For Whom The Death Knell Tolls: Head Contact Sports

In my last post, I started on the subject of head contact induced CNS [central nervous system damage], CTE, dementia, etc. Today I saw and read an article from the Guardian that so upset me that I had to write this follow-up piece. And this one will be pure American Heresy. As the old pre-Metallica genre band of Detroit, “MC5,” said in their one hit, I am going to in this post, “Kick Out The Jams.” I have been putting this post off for a very long time, paradoxically, even before I started this blog, this topic has been boiling in my scientific mind with growing anger and apprehension. Pro football, boxing, hockey and many of the other head contact [read: traumatizing] sports must be given up in this country someday.

I have been putting this post off for a very long time, paradoxically, even before I started this blog.Tthis topic has been boiling in my scientific mind with growing anger and apprehension for years.. Pro football, boxing, hockey and many of the other head contact [read: traumatizing] sports must be given up in this country someday.

The article entitled, “It’s been devastating’: former NFL players count the cost of concussion,” published in The Guardian, really hit home and set off this rant/post.

As a psychiatrist who started in brain science in college, I initially aspired to be a “brain scientist.” I operated on animal and human brains, in undergraduate research for the former and then in neurosurgery training for a time in my medical training years, before I decided upon psychiatry as my calling,

I had followed for over a decade the kept-behind-the-Wizard’s curtain scandal in pro football as the evidence mounted of the high rates of brain damage in pro football. Then we had the scandal of paid “kept man” neurologist who headed up the NFL’s PR spin advisory committee on dementia in retired players. That neurologist was too close to the NFL and in my view had a fundamental conflict of scientific ethics. Then we had the succession of suicides of pro players, including Junior Seau and Dave Duerson who preserved their brains in their modes of suiciding for brain research. They KNEW something bad was wrong with them. And now it was revealed that the beloved Frank Gifford of the NY Giants in the 50’s died in August at 84 and was suffering from an unspecified memory disorder. [Disclaimer: his may well have been related to ageing as up to 25% of the elderly develop dementia no matter what], the revelations of the coverups, the reformation of the NFL’s advisory committee and appointment of hopefully a more honest neuroscientist chairperson, an independent research effort and the massive multi-hundreds of million dollars class action suit settlement which finally officially legally acknowledged the problem.

Another factor we had, from another quarter, spurring interest in this phenomenon, has been the generation of thousands of TBI brain injured veterans victims of IED brain trauma. That, likely more than anything, perhaps, indirectly helped also shine the continuing spotlight on head contact CNS trauma, CTE, sports induced dementias as I call it. And for years we were hit with the realization that the military medical establishment, the VA Hospital system was just as ill equipped to take on this relatively new problem as any other quarter of our medical world.

The above cited Guardian newspaper article portrayed more strongly from a “human interest” viewpoint as is said in journalsim, as I have ever seen.It lasys out as strongly as I have ever seen in print, the  mutterings among physicians, that football has done grievous damage to thousands who will continue to manifest themselves as demented/brain damaged for generations to come. It also extremely forcefully casts well-deserved blame and judgment on many quarters involved in this whole 100-year mess. Until the last 20-30 years we cannot be judgmental of my father’s football era in the ’30’s or Red Grange’s era to put a name to that time, but we sure have more than enough evidence and real brain science ‘data’ to start casting aspersions, blame and paying out massive punitive settlements till the cows come home. The days of reckoning for the Princes of the NFL are here and will not recede.

