League of Denial: The NFL’s Concussion Crisis
ANNOUNCER: Tonight on FRONTLINE, the epic story of football’s concussion crisis.
HARRY CARSON, Author, Captain For Life: These players come down with dementia.
ANNOUNCER: A major FRONTLINE investigation of what the NFL knew and when it knew it.
STEVE FAINARU, FRONTLINE/ESPN: The level of denial was just profound.
BETH WILKINSON, NFL’s Attorney: We strongly deny those allegations that we withheld any information or misled the players.
Dr. MICKEY COLLINS, Univ. of Pittsburgh Medical Ctr.: We don’t know who is at risk for it. We don’t know if concussion in and of itself is what causes the abnormalities.
ANNOUNCER: A decades-long battle between scientists, players and the nation’s most powerful sports league.
BENNET OMALU, M.D., Medical Examiner: You can’t go against the NFL. They will squash you.
ANNOUNCER: Next, League of Denial: The NFL’s Concussion Crisis.
ANN MCKEE, M.D., Neuropathologist, BU CTE Center: I’m really wondering if every single football player doesn’t have this.
FOOTBALL ANNOUNCERS: Erenberg touchdown! Listen to this crowd! They’re on fire!
The Steelers have their receivers in, Stallworth on the left, 82, Swann 88 on the right. Franco Harris is down to 30, big pileup.
He fumbled the ball! And let’s see— Minnesota has it! Jeff Seamon on it.
Oh, yeah! It’s still wild and woolly, and I love ‘em that way!
You love ‘em wild and woolly, and you’re seeing it now.
Impressive drive by the Steelers!
Everybody loves everybody when you win.
The drive is used a lot of times. Here’s a roll-out. Bradshaw fires. Stallworth touchdown!
An awesome physical team were the Steelers today, Pittsburgh, the Super Bowl champs!
NARRATOR: Pittsburgh. For 70 years, they’ve loved their football team, the Steelers.
STAN SAVRAN, Pittsburgh Sports Reporter: This is a tough town. The people here are tough, tough-minded. The way the Steelers played the game meshed perfectly with the people.
STEELERS FAN: Hit ‘em! Hit ‘em!
STAN SAVRAN: They loved that hard-hitting, punishing, brutal defense that they played.
NARRATOR: They called the defensive line the “steel curtain.”
STAN SAVRAN: That just fit perfectly into the way they saw their own lives and what they had to be in order to survive.
NARRATOR: And if there was one iconic Steeler, it was number 52, “Iron Mike” Webster.
JULIAN BAILES, M.D., Team Physician, Steelers, 1988-97: Well, Mike Webster exemplified what it was like to be a player in the Steel City and a player in that era that for me was the greatest team of all time.
NARRATOR: In the 1970s, Webster anchored four Super Bowl championship teams.
BOB FITZSIMMONS, Webster’s Attorney: Mike was a legend and a hero. He may have been “the” legend and “the” hero because here’s that blue-collar worker, a center, who doesn’t get any glory, doesn’t catch the touchdown passes, doesn’t kick the 52-yard field goal to win a game. He’s just in every play.
PAM WEBSTER, Wife: I just loved watching him play. And Mike’s favorite games were the ones that were cold and snowy and frigid. And he could get up there with his short sleeves. And the dirtier and muddier it got made things better.
NARRATOR: Then 11 years after he retired, the people of Pittsburgh received some bad news.
NEWSCASTER: At what price glory? The Hall of Fame center Mike Webster died at the age of 50.
NEWSCASTER: He died on Tuesday. He was just 50 years old. He was known as “Iron Mike”—
NEWSCASTER: He had heart disease—
NARRATOR: The news that day would start a chain of events that would threaten to forever change the way Americans see the game of football.
NEWSCASTER: It is hard to find a former pro football player whose body hasn’t paid a very high price.
NARRATOR: Mike Webster’s body was delivered to the Allegheny County coroner’s office.
MARK FAINARU-WADA, FRONTLINE/ESPN: Webster ends up in the autopsy room. And the pathologist who’s on call that day is this guy, Bennet Omalu.
STEVE FAINARU, FRONTLINE/ESPN: Omalu parked his car and walked into the office. And he said, “What’s going on?” And one of his colleagues said, “It’s Mike Webster. He’s— he’s up in the autopsy room.” And Omalu’s response was, “Who’s Mike Webster?”
BENNET OMALU, M.D., Medical Examiner: And everybody looked at me, like, “Where is he from? Is he from outer space? Who is this guy who doesn’t know Mike Webster in Pittsburgh?”
MARK FAINARU-WADA: He’s a Nigerian-born, incredibly well-educated guy. But he doesn’t know anything about football.
NARRATOR: A doctor, Omalu was also a trained neuropathologist. From the beginning of the autopsy, Dr. Omalu could see the effects of 17 years in the football wars.
Dr. BENNET OMALU: Mike looked older than his age. He looked beat up. He looked— he looked worn out. He looked drained. If I had not been told his age, I would say he looked like 70.
NARRATOR: Omalu started at the feet and worked his way up.
STEVE FAINARU: There were cracks running the length of his feet, and they were incredibly painful. And so Webster would duct tape his feet, as well, to sort of close those cracks and keep them— and keep them together.
GARRETT WEBSTER, Son: His feet and his legs were definitely— you could just tell were destroyed. You know, he had veins all over his legs, varicose veins and stuff like that.
NARRATOR: There were several herniated discs, a broken vertebra, torn rotator cuff and separated shoulder.
PAM WEBSTER: His teeth were falling out. His body— he had cellulitis. He had a heart— his heart, you know, was getting enlarged.
COLIN WEBSTER, Son: You know, he was supergluing his teeth back into his head, and he actually made that work. I mean, I think Dad’s the only person who could actually, you know, have a medical problem like that and decide to fix it with superglue.
NARRATOR: Then there was the matter of Webster’s forehead.
STEVE FAINARU: Webster’s forehead was essentially fixed to its scalp. The skin on his forehead had built up almost a shelf of scar tissue that— from the continuous pounding of his head into other people.
NARRATOR: Webster’s death certificate made Omalu suspect he may have suffered from a brain disorder.
Dr. BENNET OMALU: When I opened up his skull, in my mind, I had a mental picture of what his brain would look like, based on my education. I was expecting to see a brain with Alzheimer’s disease features, so a shriveled, ugly-looking brain. But upon opening his skull, Mike’s brain looked normal.
JEANNE MARIE LASKAS, GQ, “Game Brain”: He didn’t understand why that would be, but he became more and more curious. It became sort of like his little private mission.
NARRATOR: Dr. Omalu wanted to fix the brain, preserve it in a chemical bath for further study.
Dr. BENNET OMALU: I said, “Let me fix this brain. Let me spend time with this brain. There’s something— something doesn’t match.” And I remember the technician telling me, he said, “What are you fixing this brain for? That brain is normal.”
STEVE FAINARU: And Omalu becomes very firm in that moment, and he says, “Fix the brain. I want you to fix the brain.”
NARRATOR: What Omalu could not see was that hidden inside Webster’s brain was evidence of a chronic disease.
STEVE FAINARU: And that decision would change the NFL because if Webster’s brain had not been examined, I don’t honestly think that we would be where we’re at today.
NARRATOR: Steve Fainaru and his brother, Mark Fainaru-Wada, are investigative reporters. Steve has a Pulitzer Prize for reporting in Iraq. Mark broke the Barry Bonds steroids story.
For FRONTLINE, ESPN and in their own book, they’ve been investigating how the NFL has handled evidence that football may be destroying the brains of NFL players.
[www.pbs.org: Read an excerpt]
MARK FAINARU-WADA: I think in the simplest form, one major piece of our reporting just revolves around the simple question of what did the NFL know and when did it know it?
NARRATOR: The NFL would not cooperate with the Fainaru brothers, nor would it talk to FRONTLINE.
MARK FAINARU-WADA: We went to New York to meet with them and say, “Look, this is what we’re doing. We’d like you to participate. We’d like you to make available these various people.” And the NFL’s message was, “Sorry. We’re not going to help you.”
NARRATOR: But they continued to report the story, beginning with Mike Webster’s career in the NFL.
STEVE FAINARU: There’s almost a Darwinian quality about the NFL. Webster wanted to prove to the world that he was going to be the toughest, and he did anything that he possibly could to do that.
NARRATOR: Webster’s Sunday afternoons were spent on the line of scrimmage, brutal territory known as “the pit.”
ART ROONEY II, Pittsburgh Steelers President and Co-Owner: He had the violence in him. He could explode into the player. Every play was a fight.
NARRATOR: Webster’s favorite weapon was his head.
FRED SMERLAS, Buffalo Bills, 1979-89: Well, Webby would hit you with his head first. And with that head, he’d pop you. And then he’d lift his shoulders. Now he’d get you up in the air. Once you hit full speed and you’re moving backwards and he hits you, you’re gone.
HARRY CARSON, Author, Captain For Life: When he would fire off the ball, he’s coming to block me, and if I’m not ready for him, you know, he’s going to pancake me. You know, he’s going to hurt me.
NARRATOR: Hall of Fame linebacker for the New York Giants, Harry Carson went to war with Mike Webster.
HARRY CARSON: And so I have to meet force with force. All of my power is coming from my big rear end and my big thighs into my forearm, and I hit him in the face. I have to stun him, get my hands on him, throw him off when I see where the ball is going. And when I hit him in the face, his head is going back. He’s going forward, but all of a sudden, his head is going back and his brain is hitting up against the inside of his skull.
ROBERT STERN, Ph.D., Neuropsychologist, Boston University: In football, one has to expect that almost every play of every game and every practice, they’re going to be hitting their heads against each other. That’s the nature of the game. Those things seem to happen around 1,000 to 1,500 times a year.
Each time that happens, it’s around 20G or more. That’s the equivalent of driving a car at 35 miles per hour into a brick wall 1,000 to 1,500 times per year.
NARRATOR: For Mike Webster, the head hits just kept on coming for 17 years.
GEORGE ATKINSON, Oakland Raiders, 1968-77: You have to survive, so you learn the methods to survive and be the best at surviving in that environment. The minute you put your pads on, you’re only one play away from getting seriously injured.
NARRATOR: For Webster and others on the field, physical injuries went with the territory.
JIM OTTO, Oakland Raiders, 1960-74: I mean, it’s affected my life. It surely has. But I’m not out there crying about it. I know that I went to war, and I came out of the battle with what I got. And you know, that’s the way it is. That’s the way Mike Webster would say it, too. I’m sure he would. I mean, we battled in there, and this is what— this is the result of it right here, sitting right here looking at you.
NARRATOR: But what Otto and others do not know is whether football has also caused injuries they cannot see, the result of what they called getting their bell rung.
ANNOUNCERS: Oh, did they hit him that time! His helmet went off.
I don’t know how he held onto that! Sammy White, he did a remarkable catch with Skip Thomas and Jack Tatum jackknifing him as he caught the ball for a first down on the Oakland 45-yard line.
NARRATOR: In 1991, Mike Webster left football. Soon he and his family would come to believe those hits to the head had taken a devastating toll.
PAM WEBSTER, Wife: Mike wasn’t Mike. He was angrier quicker than before, and didn’t have the patience to have, you know, the kids on his lap or take a walk with the kids. Like, he didn’t have that stamina physically.
NARRATOR: Over the years, he became increasingly confused.
COLIN WEBSTER, Son: He would forget, you know, which way the grocery store was, which way it was to go home. He was— he actually— he broke down in tears in front of me a couple of times because he couldn’t get his thoughts together and he couldn’t keep them in order.
NARRATOR: At home, there were bouts of rage.
PAM WEBSTER: He took a knife and slashed all his football pictures. They were all destroyed and gone and broken glass, and they were all down, you know? And it wasn’t Mike.
