by Bennet Omalu
After calling everyone I could, I tried to go to sleep. The pillows and bedsheets reeked. The awful smell kept me awake. Across the room, I could see the eyes of rats staring at me in the shadowy darkness. I turned the light back on. The rats scattered, as did the roaches. The night wore on. At about 10:00 p.m., the motel became noisy. I went out on the balcony of my second-floor room and looked down at the street below. A parade of men and women went in and out of the motel. As it turns out, the motel was full not only of rats and roaches but of prostitution as well. Part of the parade ended up in the rooms around me. The loud sound of people having sex echoed through my room. The stench of marijuana also hung in the air from the street below.
I felt trapped. I could not go out because the streets seemed like a dangerous place to go in the middle of the night in a country where I stood out. My fears rose up inside of me. With nowhere else to turn, I began to pray. I prayed every prayer I knew. After I went through all the prayers I had learned over the years, I started talking to God like one speaks to a dear, trusted friend. I poured out my heart and my tears to him. O God Almighty, You have guided me from the shores of Nigeria to the mountains of America. You did not bring me into the middle of the sea to let me drown. I prayed this over and over, weeping as I did. Finally the rooms around me grew quiet, as the sky outside began to brighten. Eventually, I nodded off to sleep, tired and overwhelmed.
At 9:00 a.m., I awoke with a start. I quickly brushed my teeth, washed my face, and ran off to the embassy in hopes of hearing some good news. When I walked into the embassy waiting area, the woman who had been so kind the day before motioned for me to come over to her window. “We have not heard back from the embassy in Nigeria,” she said, “but I have talked to your attorney, and we sent a reminder to Nigeria. All we can do at this point is wait. I’m sorry.”
I thanked her and left to go back to my hotel. Walking once again down the dusty streets of Nogales, I watched the hustle and bustle around me. Poverty surrounded me. The city lacked the basic infrastructure of even a small American town. Yet in the midst of the poverty, I noticed teenage boys and girls and young adults, all dressed like Americans. They wore the same brands and carried themselves with the same distinctive American swagger. The scene around me told me why the embassy had such a long line every day. People stood in line to get a day pass to go across the border to Nogales, Arizona, to go shopping. I wondered where they got the money to afford such expensive clothes and shoes.
On my way back to my motel room, I stopped at a store and bought more food and another calling card. Surely tomorrow God will answer my prayer, I thought. The one person I had not called the day before was my younger sister, Mie-Mie. She was an attorney who was working for Shell Petroleum in London at the time. She had just completed her PhD in energy law in Dundee, Scotland. When I heard her voice, I poured out everything that had happened.
“I know it looks dark, Bene, but be patient and do not panic. God will manifest Himself. You will see,” she said.
“I hope you are right, but I don’t know what I can do. There is no one I can call, no one I can contact. I feel trapped here,” I said. I went on to explain how the problem was all the way back in Nigeria with the American Embassy there.
Mie-Mie had an idea. “Do you remember our friend Eddy? He is very well connected to the current Nigerian government. I will call him and see if there is anything he can do.”
We talked a little longer. After I hung up, I went back out onto my balcony to watch the parade of people on the street below. However, on this my second night in Nogales, something was different. I noticed four men dressed in some type of security attire in front of the motel, as if they were standing guard. Right off, I could tell they were law enforcement officers, perhaps secret service. Word must have gotten out that a possible Nigerian terrorist is in this motel, I thought. One of the men turned and looked up at me. He stared at me until I became uncomfortable. I felt like they were there to keep an eye on me.
I moved back inside my room and decided to go to bed. First I washed my clothes in the sink. After two days, they were starting to smell. I also feared I would look even more suspicious if I appeared disheveled the next day. I lay down and tried to get to sleep. The light stayed on. I didn’t dare turn it off because of the rats and roaches. The noises of the prostitutes and their customers echoed through the room once again, while the rats sat in their holes staring at me. My mind kept turning to the officers on the street below me. I wondered if they really were police officers. What if they were part of a drug cartel? At some point, I feared I could be killed in this motel and no one would ever know what had happened to me.
