League of Denial (20 page)

Elliot Pellman’s views on concussions were perfectly aligned with the NFL doctrine at the time, as articulated by Tagliabue and the NFL’s PR machine. When he spoke publicly, he seemed to suggest that they were a routine part of the game and not a major concern. In 1994, the year the MTBI committee was formed, he told
Sports Illustrated
that “concussions are part of the profession, an
occupational risk.” A football player, he told the magazine, is “like a steelworker who goes up 100 stories, or a soldier.” In 1999, by siding with Munsell, the Bears’ doctor in the
Hoge case, Pellman—himself an NFL doctor and by then the head of scientific research for the league—had endorsed a treatment model that most leading concussion researchers would have equated with bloodletting and the application of leeches: allowing a severely concussed athlete who had no idea where he was to return to play without even a cursory exam.
The same year, Pellman repeated the statistics the league had now floated for a decade—just one concussion every three games—and suggested that injuries to high-profile players such as Toon, Hoge, Aikman, and Steve Young had created a “mirage” that led people to “think the injuries have increased though they’ve really been there all the time.”

Pellman seemed to practice what he preached. Former players described how, as the Jets’ doctor, he often allowed concussed athletes back on the field.
During a 1999 playoff game against the Jacksonville Jaguars, tight end Kyle Brady reached back for a pass from Vinny Testaverde and was knocked unconscious by a helmet-to-helmet hit. Dazed and nauseous, Brady was helped to the sideline, where Pellman and the medical staff examined him. Suddenly, out of the fog, Brady heard the booming voice of Jets head coach Bill Parcells: “Is he gonna be all right? When’s he gonna get back in there?”

“You know, in a classic Parcells kind of way,” recalled Brady, chuckling as he described the memory to ESPN’s John Barr. “I’m not sure if it was a question. It might have been a command.” Brady returned for the next offensive series, still woozy, his teammates telling him where to go. Asked if there was any basis for clearing him, Brady replied: “No. None.” But he said he was just as eager as Parcells to see himself back on the field. “At that point, you’re kind of like a slobbering dog,” Brady said.

Kevin Mawae, who played center for the Jets for eight seasons, said he
liked Pellman immensely, respected him “as a man,” and even trusted him as his family physician. But he said it was clear in the Jets’ locker room that Pellman served multiple masters. Pellman had cofounded a Long Island health care network, ProHEALTH Care Associates, which worked with multiple New York sports teams, including the Jets. The building was filled with memorabilia. “There’s definitely some influential weight that goes with being a team doctor, and there’s a conflict of interest because they work for the team,” said Mawae. As more information about Pellman surfaced—his résumé embellishment, the
overlapping relationship between the Jets and his private practice, his brain research for the NFL despite his total lack of qualifications—Mawae began to hear “jokes in the locker room about Pellman’s status with the NFL and things like that.”

One running joke involved a three-word code—“
Red Brick Broadway”—that Pellman had players recite to determine if they were able to play after a concussion. According to Mawae, “The three words were always the same. He would leave you and come back before the next series, and you’d go, ‘Red Brick Broadway. I’m ready to go.’ ” In 2003, Pellman would face pointed questions about his treatment of a wide receiver, Wayne Chrebet, who was allowed to reenter a close game against the Giants after being knocked out for several minutes. “This is very important for your career,” Pellman reportedly said before sending him back in. Chrebet was never the same and retired in 2005.

But players such as Mawae and Brady said such incidents were common. On one occasion, Mawae said, he suffered the same injury as Chrebet: He took a knee to the head and blacked out. “Next thing I know I’m laying prostrate on the ground,” he said. “The first realization was, ‘Wow I just got knocked out.’ ” After performing a “systems check,” Pellman and the Jets’ medical staff allowed Mawae to return for the next series, but “my teammates were telling me that I was making calls that weren’t even in our playbook.”

