if that wasn’t enough, each time an injury occurred while I was watching a game last year, and a somber time-out followed — at least until a gaggle of whitened teeth began celebrating a jar of zesty salsa, or a shimmering automobile sailed through a landscape void of medical maladies — I found myself thinking about the hundreds if not thousands of players I’d seen in the past, who’d taken the same kind of hit, or suffered the same kind of injury, yet at the time they not only received no on-field attention, I often thought only about how that injury would affect the outcome of the game. Now, today, each new injury, and particularly each new blow to the head, isn’t simply that injury, it also evokes my own long history of complicit naivete.
But it gets worse. I have always known that the athletes in any sport at any level are themselves the result of a filtering process. The better athletes progress, the lesser athletes fall by the wayside. From Pee-Wee league to junior high to high school to college to the professional game, football players must run a gauntlet not only of literal head-to-head competition, but also of physical injury. At each successive level, the players in uniform thus not only represent themselves, they represent dozens or hundreds or thousands of players who didn’t make the cut — and who, inevitably, endured repeated blows to the head that will never show up in any stat sheet.
For every football player who ultimately makes it to the NFL, as did Tyler Sash, there are thousands and thousands of players who fell short for whatever reason. And I now see those players, metaphorically, when I’m watching the players who excelled and survived. Every professional QB or linebacker is now also a proxy for players that I will never know, all of whom took a beating. Players like Michael Keck, who came to my attention not because of his on-field glory, but because he died, and after he died his brain was found to have been ravaged by CTE.
That’s why I decided to stop watching football — because I can’t pretend any more. Football is no longer entertainment, it’s a reminder of the atavistic means by which that sport, at the college level, and high school, and junior high, and even in youth leagues, finds the best by breaking the rest. For a long time we’ve known that athletes who fall short of their dreams can carry that grief with them the rest of their lives. Until recently, however, we believed that loss, that pain, was purely mental or emotional. We now know, because of players like Tyler Sash and Michael Keck, that there may be thousands of similar tragedies across the country which have never been properly diagnosed. Blows to the head on the football field prompt behavioral changes or mental problems only a few years later, yet football itself avoids suspicion because those problems arise when the afflicted individuals no longer play the game.
For the Love of the Game
If you want to succeed in football there are two ways to go about it. First, be massively huge, insanely athletic, or preferably both. If you are faster than everyone, stronger than everyone, bigger than everyone, you will always find a spot on a roster. You may still end up with a pulped brain, of course, but the odds of that will be diminished by virtue of your gifts.
The second is to be willing to sacrifice your body more than anyone else. You may not be bigger, stronger or faster than the players you’re competing with, but if you are willing to run through a brick wall again and again you will probably also find a spot on a roster. Maybe you’ll end up on special teams, or the practice squad and only see playing time when other players are injured, but you’ll still make it. You’ll be a football player, at least as long as your body holds up, which may only be a few years.
Unfortunately, if you follow that second path it should be fairly obvious that your potential for developing CTE will go up, and perhaps dramatically so. If you’re undersized at your position, or everyone else is faster or stronger than you are, then each collision is going to do more damage to you than the other guy, even if you’re the one dishing out the hits. Force equals mass times acceleration, and all that.
Tyler Sash got to the NFL by following that second route. By all accounts he loved playing football, and he committed himself to getting everything out of his body that he could in order to pursue that passion. What he did not know back when he started playing football, however, is that what he was doing to his body he was inevitably also doing to his brain, and his brain would never heal.
In the pro game, the excuse the NFL leans on most heavily in absolving itself of its remorseless exploitation of its own players — many if not most of whom have little or no contractual safety net in case of injury — is that those players are adults who choose to risk their bodies for the love of the game. Or, at the very least, for the money they are being paid. And of course in a legal sense that’s true, but it doesn’t explain where the love powering such voluntary commitments comes from.