NARRATOR: They’d been college sweethearts. But 27 years and four children later, Mike and Pam Webster’s marriage ended.
PAM WEBSTER: We didn’t understand what was happening. You’re just trying to get by in this storm. I mean, your money’s gone. Your pride’s gone. Our bills are all overdue. Our house is getting foreclosed. All this security is gone. All those parameters are removed. So everything’s crumbling.
NARRATOR: Once one of Pittsburgh’s greatest football heroes, Webster began living out of a pickup truck.
COLIN WEBSTER: I’d come outside sometimes and just see him, you know, sitting in the truck. And it would be freezing and he’d just be sitting there, just looking miserable. He’d say, “You know, the worst thing is, is I’m actually getting to the point where sometimes, or if I don’t have my medicine,” he said, “I’m cold and I don’t realize that I can fix it by putting a jacket on.”
NARRATOR: Webster was often unable able to sleep.
SUNNY JANI, Friend: He had a lot of pain, and he hasn’t slept for days. So he asked me, said, “Sunny, can you tase me?” I’m, like, “What does that mean?
So he pulls out this stun gun and goes “Bzz, bzz.” I’m, like, “Mike, that’s not healthy.” He said, “But I haven’t slept nothing.” He said, “All you got to do is tase me right here.” And I’m, like, “OK.” I don’t know, you know, he’s my hero, I’m going to do whatever he tells me. So I tased him, and he goes—and he goes to sleep. I’m, like, “Wow!”
NEWSCASTER: A true champion who wound up homeless, depressed—
NARRATOR: The story of Webster’s decline was revealed on ESPN, and then the local newspapers.
NEWSCASTER: He was arrested for forging 19 prescriptions for Ritalin, which he used to combat the erratic behavior caused by—
PAM WEBSTER: I think he was embarrassed. He was a leader on the team. He was Mike Webster. And then to be down to a place of poverty, a place where, you know, your brain can’t function to finish a sentence without some help from Ritalin or whatever you need to function for a short period of time.
NARRATOR: For Iron Mike, TV interviews became impossible.
MIKE WEBSTER: No, I’m talking about— no, I’m just trying to find— yeah, well, everybody went through trauma as a kid. I’m not saying I was different than that. I’m just saying— the things we do to one another, OK—
Hell, I don’t know what I’m saying. I’m just tired and confused right now, that’s why I say I can’t really— I can’t say it the way I want to say it. I could answer this real easy at other times, but right now, I’m just tired.
COLIN WEBSTER: Maybe the saddest I ever heard him say was when someone saw my dad and, “Aren’t you Mike Webster?” And he said, “I used to be.” I think that really was how he felt because he really was. He wasn’t the same person. It was— it was like, you know, a picture of him that was just shattered into a million pieces.
NARRATOR: Nearly broke, homeless and losing his mind, Webster decided football had hurt him, and the NFL was going to pay for it. In 1997, he went to see a lawyer.
BOB FITZSIMMONS, Webster’s Attorney: The thing that struck me the most was how intelligent Mike was, and the problem was that he just couldn’t continue those thought patterns for longer than a 30-second period, or a minute or two minutes. He would just go off on the tangents at that point. It was pretty obvious, actually, the first interview that he had some type of cognitive impairment.
NARRATOR: Attorney Bob Fitzsimmons drew up a disability claim against the NFL.
STEVE FAINARU, FRONTLINE/ESPN: He began to assemble a case with Webster to basically say that Webster had suffered brain damage as a result of his 17-year career in the NFL.
NARRATOR: Fitzsimmons pulled together Webster’s complicated medical history.
BOB FITZSIMMONS: So I took the binder of records and got four doctors together, four separate doctors, all asking them, “Does he have a permanent disability that’s cognitive? And is it related to football?”
NARRATOR: Webster’s final application for disability contained over 100 pages and the definitive diagnosis of his doctors— football had caused Webster’s dementia. His claim for disability was filed with the National Football League’s retirement board.
STEVE FAINARU: The Disability Committee is part of the NFL. The head of the Disability Committee is the commissioner himself, so it’s very much a creature of the NFL.
NARRATOR: From the beginning, the league’s board was skeptical, reluctant to give Webster money.
COLIN WEBSTER, Son: They were fighting it from the beginning, against just the common sense of, you know, here’s this guy, look at him, you know? He played for nearly 20 years in a brutal and punishing sport, and you know, this is what’s going on with him. Why would you fight that? What possible motive?
NARRATOR: The league had its own doctor review Webster’s case.
BOB FITZSIMMONS: The NFL had not only hired an investigator to look into this, they also hired their own doctor and said, “Hey, we want to evaluate Mike Webster.”
NARRATOR: Dr. Edward Westbrook examined him.
MARK FAINARU-WADA, FRONTLINE/ESPN: Dr. Westbrook concurs with everything that the four other doctors have found and agrees that absolutely, there’s no question that Mike Webster’s injuries are football-related and that he appears to be have significant cognitive issues, brain damage, as a result of having played football.
NARRATOR: The NFL retirement board had no choice. They granted Webster monthly disability payments.
DOCUMENT: —”has determined that Mr. Webster is currently totally and permanently disabled.”
NARRATOR: And buried in the documents, a stunning admission by the league’s board— football can cause brain disease.
DOCUMENT: —”indicate that his disability is the result of head injuries he suffered as a football player.”
BOB FITZSIMMONS: The NFL acknowledges that repetitive trauma to the head in football, football can cause a permanent disabling injury to the brain.
NARRATOR: The admission would not be made public until years later, when it was discovered by the Fainaru brothers.
MARK FAINARU-WADA: And that was a dramatic admission back in 2000. And in fact, when you talk about that later with Fitzsimmons, he describes that as the sort of proverbial smoking gun.
NARRATOR: It was now in writing. The NFL’s own retirement board linked playing football and dementia. At the time, it was something the league would not admit publicly. And Webster felt he’d never received the acknowledgment that his years in the NFL had caused his problems.
PAM WEBSTER: Mike would call this his greatest battle. He’d say it was like David and Goliath, over and over, because it was. He was taking on something that was bigger than him. He took on this battle for the right reasons. He was the right person to do it. Unfortunately, it cost us everything.
NARRATOR: Just two years later, in 2002, Mike Webster died.
BROADCAST DIRECTOR: 15 seconds to air. Stand by all cameras. Ready with slow motion and isolated—
NARRATOR: The first broadcast of Monday Night Football in 1970 marked a turning point in the game’s popularity and its revenues.
BROADCAST DIRECTOR: Take tape.
MARK FAINARU-WADA: I think the NFL has done an incredible job at marketing itself and turning itself into a spectacle, a sort of cultural part of our lives.
STAN SAVRAN, Pittsburgh Sports Reporter: It fit the personality of a society that became more violent, that became faster, wanted instant gratification.
ANNOUNCER: [ABC "Monday Night Football," 1970] O.J. Simpson gets the call. Look out!
STAN SAVRAN: Football, from the opening kickoff, it’s full go.
ANNOUNCER: What a football player!
NARRATOR: The Monday night games were always among the highest rated television broadcasts.
ANNOUNCER: Look out! Look out!
MARK FAINARU-WADA: _Monday Night Football_— it’s not just for football fans.
ANNOUNCER: Speaking of color commentators—
LEIGH STEINBERG, Sports Agent: It became an entertainment show.
ANNOUNCER: [ABC "Monday Night Football," 1983] —vivid picturization of the excitement—
ANNOUNCER: They’re number one in the nation.
LEIGH STEINBERG: It became a happening.
HANK WILLIAMS, Jr.: [ABC "Monday Night Football," 1996] [singing] Are you ready for some football, a Monday night invasion—
NARRATOR: The glory and the violence of football was beamed into tens of millions of American living rooms during primetime.
HANK WILLIAMS, Jr.: [singing] Here come the hits, the bangs, the blocks and the spikes, because all my rowdy friends drop in on Monday nights!
STAN SAVRAN: People liked the violence of it. You watch a pro football game, and naturally, the biggest cheers are for the touchdowns, but the second biggest cheers are for a nasty hit.
STEVE YOUNG, San Francisco 49ers, 1987-99: And I describe it as the moment of impact, the moment when you actually have to go tackle somebody, it’s really a game of will.
LEIGH STEINBERG: The actual logo of Monday Night Football showed helmets hitting together. And it became part of the popular jargon, you know, “He knocked him silly. He knocked him to the moon.”
PLAYER: Set the tone! Knock him out! Knock him out! Let’s go!
MARK FAINARU-WADA: There’s no question the NFL marketed that violence. That’s what we love about the game.
NARRATOR: The NFL’s own highly crafted film productions celebrated the violence and the spectacle.
NFL NARRATOR: On this down and dirty dance floor, huge men perform a punishing pirouette. The meek will never inherit this turf because every play is hand-to-hand and body-to-body combat!
MIKE ORIARD, Kansas City Chiefs, 1970-73: NFL Films captures the essence of football itself, that tension between the violence and the beauty.
NFL NARRATOR: In the pit, there is more violence per square foot than anywhere else in sport!
MIKE ORIARD: The sense of football as something powerful and elemental and mythic and epic.
NFL NARRATOR: When you talk about big-hitting safeties, the Eagles Donnie Dawkins always emerges.
DONNIE DAWKINS: We’re going to dominate this thing! Respect is not given—
MARK FAINARU-WADA: What the NFL would do was they would market tapes of “Crash Course,” “Moment of Impact,” “Search and Destroy” in the context of describing the brutal nature of the violence of the NFL.
NARRATOR: But away from the glamorized hits, there was a darker side. Superagent Leigh Steinberg saw it firsthand.
LEIGH STEINBERG: I watched athletes I represented play with collapsed lungs. I watched them completely fight with doctors at every time to get into the game. I watched players deceive coaches on the sidelines when they were injured and run back into a game.
NARRATOR: The inspiration for the movie sports agent Jerry Maguire, Steinberg was a powerhouse alongside the new NFL.
STEVE FAINARU: He was very much a creature of this expanding juggernaut of the NFL.
MARK FAINARU-WADA: He ends up at one point representing 21 quarterbacks in the— 21 starting quarterbacks in the NFL one year.
NARRATOR: In the early 1990s, Steinberg represented one of football’s top stars, Dallas quarterback Troy Aikman.
ANNOUNCER: Second and 14, passing down, coming up for Aikman again—
NARRATOR: In 1994, during the NFC championship, Aikman took a knee to the head.
ANNOUNCER: Down he goes! Stubblefield was there first. Troy Aikman took a knee to the head.
ANNOUNCER: You see it right here. It’s Dennis Brown coming in. You see the knee right there, knee right on his helmet.
NARRATOR: Aikman’s concussion was bad enough that he could not return to the game. Aikman was taken to a local hospital.
ANNOUNCER: —back to the locker room.
LEIGH STEINBERG: I went to visit Troy, who was sitting in a darkened hospital room all alone.
STEVE FAINARU: The room is dark because Aikman can’t even stand looking into the light. It’s— you know, it’s this sort of surreal scene where the city is celebrating and the quarterback who won the game is in the hospital with his agent.
LEIGH STEINBERG: He looked at me and he said, “Leigh, where am I?” And I said, “Well, you’re in the hospital.” And he said, “Well, why am I here?” And I said, “Because you suffered a concussion today.” And he said, “Well, who did we play?” And I said, “The 49ers.” And he said, “Did we win?” “Yes, you won.” “Did I play well?” “Yes, you played well.” “Did— what does that— and so what’s that mean?” “It means you’re going to the Super Bowl.”
MARK FAINARU-WADA: Five minutes later, they’re sitting there, they’re continuing to hang out, and Aikman suddenly turns to Steinberg and says, “What am I doing here?” And the next thing you know, they are reliving this conversation they’d had five minutes earlier.