Reflecting on Pellman’s selection as the NFL’s top medical adviser and leading expert on concussions, Mawae said: “If you’re gonna get a doctor that’s a yes man, then it makes it easy for you.” He regarded Pellman as a pawn. “Pellman’s just a small part in this,” Mawae said. “The bigger part is it’s a multibillion-dollar industry that cannot afford something such as this.”

In North Carolina, Kevin Guskiewicz was beginning to perform his own concussion studies, each with results more ominous than the one that preceded it. He watched the development of the NFL’s new concussion committee with incredulity and amazement. Guskiewicz, of course, loved football—the Steelers, after all, had paid his way through grad school while he worked as an assistant trainer—but he felt that the NFL’s new committee had willfully excluded the most respected researchers, especially those whose research indicated the potential for long-term
problems. “Quite frankly it was
comical the way in which that original committee was pulled together; comical is probably the nicest way I could describe it,” he said. “It seemed like they were cherry-picking anyone who seemed to be dabbling in this topic who was local in the New York area.” Guskiewicz found the choice of Pellman (“a rheumatologist!”) “bizarre.” He wondered: “Who looked at the résumés of these individuals?”

“I’m trying to think of an analogy here: like in an airport when there’s a major breach of security,” said Guskiewicz. He thought the NFL’s approach to the concussion problem was essentially: “Let’s pick these folks, that will be the solution, ignore the problem, and it will all go away.”

Lovell was part of the committee, but he too wondered how Pellman, with his limited neurological background, could possibly have landed the job.
Pellman offered one explanation when he later wrote about the MTBI committee’s formation: “On the basis of my experience with Mr. Toon, I was invited to the Commissioner’s office to offer my limited insight into this problem. The Commissioner and I realized that we had more questions than answers. Was this a new problem or just an often misdiagnosed or unrecognized one? Was the premature retirement of these men a statistical anomaly or the beginning of an epidemic? I was asked to mount an effort to answer these questions.”

Multiple sources, however, said Pellman had been Tagliabue’s personal physician and they believed that was at least part of the reason he was named chairman.

“
That’s my understanding,” said Lovell, a member of the committee from its inception.

In a statement to ESPN, Tagliabue acknowledged he was treated by Pellman but said that the first time he saw him as a patient was October 1997—three years after the formation of the MTBI committee. “No personal medical care had anything to do with Dr. Pellman’s appointment to the committee in 1994,” Tagliabue wrote, adding that Pellman got the job “based on his experience in sports medicine, his work with the Jets that included Al Toon’s concussion-related retirement … and recommendations from Jets ownership and management.”

The committee didn’t publish its first research until October 2003—six years after Tagliabue became one of Pellman’s patients. Pellman would continue as one of the commissioner’s personal doctors until 2006.

Pellman, as promised, started from scratch. The MTBI committee began its work by spending months establishing an official
NFL definition of a concussion. The lack of a consensus definition “has plagued the study of mild head injury in general and concussive injuries in athletes in particular,” the committee wrote in an internal status report circulated in 1996. The new league definition was broad: “any traumatically induced alteration of brain function.” That included a long list of symptoms: blackouts, wooziness, amnesia, headaches, vertigo, memory loss, personality change, lethargy, and so on. All constituted an NFL concussion, “or, as we quickly decided, the more academically appropriate term,
mild traumatic brain injury
,” Pellman wrote.

The committee used that definition as the starting point for an epidemiological study it called the NFL Mild Brain Injury Surveillance Study, a system to monitor concussions across the league. The MTBI committee distributed forms to medical personnel from all 30 teams with instructions to keep up-to-date records every week. “A major obstacle to head injury research is the unavailability of
willing test subjects,” said one memo prepared by a bioengineering firm contracted to participate in the study. “The NFL has graciously sponsored a research program offering its players as those living subjects.”