The answer, of course, is that love of the game is instilled in players when they are young — meaning when they are legally under age. Whether initiated by parents who have an ulterior motive or parents who simply enjoy athletics, or by coaches who see potential — even if only as fodder for the line, or another disposable body in the backfield — there is a process of indoctrination in football, as there is in all sports and all pursuits in life. As history has borne out, the earlier that indoctrination takes place the stronger its hold will usually be, and the families of fallen football players know that better than anyone:
Sash came from a football family. His father, Michael, played in college and his brother, Josh, was a good enough high school player that he considered playing in college as well.
Josh Sash, eight years older than Tyler, said his brother sustained at least two concussions in high school, one documented concussion in college and two with the Giants, including one in the Giants’ playoff victory over the San Francisco 49ers that earned the team its berth in the Super Bowl after the 2011 season.
In the San Francisco game, Sash, who was 215 pounds, was blindsided by a brutal and borderline late hit on a punt return by a 281-pound defensive lineman.
“Those concussions are the ones we definitely know about,” Josh Sash said. “If you’ve played football, you know there are often other incidents.”
Josh Sash, who has two young sons, said it would be difficult for him to recommend that his children play football when they grow older. Barnetta Sash [Tyler’s mother], who said she had always loved football, felt similarly.
“I want other parents to realize they need to have a conversation with their kids and not just think it’s a harmless game — because it’s not,” said Barnetta Sash, whose daughter, Megan, has three children.
Tyler Sash’s mother initially believed that his scrapes with the law and his trouble at home after retiring from the NFL stemmed from the pain meds which did indeed claim his life. But she still donated his brain to rule out CTE, which we now know was rampant. Here is Sash’s mother, Barnetta, on ESPN’s Outside the Lines, after she found out that her son’s brain was riddled with CTE:
“I have a deep sadness thinking that my son suffered his last couple of years and we couldn’t put a finger on what was wrong,” Barney Sash said. “We thought it was the need of a surgery and the pain medication that was causing him to conduct himself in a way that was different than the Tyler we knew and loved.
“The sadness was he was kind of alone in this. He couldn’t explain it. He never complained. He said ‘I got this, Mom.’”
Nobody set out to hurt Tyler Sash, least of all his family. To the extent that everyone knew football was a dangerous game, it was still assumed, perhaps naively, to be relatively safe in terms of long-term mental health. We now know that’s not the case, and in all the reading I have done on the subject I have yet to come across a single account from anyone who was suffering with what was later diagnosed as CTE, or any family member who witnessed a loved one struggling with CTE, who said it was worth it. Not even one cynical distant cousin, who got a couple of signed footballs to sell on the internet, or a few tickets to sell for a tidy profit, has stepped forward and said that what football does to the human body is worth what anyone gets from the game.
Unfortunately, that kind of future risk is hard to impress on a young, strong and fearless athlete, which is why I think more and more parents will simply take that decision out of the hands of their kids and refuse to allow them to play football. That in turn will prevent any love for the game from ever taking hold, while allowing less-risky passions to evolve. Over time, in concert with diminished social acceptance, football will die on the vine, even if there is never any increased regulatory oversight or prohibitive legal ruling spurred by long-established principles regarding the welfare of children.
Football and Financial Risk
In terms of the financial risk to the institutions which host and promote the game, I think the most immediate threat is aimed not at high school or the pros, but again, at the college game. High school football is, in general, not-for-profit, though plenty of weasels can be found there as well, exploiting kids if not entire communities. The professional game is entirely for profit, and mercilessly so, yet as already noted that single-minded focus actually insulates the NFL, at least in the short term. In college, however, particularly at smaller schools, but even at some of the bigger universities, there is often a co-mingling of funds from football and academics, and therein lies the potential for an almost immediate disruption of the game.
Currently, at the University of Iowa, the academic ledger and the athletics ledger are separate. Just recently, however, the newly and fraudulently elected president of the school, J. Bruce Harreld, resurrected the previously rejected idea of siphoning off profits from the athletic department in order to support academics — even though it’s not clear that the athletics department always runs a profit. Yet the possibility that academics could end up on the hook for routine athletic losses is not the most pressing concern. The most pressing concern is that in taking profits from the athletic department — assuming they materialize — the academic department may be exposed to potential legal liabilities from athletics.