LEIGH STEINBERG: For a minute, I thought he was joking. And I went through the same sequence of answers again. And his face brightened and we celebrated again. Maybe 10 minutes passed, and he looked at me with the same puzzled expression and asked the same sequence of questions.
It terrified me to see how tender the bond was between sentient consciousness and potential dementia and confusion was.
ANNOUNCER: Third down and 9, Young throws, and that’s incomplete, and— down!
NARRATOR: 49ers quarterback Steve Young was another one of Leigh Steinberg’s clients.
ANNOUNCER: —a sight that is the last thing in the world the 49ers would want to see. It looks as almost as if he’s out cold.
ANNOUNCER: Al, I’ve been there. And there he is. He’s up. That’s a good sign. And what I like is he wants to get up off the ground.
ANNOUNCER: Look at this. He looks like he’s out cold, and now he’s walking off.
STEVE YOUNG, San Francisco 49ers, 1987-99: I remember thinking as I walked to the sidelines, “This is not good,” you know? “This is just not the right thing to happen.”
NARRATOR: It was young’s seventh concussion.
ANNOUNCER: Well, that’s a sight we thought would be impossible. Steve Young apparently knocked cold, knocked out cold, walks off the field—
NARRATOR: He would never play again.
STEVE YOUNG: If my knee is hurt, everyone knows it and I know it, and we can go deal with it, and shoulders. And there’s only one place in your body that you really don’t understand. And people always say the brain is the last frontier.
NARRATOR: For Steinberg, there was a growing recognition of just how dangerous the sport was.
LEIGH STEINBERG: The damage was occurring every week. And I had people who I loved and cared for. And I intuitively knew that this was not just a football issue, that it was happening to football players in the pros, it was happening in college, it was happening in high school. It was happening to every player in every collision sport. So not only was it an issue for my clients, it was a huge societal issue.
[www.More from Leigh Steinberg]
NEWSCASTER: We have put football injuries on the “American Agenda” tonight—
NEWSCASTER: —playing with pain, increasingly the price of life in the National Football League—
NEWSCASTER: We’ve heard so much recently on the danger of concussions in sports—
NEWSCASTER: This year, injuries in the National Football League may be out of control—
NARRATOR: By the mid-90s, the concussion crisis had made its way to NFL headquarters on Park Avenue in New York City.
NEWSCASTER: —escalates over the long-term effects of taking hits to head on the football field—
NARRATOR: NFL commissioner Paul Tagliabue orchestrated the league’s response. Tagliabue had begun his career as a lawyer.
PETER KEATING, Reporter, ESPN: People have suggested strongly to me that he picked up a lot of techniques about how to aggressively defend things that could turn out to be class actions. You know, the NFL has had this strategy of going nuclear every time it goes to court because the first time you ever lose, you open up the floodgates to potential billions of dollars of damage.
NARRATOR: And Tagliabue said he was skeptical about the risk from concussions, once calling the controversy the result of “pack journalism.”
PAUL TAGLIABUE, NFL Commissioner: [Sports panel discussion, December 1994] Concussions I think is, you know, one of these pack journalism issues, frankly. There’s no increase in concussions. The number is relatively small. The problem is it’s a journalist issue.
LEIGH STEINBERG: This is the commissioner of the NFL saying that there’s no concussion issue. If it was ignorance, they should have known. They should have known because the issue is so critical.
NARRATOR: Still, Tagliabue created a scientific committee, the Mild Traumatic Brain Injury Committee, the MTBI. To lead it, he chose Elliot Pellman, the New York Jets team doctor, a firm believer that concussions were not a serious problem.
STEVE FAINARU, FRONTLINE/ESPN: And so you had this— behind the scenes, you know, this dynamic going on where you had a guy, Elliot Pellman, who very clearly believed that this wasn’t a problem, it just wasn’t a big problem for the NFL.
NARRATOR: To outsiders, the choice of Pellman was unusual. He was not an expert in neurology and had no background in brain research.
PETER KEATING: He went to a school in Guadalajara. Dr. Pellman is not a neurosurgeon. He’s not a neuro anything. He’s a rheumatologist.
STEVE FAINARU: You know, putting a rheumatologist on the head of the committee that arguably was going to have more influence over brain research, you know, than any other— any particular institution in the country at the time, you know, was, I think a lot of people felt, surprising.
NARRATOR: Most of Pellman’s committee was made up of NFL loyalists. Nearly half the members were team doctors.
ROBERT CANTU, M.D., Neurosurgeon, Boston University: If you’re going to put together a blue ribbon committee to study brain trauma, it should have as its chair somebody who has that as a background, either a neurologist, neurosurgeon, neuropathologist, preferably a clinician.
NARRATOR: For years, Pellman’s committee would insist they were studying the problem, that the danger from concussions was overblown.
PETER KEATING: The way the NFL handled this was for 15 years to do research that looks awfully like it was designed to say that the league was OK in doing what it was doing — which wasn’t much — to protect players from the dangers of concussions.
NARRATOR: Pellman’s committee began writing a series of scientific papers, and in 2003, got the first of them published in the medical journal Neurosurgery.
ROBERT STERN, Ph.D., Neuropsychologist, Boston University: Those initial studies from the NFL were notorious in telling the world over and over and over again, “No, there’s no relationship between hitting your head in football and later life problems. No, there’s no relationship.”
NARRATOR: The papers downplayed the risk of concussions—
DOCUMENT: —”Mild TBIs in professional football are not serious injuries.”
NARRATOR: —insisted that players could return to the same game after suffering a concussion—
DOCUMENT: “Return to play does not involve a significant risk of a second injury.””
NARRATOR: —denied players suffered any long-term problems from concussions sustained while playing football—
DOCUMENT: —”that there was no evidence of worsening injury or chronic cumulative effects of multiple MTBIs in”—
NARRATOR: —and in one of the papers, even suggested their research might apply to younger athletes, despite the fact they had not studied high school or college players.
DOCUMENT: “It might be safe for college/high school football players to be cleared to return to play on the same day as their injury.”
Dr. ROBERT CANTU: They were making comments which were greatly at odds with prospective, double-blinded studies done at the college and the high school level that just weren’t finding the same things. And that just didn’t make sense to anyone that’s a scientist.
NARRATOR: Dr. Robert Cantu edited the journal’s sports medicine section. The papers were published despite his objections.
Dr. ROBERT CANTU: The papers started to make statements about multiple head injuries were not a problem in the NFL. If they went back into the same contest with a concussion, it didn’t matter. If they got knocked out and went back into the same contest, it didn’t matter. There were no long-term psychological problems or cognitive problems in these athletes, in essence, saying it wasn’t a problem.
NARRATOR: Dr. Cantu says he took his concerns to the journal’s editor-in-chief, Dr. Michael Apuzzo. Apuzzo was also a consultant for the New York Giants.
Dr. ROBERT CANTU: I said that I really think this data is flawed. I really think it shouldn’t be published. He’s the one that made the decision to publish papers, no matter whether the reviewers felt they should be published or not, no matter whether the section editor felt they should be published or not.
NARRATOR: Mark Lovell was a member of the committee and an author on some of the studies. He now admits there were problems with the research.
MARK LOVELL, Ph.D., Neuropsychologist: I look back on some of the papers, yeah, I think I could have done it differently. I think the fault of the paper was, it was maybe too early to be making those statements based on a fairly small sample of players, which is the major criticism of the study which I think is a valid one.
NARRATOR: The NFL committee published 16 papers. Neither Dr. Apuzzo, Dr. Pellman, nor Commissioner Tagliabue would speak to FRONTLINE about the papers. But in those articles, the league had issued its definitive denials.
PETER KEATING, Reporter, ESPN: The closer you look, the less this holds up. But it did establish, you know, this kind of impressive-looking set of findings which pushed off the day of reckoning for the league.
That’s really what is happening here, right? During this whole run of research that’s being published, the day of reckoning, where the league has to answer to somebody about what it’s doing about concussions, just keeps getting pushed off and pushed off and pushed off.
NARRATOR: In Pittsburgh at just about this time, Mike Webster’s brain tissue was being examined. Dr. Bennet Omalu was studying the microscopic samples.
BENNET OMALU, M.D., Medical Examiner: I put the slides in and looked. Whoa! I had to make sure the slides were Mike Webster’s slides. I looked again. Ah! I looked again. I saw changes that shouldn’t be in a 50-year-old man’s brains, and also changes that shouldn’t be in a brain that looked normal.
JULIAN BAILES, M.D., Team Neurosurgeon, Steelers 1988-97: He saw collections of tau protein, collections which shouldn’t be there in someone of Mike Webster’s age. And this is what jumped out at him as he looked at it through the microscope.
NARRATOR: Dr. Omalu believed he saw physical evidence of the long-term damage playing football could have on the brain. It was a scientific first.
Dr. BENNET OMALU: Because after I looked at it over and over and over and over, I was convinced this was something.
NARRATOR: It was a disease never previously identified in football players, chronic traumatic encephalopathy— CTE.
Dr. ROBERT CANTU: Chronic traumatic encephalopathy is a disease, a progressive neuro-degenerative disease, where the end stage leaves tau protein deposition in distinctive areas of the brain, in distinctive locations that separate this disease from any other, like Alzheimer’s or some other dementia.
ROBERT STERN: For some reason, the repetitive brain trauma starts this cascade of events in the brain that changes the way this tau looks and behaves. It goes awry. And it starts destroying the integrity of the brain cells.
[www. More about CTE and the brain]
MARK FAINARU-WADA, FRONTLINE/ESPN: The tau is effectively closing in around the brain cells and choking them. And it’s impacting the way the brain is working, and ultimately, erupting in issues around memory, agitation, anger.
NARRATOR: Omalu shared his evidence with leading brain researchers, who confirmed his findings. Then he submitted a scientific paper on the Webster case to the one journal that seemed to be most interested in head injuries in football, Neurosurgery, and Dr. Apuzzo accepted it.
STEVE FAINARU: Omalu is a junior pathologist in the Allegheny County coroner’s office, but the people he published with were one of the leading Alzheimer’s disease experts in the country, one of the leading neuropathologists in the country, and one of the most well-known coroners in the country.
NARRATOR: It was the first hard evidence that playing football could cause permanent brain damage.
JULIAN BAILES, M.D., Team Neurosurgeon, Steelers, 1988-97: Certainly, we knew that if you got hit on the head so many times, maybe you had a 20 percent chance of having dementia pugilistica if you were a former professional boxer. But we didn’t really relate that in a modern sport like football, in a helmeted sport, that it could lead to that. And that was the big discovery, I think.
NARRATOR: Dr. Omalu believed the National Football League would want to know about his discovery.
Dr. BENNET OMALU: That was what I thought, in my naive state of mind. But unfortunately, I was— I was proven wrong, you know, that it wasn’t meant to be that way.
NARRATOR: In a letter to the journal Neurosurgery, Dr. Pellman and other members of the NFL’s MTBI committee attacked Dr. Omalu’s paper.
DOCUMENT: “These statements are based on a complete misunderstanding of the relevant medical literature.”
NARRATOR: They even questioned whether Mike Webster was suffering from neurological problems.
DOCUMENT: —”that there is inadequate clinical evidence that the subject had a chronic neurological condition”—
PETER KEATING, Reporter, ESPN: The league officials, the doctors and scientists serving on the MTBI committee, not only disputed those findings, they went after Dr. Omalu with a vengeance. They publicly said he should retract his findings.
NARRATOR: The NFL doctors insisted Dr. Omalu was misunderstanding the science of brain injury.
DOCUMENT: “We therefore urge the authors to retract their paper”—
STEVE FAINARU, FRONTLINE/ESPN: It’s an extraordinary move under any circumstances. Like, you don’t try to get a paper retracted unless there’s evidence of fraud or plagiarism or something like that.
