By Arturo R. García
Advisory: This post deals in part with suicide and brain trauma
At its core, League Of Denial is a story about hurt. The special report by PBS’ Frontline traces the shameful history of the National Football League’s attempts to stymie, then co-opt research into the increasingly hard-to-hide connection between football, concussions and, ultimately, chronic traumatic encephalopathy — the disease known as CTE for short.
And while the report gives due time to the hurt experienced by not only the players affected but their families, another story emerges: how far the NFL went to hurt the career of Dr. Bennet Omalu, the Nigerian-born pathologist who first discovered the fatal link.
The story literally begins in Omalu’s office: While working for the Allegheny County Coroner’s Office in Pennsylvania in 2002, Omalu was called upon to perform the autopsy for Pittsburgh Steelers great Mike Webster, who died of unreleased causes at the age of 50. Omalu decided to examine Webster’s brains for signs of dementia pugilistica, to see if he had been “punch-drunk” in the turbulent years following his career.
“I had to make sure the slides were Mike Webster’s slides,” Omalu says. “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.”
What Omalu found was even more disturbing: the telltale protein formations symbolizing the advent of CTE. In a paper subsequently published in the journal Neurosurgery, Omalu and a group of colleagues suggested the repetitive head-on collisions intrinsically connected to football was to blame.
“Omalu was the junior coroner at the Allegheny County Coroner’s Office,” reporter Steve Fainaru, who purused the story with his brother Mark Fainaru-Wada, explains. “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, one of the most well-known coroners in the country.”
Instantly, the league’s in-house researchers, the Mild Traumatic Brain Injury Committee (MBTI), not only questioned Omalu’s findings, they demanded the paper be retracted — the scientific version of “shots fired.” This despite the fact that committee head Dr. Elliot Pellman was a rheumatologist by trade, with no experience researching brain injuries.
The MBTI’s accusations, Omalu says, included allegations that, “what I practice is not medicine, it’s not science. They insinuated I was not practicing medicine — I was practicing voodoo. Voodoo.”
The committee came after Omalu again after he published a second study detailing similar findings in the brain of Terry Long, a former teammate of Webster’s who committed suicide in 2005 by drinking antifreeze. But Omalu tells Frontline that one NFL researcher did meet with him in secret, and attempted to put him off the trail.
“The NFL doctor, at some point, said to me, ‘Bennet, do you know the implications of what you’re doing,'” Omalu says. “I looked to my left, and I said to him, ‘Yeah, I think I do.’ He said, ‘No, you don’t. “He said, ‘If 10 percent of mothers in their country would begin to perceive football as a dangerous sport, that is the end of football.'”
While the MBTI’s early findings denied any links between concussions and long-term concerns for football players, in 2007 the league convened its own more inclusive meeting, as Fainaru and Fainaru-Wada chronicle in their own book on the issue:
The NFL gathered all medical personnel — team doctors, trainers, neurological consultants — in one room to debate the science of concussions. Also invited was a small group of independent neuroscientists who had become known as “The Dissenters” for openly challenging the MTBI Committee, which they regarded as a sham. The Dissenters included Kevin Guskiewicz, a former Pittsburgh Steelers assistant trainer, and [Dr. Julian] Bailes, a former Steelers neurosurgeon, who had co-authored some of the earliest research showing higher rates of dementia and depression among football players; Bob Cantu, a neurosurgeon and one of the nation’s pre-eminent concussion experts; and Bill Barr, a former New York Jets neuropsychologist, who had come to believe the MTBI Committee had cherry-picked data to make its case that concussions were minor injuries.
The daylong meeting took place in a crowded, 218-seat amphitheater at Chicago’s Westin O’Hare. The audience was composed mostly of white men in coats and ties. Goodell made the opening remarks at 9:15 a.m., emphasizing the NFL’s commitment to the concussion issue and thanking the MTBI Committee for its work. The keynote speaker was Michael Apuzzo, a USC neurosurgeon and New York Giants consultant who had published the NFL’s controversial research in the medical journal Neurosurgery — despite the objections of reviewers like Bailes, Guskiewicz and Cantu.
