Jeff Lail

Malcolm Gladwell had an amazing article (isn’t all his stuff great, really?) last week about concussions and football.  He goes on in the article to make the argument that dogfighting and football really aren’t all that different, other than the level of hypocrisy that is carried about football (America’s sacred cow of athletics).

Several of these stories are about college players and the rest of the excerpts will give you the scope of the article. Bear in mind that tremendous investments are put into football, some reaping rewards for the college, but at what cost?  Many of my student affairs colleagues talk about social justice and say that one of their life goals is “making a difference”.  Think about what that means as you read the story and the excerpts written below….

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“Lately, I’ve tried to break it down,” Turley said. “I remember, every season, multiple occasions where I’d hit someone so hard that my eyes went cross-eyed, and they wouldn’t come uncrossed for a full series of plays. You are just out there, trying to hit the guy in the middle, because there are three of them. You don’t remember much. There are the cases where you hit a guy and you’d get into a collision where everything goes off. You’re dazed. And there are the others where you are involved in a big, long drive. You start on your own five-yard line, and drive all the way down the field—fifteen, eighteen plays in a row sometimes. Every play: collision, collision, collision. By the time you get to the other end of the field, you’re seeing spots. You feel like you are going to black out. Literally, these white explosions—boom, boom, boom—lights getting dimmer and brighter, dimmer and brighter”

“They cleared me for practice that Thursday. I probably shouldn’t have. I don’t know what damage I did from that, because my head was really hurting. But when you’re coming off an injury you’re frustrated. I wanted to play the next game. I was just so mad that this happened to me that I’m overdoing it. I was just going after guys in practice. I was really trying to use my head more, because I was so frustrated, and the coaches on the sidelines are, like, ‘Yeah. We’re going to win this game. He’s going to lead the team.’ That’s football. You’re told either that you’re hurt or that you’re injured. There is no middle ground. If you are hurt, you can play. If you are injured, you can’t, and the line is whether you can walk and if you can put on a helmet and pads.”

Here is a description of a dogfight given by the sociologists Rhonda Evans and Craig Forsyth in “The Social Milieu of Dogmen and Dogfights,” an article they published some years ago in the journal Deviant Behavior. The fight took place in Louisiana between a local dog, Black, owned by a man named L.G., and Snow, whose owner, Rick, had come from Arizona:

The handlers release their dogs and Snow and Black lunge at one another. Snow rears up and overpowers Black, but Black manages to come back with a quick locking of the jaws on Snow’s neck. The crowd is cheering wildly and yelling out bets. Once a dog gets a lock on the other, they will hold on with all their might. The dogs flail back and forth and all the while Black maintains her hold.

It’s the shot ringing out that seals the case against dogfighting. L.G. willingly submitted his dog to a contest that culminated in her suffering and destruction. And why? For the entertainment of an audience and the chance of a payday. In the nineteenth century, dogfighting was widely accepted by the American public. But we no longer find that kind of transaction morally acceptable in a sport.

McKee realized that he had a different condition, called chronic traumatic encephalopathy (C.T.E.), which is a progressive neurological disorder found in people who have suffered some kind of brain trauma. C.T.E. has many of the same manifestations as Alzheimer’s: it begins with behavioral and personality changes, followed by disinhibition and irritability, before moving on to dementia. And C.T.E. appears later in life as well, because it takes a long time for the initial trauma to give rise to nerve-cell breakdown and death. But C.T.E. isn’t the result of an endogenous disease. It’s the result of injury. The patient, it turned out, had been a boxer in his youth. He had suffered from dementia for fifteen years because, decades earlier, he’d been hit too many times in the head.

She has now examined the brains of sixteen ex-athletes, most of them ex-football players. Some had long careers and some played only in college. Some died of dementia. Some died of unrelated causes. Some were old. Some were young. Most were linemen or linebackers, although there was one wide receiver. In one case, a man who had been a linebacker for sixteen years, you could see, without the aid of magnification, that there was trouble: there was a shiny tan layer of scar tissue, right on the surface of the frontal lobe, where the brain had repeatedly slammed into the skull. It was the kind of scar you’d get only if you used your head as a battering ram. You could also see that some of the openings in the brain were larger than you’d expect, as if the surrounding tissue had died and shrunk away. In other cases, everything seemed entirely normal until you looked under the microscope and saw the brown ribbons of tau. But all sixteen of the ex-athlete brains that McKee had examined—those of the two boxers, plus the ones that Nowinski had found for her—had something in common: every one had abnormal tau.