DOCUMENT: “Omalu et al’s description of chronic traumatic encephalopathy is completely wrong.”
PETER KEATING: They went after him with missiles— I mean, like a nuclear missile strike on a guy’s reputation. They basically told him to go away and never come back. And that was just for starters.
NARRATOR: In the end, Dr. Omalu’s paper was not retracted. And now Omalu had another case.
NEWSCASTER: Terry Long killed himself by drinking anti-freeze.
NARRATOR: A second Steeler had died.
NEWSCASTER: Terry Long committed suicide by drinking anti-freeze.
NEWSCASTER: Terry Long was young—
NARRATOR: And Dr. Omalu received his brain.
Dr. BENNET OMALU: I came to work one morning and everybody there said, “Hey, we have another case for you.” I said, “What are you talking about?” They said, “Oh, Terry Long died.” I’m, like, “Who’s Terry Long?” Said, “Oh, he’s another NFL player. He died.”
NARRATOR: Long was an offensive lineman with the Steelers for eight years. He battled in the pit alongside Mike Webster.
MARK FAINARU-WADA: He— like Webster, his life had sort of fallen apart in a lot of ways. He had issues, certainly, during his career.
STEVE FAINARU: He was a steroid user. He had been involved in some serious financial problems.
MARK FAINARU-WADA: And so ultimately, he committed suicide by drinking antifreeze.
NARRATOR: As he had for Webster, Dr. Omalu sectioned part of Long’s brain and again had it stained.
JEANNE MARIE LASKAS, GQ, “Game Brain”: He ran the same test, same stains, found the same splotches, CTE in his brain, too. Now two former Steelers who had gone crazy about the same time.
Dr. BENNET OMALU: When I saw Terry Long’s case, I became more convinced that this was not just an anomaly, a statistical anomaly.
NARRATOR: Omalu submitted another paper to Neurosurgery, this one about Terry Long.
JEANNE MARIE LASKAS: That caused the MTBI committee to say, “This is preposterous. This is not good science. This is still not something that we’re buying into.”
Dr. BENNET OMALU: If you read, Pellman made statements like what I practice is not medicine, it’s not science. They insinuated I was not practicing medicine, I was practicing voodoo. Voodoo!
NARRATOR: The NFL would not publicly sit down with Dr. Omalu. But one night, in a private meeting, he brought his CTE slides and finally met face to face with one of the NFL’s doctors.
Dr. BENNET OMALU: And the NFL doctor at some point said to me, “Bennet, do you know the implications of what you’re doing?” I looked. He was on my left. I said, “Yeah, I think I do.” He said, “No, you don’t.” [laughs] So we continued talking, talking. At some point, he interrupted me again, “Bennet, do you think you know the implications of what you’re doing?” I said, “I think I do. I don’t know.” He said, “No, you don’t.” So we continued talking again.
Then a third time, he interrupted me, and I turned to him and I said, “OK, why don’t you tell me what implications are?” He said, “OK, I’ll tell you.” He said, “If 10 percent of mothers in this country would begin to perceive football as a dangerous sport, that is the end of football.”
[www. Watch on line]
JULIAN BAILES, M.D., Team Neurosurgeon, Steelers, 1988-97: For the most part, people didn’t want to believe it’s true. They didn’t want to admit to themselves or anybody else that our beloved sport, probably our most popular sport, could end up with brain damage. I didn’t want to admit it to myself, either. It was a hard message, a difficult message, a bad message, but it appeared to be true.
NEWSCASTER: Owners of the 32 teams—
NARRATOR: Then in New York, a change in the NFL’s top leadership.
NEWSCASTER: The NFL will have a new commissioner—
NEWSCASTER: There’s a changing of the guard at the National Football League.
NARRATOR: In September of 2006, Commissioner Paul Tagliabue stepped down.
NEWSCASTER: The right-hand man to Tagliabue is running the show.
NEWSCASTER: Tagliabue will be succeeded by Roger Goodell.
NARRATOR: His second in command and closest aide, Roger Goodell, took over. Goodell had grown up in Washington, the son of a United States senator from New York. Early in his career, he worked as former commissioner Pete Rozelle’s driver.
MARK FAINARU-WADA: He basically got his job by writing to the commissioner and saying, “Please, I’d like to work in the NFL.”
NARRATOR: It took Goodell 24 years to work his way to the top. He was chief operating officer when the league’s scientific committee sent those controversial papers to the journal Neurosurgery.
STEVE FAINARU: Here’s a guy who’s spent more than half of his life in the NFL, and more than anyone should be acutely aware of the sort of dangers that are lurking in this problem.
NARRATOR: Now Goodell was fully in charge of the league’s handling of the concussion crisis. He soon replaced the rheumatologist Dr. Elliot Pellman and promoted the neurologist Dr. Ira Casson.
PETER KEATING: Dr. Ira Casson, who is an expert, but an abrasive person who is contemptuous of the arguments that concussion can cause damage.
NARRATOR: Casson had once joined Pellman in attacking Omalu’s work. Now one of Casson’s first moves, a public denial of Omalu’s conclusions.
[HBO Real Sports, May 14, 2007]
CORRESPONDENT: Ira Casson leads a team of NFL doctors who did a study of several hundred active players and reported that the concern over head injuries is overblown.
Is there any evidence, as far as you’re concerned, that links multiple head injuries among pro football players with depression?
IRA CASSON, M.D., Co-Chair, MTBI Committee, 2007-09: No.
MARK FAINARU-WADA: Dr. Ira Casson ends up with this sort of very famous exchange that earns him the nickname “Dr. No.”
CORRESPONDENT: With dementia?
Dr. IRA CASSON: No.
CORRESPONDENT: With early onset of Alzheimer’s?
Dr. IRA CASSON: No.
JEANNE MARIE LASKAS, GQ, “Game Brain”: And Ira Casson was asked repeatedly, “Is there any link between trauma, head trauma, and the kind of dementia we’re seeing in these players?” And he says, “No. No. No. No.”
CORRESPONDENT: Is there any evidence as of today that links multiple head injuries with any long-term problem like that?
Dr. IRA CASSON: In NFL players?
Dr. IRA CASSON: No.
NARRATOR: Then just one month later, in Chicago, a dramatic gesture from Commissioner Goodell. At an airport hotel, the league gathered the top NFL brass, team doctors and trainers.
MARK FAINARU-WADA: The NFL convenes a summit in the summer of 2007.
STEVE FAINARU: About 200 people are gathered there, and running the show is Ira Casson. The stakes for the NFL are obvious. It’s huge business. If the business is potentially lethal, then that’s going to have major implications for the game.
NARRATOR: On this day, the commissioner would take a front row seat to listen to the best medical minds in the league.
PETER KEATING: All the teams are present. All the teams had to send doctors and trainers. And the league’s concussion people are there.
NARRATOR: They had even invited outside scientists who had become some of the league’s biggest critics. But one person was missing.
PETER KEATING: Dr. Omalu is excluded, just underscoring how they don’t want to do business with him.
BENNET OMALU, M.D., Neuropathologist: I was not aware of it. Nobody ever told me. Dr. Bailes called me and said the NFL is putting together a conference on CTE, that you were not invited.
JEANNE MARIE LASKAS: He is shunned. I mean, it was a loud just, “No, not you. Yes, you’re the guy with all the research, you’re the guy who’s published the papers, you’re the guy who’s got the brains. But no, you’re not coming.”
NARRATOR: Former Steelers team doctor and neurosurgeon Julian Bailes had become a true believer in CTE and Omalu. They were now research partners. He offered to present Omalu’s work to the group.
Dr. JULIAN BAILES: So I presented and showed our data, which was four or five cases at that point.
NARRATOR: Besides Mike Webster and Terry Long, Omalu also found CTE in the brains of Andre Waters and Justin Strzelczyk. Bailes delivered Omalu’s message: Playing football could cause permanent brain damage.
Dr. JULIAN BAILES: It wasn’t met with any broad acceptance, to say the least.
STEVE FAINARU: Julian Bailes got up and talked about Omalu’s work. And while he’s up there, Casson is off to the side and he’s rolling his eyes. He’s clearly distressed by what he’s hearing. And that was basically the idea that was conveyed by the NFL in that moment.
Dr. JULIAN BAILES: There was skepticism. There was dismissiveness on his part. There was great doubt.
NARRATOR: As Bailes left the meeting, he ran into New York Times reporter Alan Schwarz.
ALAN SCHWARZ: I remember Julian being furious, absolutely furious at how they had been treated in that room. And there was clearly— among the NFL committee, there was just a very steadfast belief that this is not a problem. “You guys don’t know how to do research the way we do. And thank you for coming.”
Dr. JULIAN BAILES: I was not the bearer of good news, probably, in many people’s minds. This was not something that I made up. This was showing what the findings were.
NARRATOR: Earlier, Goodell had watched his mentor, Tagliabue, downplay the concussion controversy. Now he had heard firsthand how serious some respected scientists thought the issue was.
MARK FAINARU-WADA: Roger Goodell’s on notice. The NFL has a serious issue around the question of concussions, around the issue of brain trauma, on the rising suggestion that there is a link between football and neuro-degenerative disease amongst its former players, and that there is a growing body of science that clearly establishes this link.
NARRATOR: Outside the conference’s closed doors, the new commissioner insisted that the NFL had the problem under control.
[June 19, 2007]
ROGER GOODELL: The evidence is that our doctors are making excellent decisions. That’s proven by the six-year study that we have and the research that’s been done that looks at that issue intensively.
NARRATOR: The head of Goodell’s concussion committee, Dr. Ira Casson, took on the critics.
IRA CASSON, M.D., Co-Chair, MTBI Committee, 2007-09: Anecdotes do not make scientifically valid evidence. I’m a man of science. I believe in empirically determined, scientifically valid data. And that is not scientifically valid data.
NARRATOR: Casson insisted there was no evidence that football players were at risk for CTE.
Dr. IRA CASSON: In my opinion, the only scientifically valid evidence of a chronic encephalopathy in athletes is in boxers and in some steeplechase jockeys.
NARRATOR: Dr. Casson declined to be interviewed by FRONTLINE.
ANNOUNCER: This venerable stadium will be a wild scene tonight!
NARRATOR: And as the teams took the field just a few months later, in the fall of 2007, the league’s definitive statement on brain injury was given to every single player in a pamphlet.
ALAN SCHWARZ, The New York Times: The cover says, “What is a concussion,” question mark. It said, you know, “If I get a concussion, am I further at risk for long-term problems?” And the answer was, and I’m virtually quoting, “Research has not shown that there are any long-term consequences to concussions in NFL players as long as each injury is treated properly.”
STEVE FAINARU: The message was that football is safe to your brain. That was the message, “Don’t worry about it.”
[www: Timeline: NFL's changing positions]
NARRATOR: The commissioner and the league had successfully held the line, denying the dangers of football.
ALAN SCHWARZ: They refused to listen to people who didn’t share their opinions about the research, and it was very much, you know, putting a stake in the ground saying everybody else is wrong. And that’s what they did.
NARRATOR: Shunned by the league, bruised by the struggle and looking to make a change, Dr. Omalu left Pittsburgh. He moved to Lodi, California.
MARK FAINARU: He ends up in the dust bowl of north central California, and he’s working as a medical examiner there, as far removed from the NFL as anybody could be, and trying to figure out how to sort of stay in it.
Dr. BENNET OMALU: I wish I never met Mike Webster. CTE has dragged me into the politics of science, the politics of the NFL. You can’t go against the NFL. They’ll squash you. I really, sincerely wished it didn’t cross my path of life, seriously.
ANNOUNCERS: Second and 3, ball on the 3—
In motion, wide open, touchdown!
