League of Denial (34 page)

Schwarz accurately described this internal split as “the first crack in a united front long presented by the NFL’s concussion committee.” Among other things, the story revealed one of the more insidious aspects of the NFL’s work: its influence over the national feeder system that funneled elite players into the league. The NFL’s science hadn’t taken place in a vacuum. Three million kids between 6 and 14 years old played tackle football. There were 1.1 million high school players and 68,000 college players. The NFL’s research had been followed by medical personnel who were making decisions involving those kids.

“That was a major disservice, and it continues to be an ongoing one in conversations I have with parents and coaches and players,” Gerard Malanga, a New Jersey team doctor for several high schools and colleges, told Schwarz. “They will reference back to that article. It creates confusion when there’s increasing clarity on the subject. They say what I tell them about it not being safe to go back in the same game is totally wrong, and they’re backed by the NFL. So they go to a doctor who tells them what they want to hear. It’s happened. Sure it’s happened. And we remain the guys holding our breath that the kid doesn’t get hurt again.”

The MTBI committee’s helmet studies were another example of this trickle-down phenomenon from the NFL’s research. The NFL’s designs on creating a concussion-resistant helmet had been shot down by the biomechanics firm involved in the project. Lovell and Collins both believed the idea was a fantasy. Yet armed with the flawed UPMC study (coauthored by Lovell and Collins), Riddell, the NFL’s official helmet maker, sold about 2 million Revolution helmets, mostly to high school and college players. The company employed an aggressive national advertising campaign that emphasized the Revolution’s concussion-reducing
properties, using numbers lifted straight from the Riddell-funded UPMC study—numbers that were both misleading and derived from the flawed NFL research.

Riddell developed PowerPoint presentations to educate its sales representatives on how best to market the Revolution to teams, school districts, and leagues. That material underscored the helmet’s “Concussion Reduction Technology,” which purportedly reduced concussions by 31 to 41 percent, the sales reps were told. At one point, the company sent out a rush mailer making the concussion-resistant claim for its youth line of helmets. The UPMC study had not examined that line. Realizing that the mailer was false, not just misleading, Riddell’s director of marketing modified it by striking one word: “Ground-breaking research shows that athletes who wear Riddell Revolution Youth helmets were 31% less likely to suffer a concussion than athletes who wore traditional football helmets.”

The claims had a major impact on the helmet industry. Riddell was able to sell the Revolution at a $50 premium, which it attributed to the cost of creating the Concussion Reduction Technology and underwriting the UPMC study. One Southern California sporting goods dealer who sold football helmets made by Schutt—Riddell’s main competitor—and other brands said the market for non-Riddell helmets in his region had all but dried up. “We just didn’t sell many helmets at that point,” he said in an interview for this book, asking that his name not be used because he was still in the business. “I think more than anything else, the end user, the dads, were believing what Riddell was saying. And that had a big effect. We were trying to sell the helmets, but if a coach or a dad believes this to be true, they’re going to purchase that product.”

Schutt modified its helmets to stay competitive. Riddell sued Schutt for patent infringement. Schutt countersued for false advertising and deceptive trade practices. A Wisconsin judge ruled in Riddell’s favor. Schutt, the judge wrote, had failed to prove that Riddell’s concussion claims were “literally false.”

“Although the presentations and internal discussions may suggest that sales representatives were trained to mislead, they fail to suggest that representatives were trained to make literally false statements,” the judge wrote.

Do you really understand?

Ted Johnson was a hard-hitting New England Patriots linebacker for 10 years, winning three Super Bowls before his retirement in 2005. When he saw that Andre Waters had been diagnosed with brain damage by Omalu after shooting himself in the head, he decided to tell his own dark story. It was a story both unique to Ted Johnson and now familiar, with echoes of Webster, Hoge, and countless others. Johnson, like Webster, found that he couldn’t function without gulping down huge quantities of stimulants, in his case Adderall. His addiction, depression, and self-loathing frequently confined him to his bed, where he lay in the dark for days. He had migraines and memory loss and felt certain he was losing his mind.