On a personal note as I mentioned in my previous recent post starting on this subject, I revealed that I have had my own lifelong exposure to football through my father. I remember when we first purchased a tv and it was for three reasons, to watch the Steve Allen Show and such comedy, the news, kids’ cartoons and above Sunday NFL pro football games. My dad was a Washington  and Green Bay fan and I remember the names of long forgotten stars such as Gino Brito, Scooter Scudero, Y. A. Title, of course Frank Gifford, Eddie LeBaron, Paul Hornung, and of course Jim Brown. As I moved on to the world of study, study, study to the exclusion of nearly all else in college, research, medical school and residencies and being a workaholic physician, I lost almost all  interest in football and came to view it with an increasingly jaundiced eye. My father was from Texas, played football in high school, was a massive sized man for his time and his younger brother was even, more huge. They played ‘both ways’ on offensive and defensive lines all game long. Neither was interested in the pro’s which was a fledging movement back then and WWII interrupted them anyway. But being from Texas they and I knew “Football Was God.” I remember being in the only restaurant in my parents’ retirement town, Belleville Texas on a Thanksgiving Day years ago, as he and I had a son and dad breakfast out. This town had only a few stores, a cattle stockyard, farminng equipment sales agency, a courthouse in a tiny ‘courthouse square,’ a bakery, post office, one grocery store, a dry goods store, and one restaurant where we always ate when I visited, and TWO saddle shops. Now that is a Texas small town and they and I loved it. That Saturday we were in the middle of breakfast when at 10:30 or 11:00 a.m. in the packed restaurant, an older middle aged rancher dressed like everyone else in real ‘cowboy’ clothes, beat up weather jeans, Stetson, pearly button western dress shirt and hand tooled initialed leather belt with a big but old and authentic belt buckle, suddenly stood up and announced loudly, “It’s time folks,” and the whole place except for one family cleared out in two minutes flat!

I had no idea what had happened. A disaster, a secret meeting or nefarious gathering, a mandatory National Guard training session, what? The waitress knew my father and that I was the son from far away and came over to explain to me. It turned out that this was the annual Longhorns-Aggies football showdown that would begin on tv at noon. Everybody lit out to home as most of them lived miles and miles out of town this being Texas, long distances to home and the store are routine. Suddenly Belleville was totally deserted except for the few of us left behind. My father took great delight in my confusion and said something humorously condescending [and well deserved toward me…], “Pancho, you forget you are in Texas. This is the biggest day of the year for football.” Dumb me, I thought it was Super Bowl Day….He then went on to tell me tales from decades ago and recent years of this rivalry, and legenedary fights and pranks between the two schools, the week before the game, the night before the game, during the games, etc. I could only shake my head in geek, intellectual “dirty doctor pinko commie rat” wonderment as Bob Dylan upt it years ago in one of his protest songs, and an appellation my sharp witted father often would apply to me when I needed it. But I never forgot that day in the restaurant. Nowadays it serves to remind me how ingrained football is in our culture.

That does not bode well for what I will now say that has been brewing in my head for  years and years as a physician with a background in the neurosciences and someone who sees, diagnoses and treats dementia day in and day out. The death of football in our culture may be approaoching and, forgive me daddy, and all you die hard fans and the NFL and all its money and the substantial stakeholders in football from all its many revenue sources too myriad to name, but it is about time todo something healthy about this scourge.

Football has also had other intellectual effects beyond count. It has corrupted college sports while paying for most of the other sports programs for decades. The most recent scandal has been at UNC-CH my wife’s alma mater and half my now North Carolina family’s diehard allegiances. The academic scandal that erupted a few years ago at UNC in the African Studies department [forgive me I do not have the name correct], continues to issue more piles of bad news every so many months and has cost at least one UNC President’s tenure and may cost another’s. The faculty’s academic body has railed for years to deaf ears about the cheating, false tutoring and the usual horribly blatant coddling academically of the athletes, not just football either, for years. Corruption has reigned supreme and money has held sway until finally the whistleblowers blew UNC out of the water. It was horrible. I could see Auburn, Texas, Michigan, SMU who suffered the “Death Penalty,” years ago, Miami, Alabama, and so many of the other perennial football powers being corrupt on a quietly approved level that went to the highest levels as they say in spy novels. I was aware of the rumors and reputations as a child for goodness sakes. It was common knowledge for generations. But UNC? Carolina Blue? Yep them too. Football coaches are some of the highest paid “executives” in the country and make millions more from all the other money making venues we have now in the media, the “Coaches Show,” bonuses for winning or getting into bowls. Does this not smack of runaway institutionalized corruption, especially when state budgets around the country including in NC are cutting academic budgets. Do we not have our priorities reversed or as the kids would boldly say “screwed up?”

