League of Denial (30 page)

“A football helmet gives you an awful lot of protection,” Wecht said. “But you don’t have to be a doctor or an engineer or even a football player to realize that the helmet does not block out all the measured force produced when some 300-pound player with a hand the size of a
Christmas ham whacks you in the head dozens of times a game, season after season.”

The NFL responded swiftly. This time the league’s defender was Maroon, who had been the Steelers’ neurological consultant during Long’s career. “I think the conclusions drawn here are preposterous and a misinterpretation of facts,” he told the
Post-Gazette
. “To say he was killed by football, it’s just not right, it’s not appropriate. I think it’s not appropriate science when you have a history of no significant head injuries.”

Maroon said Long’s only recorded head trauma was from a 1990 car accident when he swerved to avoid hitting a deer. “I was the team neurosurgeon during his entire tenure with the Steelers,” Maroon said. “I rechecked my records; there was not one cerebral concussion documented in him during those entire seven years. Not one.”

Maroon cited Long’s previous suicide attempts and his steroid use as other possible causes. “The bottom line is, in a patient who has not had truly documented head injury, no evidence of concussions—I would have seen him if he had—who has had a history of substance abuse, a history of suicide attempts with extremely neurotoxic materials, and then to conclude that this brain was damaged from football is more than a long stretch,” he said.

Wecht knew Maroon well—his son Danny was a neurosurgeon in Maroon’s practice and often worked the sidelines with the Steelers—and he became concerned by the aggressive denials.
Wecht called Omalu at home.

“Bennet, are you sure?” Wecht asked.

“Cyril, if Terry Long did not have CTE, may I drop dead tonight,” said Omalu.

Wecht ordered Omalu to speak to the media. Omalu, as it turned out, had Long’s medical records, including those from the Steelers. They included
a 1987 letter written by Maroon describing a concussion Long had suffered after colliding not with a deer but with an opposing player. Maroon wrote that Long was light-headed, had difficulty concentrating, and walked unsteadily. He recommended that Long sit out a week. Omalu told the
Post-Gazette
those symptoms were consistent with “massive concussive injuries.”

One day earlier, Maroon had insisted that Long had not had a single
concussion from playing football. Now he had to admit that he had “overlooked” the letter. But he said a concussion like Long’s “happens in the NFL on a weekly basis.” He said it was still a stretch to link Long’s death to football. Pellman rushed to Maroon’s defense, calling Omalu’s conclusions “speculative and unscientific.”

The Long case became
even more confusing when a toxicology report came back and revealed that the swelling in Long’s brain had been caused by the antifreeze he had ingested and not by football, as Wecht had told the media. When the toxicology report came back, Wecht had quietly changed the cause of death on the autopsy report to “suicide.” Omalu was unfazed. The presence of neurofibrillary tangles was consistent with CTE, which, he said, could only have been caused by football. “People with chronic encephalopathy suffer from depression,” Omalu said. “The major depressive disorder may manifest as suicide attempts. Terry Long committed suicide due to chronic traumatic encephalopathy due to his long-term play.” Omalu added, “The NFL has been in denial.”

“I think it’s fallacious reasoning,” Maroon shot back, “and I don’t think it’s plausible at all.”

While the Long dispute played out, Omalu, Hamilton, and DeKosky put the
finishing touches on their response to the NFL’s demand for a retraction of the Webster paper. Not surprisingly, Omalu’s initial response had been emotional. He called the NFL’s reasoning “archaic” and “naive” and accused the MTBI committee of “ignoring possible long-term neurodegenerative outcomes of play in the NFL” for over a decade. Omalu described his reaction as “a typical manifestation of an Igbo man: ‘Who do you think you are? Who do you think you are fucking with? C’mon, bring it on!’ ”

DeKosky wanted something more measured. “Ron, I don’t want anything to do with this preachy polemic,” he wrote in an e-mail to Hamilton. “The only way to respond to THEIR polemic is with a short, fact-based response.”

Hamilton agreed to play editor and dial it back from the original Igbo. He stripped out Omalu’s indignation and reduced the letter to two pages, although he did allow himself one bit of amusement, beginning the response to the NFL with a quote: “The lady doth protest too much, methinks” (Shakespeare,
Hamlet
III, ii).