JANE LEAVY, Journalist: The brains are precious cargo.
ANNOUNCER: Now back to the third, and he goes outside—
CHRIS NOWINSKI, Author of the Book/Film Head Games: We have to get the brain usually within hours of the death.
ANNOUNCER: —scores a touchdown.
Dr. ROBERT CANTU: You have a brain that’s intact. It’s been removed from the upper spinal cord.
ANNOUNCER: He’s at the 40! He’s at the 45! Midfield! He’s going to go!
NARRATOR: It is the brain of a former football player.
JANE LEAVY: This is a process that is awe-inspiring in the old-fashioned sense of the word.
CHRIS NOWINSKI: You have the responsibility of actually possessing somebody’s brain, which is probably the best representation of who they were. You know, you really treat it with the utmost respect.
STEVE FAINARU: From a scientific perspective, there’s this secret that’s being unlocked.
ANN McKEE, M.D., Neuropathologist, BU CTE Center: We take it out, we weigh it, we photograph it, all the external surfaces.
JANE LEAVY: The attitude is so careful about— that this is a person that’s being delivered into their care.
Dr. ANN McKEE: I never forget that the brain is a human being. I feel very privileged that someone has , Fed me with this— with this— this duty.
NARRATOR: IN 2008, Dr. Ann McKee was a leading Alzheimer’s researcher.
Dr. ANN McKEE: This is what I do. I look at brains. I’m fascinated by it. I can spend hours doing it. In fact, if I want to relax, that’s one way I can relax.
NARRATOR: Then one day, she received a phone call from the Boston University medical school.
ROBERT STERN, Ph.D., Neuropsychologist, Boston University: I called her and said, “Are you interested in looking at the brains of former football players?” And she didn’t drop a beat and said, “Are you kidding!” I had no idea that she was a super football fan.
Dr. ANN McKEE: I was born with football— my brothers, my dad. I played football when I was a kid. I mean, you know, it was part of life. It’s a part of growing up. It’s— you know, it’s a way of life. So I get it.
NARRATOR: Now Dr. McKee was joining a team of researchers to build on Dr. Omalu’s discovery.
MARK FAINARU-WADA: She’s learned a little bit about the work that had previously been done in this issue by Omalu and others, and she’s eager to find some brains.
NARRATOR: McKee and colleagues from Boston University were determined to examine as many brains as they could, and this man knew how to get them.
MARK FAINARU-WADA, FRONTLINE/ESPN: Chris Nowinski shows up and says, “Look, I’ll find the brains for you. I’ll bring them to you. And they’re going to be football players. Are you interested?” And she says, “Absolutely.” You know, she describes it as like the greatest collision on earth for her.
NARRATOR: For Nowinski, the issue of CTE is personal. he worries he has it.
CHRIS NOWINSKI, Author of the Book/Film Head Games: I’d be a fool not to worry about CTE personally. And I took as much brain trauma as anybody. I think I have more than enough reasons to believe that I’m going to be fighting this myself. I am fighting it.
NARRATOR: At Harvard, Nowinski was a punishing tackler. He suffered countless head injuries. Then instead of the NFL, he became a professional wrestler..
MARK FAINARU-WADA: He ends up with the nickname Chris Harvard, the persona of this sort of snobbish wrestler who’s smarter than all the fans.
CHRIS HARVARD: You people should be grateful to have someone of my intelligence in your presence!
NARRATOR: For Chris Harvard, the performance often ended with a blow to the head.
CHRIS NOWINSKI: Chris Harvard landed on his head quite a bit. You know, as much as wrestling is performance, there’s a very, very small margin of error. And especially when you’re learning the thing, you know, you fall on your head a lot.
NARRATOR: Nowinski began to have violent nightmares and migraine headaches.
CHRIS NOWINSKI: And I said, “There’s something really wrong with me.” And the headache didn’t go away for five years.
NARRATOR: Brain trauma became an obsession.
CHRIS NOWINSKI: What motivated me every day was the fact that my head was killing me. And I knew that I felt awful. And I knew that I wasn’t the only person, but I was a person in a position to make a difference.
NARRATOR: He would take on the task of finding brains of former football players for Dr. McKee.
STEVE FAINARU, FRONTLINE/ESPN: They call him, like, the designated brain chaser, like that’s his job, to go out and get the brains.
NARRATOR: Nowinski made the hard calls, asking families to donate the brain of a deceased loved one.
CHRIS NOWINSKI: At the beginning, when I first kind of got up the nerve to do it, you know, I wrote down a script and I prepared, I practiced, mentally preparing myself for wandering into someone’s life like this.
NARRATOR: Almost right away, Nowinski secured a portion of the brain of a 45-year-old former Tampa Bay Buccaneer, Tom McHale.
ROBERT STERN: Tom McHale was a brilliant guy, went to Cornell, had been playing football since a kid. His brilliance intellectually was matched by being an incredible athlete.
NARRATOR: Tom and Lisa McHale had three sons. Once his career was over, McHale ran a successful chain of restaurants. But then, uncharacteristically, trouble.
LISA McHALE, Wife: Restlessness, irritability and discontent describe Tom to a T today, but no way is it anywhere near the man I had known and the man I had been married to for years.
JANE LEAVY, Journalist: The change was so diabolical. He became a drug addict. He became depressed. He became— you know, had irate moments of, you know, violent temper.
NARRATOR: McHale’s addictions spiraled out of control— pain killers, cocaine.
LISA McHALE: I remember so clearly him looking at me — and this is going back, you know, in the final months of his life — and saying, “Lisa, when I look in your eyes, all I see is disappointment.”
And I honestly don’t know whether he was seeing my disappointment, or whether it was his own disappointment that he was seeing reflected back. But it pains me to think of how much that hurt him.
NEWSCASTER: A former Tampa Bay Buccaneer was found dead this morning—
NEWSCASTER: A former Tampa Bay Buccaneers player—
NARRATOR: He had died of an overdose. Dr. McKee had read Dr. Omalu’s research, but she wanted to see for herself.
ANN McKEE, M.D., Neuropathologist, BU CTE Center: We dissect and section his brain, do a whole series of microscopic slides, look at it with all sorts of different stains for different things, and then come to a conclusion about what the diagnosis is.
NARRATOR: What she saw was that telltale protein, tau.
Dr. ANN McKEE: This is a 45-year-old with terrific disease. I mean, he had florid disease. He has tau in all these regions of the his brain.
NARRATOR: Dr. McKee had examined thousands of brains, but the location of the damage from CTE was different.
ROBERT STERN, Ph.D., Neuropsychologist, BU CTE Center: I remember my feeling. I was scared. I was really scared. It really was a turning point. It was a new understanding that, “Hey, you know, this might be bigger than we think.”
NARRATOR: Dr. McKee soon had three brains, all with CTE. But rather than just publish in scientific journals, Chris Nowinski was determined to get the word out.
JANE LEAVY: Nowinski, who is not a scientist, says, “There are people getting hit here. If we speak up now, we may be able to, if not save lives, at least prevent the damage that we are seeing on Ann McKee’s table.”
NARRATOR: Nowinski decided to take on the NFL in a very public way, at their biggest event, the 2009 Super Bowl.
FAITH HILL, Entertainer: [singing] All right, what a night, it’s finally here. Super Bowl Sunday’s kicking into high gear—
NARRATOR: The glitz and glamour of the NFL production machine was in full gear, developed over decades—
FAITH HILL: [singing] We’ve been waitin’ all day for a Super Bowl fight—
NARRATOR: —highly choreographed—
FAITH HILL: [singing] —running and hitting with all their might, yeah, everyone’s ready for—
NARRATOR: —a national event with a carefully crafted story.
FAITH HILL: [singing] The whole world’s ready, kick that ball off the tee because it’s Super Bowl rocks on NBC—
NARRATOR: In Tampa, before the big game, Nowinski and McKee tried to crash the festivities by holding a press conference.
MARK FAINARU-WADA, FRONTLINE/ESPN: This is the genius of Nowinski, really, I mean, right? I mean, we’re going to present her findings.
Dr. ANN McKEE: This is something you would never—
MARK FAINARU-WADA: Where do we want to announce that? Oh, let’s go to Tampa Bay where the Super Bowl’s about to play out, where there’s 4,000 media members who are there waiting to watch.
Dr. ANN McKEE: We have examined thousands of brains, and this is not a normal part of aging. This is not something you normally see in the brain.
MARK FAINARU-WADA: They were saying, “Football caused this. This is an issue.” I think McKee uses the word “crisis.” She says, “This is a crisis, and anybody who doesn’t believe it is in denial.”
NARRATOR: Also on the panel, Nowinski’s other star, Lisa McHale.
LISA McHALE: Eight months ago, I lost my best friend, my college sweetheart and my husband of 18 years—
NARRATOR: Lisa McHale had decided to go public with her husband’s story.
LISA McHALE: I never hesitated to be public with Tom’s findings because I was so fully blown away to know that Tom could have had the kind of injury he had to his brain and that it could have been caused by football. And I said, “My God, of course. This is information that I would have like to have had.”
NARRATOR: And after her husband’s death, McHale decided to become an advocate for Dr. McKee’s research.
LISA McHALE: He is now the sixth confirmed case of CTE among former NFL players. And bearing in mind that only six former NFL players have been examined for CTE, I find these results to be not only incredibly significant but profoundly disturbing.
NARRATOR: But that day, there were few reporters listening.
CHRIS NOWINSKI: There were thousands of reporters across the street and probably two dozen who were willing to walk across and learn about CTE.
ROBERT STERN: That was the shocking part. You know, here we were in the midst of everything and this potentially giant story was being told, and virtually no one was there.
CHRIS NOWINSKI: Everyone, thank you so much for your time, and we’re available if you want to stick around.
NARRATOR: Nowinski’s press conference was no match for the show the NFL was putting on across town.
ANNOUNCER: The build-up is over, and away we go in Super Bowl 43!
NARRATOR: Then one of the most watched television broadcasts in history, a 30-second ad sold for $3 million. It was the crowning event for a year in which the NFL earned almost $8 billion.
ANNOUNCER: Here’s the run-up, and Super Bowl 43 is under way with the flashbulbs a-poppin’!
MARK FAINARU-WADA: The league is this massive force financially. The Super Bowl is a spectacle. TV is paying huge money to televise the sport.
ANNOUNCER: He gets it away quickly and finds the tight end over the middle, and it’s Heath Miller!
STEVE FAINARU: The NFL is broadcast over five networks. ESPN, where we work, their new contract with the NFL is worth almost $2 billion year. So they’re basically paying around $120 million per game. That’s, like, the budget of a Harry Potter movie every week, week in, week out.
ANNOUNCER: And the Pittsburgh Steelers become the first franchise in history to win six Super Bowls!
STADIUM ANNOUNCER: Ladies and gentlemen, here to present the Vince Lombardi Trophy, the commissioner of the National Football League, Roger Goodell.
ROGER GOODELL: Well, some said that we could not top last year’s Super Bowl, but the Steelers and Cardinals did that tonight!
NARRATOR: Presiding over it all, the most powerful man in sports.
ROGER GOODELL: —and all the Steelers fans, congratulations on your sixth world championship!
NARRATOR: He sat atop a multi-billion-dollar empire that he was determined to protect.
STEVE FAINARU: One of his mantras was to “protect the shield,” the NFL shield, to protect the integrity of the game.
NARRATOR: But now the league might face huge lawsuits and a tarnished image if Dr. McKee’s findings about CTE held up.
Not long after her trip to Tampa, Dr. McKee received a phone call.
Dr. ANN McKEE: I was called by Ira Casson. And I remember thinking, “Why is Ira Casson calling me?”
STEVE FAINARU: She’s intimidated from the start because she knew enough about Ira Casson, she said, to know that he wasn’t necessarily a friend.
