League of Denial (31 page)

“Medical guys write books all the time, but no one reads them,” Cantu told Nowinski. “You have a platform from wrestling.”

As Nowinski began his work on the book, Cantu directed him to other research scientists and some of his other patients. Nowinski also reviewed the literature on concussions. That was how he came upon Omalu. Nowinski’s book,
Head Games: Football’s Concussion Crisis
, was published several months later, with an introduction by former professional wrestler turned governor Jesse “the Body” Ventura. Nowinski’s dedication read: “To the players, young and old, whose lives have been changed forever by head injuries.”

On November 20, 2006,
Nowinski was checking SI.com when he read that the 44-year-old
Andre Waters, a former Philadelphia Eagles safety, had committed suicide by shooting himself in the head. Nowinski remembered that Waters, nicknamed “Dirty Waters,” had a reputation as one of the hardest hitters in the game. Waters had spent 12 seasons in the NFL. In 1994—the NFL’s Year of the Concussion—he had told the
Philadelphia Inquirer
that he had tried to count how many concussions he sustained during his career and lost count at 15. His treatment? “I just wouldn’t say anything,” he said. “I’d sniff some smelling salts, then go back out there.”

Reflecting on Omalu’s work,
Nowinski played a hunch. He contacted Dr. Leszek Chrostowski, the associate medical examiner in Tampa, where Waters had killed himself. Nowinski explained who he was and asked Chrostowski if he was aware of the literature connecting
concussions and depression. He then politely made an unusual request: Could he please obtain what remained of Andre Waters’s brain for further study?

“He said, ‘There’s no evidence that there’s any connection,’ ” Nowinski recalled. “He kind of implied that I was crazy to think so.”

Nowinski sent the medical examiner Omalu’s paper as well as the studies done by Bailes and Guskiewicz for the Center for the Study of Retired Athletes. He then called Omalu to tell him about Waters.

“If I can get you another brain, would you study it?” Nowinski asked.

“Absolutely,” said Omalu.

Omalu called Chrostowski to support Nowinski’s efforts. The medical examiner agreed to give them the tissue if they could get permission from Waters’s family. Omalu told Nowinski he wanted no part of calling the family, and so Nowinski’s career as a brain chaser was launched. It was the hardest assignment imaginable. He would have to cold-call the family members of somebody he didn’t know who had just put a gun in his mouth and pulled the trigger. Nowinski wrote up a script, closed the door to his room, and practiced for half an hour.

“The most difficult cold call I’ve ever been part of,” he said.

Nowinski spoke with one of Waters’s sisters, describing his own experiences with concussions and the cases of Mike Webster and Terry Long, raising the possibility that her brother might have had the same terrible disease. The family agreed. Despite the bullet wound, enough tissue had been recovered from Waters’s brain for Omalu to examine it. The medical examiner sent the tissue to Omalu in Pittsburgh.

Nowinski began to prepare for the possibility that Waters might have CTE. He thought it would be huge news, a third documented case of a former NFL player diagnosed with brain damage after dying tragically. He didn’t want to wait for the slow wheels of science to turn—the publication of yet another peer-reviewed paper—before word got out. He wanted people to know. “There were people that were going to kill themselves between now and then because they didn’t know what was happening to them,” Nowinski said. “And there were kids who were going to play through concussions because they didn’t know that it mattered. And to have something with this sort of public health implication
sitting on a shelf for a year when you know it’s true, and it’s the third case of three, was to me impossible.”

While trying to get his book published, Nowinski had been introduced to a New York–based freelance journalist named Alan Schwarz. Schwarz had been encouraging: He told Nowinski that his book was well written and thoroughly researched. Schwarz then pointed him to a literary agent and a couple of prospective publishers. Schwarz had no particular expertise in concussions; he was
primarily a baseball writer, an expert on statistics who had graduated from the University of Pennsylvania with a mathematics degree. Schwarz described himself as “an accidental journalist.” He had decided to become a sportswriter only after learning that he needed a master’s degree to teach high school math, his longtime ambition. Schwarz had recently published his own book:
The Numbers Game: Baseball’s Lifelong Fascination with Statistics
. Now Nowinski called Schwarz again, thinking perhaps he could help with the Waters story.

“I think I have something good,” Nowinski told Schwarz. “I think I have something important. But I’m not sure what to do with it. And you’re the only one who ever took me seriously.”

Schwarz, then 38, had a developing relationship with the
New York Times
. He had written some baseball stats columns and a few front-page stories, including a profile of a 111-year-old former Negro League player who was living in St. Petersburg, Florida. Schwarz told Nowinski he would try to set up a meeting with Tom Jolly, the
Times
’ sports editor. Nowinski traveled to New York for the meeting and explained the story and how he was awaiting the results of the analysis on Waters’s brain. Schwarz thought he was there as the go-between, but Jolly told him as he was leaving that he would write
the story on the Waters results.

Schwarz was excited, but he didn’t immediately recognize it as big news. “I didn’t necessarily have the keenest nose for news,” he said.