That, too, was cut out of the final version, which was published in the May 2006 issue of
Neurosurgery
, alongside the NFL’s demand for a retraction.
Omalu, Hamilton, and DeKosky wrote that they had not suggested that Webster’s brain was identical to that of a punch-drunk boxer. Boxers endure more severe head trauma, they wrote, largely because they don’t wear helmets. “We doubt Casson et al. really feel that NFL offensive linemen do not experience repeated episodes of head trauma,” the letter said. “It is far more likely that the majority of the head trauma in the NFL, as well as in American football in general, is underreported by the players and the team staff, who accept the occasionally ‘dazed’ recovery during the game and postgame headaches simply as part of the sport, not unlike bruises and sprains.” They reminded the NFL’s concussion committee that Webster’s brain damage was well known in the league. “Of course, the NFL, at least the Disability Plan, acknowledged the cognitive impairment and its relationship to his profession,” they wrote.

In conclusion, they wrote, “Our case is important primarily because it indicates there may be brain damage in NFL players that is currently under-reported.” They said the NFL needed to begin a long-term study and they would be “happy to collaborate.”

Left unsaid was the self-evident fact that the NFL’s demand for a retraction had been denied. The Webster paper stood.

When Apuzzo and
Neurosurgery
published the Long study six months later, the NFL kept up its attack. The diagnosis of CTE was still wrong. Football players didn’t get brain damage.

The public brawl was taking a toll on Omalu. The young Nigerian immigrant who had barely heard of the NFL suddenly found himself the target of some of the most powerful doctors in the country, who had the full weight of a rich and powerful corporation behind them.

One afternoon,
the phone rang at Omalu’s desk at the coroner’s office. Omalu thought twice about answering. He was never sure who might be calling these days and what might happen next. But he picked up.

“Hello, is this Bennet?” said a baritone voice with a slight drawl.

“Yeah.”

“This is Julian Bailes. I’m the chairman of the Department of Neurosurgery at West Virginia University.”

“What can I do for you?”

“Bennet,” said Bailes. “I believe you.”

In Omalu, the Dissenters had found an ally. In many ways, his discovery was a validation of their own work. Bailes and Guskiewicz had found a large number of players with signs of dementia. Omalu and his colleagues had taken it a step further, confirming neuropathological changes in the brains of two players who were mentally impaired at the time of their deaths. Yet the NFL had dismissed Omalu, Hamilton, DeKosky, and Wecht in the same way the league’s doctors had dismissed Bailes and Guskiewicz. The Dissenters found it appalling. Their concern was no longer whether this was a problem; it was how many players like Mike Webster and Terry Long were out there: walking time bombs who were a danger to themselves and a nightmare to the people who cared about them.

Bailes told Omalu he wanted to help any way he could. Cantu also threw his support behind him. One day, Omalu received an e-mail from a man who identified himself as
one of Cantu’s former patients. His name was Chris Nowinski, and he told Omalu he wanted to interview him about his work for a book he was writing about the concussion crisis. They arranged a time to chat, and during the 45-minute conversation, Omalu educated Nowinski on CTE and his certainty about its significance. He also talked about the NFL’s hostile reaction to his research.

Nowinski soaked it up. He was
a new breed of Dissenter: not a research scientist but a concussion activist, for lack of a better term. He was trying to create public awareness of the underreported problem. Nowinski was tall, blond, and preppy, a former Harvard lineman and pro wrestler who became interested in concussions as a result of his own painful fieldwork. At the time, Nowinski was just 27, but he had been bashed in the head for years. Nowinski had played football at John Hersey High School in Arlington Heights, near Chicago, starting out as a spindly 6-foot-3, 160-pound middle linebacker. He loved the sanctioned violence and macho culture. Nowinski played with a broken hand, gulped down ibuprofen to fight through an injured shoulder, lived for the big hit. In one game, he sprinted down the field on punt
coverage and knocked out the returner with a helmet-to-helmet hit. Nowinski stood over his opponent and played to the crowd. He lifted weights constantly. By the time he graduated, Nowinski was a 6-foot-5, 230-pound defensive end. He also was an excellent student—in junior high, he was the Illinois champion in the Scientific Olympiad in the map-reading category—and a budding actor, performing in
West Side Story
in high school.