Dr. ANN McKEE: And he wanted me to come to the NFL office and present the data.
NARRATOR: That May, McKee and Nowinski arrived at NFL headquarters.
CHRIS NOWINSKI: We head on up to a very, very fancy conference room, nice wood paneling, jerseys and trophies in the glass. And it was probably 15 members of the committee.
MARK FAINARU-WADA: And one of the first things McKee notices is that there’s only one other woman in the room, and it’s not a doctor, it’s a lawyer.
PETER KEATING, Reporter, ESPN: A lawyer is not there to offer medical advice. And a lawyer is not there to offer competitive athletic advice, either. A lawyer is there to figure out what the league needs to do to defend itself against a storm that may or may not come, but the league has to be ready to fight.
Dr. ANN McKEE: I’m up against a lot of doubters. I’m up against people who don’t think that any of this holds any water. So, fine. I’m just going to show them what I have. And they kept interrupting.
NARRATOR: Dr. Ira Casson and others on the committee expressed their skepticism that playing football was the cause of CTE.
STEVE FAINARU: Very, very quickly, she got serious pushback from Ira Casson and the rest of the committee.
NARRATOR: Indianapolis Colt team physician Dr. Henry Feuer was one of the NFL doctors the meeting.
HENRY FEUER, M.D., MTBI Committee, 1994-2010: I just have a problem. Ann McKee— she cannot tell me where it’s starting. We don’t know the cause and effect. We don’t know that right now. We don’t know the incidence.
NARRATOR: The committee members believed Dr. McKee could not answer two important questions. Causation— did football cause CTE? And prevalence— how many players had it.
Dr. HENRY FEUER: She was seeing only those that were in trouble, and we know that there are thousands roaming around that are not having problems. So again, I think that’s where we had— we may have had an issue.
JOSEPH MAROON, M.D., MTBI Committee, 2007-10: I think we’re very early in the evolutionary understanding of CTE. A certain percentage of the individuals diagnosed with this have had steroid abuse, alcohol abuse, other substances abuses. We don’t know the concussion history in many of these. And there may be other confounding factors in terms of the genetics that we simply don’t understand.
ANN McKEE, M.D., Neuropathologist, BU CTE Center: They were convinced it was wrong, and I felt that they were in a very serious state of denial.
CHRIS NOWINSKI, Co-Director, BU CTE Center: I remember at one point, one of the NFL doctors asking, you know, “Couldn’t you be misdiagnosing this? You know, these all look like they could be frontal temporal dementia.” And Ann said, “Well, actually, I was on the NIH committee that defined how you diagnose that disease. So no, they’re definitely different diseases.” You know, like, she had the experience and they didn’t.
NARRATOR: And according to Dr. McKee, there was something else, something familiar about the way the NFL committee was acting.
Dr. ANN McKEE: I don’t want to get into the sexism too much, but sexism plays a big role when you’re a doctor of my age who’s come up in the ranks with a lot of male doctors. Sexism is part of my life. And getting in that room with a bunch of males who already thought they knew all the answers— more sexism. I mean, you know, it was, like, “Oh, the girl talked. Now we can get back into some serious business.”
Dr. HENRY FEUER: I— you know,I don’t know why she feels that way. I thought that she presented herself, as I recall — it’s been several years — that there was something— something in her manner. And— and I think she’s a brilliant woman. She’s done a great job. There was just something just about the way she said it. And not that everybody was looking down. You know, it was just—
NARRATOR: Dr. Feuer insists Dr. McKee is mistaken about how she was treated.
Dr. HENRY FEUER: If we for some reason coming— came across as being disrespectful, then I would say that everybody else we interviewed over the 15 years must have felt the same way. That’s all I can say about that. And I feel strongly about that, too.
We would just— we would listen, and “Thank you,” and that’s it. Whether she wanted us to start— you know, I don’t know where she’s coming from on that.
NARRATOR: The meeting had changed nothing.
Just a few blocks from NFL headquarters, the commissioner had another problem. In a midtown Manhattan restaurant, an internal NFL research document was leaked to a reporter.
ALAN SCHWARZ, The New York Times: Documents were passed to me at Smith and Wollensky’s in Manhattan, in an envelope. I mean, it was great — it was very “Deep Throat”— by somebody who shall remain nameless. But he literally slid it across the table in an envelope.
NARRATOR: It was a scientific study of former players commissioned by the National Football League itself.
ALAN SCHWARZ: At the bottom of page 32, there it was, “dementia.” And they had asked players, or their representatives, their wives, “Have you been diagnosed by a physician as having Alzheimer’s, dementia, or any other memory-related disease?””
ROBERT STERN, Ph.D., Neuropsychologist, BU CTE Center: What it showed was that former NFL players seem to have memory-related disorders at a much, much higher rate than people in the regular community. And here was a study that the NFL supported, and it came out not looking too good for the NFL.
ALAN SCHWARZ: It was the people who the league hired to find out the answers to these questions giving them the answers. And that’s what they were. And so you knew that this was going to be big.
NARRATOR: The study went to the heart of the prevalence question. In this case, it showed the prevalence of brain disorders was far higher among football players than the NFL anticipated.
STEVE FAINARU, FRONTLINE/ESPN: So now Schwarz calls up the NFL to get a response. And what he gets from Greg Aiello, the league spokesman, is more denials. They’re now denying their own study.
NARRATOR: Aiello insisted the study’s design was flawed. But now the NFL’s concussion crisis was again national news.
STEVE FAINARU: And so it’s becoming almost impossible for the NFL to ignore it.
NARRATOR: At the same time, another force was also causing trouble for the NFL and the commissioner, the wives and widows of players with CTE.
JANE LEAVY, Author, The Woman Who Would Save Football: I don’t think anyone else but the wives, sisters, mothers, daughters, and Ann McKee, could have forced this issue into American consciousness.
NARRATOR: Eleanor Perfetto was one of them. Her husband, Ralph Wenzel, had played for the Pittsburgh Steelers.
ELEANOR PERFETTO, Wife of Ralph Wenzel: As the disease progressed, he went from being ill but fairly functional to getting to the point where he could no longer, you know, dress or feed himself. And in the last year-and-a-half to two years before he died, he couldn’t even walk anymore.
NARRATOR: She’d spent years trying to get help from the NFL and its players association. Then Perfetto took matters into her own hands. She showed up uninvited to a league meeting about caring for retired players.
MARK FAINARU-WADA, FRONTLINE/ESPN: There’s going to be a meeting that the commissioner is holding with former players. And you know, her husband, suffering, you know, from dementia, obviously can’t be represented there by anybody but her. And she’s told she’s not allowed to enter the room.
NARRATOR: It was the commissioner himself who kept Perfetto out.
ELEANOR PERFETTO: And I said, “I’d like to attend this meeting.” And he said, “No, you can’t attend. It’s only for players. It’s not for anyone else.” And I said, “But my player— my husband is a player who’s severely disabled, and he can’t be here right now.”
NARRATOR: Nevertheless, the commissioner said no.
NEWSCASTER: The issue is head injuries among players, and if those injuries can lead—
NARRATOR: As the concussion story received more attention, the coverage helped spark interest in the nation’s capital.
NEWSCASTER: Congress considers concussions in the NFL—
NEWSCASTER: Congress is getting into the game. They’re looking into the long-term impact—
Rep. JOHN CONYERS, Jr., (D-MI), Judiciary Committee Chairman: The meeting will come to order.
NEWSCASTER: Congress is looking into the long-term impact of concussions.
STEVE FAINARU: Congress saw it as a way to put the NFL’s concussion policies on trial in the court of public opinion.
NARRATOR: The commissioner arrived like a celebrity, the star attraction at the hearing and the focus of all the cameras.
PETER KEATING, Reporter, ESPN: Goodell is asked point-blank if he stands by the idea that concussions don’t hurt pro football players.
ROGER GOODELL: Let me address your first question—
PETER KEATING: He can’t answer.
ROGER GOODELL: You’re obviously seeing a lot of data and a lot of information that our committees and others have presented with respect to the linkage. And the medical experts should be the one to be able to continue that debate.
Rep. JOHN CONYERS: I just asked you a simple question. What’s the answer?
ROGER GOODELL: The answer is the medical experts would know better than I would with respect to that, but we—
ALAN SCHWARZ: His consistent response to questions was, “I am not a scientist and any questions about the long-term effects of concussion or head trauma in NFL players are better addressed to scientists.”
NARRATOR: One at a time, committee members went after Goodell.
Rep. MAXINE WATERS (D), California: We have heard from the NFL time and time again. You’re always studying, you’re always trying, you’re hopeful. I want to know, what are you doing now?
Rep. LINDA SANCHEZ (D), California: The NFL sort of reminds me of the tobacco companies pre-’90s, when they kept saying, “No, there’s no link between smoking and damage to your health or ill health effects.”
MARK FAINARU-WADA: The last thing the league wanted to be dealing with in that moment was the analogy to big tobacco. There’s nobody in America who doesn’t know what that means. That means denial.
STEVE FAINARU: You have the commissioner of the NFL who’s being hauled before Congress to answer why his own research arm has been denying since 1994 that football causes brain damage, when everybody from The New York Times to former NFL players, to the respected research scientists are saying, in fact, the opposite is true.
NEWSCASTER: —talked about NFL owners as being like tobacco executives—
NEWSCASTER: —but I think it’s seen as being plausible—
NEWSCASTER: —the NFL, similar to what the tobacco industry engaged in—
NARRATOR: Back in New York, with the pressure mounting, the commissioner decided to make some dramatic changes.
[www: The NFL's positions]
NEWSCASTER: The NFL changes its playbook—
NEWSCASTER: New rules for treating athletes with concussions—
NEWSCASTER: NFL commissioner Roger Goodell wants all teams to adhere to a new policy for head injuries—
STEVE FAINARU: They’d just been hauled before Congress and the commissioner was embarrassed by Linda Sanchez. They’d been compared to big tobacco. And they were trying to fight back.
NARRATOR: The commissioner initiated a series of new rules designed to protect players from concussions.
STEVE FAINARU: It was quite obvious what they were doing. They were in the middle of a major damage control operation.
NEWSCASTER: From now on, teams should consider a concussion a game-ending injury.
NARRATOR: Dr. Casson was out.
NEWSCASTER: Dr. Casson resigned from the NFL’s concussion committee.
NARRATOR: And a new concussion committee would be formed, led by two prominent neurosurgeons.
NEWSCASTER: The NFL is committed to medical and scientific research—
NARRATOR: And there was one other surprise.
ALAN SCHWARZ: I read on the wire that the NFL had given a million dollars to Boston University. What? And so I called up Chris, like, “What the hell’s going on?” He didn’t know what was going on. He’s, like, “What are you talking about?”
CHRIS NOWINSKI, Co-Director, BU CTE Center: The answer was, “I don’t know what you’re talking about. This doesn’t sound right at all.”
ANN McKEE, M.D., Neuropathologist, BU CTE Center: A CBS reporter wanted to know what I thought of the gift of a million dollars. That was the first I heard of it. I was, like, floored.
NARRATOR: And Goodell offered Dr. McKee something she needed even more than money— brains.
MARK FAINARU-WADA: They get a letter from the league. It says you guys are now the NFL’s “preferred” brain bank and that the league will help with efforts to direct families to donate the brains of former players to Boston so that they will be studied for CTE.
NEWSCASTER: The National Football League says it will encourage current and former players to donate their brains—
NARRATOR: As the story of the deal broke—
NEWSCASTER: The NFL is donating $1 million towards the study—
NARRATOR: —the NFL’S spokesman, Greg Aiello, received a call from reporter Alan Schwarz.