Johnson first told his story in 2006 to the
Boston Globe
’s Jackie MacMullan, who was about to publish it until Johnson was arrested for assault and battery for pushing his wife into a bookcase. After the incident, Johnson begged MacMullan to delay the piece; she reluctantly agreed, not wanting to take advantage of a man she thought was clearly unstable. What happened next revealed a lot about not only Johnson but also Nowinski, who was intent on exploiting his budding relationship with the
New York Times
to the fullest. With MacMullan still sitting on her exclusive, she received word that Johnson had given his story to Alan Schwarz and the
Times
. MacMullan was furious at Johnson, who later told her that Nowinski had advised him to spurn her because the
Times
would bring “the best bang for the buck.” The betrayal was so audacious that Nowinski’s embarrassed colleagues and
Times
editors alerted MacMullan, who, after screaming at Nowinski, scrambled to get her own story published.

The two pieces ran on the same Sunday: February 2, 2007. They were devastating. Johnson traced his problems to a concussion he had sustained in a 2002 preseason game against the New York Giants. Four days after the injury, still groggy, he took the practice field wearing a noncontact red jersey. Before a set of running drills, however, an assistant trainer handed him a blue jersey—essentially an order to get out and hit. Johnson knew right away the switch had been made not by the
team’s medical staff but by the Patriots’ head coach, Bill Belichick. He feared that if he refused, he’d lose his job and his $1.1 million salary. “I’m sitting there going, ‘God, do I put this thing on?’ ” he said. He added that such intimidation is common in the NFL. “That day it was Bill Belichick and Ted Johnson,” he said. “But it happens all the time.”

Johnson got hit in the head on the first play, leaving him dazed. When he reported the second concussion to a trainer after practice, the Pats sent him to Massachusetts General Hospital.

“You played God with my health,” Johnson said he later told Belichick. “You knew I shouldn’t have been cleared to play, and you gave me that blue jersey anyway.”

MacMullan got hold of Belichick. The coach told her that he and Johnson apologized to each other during the air-clearing meeting. He never denied ordering Johnson to wear the blue jersey. “If Ted felt so strongly that he didn’t feel he was ready to practice with us, he should have told me,” Belichick said.

Rendered in painful detail—Johnson also revealed that he nearly underwent electroshock therapy—the Ted Johnson story read like another real-world counterargument to years of NFL denials. Johnson hadn’t returned to play because the Pats’ astute medical staff had cleared him; his head coach had ordered him to go out and hit. His first concussion wasn’t unconnected to the second; his brain had been primed for further injury. Johnson estimated he’d had as many 30 concussions during his career. Cantu, his doctor, concluded that he had post-concussion syndrome and incipient dementia.

As the voices challenging the NFL proliferated, the league began to respond. It was a little like the scene in
Titanic
when the ocean liner struggles to avoid the iceberg. The league rushed out a series of new policies. The “
88 Plan” was established in honor of John Mackey, the legendary Colts tight end, who was experiencing advanced dementia. Mackey, the former head of the players union, sometimes spooned his coffee, thinking it was soup; was unable to recognize people he had just met; and flew into illogical rages distantly connected to his illustrious career. Mackey wore two rings—one from Super Bowl V, when the Colts scored 10 points in the fourth quarter to beat the Cowboys, and one from his induction into the Hall of Fame. In 2006, when airport
security asked him to remove the rings, he became enraged, ran toward the gate, and had to be wrestled to the ground by armed guards, screaming and mumbling: “I got in the end zone!” The 88 Plan, named after Mackey’s old number, provided up to $88,000 a year for players with dementia, Alzheimer’s, amyotrophic lateral sclerosis (ALS), or Parkinson’s. It originated with a wrenching three-page letter that Mackey’s wife, Sylvia, had sent to Tagliabue, describing her husband’s condition as “a slow, deteriorating, ugly, caregiver-killing, degenerative, brain-destroying tragic horror.” Dozens of applications soon poured in.

The NFL also adopted mandatory neuropsychological testing—providing more business to Lovell, Collins, and ImPACT—and established a hot line for players to report improper concussion treatment by their coaches or trainers. The policy immediately became known as the Ted Johnson Rule.