Nowinski’s successful career at Harvard was marred by at least a couple of concussions, though they weren’t diagnosed at the time and he didn’t miss any action. Once, during an intrasquad game, he collided so hard with a teammate that they both fell down sideways, toppling like bowling pins. “That was the first time I remembered the sky turning orange,” he said.

By his senior year, Nowinski was 6-5 and 295 pounds and harbored dreams of playing in the NFL. He worked out for a handful of teams, but when it became clear he wasn’t going to make it, Nowinski began to focus on life after football. Although he had majored in sociology, Nowinski landed an internship at Trinity Partners, a Boston-area consulting firm. One of his bosses, John Corcoran, was a pro wrestling fan. He knew Nowinski had a background in sports and theater and also loved the spectacle of pro wrestling. Corcoran suggested that he try it. It turned out to be a perfect fit, a chance for Nowinski to combine his athletic skills with his acting bug.

After work, Nowinski spent his evenings training at
Killer Kowalski’s Pro Wrestling School in Malden, Massachusetts, founded by the fabled wrestler who mentored some of the sport’s future stars, including Triple H, Big John Studd, and Chyna. Nowinski made $20 in his first match, wrestling under the name Jake Champski in front of 150 people at an armory in Portland, Maine. He then put together a video application that earned him a spot on an MTV wrestling reality show,
Tough Enough
. The writers dubbed him Chris Harvard, creating a character fans would love to hate: the snobbish Harvard graduate who taunted his opponents with his superior intellect. Nowinski repurposed a chant he recalled hearing from the fans of an opposing high school back in Illinois: “Five, ten, fifteen bucks, we own the company, you drive the trucks!” In 2002, he was signed by the WWE and made his debut on
Monday Night Raw
, with 5 million people watching. He was a rising star.

“I played the hateable character very well,” he recalled. “I had, you know, they liked to use the term ‘natural heat.’ People just liked to dislike me.”

Chris Harvard wore tight crimson trunks with the school logo on his butt. Sometimes he recited poetry to incite the crowd. At one match in Moncton, New Brunswick, he shouted:

Nowinski, of course, knew that the sport was staged, that the moves and the results were choreographed. But there was no way to comprehend the true violence of pro wrestling until he was in it. “You don’t appreciate how the sausage is made,” he said.

Nowinski got kneed, elbowed, drop-kicked, punched, and otherwise smashed in the head. That was all very real. The concussions began with a kick to the chin from Bubba Ray Dudley’s boot. Nowinski sucked it up and kept going. When more concussions followed, he never gave himself time to recover. Soon he was experiencing pounding headaches and blurred vision; sometimes he forgot how his matches were supposed to play out, like an actor forgetting his lines. He began sleepwalking. One night his girlfriend woke up at a hotel in Indianapolis and saw Nowinski standing on the bed, trying to climb the wall. She tried unsuccessfully to wake him by shouting his name, only to watch him leap off the bed and slam headfirst into the wall.

After that, Nowinski set out on a journey to try to figure out what was going on inside his head. He visited a series of head trauma experts, including Lovell at UPMC, but never felt that he truly understood. Finally, he was referred by a friend to one of the world’s leading concussion experts, a doctor right in his own backyard. It was Cantu, one of the original Dissenters. Nowinski had found his savior, a man who took the time not only to define concussions for him but to explain how poorly
understood they were and the dangers of not allowing them to heal. The two met many times over the coming months, and Cantu became more than Nowinski’s doctor; he became his mentor, his teacher, his friend, and his champion. It was Cantu ultimately who encouraged Nowinski to write the story of his concussions, to help educate the world. Cantu saw “
a dynamic individual, a very brilliant mind, whose background is 180 degrees from mine. He had lived reality TV life. He had lived the star athlete life. And he knew how to use the media to get across ideas in a way that, duh, never occurred to me in 30 years of writing papers. Reminds me of the monk in the monastery approach, as compared with what can happen instantaneously if you get that message out.”