ALAN SCHWARZ: While we were talking, he said “It’s clear that there are long-term consequences to concussions in NFL players.” Now, that kind of statement don’t make news if anybody else says it. But this time, it was the league saying it.
STEVE FAINARU: Schwarz stops. You know, he knows that the NFL has not only been denying this for years, that they’ve never come close to uttering anything even remotely close to this.
ALAN SCHWARZ: And I said, “Greg, you realize that’s the first time that anyone associated with the league has made that connection.” And I remember, he was a little— I don’t— what’s the adjective? Annoyed. He was annoyed.
MARK FAINARU-WADA: The Times now suddenly has a huge story, that the NFL has acknowledged a link between brain damage and football. And sure enough, stripped across the top of The Times sports section the next day is that very story.
NARRATOR: At Dr. McKee’s research lab, thanks to the NFL’s endorsement, the brain bank business was booming.
Dr. ANN McKEE: There were NFL players out there that were talking to their wives and saying, “I think this might be something.” You know, “I’m experiencing some problems. And I’m thinking I should donate my brain to this work.”
NARRATOR: By 2010, Dr. McKee had looked at the brains of 20 NFL players. She had found CTE in 19 of them. It was during that time that a brain arrived that would dramatically raise the stakes.
ROBERT STERN, Ph.D., Neuropsychologist, BU CTE Center: Owen Thomas to me was a critical case. Here we have a 21-year-old who was a hard-hitting lineman from the age of 9 on.
CHRIS NOWINSKI: And then, seemingly out of nowhere, he decided to take his own life. Never been diagnosed with a concussion, never had a problem in the world.
NARRATOR: Owen Thomas had hanged himself in his off-campus apartment. Chris Nowinski secured his brain for Dr. McKee. without any history of diagnosed concussions, it seemed unlikely he had CTE.
Dr. ANN McKEE: I was fully prepared to see nothing. I remember late at night looking at the brain and thinking, “Just going to knock this one off.” And it just floored me. It just— I just couldn’t believe what I was seeing.
NARRATOR: Such an advanced case of CTE had never been found in such a young person.
Dr. ANN McKEE: In, like, 20 spots in his frontal lobe. He’s 21. He’s so young. You know, that changes the game to me.
ANNOUNCER: —wrapped up and brought down by Owen Thomas—
NARRATOR: Because he’d never had a diagnosed concussion, Dr. McKee suspected Thomas might have gotten CTE from the everyday sub-concussive hits that are an inherent part of the game.
ANNOUNCER: Another nice play by Owen Thomas—
Dr. ANN McKEE: Those sub-concussive hits, those hits that don’t even rise to the level of what we call a concussion, or symptoms, just playing the game can be dangerous.
ANNOUNCER: A crucial matchup in the AFC—
MARK FAINARU-WADA: McKee is saying, “Look, this is very much an issue at the core of the game, of offensive lineman and defensive linemen pounding the crud out of each other on every single play, on every single down and every single practice, and there’s no getting around that.”
NARRATOR: It was a controversial theory that raised fundamental questions about the way the game was played.
HARRY CARSON, Author, Captain For Life: The human body was not created or built to play football. When you have force against force, you’re going to have injuries. And I’m not talking about the knees and— you know, all of that stuff is a given. But from a neurological standpoint, you’re going to have— you’re going to have some brain trauma.
NARRATOR: Harry Carson has been studying the matter since he retired 25 years ago.
HARRY CARSON: You know, most people are keyed in on the big hit. But the little mini-concussions are just as dangerous because you might be sustaining six to ten, maybe a dozen of these hits during the course of a game. And you know, if you’re going up against top-flight players who are able to perfect those skills of hitting you upside the head, or you know, getting hit with an elbow or— it’s one of those things that at some point, you’re going to pay for it down the line.
[www: More from Harry Carson]
STEVE YOUNG, San Francisco 49ers, 1984-99: You know, I really worry about my lineman brothers. I really worry for my running back brothers. I mean, that’s the truth. We’re talking about a nefarious injury, one that you never feel until it’s too late. So that’s the— that’s just— when I look back over 30 years of— associated with football, that’s the thing that’s most alarming to me.
MICHAEL ORIARD, Center, Kansas City Chiefs, 1970-73: The way the game is played, I don’t see how you can eliminate all of those routine hits that linemen make every play. How do you eliminate them with— and have the game still be football?
NARRATOR: Back in the lab, McKee had seen another surprising case.
Dr. ANN McKEE: We had been able to get the brain of an 18-year-old who had died 10 days after suffering his fourth concussion playing high school sports.
NARRATOR: It was the brain of 18-year-old Eric Pelly. A high school senior, a straight-A student, he’d played multiple sports. His dream was to play for the Steelers.
ROBERT CANTU, M.D., Neurosurgeon, BU CTE Center: No one, I think, would have thought that you were going to find chronic traumatic encephalopathy in a high school athlete.
Dr. ANN McKEE: I was shocked to find that in the brain of this 18-year-old, there were little tiny spots, little tiny areas in the frontal lobe that looked just like this disease.
Dr. ROBERT CANTU: You have an 18-year-old with chronic traumatic encephalopathy. That just shouldn’t happen.
Dr. ANN McKEE: I had an 18-year-old at that time. You know that that brain is supposed to be pristine. The fact that it was there, and he was only playing high school level sports, I mean, I think that’s a cause for concern.
NARRATOR: For Dr. McKee and others, it raised the obvious question. How safe is it for children to play football?
YOUTH FOOTBALL TEAM: What time is it? Game time! What time is it? Game time!
HARRY CARSON: From a physical risk standpoint, you know what you are doing when you sign your kid up, that he can hurt his knee, OK? But what you should know now is your child could develop a brain injury as a result of playing football. It’s not just on the pro level, it’s on every level of football. The question is, do you want it to be your child?
NARRATOR: For Dr. McKee’s colleague Dr. Cantu, the controversial answer was that no one under 14 should play tackle football.
Dr. ROBERT CANTU: With what we know about the youth brain compared with the adult brain, that it’s more easily disrupted than the adult brain— the youth brain is lighter in weight, so it has less inertia to put it in motion, so you tap a youth head, and his brain moves much quicker than an adult brain that’s heavier and therefore has more inertia. So I think we should be treating youths differently.
NARRATOR: And for the BU advocate Chris Nowinski, it was a danger the NFL helped to create.
CHRIS NOWINSKI: As long as the NFL dismissed this, that meant that parents were signing their kids up to go play football, believing that there was no risk. And you know, that wasn’t fair to those kids or those parents, but especially those kids.
ANNOUNCER: Let’s give him a big round of applause!
NARRATOR: Dr. McKee, who had grown up loving football, has struggled with her feelings about the sport.
Dr. ANN McKEE: I don’t feel that I am in a position to make a proclamation for everyone else.
NEWSCASTER: If you had children who are 8, 10 and 12, would they play football?
Dr. ANN McKEE: 8, 10, 12? No. They would not.
Dr. ANN McKEE: Because the way football is being played currently that I’ve seen, it’s dangerous. It’s dangerous and it could impact their long-term mental health. You only get one brain. The thing you want your kids to do most of all is succeed in life and be everything they can be. And if there’s anything that may infringe on that, that may limit that, I don’t want my kids doing it.
NARRATOR: McKee’s warnings about the danger of the game have made her the subject of sharp criticism.
JANE LEAVY, Author, The Woman Who Would Save Football: She’s a lightening rod because people see her as the woman out to destroy football as we know it. Probably the most hurtful charge that’s been leveled against her is that she’s crossed a line from scientist to activist.
NARRATOR: A number of prominent scientists believe she has overstated the dangers of playing football.
PETER DAVIES, Ph.D., Neuroscientist, Feinstein Institute: There’s a kind of polarization in that the BU group are clearly the advocates for CTE research. But it’s not the only issue. You know, there are other issues that we’ve got to look at. And how common is this? How many brain traumas do you need to get this? Is this something that everybody will get if they have enough brain trauma? Or is it the result of steroid or drug abuse in a small number of NFL players? We don’t know. These are questions, not statements of fact.
NARRATOR: Some researchers say Dr. McKee has examined only a limited sample of players and too few brains to justify her conclusions.
MARK LOVELL, Ph.D., Neuropsychologist: There’s been a sense of fear that’s been put into parents that “Maybe I shouldn’t let my kids play sports.” Having said that, I still think it’s something that we need to be concerned about. We just need more information on it in terms of, you know, what exactly is the incidence and the risk. Nobody knows that at this point in time. It’s still being debated. Depends on who you listen to.
KEVIN GUSKIEWICZ, Ph.D., NFL Head, Neck and Spine Cmte.: Those that have been conducting the autopsies are working with what they have to work with.
I think that we need to learn more about these former athletes, learn more about them during their living years so that we can better understand what their neuro-cognitive function is like, what their emotional status is like. We just have to be careful not to say that this causes that and be able to connect those dots without having more prospective analysis.
Dr. ANN McKEE: I’m not surprised that people don’t believe me. They don’t have— they don’t look at— they haven’t done this work. They haven’t looked at brain after brain after brain. I just feel that, I guess, the more cases we get, the more we persevere, the more they hear, eventually, they’ll change their mind.
NARRATOR: Still, McKee and her colleagues at BU acknowledge there are limits to her research.
ROBERT STERN, Ph.D., Neuropsychologist, BU CTE Center: Not everyone who hits their head gets this disease. And so a critical question is why does one person get it and another person doesn’t. There must be really important variables, genetics, things about the type of exposure to brain trauma people get. We need to figure those things out.
NARRATOR: Dr. McKee admits she’s seeing only a small sample.
Dr. ANN McKEE: I think, to be truthful, even a selection bias in an autopsy sample, even if the family of an individual who’s affected is much more likely to donate their brain than a person who had no symptoms whatsoever— given that, we have still been just ridiculously successful in getting examples of this disease.
NARRATOR: Dr. McKee has now examined the brains of 46 former NFL players. 45 had CTE.
Dr. ANN McKEE: We have an enormously high hit rate. I mean, you know, that would be extraordinary with any other disease, to be able to pull in that many cases just that were suspected. So I think the incidence and prevalence has to be a lot higher than people realize.
NARRATOR: To her, it may be the beginnings of an epidemic.
Dr. ANN McKEE: I think it’s going to be a shockingly high percentage. I’m really wondering where this stops. I’m really wondering, on some level, if every single football player doesn’t have this.
911 OPERATOR: 911 emergency.
NARRATOR: And then another death.
MEGAN NODERER: Oh, my God! My boyfriend’s been shot! My boyfriend’s been shot!
NEWSCASTER: An apparent suicide by a powerful athlete—
911 OPERATOR: Your boyfriend?
MEGAN NODERER: Yes!
NEWSCASTER: A beloved NFL star apparently took his own life today—
911 OPERATOR: What is your boyfriend’s name?
MEGAN NODERER: Junior Seau.
NEWSCASTER: Linebacker Junior Seau died today in an apparent suicide—
911 OPERATOR: Where did he shoot himself?
MEGAN NODERER: I can’t tell, ma’am. It looks like in the heart.
NEWSCASTER: The untimely death of Junior Seau is provoking questions—
NARRATOR: As the news broke, the question emerged— did CTE play a part in Junior Seau’s death?
ANNOUNCER: Here comes Seau! And he’s sacked!
ANNOUNCER: All the way back at the…
NARRATOR: He had used his body and his head for 20 years in the NFL. Number 55 was a hard-hitting linebacker. Pain and injury were his specialty. he even bragged about it once on an NFL film.
JUNIOR SEAU: [NFL Films] A perfect hit is when you’re faced up, coming one on one, and you hear him go, “Uh”— just a little “Uh.”
NARRATOR: He talked about the price he was willing to pay.