At the vast majority of schools athletics are subsidized by academics, because the athletic department simply can’t stand on its own. At Iowa the athletics department currently has to live within its own means, which protects academics from suddenly having to bail out the athletic department if the administrators make a dumb move or take a financial hit. And by athletics we of course largely mean football on most campuses, because football is both the largest consumer and greatest generator of athletic revenue. Even if you’re not a sports fan you probably still know that not only is football a violent sport, it is an incredibly expensive sport. Between uniforms — particularly if those costs are not defrayed by a corporate sponsor — and training facilities, and stadium expenses and travel expenses, it’s not at all rare for a college football program to burn through tens of millions of dollars in a single season, and the biggest programs burn through considerably more.
Even going to a high-profile bowl game, with multi-million-dollar payouts to each school’s conference, is not a guarantee of profits. For example, the Iowa Hawkeyes went to the Rose Bowl in 2016, and were granted an unprecedented allocation in order to do so, yet still lost money:
The University of Iowa’s first trip to the Rose Bowl in a quarter century resulted in its largest bowl-related deficit in recent history — with expenses climbing $228,445 above the Big Ten allotment of $2.5 million.
That $2.5 million represented the university’s highest-ever allocation for a bowl game, and the UI athletics department absorbed the overage.
Schools which do not generate enough revenue to cover the cost of their football program must shift money from academics to keep the sport viable, often in the form of student fees and other subsidies. In the long-term, if football ceased to exist, all of that money might be better spent elsewhere, but between that future and now there exists the very real possibility that a massive amount of unrealized liability is about to come due. As such it would seem self-evident that college and university presidents should be doing everything possible to wall-off and segregate athletics from academics simply as a means of minimizing risk. And yet, at least at the University of Iowa, the new, business-oriented president believes the right course of action is to actually expose the entire institution to that risk.
Lawsuits which are currently playing out in the pro game are not the end of the legal conversation about concussion and CTE, they are the beginning, and will continue to spread through the courts to all levels of play. It is literally only a matter of time before former college players begin suing the schools they attended, alleging that they’re now having trouble in life because of injuries sustained while playing the game. And of course if private schools are at risk of all this — and they are — imagine the trouble that deep-pocketed state schools will have, particularly if they are already co-mingling funds from academics and athletics. The minute the first legal domino falls on any campus you’re going to see absolute panic because no one will have the slightest idea how to protect themselves from future football liability. Which of course they can’t, because liability is inherent in the game.
Football and Denial
Whether you buy into the five stages of grief or not, there can be no doubt that by that gauge we are, culturally, still in the denial phase, and I think that phase is going last a long time. Then again, just recently the head coach of the Arizona Cardinals, Bruce Arians, gave us a preview of what’s to come by leaping ahead to the anger phase. Without irony, Arians claimed that mothers were attacking the game of football because they were reluctant to allow grown men like Arians to expose their children to the risk of brain damage:
“We feel like this is our sport. It’s being attacked, and we got to stop it at the grass roots,” he said. “It’s the best game that’s ever been f—— invented, and we got to make sure that moms get the message, because that’s who’s afraid of our game right now. It’s not dads, it’s moms.”
While Arians quickly walked back those comments, his rant sprang from the same kind of macho attitude that football players and their families have been exposed to for generations. It’s not that the game itself is inherently dangerous, it’s that people who do not love the game more than they love their own children are a threat which must be neutralized.
Evidence of cultural denial can also be seen in the disappointing box office returns for the movie Concussion, which was released this past winter. While apparently a workmanlike film (I haven’t seen it), the public did not want to see that story on the big screen, and it’s not hard to understand why. If you watch a movie about how the NFL routinely lied to its own players regarding the link between concussion and CTE, and you see a dramatization of the horrible lives those players lived as they grew older, you’re going to have a hard time enjoying the next neck-snapping act of on-field brutality with your family or friends.
Denial is also cleaving the sporting press in twain, between those who are serious journalists and those who are tools of the NFL and the major college conferences. Denial also plays a big part in efforts to solve or fix the concussion problem, because there is no way to prevent concussion when two human beings crash into each other, often at combined speeds in excess of thirty miles an hour or more. While no sane physician would ever recommend such activity, particularly for kids — and again, football isn’t the only sport where concussions occur — such collisions are inherent in football.