“I said that the data collection is all biased,” Barr said. “And I showed slides of that. Basically I pointed out that we had been obtaining baselines on players for 10 years, and when you look at the study it only included a small amount of data. My calculations were that their published studies only included 15 percent of the available data. Let’s put it this way: There were nearly 5,000 baseline studies that had been obtained in that 10-year period. And only 655 were published in the study.”
Barr hadn’t come right out and said it, but essentially he was accusing the NFL’s researchers of fraud. The implication was that Pellman and Lovell had purposely excluded data that didn’t support their findings. Those NFL researchers were in the room. Pellman was seated in the audience. Lovell, the director of the NFL neuropsychology program, had been asked to make his own presentation to the group.
But Amalu was not invited to that gathering.
“I was not aware of it,” he says. “Nobody ever called me. Dr. Bailes called me and said, ‘The NFL is putting together a conference on CFL. You were not invited.'”
By that time, however, Amalu had begun working with former pro wrestler and Harvard University player Christopher Nowinski, who had already been pursuing the issue following his own sports retirement due to the effects of multiple concussions. As The Washington Post reported at the time:
[Omalu] realizes his inquiries are going to put off people and is certain his accent is a burden. He thinks people are convinced he is out to ruin football and are threatened the moment they pick up the phone.
“They seem to think: ‘A foreigner is coming in to teach something of value to us. Is he telling us to stop playing football? Who is he?’ ” Omalu said. “It’s not about the game, it’s about the science.”
But after being shunned and called into question by the league, Omalu also escaped: he left Pennsylvania for a job in California.
“I wish I never met Mike Webster,” Omalu says. “CTE has dragged me into [the] politics of science, politics of the NFL. You can’t go against the NFL. They will squash you.”
Five years later, they squashed him again: Omalu had managed to obtain verbal consent from the son of former San Diego Charger Junior Seau, who had also killed himself, to examine his brain for evidence of CTE. As Fainaru and Fainaru-Wada reported for ESPN, Omalu was literally in the midst of cutting into the brain when he was interrupted by the chaplain for the San Diego County Medical Examiner’s office, Joe Davis:
“Houston, we have a problem,” Davis said.
Seau’s son Tyler had just called, Davis told Omalu and Craig Nelson, the deputy medical examiner.
“I talked to the NFL,” Tyler Seau, then 22, told the chaplain. The league, he said, informed him that Omalu’s “research is bad and his ethics are bad.” Tyler was in a rage. Omalu “is not to be in the same f—ing room as my dad!” he screamed. “He’s not to f—ing touch my dad! He’s not to have anything to do with my dad!”
Omalu left and returned home, his brain briefcase empty.
From that point on, the NFL played a powerful role in determining what happened to Junior Seau’s brain — who studied it and where. In the hours, days and weeks after Seau shot himself in the chest with a .357 Magnum revolver — the shocking end to the life of one of the most admired players in history — the league muscled aside independent researchers, ignored a previous commitment to Boston University and directed Seau’s brain to the National Institutes of Health — four months before the NFL donated $30 million to that institution for concussion and other research.
The NFL’s intervention in the fate of Seau’s brain — the most prized specimen yet in the race to document the relationship between football and brain damage — was part of an aggressive strategy to dictate who leads the science of concussions. By shunting aside Omalu, whose discovery sparked the concussion crisis; Boston University researchers, theleading experts on football and brain damage; a Nobel laureate; and other suitors, the league directed Seau’s brain away from scientists who have driven the national debate about the risks of playing football — the central issue to the NFL’s future.
“I was very demoralized,” Omalu says about the experience. “People didn’t notice when I got into the cab I was crying. I’m like, ‘What have I done?'”
If there is a victory for Omalu, it’s that many of his peers, at least, have rightly recognized his research.
“The motive to do good knows no boundary,” Omalu said at a conference earlier this year. “It knows no race. It knows no religion.”
And ESPN itself might have given both him and Frontline the ultimate compliment: The network, a broadcast partner for the NFL, pulled out of its co-sponsorship of the report.