Lovell was put in charge of setting up the NFL’s neuropsychological testing program, which he based on the model that he and Maroon had created for the Steelers. A few years later, after Lovell testified on behalf of Hoge—and, by extension, against the Chicago Bears and the league—
Lovell thought he’d probably be ousted from the committee and would never work in the NFL again. But Pellman never brought it up, nor did anyone else. Instead, the league gave Lovell
$12,000 in seed money to spread the gospel of neuropsychological testing. He traveled from city to city, team to team, armed with a letter of support from Tagliabue, who wrote: “We
strongly recommend that all clubs in the NFL implement such a testing program so that neuropsychological data is available to club physicians, or other treating physicians, in the event of player concussions.”

The NFL’s concussion committee was up and running. Pellman reported
directly to Tagliabue. The commissioner was rarely seen at the committee’s meetings—Feuer recalled him sitting in on only a couple of sessions, during which he rarely spoke—but his representatives frequently attended. Those representatives included, from the very beginning, NFL attorneys. Two lawyers who supported the early work of the MTBI committee were Jeff Pash, the league’s general counsel, and Dorothy C. Mitchell, a young lawyer who served as counsel for policy and litigation.
Mitchell’s responsibilities included providing legal oversight for the NFL’s medical and safety committees. Pellman and his colleagues later wrote that Mitchell “
worked tirelessly to initiate the MTBI research.”

Dorothy Mitchell’s contribution to the MTBI committee wasn’t totally clear, but at one point she used information related to the NFL’s concussion research to try to discredit an
expert witness in Hoge’s lawsuit. That witness, John McShane, had been the team doctor for the Philadelphia Eagles and a clinical assistant professor at Thomas Jefferson University in Philadelphia. In 1996, McShane received a $134,000 grant from the NFL to study changes in the brain chemistry of concussed NFL players, a study that included other league-affiliated doctors, including Lovell. But before the study got off the ground, the Eagles sold their medical rights to another provider, and McShane was ousted as team doctor, leaving him without access to the players for his league-commissioned study.

Instead of intervening to keep the study alive, the NFL—first Pellman and then Mitchell—sought to recover the grant money, some of which already had been spent on sophisticated software. The aborted study had long been forgotten until July 2000, when Mitchell FedExed material related to the dispute to the attorney defending John Munsell, the Bears doctor who had treated Hoge. Munsell’s attorney walked into court the next day and tried to use the NFL’s documents against McShane, a former league physician who was prepared to testify that Munsell and the Bears had negligently sent Hoge back on the field to his doom.

McShane, sitting in the back of the courtroom as he watched the argument unfold, was baffled and angry. He felt he had tried to do research that would help the NFL with its concussion problem, only to be thwarted because the Eagles had changed medical providers. Now he
was under attack by the league because he planned to testify on behalf of Hoge. “I couldn’t understand why anybody would be mad at me,” he said. “I had all good intentions; I wanted to do a study that would provide valuable information. Then this change happened that I had no control over, and they were impugning me. I was just stunned.”

The judge ruled that the dispute had nothing to do with the case, and McShane was allowed to testify. But it was an early sign of how the NFL and its ostensibly independent concussion committee were willing to throw their weight around—and for which side. The league was prepared to send Elliot Pellman, in his authority as chairman of the MTBI committee, to testify that Munsell’s questionable treatment of Hoge was in fact sound. And the NFL lawyer who helped form that committee was willing to intervene in a concussion lawsuit against an NFL doctor. Before the MTBI committee had published a word of scientific research, it had staked out a position as a defender of the NFL.

The McShane study was just one of
a number of early NFL concussion projects. The MTBI committee produced an educational video about how to wear a helmet properly. It looked at special mouthpieces and Kevlar caps that purported to reduce concussions. There seemed to be no end to the parade of gadgetry that passed before the MTBI committee from entrepreneurs seeking the imprimatur of the NFL. Many of the projects were considered and discarded, but Pellman was especially passionate about one initiative: helmet
design
. For various reasons, including the threat of lawsuits and a regulatory process that effectively was run by the helmet companies, there had been little in the way of helmet innovation over the years. With appropriate testing and the right design, Pellman thought, the NFL could use its vast resources to create a concussion-resistant helmet.