That is in fact why there is a growing movement at all levels of play to limit the number of simulated car crashes that football players experience, at least during practice. In the most recent contract with the NFL, the Player’s Association bargained hard for fewer practices overall, and fewer contact drills in full pads. Only last year, the Ivy League actually banned hitting at practices, at least during the season. While avoiding collisions obviously decreases the amount of potential injury each player’s brain receives, it still does nothing to prevent concussions during play, and even the best advice that science has to offer is never going to solve that problem:
Even with every possible intervention and innovation, short of drastic changes to the game, football players will always be at risk for concussions. For this reason, [Erik] Swartz cautions against looking too hard for solutions to this problem.
“Concussions happen in football because of the nature of the sport and we shouldn’t feel like we have to portray the game as something we can eliminate concussions from or make safe,” he said. “In comparison to other sports and other activities, it’s not safe. That’s the nature of the game.”
Caught between the desire to keep football as it is, and the undeniable reality that the sport of football does damage to the people who play it — including causing advanced, irreversible brain damage in players who are only in their twenties — it is understandable that some people will cling to the belief that the problem can be fixed. And yet, as just noted, there is no safe form of tackle football, just as there is no safe form or car racing. You can make each sport safer, but any time a brain sloshes around inside a skull the potential for damage is there. The best you can hope for — in any sport — is to limit the total number of blows to the head, but even then no one knows what the dangers truly are.
The only answer, and conceivably the only answer we will ever have, is of course the obvious answer. Do everything you possibly can to limit head trauma. Accidents happen, yes, but the head trauma in football is not an accident, it is an inevitable byproduct of playing the game. And I can no longer pretend otherwise.
Walking Away From the Game
Maybe I’m the only person who now thinks of football as the industrial equivalent of brain-damage manufacturing, but I don’t think so. Which means at some point we’re going to cross another threshold, and that will occur when fans start openly talking about the difficulty they’re having enjoying game. At that point someone will also do real polling on the subject, asking people not simply if they like football, but if they have concerns about long-term health risks for the players, and whether those concerns impact their enjoyment as fans. There may even be a movement — small at first — to outlaw football, because it is, from a health perspective, completely insane, and again the most likely place for such a spark is on a college campus.
If you’ve stayed with this post this far, chances are you have misgivings about football yourself. But even this post is a relatively safe abstraction of the problem, which is why I think the best gauge of where you are in your own cultural football journey is whether or not you took the time to read the full article about Michael Keck. Because it’s one thing to talk about CTE in a middle-aged former professional, or even a younger player like Tyler Sash, who played a couple of years in the NFL, and another altogether to think about a player who only played two years in college, whose brain was still ravaged by CTE. Because that means there are almost certainly thousands and thousands of former college players walking around who have suffered similar levels of undiagnosed brain damage, assuming they’re still alive.
Although CTE is now evident in the college game, and almost certainly present in the high school game as well, I think a lot of people are going to have a very hard time coming to grips with that reality. And because of that I think they’re going to be particularly predisposed to turn away from the Michael Kecks of the world, if not also the Tyler Sashs, because they’re just not ready to give up whatever football means to them as fans. And for the record I’m not asking anyone to make that leap, and I’m not going to go ‘vegan’ on anyone if they still enjoy watching the game.
What I do think, however, is that we’re a lot closer to the point of cultural collapse with football than most people realize, and again I think that collapse will happen first in the college ranks. At some point the sheer weight of evidence, perhaps in combination with player tragedies connected to a particular school, perhaps due to legal risks and liabilities, will prompt a school to stop playing football on the basis of player safety. That won’t happen in the power conferences of course, or schools were football is that institution’s identity, but it will happen.
For the time being the players will keep playing because they don’t know how to stop. The fans will keep tailgating or tuning in because they don’t know how to stop. The networks will keep selling the games because they don’t know how to stop. And the truth of it is, I don’t know how to stop either. I fire up my computer, I go about my business, and the next thing I know I’m halfway through a story about a famous player or the upcoming draft before I remember that I swore off the game.