McKee got up and walked across the corridor, back to her office. “There’s one last thing,” she said. She pulled out a large photographic blowup of a brain-tissue sample. “This is a kid. I’m not allowed to talk about how he died. He was a good student. This is his brain. He’s eighteen years old. He played football. He’d been playing football for a couple of years.” She pointed to a series of dark spots on the image, where the stain had marked the presence of something abnormal. “He’s got all this tau. This is frontal and this is insular. Very close to insular. Those same vulnerable regions.” This was a teen-ager, and already his brain showed the kind of decay that is usually associated with old age. “This is completely inappropriate,” she said. “You don’t see tau like this in an eighteen-year-old. You don’t see tau like this in a fifty-year-old.”

Take the experience of a young defensive lineman for the University of North Carolina football team, who suffered two concussions during the 2004 season. His case is one of a number studied by Kevin Guskiewicz, who runs the university’s Sports Concussion Research Program. For the past five seasons, Guskiewicz and his team have tracked every one of the football team’s practices and games using a system called HITS, in which six sensors are placed inside the helmet of every player on the field, measuring the force and location of every blow he receives to the head. Using the HITS data, Guskiewicz was able to reconstruct precisely what happened each time the player was injured.

“The first concussion was during preseason. The team was doing two-a-days,” he said, referring to the habit of practicing in both the morning and the evening in the preseason. “It was August 9th, 9:55 A.M. He has an 80-g hit to the front of his head. About ten minutes later, he has a 98-g acceleration to the front of his head.” To put those numbers in perspective, Guskiewicz explained, if you drove your car into a wall at twenty-five miles per hour and you weren’t wearing your seat belt, the force of your head hitting the windshield would be around 100 gs: in effect, the player had two car accidents that morning. He survived both without incident. “In the evening session, he experiences this 64-g hit to the same spot, the front of the head. Still not reporting anything. And then this happens.” On his laptop, Guskiewicz ran the video from the practice session. It was a simple drill: the lineman squaring off against an offensive player who wore the number 76. The other player ran toward the lineman and brushed past him, while delivering a glancing blow to the defender’s helmet. “Seventy-six does a little quick elbow. It’s 63 gs, the lowest of the four, but he sustains a concussion.”

“The second injury was nine weeks later,” Guskiewicz continued. “He’s now recovered from the initial injury. It’s a game out in Utah. In warmups, he takes a 76-g blow to the front of his head. Then, on the very first play of the game, on kickoff, he gets popped in the earhole. It’s a 102-g impact. He’s part of the wedge.” He pointed to the screen, where the player was blocking on a kickoff: “Right here.” The player stumbled toward the sideline. “His symptoms were significantly worse than the first injury.” Two days later, during an evaluation in Guskiewicz’s clinic, he had to have a towel put over his head because he couldn’t stand the light. He also had difficulty staying awake. He was sidelined for sixteen days.

When we think about football, we worry about the dangers posed by the heat and the fury of competition. Yet the HITS data suggest that practice—the routine part of the sport—can be as dangerous as the games themselves. We also tend to focus on the dramatic helmet-to-helmet hits that signal an aggressive and reckless style of play. Those kinds of hits can be policed. But what sidelined the U.N.C. player, the first time around, was an accidental and seemingly innocuous elbow, and none of the blows he suffered that day would have been flagged by a referee as illegal. Most important, though, is what Guskiewicz found when he reviewed all the data for the lineman on that first day in training camp. He didn’t just suffer those four big blows. He was hit in the head thirty-one times that day. What seems to have caused his concussion, in other words, was his cumulative exposure. And why was the second concussion—in the game at Utah—so much more serious than the first? It’s not because that hit to the side of the head was especially dramatic; it was that it came after the 76-g blow in warmup, which, in turn, followed the concussion in August, which was itself the consequence of the thirty prior hits that day, and the hits the day before that, and the day before that, and on and on, perhaps back to his high-school playing days.

At one point, while he was discussing his research, Guskiewicz showed a videotape from a 1997 college football game between Arizona and Oregon. In one sequence, a player from Oregon viciously tackles an Arizona player, bringing his head up onto the opposing player’s chin and sending his helmet flying with the force of the blow. To look at it, you’d think that the Arizona player would be knocked unconscious. Instead, he bounces back up. “This guy does not sustain a concussion,” Guskiewicz said. “He has a lip laceration. Lower lip, that’s it. Now, same game, twenty minutes later.” He showed a clip of an Arizona defensive back making a dramatic tackle. He jumps up, and, as he does so, a teammate of his chest-bumps him in celebration. The defensive back falls and hits his head on the ground. “That’s a Grade 2 concussion,” Guskiewicz said. “It’s the fall to the ground, combined with the bounce off the turf.”