Then, in January, the slides came back:
Waters had brain damage. Omalu told Nowinski, who relayed the news to Schwarz. Schwarz contacted several experts for comment: Cantu, Bailes, Guskiewicz—most of the Dissenters—and members of the NFL’s concussion committee. Guskiewicz told him: “I think that some of the folks within the NFL
have chosen to ignore some of these earlier findings, and I question how many more, be it a large study like ours, or single-case studies like Terry Long, Mike Webster, whomever it may be, it will take for them to wake up.” Schwarz didn’t know what he was getting into. He figured he would write the story and move on. “I thought it was going to be one story and that was it,” he said. “You know, you do a story on this thing, and then you get back to writing about baseball.”

When he drafted the piece, Schwarz focused on Nowinski’s compelling life story and how he’d gotten possession of Andre Waters’s brain. It was basically a human interest story about a concussed former wrestler turned activist. Late in the day, after the story had passed through the news desk, Schwarz was told to rewrite the top to get straight to the heart of the matter: “Since the former National Football League player Andre Waters killed himself in November, an explanation for his suicide has remained a mystery. But after examining remains of Mr. Waters’s brain, a neuropathologist in Pittsburgh is claiming that Mr. Waters had sustained brain damage from playing football and he says that led to his depression and ultimate death.”

“The beginning was restructured at the last second because the
Times
had a better idea of what news was,” Schwarz said. “I knew what a feature was, and I could do a pretty good feature. But they recognized what this could be.”

The story ran on page 1 of the
New York Times
on January 18, 2007. That was the day the NFL’s concussion problem hit the mainstream. The story had been percolating for over a decade, from Greg Garber’s ESPN piece on players such as Toon and Hoge back in 1994, to Peter Keating’s powerful
ESPN The Magazine
story in 2006 about Pellman’s dubious reign as head of the concussion committee (“Dr. Yes”), to Wecht’s public announcement in Pittsburgh that Terry Long had brain damage.

But the
New York Times
had elevated the story by virtue of being the
New York Times
.

“Without the
Times
, it never moves,” Nowinski said. “It cannot be overstated how important it was.”

When Bailes contacted Omalu—“Bennet, I believe you”—he explained that he had been asked by the American Association of Neurological Surgeons to see if he could examine Omalu’s research. Omalu readily agreed. Bailes thought the meeting also presented a huge opportunity to bring the NFL into the fold. The denials could go on for only so long before the league had to act, he thought. Bailes decided to invite his former boss, Maroon, to the session. Despite Maroon’s harsh criticism of Omalu, Bailes thought he was a serious, reasonable man and would respond to evidence.

By that time,
Omalu and Maroon had struck a truce. Omalu had gone to visit the distinguished neurosurgeon in his office at UPMC, and the two had talked it out after Maroon’s “fallacious reasoning” comment in the
Post-Gazette
. Omalu, in fact, had proposed making Maroon director of a longitudinal study of CTE in retired players that he, Hamilton, and DeKosky were planning to propose to the NFL. Omalu, like Bailes, felt the NFL would eventually have to come around. In an e-mail to Hamilton and Hamilton’s boss, Clayton Wiley, Omalu attached a copy of the proposal and wrote: “I intentionally suggested that Dr. Maroon should be the Director of the project since the NFL will be more likely to fund the study if they know that their own man is at the helm of affairs and will be less likely to undermine them.”

Omalu, Bailes, Maroon, Hamilton, and DeKosky
gathered in Hamilton’s office on the fifth floor of the A Wing at UPMC Presbyterian. Nearby was a conference room with a multiheaded microscope that would allow Bailes and Maroon to look at the slides while Omalu walked them through the material.

Omalu was nervous. It was one thing to write a paper, but the young Nigerian was about to present his findings to two of the top neurosurgeons in the country, Bailes and Maroon; an internationally recognized Alzheimer’s expert, DeKosky; and Omalu’s widely respected mentor, Hamilton. Bailes took pages of notes. He was struck by the magnitude of the moment, the potential significance to the game he had played and continued to love.

“To realize the implications and that we were on the very cutting edge of it, it’s a very striking realization,” Bailes recalled. “It was not going to be a fun journey.”

Maroon hadn’t said much throughout the meeting, but finally he asked Omalu: “Where do you think this is going?”

“To be honest, I don’t know,” Omalu said quietly. “But I think many, many more players have this disease than we have acknowledged.”

“Do you understand the impact of what you’re doing?” Maroon asked.

“Yes,” Omalu said.

Maroon seemed to be coming to his own moment of reckoning. He had been with the Steelers for two decades. He had helped launch ImPACT, the neurocognitive test that raised awareness within football about the serious effects of concussions. But in recent years, as the debate grew, more often than not he had sided with the NFL, praising the committee’s research and casting doubt on Omalu’s findings.

Maroon asked Omalu again: “Do you really understand the impact of what you’re doing?”

“Yes,” Omalu answered.

The conversation continued, and Maroon asked Omalu one more time: “Bennet, do you
really
understand the impact of what you’re doing?”

“Okay, what is the impact?” said Omalu.

Maroon tilted his head back.

“If only 10 percent of mothers in America begin to conceive of football as a dangerous game,” Maroon said, “that is the end of football.”

At the University of Wisconsin, Mike Webster began his transformation into “Iron Mike,” obsessively driven by fear that he would never escape his tormented childhood. (
photo insert credit i1
)