I know the temptation is only going to get worse going into summer, with training camps opening at every level. Then the preseason games literally kick off in August, and the regular season games in September, and there will be wall-to-wall coverage even as everyone now knows that the physical punishment being absorbed on any play may take years off a player’s life. I know I won’t be able to avoid reports about football in the news, or highlights on TV, but I do know I won’t be turning a game on myself. I’ll miss rooting for my favorite players and teams, and I’ll miss rooting against the teams I’ve always despised, but over time I also know I’ll find something else to do.
I know there will be days when it will be tough. Days when the whole country is buzzing about a win or a loss or just a great play. Days when sports talk is wall-to-wall football, when social media is wall-to-wall football, when the internet is wall-to-wall football, and on those days it’s going to be hard to walk away. Right up until I remember Tyler Sash and Michael Keck, and then it will be easy.
It was Tyler Sash’s decision to play football instead of basketball that contributed to his death, his mother said in a report on ESPN’s “Outside the Lines” that aired Sunday.
“I love football. I’m not trying to ruin football for anyone,” Barney Sash said in an emotional interview on the program. “My son went the football route. He could have played basketball. It wouldn’t have cost him his life.”
Notwithstanding cynical denials motivated by a fear of lost revenue or institutional prestige, the linkage between normal, routine football and Sash’s death should be clear to everyone. Because of cultural inertia, however, it’s going to take time for more and more people to realize that there’s no difference between the game they enjoy watching and the damage that occurred to Sash’s brain.
I do think the reporters who cover Iowa sports have done a good job of not turning a blind eye to Sash’s tragedy, but it’s also going to take time before reporters figure out how to bridge that same cognitive divide. If you want to report on football as entertainment, you can’t stick a microphone in the face of every high school or college kid — or that kid’s parents — and ask them how they feel about playing a game that not only might leave them dead on any given play, but lead to an untimely early death or life-long brain damage. Yet because of the growing mountain of medical evidence, there’s no longer any way to simply ignore or deny those risks.
Culturally, the only answer is banning the kind of contact that causes CTE, which is unfortunately inherent in football. What has changed between the time Tyler Sash started playing football and now is that we now know his death was entirely preventable. The number of Tyler Sashs and Michael Kecks that might be saved will simply be determined by how long it takes for fans themselves to embrace that reality.
To the credit of Tyler Sash’s mother, she has done many families a great service by refusing to perpetuate the dissonance that America will be struggling with for some time. And I think the reason she did that is because not only did football kill Tyler Sash, his death wounded her and others in ways that will never heal.
Update: On 05/18/16 CBSSports.com reported on the “Next wave of concussion lawsuits” hitting college conferences and schools. I don’t see any way that the liabilities inherent in the game can ever be legally mitigated. Past players can be compensated, but going forward no one can feign ignorance of the dangers of CTE.
Update: On 05/23/16 USAToday reported on the findings of a congressional investigation into charges that the NFL tried to subvert government research:
A congressional investigation claims NFL officials “improperly attempted to influence the grant selection process” in a concussion study led by the National Institutes of Health (NIH), according to a report released on Monday.
The investigation was launched after ESPN reported in December that the NFL, which had promised as much $30 million for the study of the debilitating brain disease chronic traumatic encephalopathy (CTE), withheld funding from the NIH due to the involvement of researchers from Boston University.
“The NFL’s interactions with NIH and approach to funding the BU study fit a longstanding pattern of attempts to influence the scientific understanding of the consequences of repeated head trauma,” the report released by the Democratic members of the House Committee on Energy and Commerce states. “These efforts date back to the formation of the NFL’s now-discredited (Mild Traumatic Brain Injury) Committee, which attempted to control the scientific narrative around concussions in the 1990s.”
One possible solution for the NFL, colleges and high schools around the country would be for Congress to pass legislation making it illegal for the government to study concussion or CTE, as has already been done with gun violence.