The league also reconfigured its concussion committee. Pellman, whose résumé embellishment had been exposed two years earlier, was removed as chairman, although he was allowed to stay on as a committee member. Casson and Viano replaced him as cochairs. It wasn’t exactly a major shake-up: The triumvirate that had steered the NFL’s science for the past 13 years remained intact, just rearranged slightly. The committee added three new members, including Joe Maroon, whom the NFL originally described as a “non-affiliated” doctor. That was quickly amended after it was pointed out that Maroon had worked for the Pittsburgh Steelers for two decades.

There was an odd schizophrenia to the policy changes. The league and the union had created a special fund for players with brain damage while at the same time vehemently denying that football caused brain damage. When Schwarz pointed out this apparent contradiction to Greg Aiello, the league spokesman replied that dementia was a disease that “affects
many elderly people.” The NFL’s criticism of Omalu continued. Casson told the
Washington Post
that Omalu’s work was riddled with “glaring deficiencies” and suggested that he had exaggerated his findings.

Casson, the new cochair, baffled researchers and laypersons alike. Even more than Pellman, he would become associated with the NFL’s refusal to admit it had a problem—the league’s true disbeliever. A bald, combative man, Casson was emphatic: He didn’t believe the evidence.
His denials were all the more confounding because of his experience with boxers. Casson’s
1982 study in the British
Journal of Neurology, Neurosurgery, and Psychiatry
was regarded as a breakthrough and had been particularly well timed, coming the same year that Duk Koo Kim, a South Korean lightweight, died of a brain hemorrhage after fighting Ray Mancini outside Caesars Palace. Casson and his colleagues performed CT scans on 10 boxers shortly after routine knockouts. Five showed signs of cerebral atrophy. Experience appeared to be a predictor: the more bouts, the more brain damage. Among the five boxers with 20 or more fights, four had cerebral atrophy. Of the five with fewer than 12 fights, only one had it. Rather than a single punch, Casson and his colleagues wrote that “a cumulative effect of multiple subconcussive head blows is the most likely culprit,” a fact that, when applied to football, had dramatic implications for the men in the Pit.

The year after his study came out,
Sports Illustrated
brought in Casson as a consultant to examine a CT scan of Muhammad Ali’s brain. The scan had been taken in July 1981, before Ali was cleared for his last fight, against Trevor Berbick. “They read this as normal?” said Casson, poring over the scan. “I wouldn’t have read this as normal.” At
SI
’s request, Casson also performed neurological exams on three other living fighters: the heavyweights Jerry Quarry and Randall (Tex) Cobb and a bantamweight named Mark Pacheco. Quarry and Pacheco had abnormal CT scans and signs of cavum septum pellucidum, a shearing of the ventricles. The exercise foreshadowed the debate about football 30 years later. Casson had become part of a long line of researchers to reveal the devastating effects of the sweet science on the brain. But on the question of whether boxing should be banned, Casson replied no. “A boxer ought to know what he’s getting into if he wants to go on and be a champion,” he said. “He should know what he may be sacrificing. A doctor has to tell the boxer if he thinks the fighter should stop, but in the end it’s not really a medical decision. Society has to decide what we’re going to do about boxing.”

Casson had studied boxers for decades and had come away with no doubts that the sport caused brain damage. But when it came to football, he wasn’t buying it. He later told Congress: “My position is that there is not enough valid, reliable or objective scientific evidence at present to
determine whether or not repeat head impacts in professional football result in long term brain damage.”
In a 2010 article for
Neurology Today
, Casson quoted Charles Darwin: “False facts are highly injurious to the progress of science for they often endure long.” He wrote that Guskiewicz’s dementia and depression studies at North Carolina suffered from “inherent methodological limitations,” especially a possible bias in how players self-reported their injuries. He wrote that the buildup of tau protein seen in the brains of “a few retired NFL players” was not “exclusive to head trauma.” NFL doctors had been treating concussed players “in a cautious and conservative manner for many years,” he asserted. Casson concluded: “The public has been led to believe that dementia and depression are a frequent and inevitable consequence of a career in professional football. This ‘false fact’ is belied by the presence of a large number of retired players who, despite experiencing multiple concussions, have gone on to have brilliant careers in broadcasting and other endeavors.”