JUNIOR SEAU: You have to sacrifice your body. You have to sacrifice years down the line. When we are 50, 40 years old, we probably won’t be able to walk. That’s the sacrifice that you take to play this game.
NARRATOR: And it had paid off. Seau made millions. He was a philanthropist, beloved in his community. But then a familiar story— his life fell apart.
NEWSCASTER: Junior Seau was arrested for domestic violence in Oceanside California early on Monday—
NEWSCASTER: Seau accused of hitting his 25-year-old girlfriend—
NEWSCASTER: Junior Seau drove his SUV right off a cliff in California—
NEWSCASTER: The former pro football star has apparently fallen on hard times—
NARRATOR: At 43, his business empire had imploded.
NEWSCASTER: His behavior changed dramatically—
NARRATOR: He’d lost millions of dollars gambling.
NEWSCASTER: —including compulsive gambling, alcohol abuse—
NARRATOR: He wasted everything.
NEWSCASTER: —and violent, off-the-field incidents.
GINA SEAU, Ex-Wife: We didn’t know why he was detached or forgetting, or why he would bark at us for nothing or— we didn’t know.
SYDNEY SEAU, Daughter: The past two years have been the roughest. And for a couple months at a time, I wouldn’t hear from him at all. And that would scare me.
TYLER SEAU, Son: We got really close, and you know, I feel like it’s turning around, OK, he wants to be part of my life. And then, all of a sudden, I wouldn’t hear from him.
He’s truly a legend, and he will be with us forever—
NARRATOR: Seau was one of the most popular players and out of the league for only two years. His brain became the most sought-after ever.
STEVE FAINARU: You’ve got a half dozen prominent researchers immediately began to mobilize to try to get their hands on this brain tissue.
GINA SEAU: I can understand where certain groups are saying, “Wow. This guy has played for 20 years. This would be a perfect candidate for us to study and see if he had it.”
CHRIS NOWINSKI, Co-Director, BU CTE Center: I spent time making calls. I had, you know, a lot of— we had a lot of mutual friends, spoke to people at his foundation and just said, you know, “We would— like every other case, we would like to review this case, if you want.”
NARRATOR: At the same time, far from the action, another researcher had received word of Seau’s death.
BENNET OMALU, M.D., Neuropathologist: So when Junior Seau died, just like every other case, people called me. I don’t follow football, so I said, “Who is Junior Seau?” They said, “Oh, you don’t”— just like Mike Webster, “You don’t know Junior Seau?” I’m, like, “How do I?” Said, “Oh, he’s even bigger than Mike Webster.” They said, “Oh, he just died. He committed suicide.”
NARRATOR: Dr. Omalu had been looking for a chance to get back in the game in a big way. He telephoned Seau’s son, Tyler, to get consent to take his father’s brain.
Dr. BENNET OMALU: We did everything, spoke to the son. He gave us verbal consent. And the medical examiner requested that I come down — they’ve never had such a big case before, I’m an expert in this field — to help him.
STEVE FAINARU: He gets the first flight out the next morning. When he arrives at the medical examiner’s office, he’s telling people that he has the verbal consent from Tyler Seau to harvest the brain.
NARRATOR: And it was Omalu who actually removed Seau’s brain.
Dr. BENNET OMALU: I assisted at the autopsy. I took out the brain, processed the brain.
STEVE FAINARU: Just as they’re finishing up the autopsy, the chaplain comes walking into the room and he says, literally, “Houston, we have a problem.” And that problem is that he had just gotten off the phone with Tyler Seau, and according to Tyler, the NFL informed him that Omalu’s research is bad and that his ethics are bad, that he’s essentially unethical.
TYLER SEAU: People started saying things about Omalu, kind of telling me the kind of character that he has. And you know, I got a lot of email about it. But at that point, I was just kind of— you know, I don’t want to hear all these things.
Dr. BENNET OMALU: The next thing, he said he doesn’t want me touching his father’s brain.
STEVE FAINARU: At that point, there’s nothing else to do except leave. I mean, he just walks out of the room, and he takes his empty brain briefcase and he gets back on the plane, and he goes back to San Francisco without having any success.
Dr. BENNET OMALU: So I was very demoralized, I remember that day I was. People didn’t notice. When I got into the cab I was crying. I mean, what have I done?
NARRATOR: Junior Seau’s brain was sent to the National Institutes of Health, the NIH.
MARK FAINARU-WADA: The NFL very directly worked not only to get the brain to NIH, but in this case, to keep it away from Omalu’s group or McKee’s group by speaking badly about them.
NARRATOR: NFL doctors say the decision was made purely in the interest of science.
KEVIN GUSKIEWICZ, Ph.D., NFL Head, Neck and Spine Cmte.: Getting it into the hands of good science is their— the goal there. So yes, I think that was probably what was driving the suggestion that “Let’s have NIH get involved.”
NARRATOR: The final diagnosis in Seau’s case was national news.
NEWSCASTER: ABC News and ESPN have learned exclusively Seau’s brain—
NARRATOR: He had CTE.
NEWSCASTER: —visible signs of CTE, chronic traumatic encephalopathy—
NARRATOR: In the months following Seau’s death, the NFL went on the offensive. The commissioner helped to promote a youth football safety initiative, the Heads Up program. The league donated $30 million dollars to the NIH to study sports injuries, including joint disease, chronic pain and CTE.
ROGER GOODELL, NFL Commissioner: We recently committed $30 million to the National Institutes of Health—
PETER KEATING, ESPN Reporter: Good PR is one part of the NFL strategy. But the other piece of it is that the NFL wants to come off as being very forward-looking. The NFL wants to keep pushing these questions into the future, keep the discoveries going, make it seem like these questions that still need to be resolved are things that the league is working with doctors and researchers on.
NARRATOR: It was a message the commissioner himself delivered, granting a rare TV news interview the morning of the Super Bowl.
BOB SCHIEFFER, CBS News Face the Nation: [February 3, 2013] I’m going to ask you this question because some widows of some NFL players have asked me to ask you. Do you now acknowledge that there is a link between the game and these concussions that people have been getting, some of these brain injuries?
ROGER GOODELL: Well, Bob, that’s why we’re investing in the research, so that we can answer the question, what is the link? What causes some of the injuries that our players are still dealing with? And we take those issues very seriously.
MARK FAINARU-WADA: Though the league previously, through Greg Aiello, acknowledged a link, there’s no more acknowledging a link exists. There’s “The science is still emerging and we’re really going to try and do long-term studies on this. And we’re going to figure out whether there’s a link.”
ROGER GOODELL: We’re going to let the medical individuals make those points. We’re going to give them the money, advance that science. In the meantime, we have to do everything we can to advance the game and make sure it’s safe.
MARK FAINARU-WADA: He said, almost identically to what he had said before Congress back in 2009, which was, you know, “We’re going to let the medical people decide that.”
NARRATOR: Almost two decades after the NFL founded its first scientific committee to research the issue, the league continues to insist the evidence of a link between CTE and football is unclear.
PETER KEATING, Reporter, ESPN: It sure looks like it was just a relentless and endless delaying action. Year after year after year, at crisis after crisis after crisis, the concussions committee and its members assured the public that the league was looking into this.
The league actually never got around to looking at it in any kind of valid way. We’re talking in the year 2013. This committee was founded in 1994. Maybe there should be better evidence by now.
NARRATOR: As the concussion crisis deepened, the commissioner faced yet another challenge, a lawsuit brought by more than 4,500 retired players.
PETER KEATING: The threat to the NFL from this litigation was existential. The threat was that the league was going to have to pay out in the billions with a B, not millions with an M.
NARRATOR: About one third of NFL veterans, including some of the biggest former stars, claimed the NFL had fraudulently concealed the danger to their brains.
THOMAS GIRARDI, Players’ Attorney: The main allegations here are— it’s very simple. There was a very severe hazard that was present in professional football, and it was a little secret. The NFL knew it, but the players certainly didn’t know it.
NARRATOR: On the other side, the NFL’s lawyers.
LEGAL AIDE: OK, representing the National Football League will be Paul Clement. He’ll be flanked by Anastasia Danias — she’s from the National Football League— and also Beth Wilkinson from Paul Weiss—
NARRATOR: They insisted the league had done nothing wrong.
BETH WILKINSON, NFL’s Attorney: Let’s be clear. Let’s be clear. We strong— we strongly deny those allegations that we withheld any information or misled the players. And if we have to defend this suit, as Paul was alluding to, we will do that and be able to make those factual allegations. But we absolutely deny those allegations.
NARRATOR: But away from the cameras, the two sides were engaged in tense court-ordered negotiations.
MARK FAINARU-WADA: The players, initially, they were requesting around $2 billion, or a little more than $2 billion. And what we’ve been told is the NFL was offering virtually nothing. They were offering “peanuts,” as one person said.
NARRATOR: The players believed they had significant leverage, a threat to the NFL.
PETER KEATING: The threat was that the doctors and trainers, neuropsychologists, maybe owners, maybe commissioners and ex-commissioners, were going to have to testify under oath as to what they knew and when.
NEWSCASTER: —historic settlement today with the NFL—
NARRATOR: Then, with football season about to begin, a surprise settlement.
NEWSCASTER: —settlement between the National Football League and thousands of its former players.
NARRATOR: The league agreed to pay $765 million to resolve the lawsuit.
ALAN SCHWARTZ, The New York Times: It appears as if it ties it up quite nicely. You know, the two sides figured out that that was fair, and they were OK with it. And so the image of the situation to most fans is that the NFL got taken to task for the concussion problem, OK?
NEWSCASTER: There is a proposed settlement in a huge concussion lawsuit—
NARRATOR: But the settlement left one big question unanswered.
MARK FAINARU-WADA: There’s no admission whatsoever of guilt by the league. The league makes it very clear they’re not admitting any guilt, that there’s no acknowledgement of any causation between football and the possibility of long-term brain damage. And that was— you know, that was a prominent part of the settlement.
PETER KEATING: I don’t think we needed a trial to know that the NFL conducted a lot of shoddy research. And it wasn’t hypothetical. It wasn’t a supposition. What the trial would have done was bring out that evidence. You didn’t need the trial to know that there was something wrong there. But the details of how they went about it, that’s what’s going to stay locked away.
[www: Inside the settlement]
NARRATOR: One week later, the commissioner made the league’s position clear.
ROGER GOODELL: [CBS "This Morning," September 4, 2013] There was no admission of guilt. There was no recognition that anything was caused by football.
NARRATOR: The league would not have to answer those tough questions about what they knew and when they knew it.
ROGER GOODELL: —that we’ve reached an agreement here that resolves these issues, and we’ll move forward from there.
HARRY CARSON, Author, Captain For Life: I think everyone now has a better sense of what damage you can get from playing football. And I think the NFL has given everybody 765 million reasons why you don’t want to play football.
ANNOUNCERS: Erenberg touchdown!
Touchdown Pittsburgh Steelers!
Listen to this crowd! They’re on fire!
NARRATOR: For now, the future of the league and the game of football seem secure.
ANNOUNCER: Franco Harris is now at the 30. Big pileup!
NARRATOR: But fundamental questions remain about how the game will be played, and who will play it.
ANNOUNCER: It’s still wild and woolly and I love ‘em that way.
ANNOUNCER: You love ‘em wild and woolly and you’re seeing it now!
MARK FAINARU-WADA: You’ve got the most popular sport in America basically on notice. You’ve got the very real question being asked of whether the nature of playing the sport exposes you to brain damage and lots of science that suggests that it can.
ANNOUNCER: An awesome physical team were the Steelers today!
MARK FAINARU-WADA: And that raises all sorts of questions for guys who are playing in the league, guys who played in the league, moms, kids, all of us who love football. It’s pretty scary. It’s a big deal.
ANNOUNCER: And the future opponents are going to have some trouble!
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