Update: On 05/24/16, ESPN reported that Dave Mirra had CTE:
Dr. Lili-Naz Hazrati, a University of Toronto neuropathologist who examined Mirra’s brain, says it was indistinguishable from those of afflicted former football and hockey players. “I couldn’t tell the difference,” she says.
There is no safe head trauma. Boxing, football, BMX, soccer, it doesn’t matter.
Update: On 05/31/16 ABCNews reported that concussions in children which do not occasion an emergency visit generally go unreported, suppressing statistics. As a result, concussion as a health issue, and particularly as a children’s health issue, may be significantly more widespread than currently believed.
Update: From a 06/01/16 story in the WaPo about Mantis Shrimp, this is why experts or researchers or scientists in one area shouldn’t talk about other areas of expertise:
Now, in a paper published in the journal Advanced Materials, the UC-Riverside scientists and engineers say they have detected a heretofore unknown natural structure in the outer layer — the critical “impact area” — of the club. Were helmets or body armor to be created following this mantis shrimp template, they say, soldiers and football players could be protected from immense blows.
If by “immense blows” they mean a 16-ton weight being dropped on their heads, maybe. But even a mantis-shrimp helmet will do nothing to prevent the brain of a football player traveling at a high rate of speed from crashing against the inside of the player’s skull on impact. (Why is that so hard for people to understand?)
Update: On 06/06/16, Des Moines Register reporter Aaron Young filed an otherwise routine story about the University of Iowa football program. The story concerned the Iowa’s Ladies Football Academy — which is both a fundraiser and an opportunity to give women insight into the program — and highlighted the participation of KCCI anchor Cynthia Fodor:
Through seven hours at the event, Fodor learned what life is like for Hawkeye players, saying she has “a whole new respect for college football players.”
“They’re in meetings since 6:45 in the morning. They train six days a week and are in meetings till 10 o’clock at night. It’s like, ‘When do these guys ever study?’, ” Fodor said on the show.
Stories like that are being written and reported all over the country this time of year, as news outlets seek to update — and profit from — fan interest in the game of football. Noticeably missing from the DMR report and Fodor’s quotes, however, was any discussion of concussion or CTE, or how that might also affect the ability to study.
This cognitive dissonance in the press will persist for much longer than anyone would like, including, probably, many members of the press. There’s too much money involved to report on what head injury does to people, or even what it feels like. That’s not the case with other sports, however, which is why you should give this article by Stef Schrader a read: What a Race Car Crash Does to Your Brain.
Even a routine play on the football field can be the functional equivalent of a motor vehicle wreck, and football players endure multiple such collisions in every game, and more in practice. Until the press starts talking about what it’s like to be concussed, instead of what it’s like to go through two-a-days or endless meetings, we’re not going to have the one cultural conversation about football that we actually need to have.
Update: On 06/14/16, Evan Moore of DNAInfo.com published a piece on unsafe equipment currently being used at some Chicago schools:
With the summer practice session for football season just weeks away, some Chicago Public High School coaches are concerned about the quality of equipment that will be available to players because of a system-wide budget crunch.
At Sullivan High School, football coach Calvin Clark said the football equipment at Sullivan wasn’t safe to use and the Rogers Park school was forced to use a GoFundMe account to raise $8,500 to buy replacements.
“Sometimes, the budget at these schools are really small. You have to find a way to update it,” Williams said. “I didn’t have that many kids so I tried to make do with what we had. Many schools don’t even want football anymore. Many principals don’t want it.”
The implications in terms of legal liability are not only obvious, such suits are already being litigated. As soon as one of them sticks, you can kiss high school football goodbye in all but the most financially well-off districts.
Update: On 07/20/16, the Center for Public Opinion released a poll which makes clear that football will change from the bottom up long before the NFL takes anything other than legal action to protect itself from liability. From the press release:
Ninety-four percent of 1,000 American adults polled believe that concussions and head injuries resulting from participation in sports are a public health issue and 65 percent say such injuries are a major problem, according to the new poll, which was independently conducted by the Center for Public Opinion. Only 6 percent said they do not view sports-related concussions as a problem.