The force of the first hit was infinitely greater than the second. But the difference is that the first player saw that he was about to be hit and tensed his neck, which limited the sharp back-and-forth jolt of the head that sends the brain crashing against the sides of the skull. In essence, he was being hit not in the head but in the head, neck, and torso—an area with an effective mass three times greater. In the second case, the player didn’t see the hit coming. His head took the full force of the blow all by itself. That’s why he suffered a concussion. But how do you insure, in a game like football, that a player is never taken by surprise?

Guskiewicz and his colleagues have come up with what they believe is a much better method of understanding concussion. They have done a full cognitive workup of the players on the U.N.C. team, so that they can track whatever effect might arise from the hits each player accumulates during his four years. U.N.C.’s new coach, Butch Davis, has sharply cut back on full-contact practices, reducing the toll on the players’ heads. Guskiewicz says his data show that a disproportionate number of serious head impacts happen on kickoffs, so he wonders whether it might make sense, in theory, anyway, to dispense with them altogether. But, like everyone else who’s worried about football, he still has no idea what the inherent risks of the game are. What if you did everything you could, and banned kickoffs and full-contact practices and used the most state-of-the-art techniques for diagnosing and treating concussion, and behaved as responsibly as Nascar has in the past several years—and players were still getting too many dangerous little hits to the head?

After the tape session, Guskiewicz and one of his colleagues, Jason Mihalik, went outside to watch the U.N.C. football team practice, a short walk down the hill from their office. Only when you see football at close range is it possible to understand the dimensions of the brain-injury problem. The players were huge—much larger than you imagine them being. They moved at astonishing speeds for people of that size, and, long before you saw them, you heard them: the sound of one two-hundred-and-fifty-pound man colliding with another echoed around the practice facility. Mihalik and Guskiewicz walked over to a small building, just off to the side of the field. On the floor was a laptop inside a black storage crate. Next to the computer was an antenna that received the signals from the sensors inside the players’ helmets. Mihalik crouched down and began paging through the data. In one column, the HITS software listed the top hits of the practice up to that point, and every few moments the screen would refresh, reflecting the plays that had just been run on the field. Forty-five minutes into practice, the top eight head blows on the field measured 82 gs, 79 gs, 75 gs, 79 gs, 67 gs, 60 gs, 57 gs, and 53 gs. One player, a running back, had received both the 79 gs and the 60 gs, as well as another hit, measuring 27.9 gs. This wasn’t a full-contact practice. It was “shells.” The players wore only helmets and shoulder pads, and still there were mini car crashes happening all over the field.

Professional football players, too, are selected for gameness. When Kyle Turley was knocked unconscious, in that game against the Packers, he returned to practice four days later because, he said, “I didn’t want to miss a game.” Once, in the years when he was still playing, he woke up and fell into a wall as he got out of bed. “I start puking all over,” he recalled. “So I said to my wife, ‘Take me to practice.’ I didn’t want to miss practice.” The same season that he was knocked unconscious, he began to have pain in his hips. He received three cortisone shots, and kept playing. At the end of the season, he discovered that he had a herniated disk. He underwent surgery, and four months later was back at training camp. “They put me in full-contact practice from day one,” he said. “After the first day, I knew I wasn’t right. They told me, ‘You’ve had the surgery. You’re fine. You should just fight through it.’ It’s like you’re programmed. You’ve got to go without question—I’m a warrior. I can block that out of my mind. I go out, two days later. Full contact. Two-a-days. My back locks up again. I had re-herniated the same disk that got operated on four months ago, and bulged the disk above it.” As one of Turley’s old coaches once said, “He plays the game as it should be played, all out,” which is to say that he put the game above his own well-being.

Casson is right. There is nothing else to be done, not so long as fans stand and cheer. We are in love with football players, with their courage and grit, and nothing else—neither considerations of science nor those of morality—can compete with the destructive power of that love.

In “Dogmen and Dogfights,” Evans and Forsyth write:
When one views a staged dog fight between pit bulls for the first time, the most macabre aspect of the event is that the only sounds you hear from these dogs are those of crunching bones and cartilage. The dogs rip and tear at each other; their blood, urine and saliva splatter the sides of the pit and clothes of the handlers. . . . The emotions of the dogs are conspicuous, but not so striking, even to themselves, are the passions of the owners of the dogs. Whether they hug a winner or in the rare case, destroy a dying loser, whether they walk away from the carcass or lay crying over it, their fondness for these fighters is manifest. ♦