My “prescription” is a bold and heretical one. Pare it down, take the money out of it, reverse the priorities back to education [now there is a nice but naive thought….] and maybe we won’t be worrying so much about why our system of higher education is not doing well in this country, why tuitions are rising, student debt is a financial bubble waiting to burst and saddle us with aother mini-recession for a couple of generations of kids who went to college for a degree not a ticket into professional sports and MONEY. But it will take a major cultural shift and sports Roman coliseum bloodlust detox intervention on a national basis to reverse this perversion. And the people who vent their pent up whatever will have to find another route to accomplish blowing it out their barracks bags, but with less harm to the gladiators who suffer years later and are cast aside like deluded ageing beauty models who lose their whatever and get shoved aside so cruelly. But that is how the socially Darwinian ruthless “selection process” seems to work in the last several decades. Damn the cost, if it makes money for the few, keeps the populace roaring in the stands and spent [in more ways than one] afterwards, so be it. Serves a social function. But there are better ways but they have the allegiance of a minority of aficionados to use a sports term tongue in my sarcastic cheek, in this society. And let us not forget soccer. All those headers, take that out of the sport and put helmets on, and soccer moms and dads will be largely correct that soccer is healtheir and should not carry the risk to the brains of their children.

On a different aspect, I would be woefull remis, as I continue to rant in my own medical roll here,in not addressing the inherent and not often noted racism in most pro sports. The pro sports worlds are now and have been for three decades at least, the avenue out of poverty for the minority athlete. This is another reality attendant to our peculiar American legacy of racism historically, like it or not sports fans. The route to so called and hoped for riches, is readily and correctly recognized overmwhelmingly unfortunately by the collegiate minority athletes. This is sorrowfully understandable in today’s still scandalous quiet racism that still sees unequal opportunities for the undereducated, white or black or Hispanic or whatever.

But demographic salvation may help to remedy that for us. In less than 20 years, us whites [I am white if you haven’t guessed by now but still a polyglot mutt of many different backgrounds ethnically but in the Census I am white…], will be the minority. Am I filled with terror? No. Do I fear it? No. Do I think the former minorities will slaughter us whites as many of the apartheid Afrikaners thought before the Ghandi like Nelson Mandella helped change South Africa? No. And I lived for a while in the Transvaal as a child when my dad sank a gold mind shaft and absorbed for some months we were there, the apartheid racism up close and personal… The push of ‘minority peoples’will remedy a lot of the informal closures we still have and we are seeing this start already in a big way and not too soon in my humble view. And maybe pro sports will lose its inherently powerful suction of hungry minorities with few other choices, into the recruiting maw of pro sports and Big Time Sports. They will and better have many other opportunities that are routinely and truly equally available. And the truth that only 1 in 10,000 or less of athletes make it into the pro’s will finally make it into the consciousness of kids who used to be hyynotized by the all too seductive refrain of “I Want to be Like Mike” of 20 some years ago when He dominated the ideals of kids in sports.

On a positive note, I have a 16 year old grandson who plays football for his high school. While my feelings about his parents supporting his playing since middle school can be easily guessed, his high school in the Chapel Hill area is participating in a long term, well designed, scientific study out of the medical school and other departments at UNC-CH. It is long term and seeks to document the effects of football on young brains. It is a commendable and I am ever grateful that fortuitously his high school is one of a number of schools selected to participate. I hope that its findings whatever they turn out to be, are transparent and make it into the scientific literature. I do not know, but I hope the study would eventually study modifications of helmets or whatever safety interventions are incorporated into the ongoing study for comparison and evaluation. This kind of effort is long overdue and hopefully can be insulated and protected against the powerful vested interests I do not need to name, that could be brought to bear, if the news is unfavorable to any degree. Just like climate change, evolution, childhood vaccines and all the other recent damaging pseudo-controversies to our cultural wars of the last 30 years, knowledge can be unsettling, especially if it requires us to change long and strongly held beliefs and notions.

And now I will go read some good medical literature as I get rested up for my on call stint tonight at the hospital, Christmas night, and not watch football…

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