Eighty-five percent of those surveyed say that they believe science shows playing football can cause Chronic Traumatic Encephalopathy (CTE) and 87 percent say that brain trauma that results in CTE is a serious public health issue.
Football as a sport is already on life support. It will continue to cripple and even kill players at all levels because of money and cultural momentum, but nobody is confused about how dangerous it is. The only remaining question is how much additional damage we’re going to do to young athletes before we act on what we know. (Again, I think insurance companies are ultimately going to answer that question for all concerned.)
Update: On 07/27/16 the New York Times published a story about the NFL’s flagship program for preventing injuries in youth football, including concussions. Called Heads Up Football, the program has repeatedly made bold claims about reducing injuries, and particularly concussions, but the program did not reduce concussions.
Update: From the WaPo on 11/09/17:
Aaron Hernandez suffered the most severe case of chronic traumatic encephalopathy ever discovered in a person his age, damage that would have significantly affected his decision-making, judgment and cognition, researchers at Boston University revealed at a medical conference Thursday.
I don’t know if the research I suggested in the post is underway or not, but if it isn’t, it’s long overdue. The idea that football may correlate with crime and/or diagnoses of mental illness should be investigated as both a public safety and public health issue.
Update: In mid-January of 2018 a story broke about new research into CTE, which shows that although concussion may be a factor, it is not the main cause. From NPR on 01/18/18:
A study published online Thursday in Brain, a journal of neurology, presents the strongest case yet that repetitive hits to the head that don’t lead to concussions —meaning no loss of consciousness or other symptoms that can include headaches, dizziness, vision problems or confusion — cause CTE.
“We’ve had an inkling that subconcussive hits — the ones that don’t [show] neurological signs and symptoms — may be associated with CTE,” says Dr. Lee Goldstein, an associate professor of psychiatry at the Boston University School of Medicine and the lead investigator on the study. “We now have solid scientific evidence to say that is so.”
If you are sensitive to the horrors of animal testing, skip the article. If you’re sensitive to the horrors of human brain damage, it should be clear that this is both important research and a devastating blow to all of the steps that have been taken to protect and perpetuate football. Perhaps not surprisingly, however, in the ten days since it was released, the sporting press has paid almost no attention to this report, because it threatens the biggest cash cow in American athletic entertainment.
After spending years perfecting the sham of the ‘concussion protocol’, which is routinely evaded and faked in the professional ranks, in college and even in high school, this new research reveals the concussion protocol to be the equivalent of the cigarette filter. It gives everyone a false sense of security so they can keep making money and enjoying things that destroy their own health and the health of others. Maybe after the Super Bowl concludes next week the press will finally deal with this story…but I doubt it.
Update: From the Gazette’s Michaela Ramm, on 04/07/18:
Among its provisions, House File 2442 requires that a student immediately be removed from an interscholastic activity if the coach, an official or a licensed health care provider observes any signs, symptoms or behaviors consistent with a concussion or brain injury. The student would be unable to return to the sport or activity until he or she has written clearance from a licensed health care professional.
The bill also would provide some protection to school districts against liability “for any claim for injuries or damages” if the district provides a licensed health care provider at an interscholastic activity — and only if that professional acts reasonably in the best interest of the student.
I ran across this mention of liability concerns in Iowa by sheer accident, and I have no idea what is going on in other states, but the convergence of high school football with prohibitive insurance costs and legal liability is inevitable. Medically, we are now at the same point that tobacco got to when healthy warnings were added to packages. The football industry will do everything it can to obscure, deflect and deny, the addicted fan base will turn a blind eye, but in terms of the science there is simply no doubt that blows to the head are potentially lethal, and you can’t eliminate blows to the head from football. (Yes, head injuries happen in all sports, but not as a matter of course.)
The reason this bill is important — whether it passes or not — is that it moves liability into the medical arena, where everyone is already conditioned to minimize risk as much as possible. If you have to get permission from a healthcare professional to put your helmet back on, that’s going to take a lot longer than getting permission from a coach. (Or even from your own parents, if they’re gung-ho about high school glory days.)
— Mark Barrett