As my fears grew, I began to pray Scripture back to God.
“Even now I know that whatever you ask of God, God will give you,” I prayed.2
“And whatever you ask in my name, I will do, so that the Father may be glorified in the Son. If you ask anything of me in my name, I will do it.3
“If you remain in me and my words remain in you, ask for whatever you want and it will be done for you.4
“ . . . so that whatever you ask the Father in my name he may give you.5
“Amen, amen, I say to you, whatever you ask the Father in my name he will give you.”6
I prayed this all night. I prayed for my family and for Prema, because I knew they were in pain with worry over me. I prayed until I fell asleep in deep mental fatigue.
While I laid on the filthy bed in my rat- and roach-infested motel room, phone calls were being exchanged on the other side of the world. Mie-Mie called our family friend, Eddy. Eddy then called a close friend who was the secretary to the president of Nigeria, General Olusegun Obasanjo. When the secretary heard of my predicament, he placed a call from the office of the president of the Federal Republic of Nigeria to the United States Embassy and asked why an innocent Nigerian man’s name had been placed on the security alert list.
This was not the first call to the embassy, but it was the first to which they paid attention. They had ignored the calls from the embassy worker in Nogales because I was a nobody to them. If they had not acted, I would have been deported from Mexico back to Nigeria. For those two extra days I was there, I was officially an illegal immigrant. But when the secretary to the president of Nigeria called the embassy, the staff sprang into action. Apparently, in the post 9/11 world, an embassy worker in Nigeria had gone over the names of those who had received temporary visas to the United States. Anyone he could not immediately trace, or anyone who had not checked back in with the embassy in Nigeria, was placed on the security alert list. I had checked in with an embassy every year when I went in to renew my visa. However, because I had not returned to Nigeria, an embassy worker in Lagos decided at whim that I was a security risk.
The president’s secretary swept this misunderstanding aside and asked them to act swiftly to clear up my predicament. The embassy did. Again, I had no idea any of this was happening when I dressed in the morning and went back to the embassy in Nogales. The men outside the motel were gone when I walked out. The moment I walked into the embassy, I looked for the only woman I knew there. When I could not find her, I sat down on the bare floor because all the chairs in the waiting area were taken. The woman spotted me before I saw her. She came out into the lobby and motioned to me to come to her window. She smiled and asked, “How are you doing this morning?”
“Uh, so-so.”
“I have good news that will brighten your day. Your name has been removed from the list. Here is your passport. The visa has already been stamped. You can go home now. Good luck.”
If I could have, I would have reached through the bulletproof glass and hugged her. Instead I said thank you over and over. She was an angel to me, the only one in a very dark place. I then gathered all my papers and went out into the street. Before I could take another step, a wave of relief and joy swept over me. I sat down on the side of the road and wept. Passersby looked at me like I was a lunatic but I did not care. Once I gathe
red myself, I walked as quickly as I could to the border station. With every step I prayed, Thank You, Jesus. The border looked like the light of resurrection to me.
As soon as I stepped back into America, I found a pay phone and called my family in Nigeria. Through tears of joy, I said to them, “I am home now.” Then I called Prema, and we cried together on the phone. I did the same with Father Carmen. He said to me, “Peace be with you, Bennet, and glory be to God. Come home.” That’s all I wanted to do as well. The cab ride from Nogales to Tucson and the flight back home to Pittsburgh cost me a small fortune, but I did not care. God had rescued me. I came away convinced that nothing is too difficult for Him. God will make a way where there seems to be no way. If you place your trust in Him, He will make the impossible possible. It was an invaluable lesson to learn in light of what I was about to face.
Chapter Fifteen
The NFL = Big Tobacco
My alarm went off at 3:00 a.m. the morning I set out to start writing my first Mike Webster paper, which was going to be the very first case study of Chronic Traumatic Encephalopathy in a football player reported in the medical literature. I took a quick shower to clear my head and sat down at my desktop computer. Then nothing happened. I stared at the screen, unable to force any words out. Once or twice, I managed to write a paragraph, but I immediately deleted it. None of the words I wrote sounded like what I wanted to say. It was very frustrating. Finally I gave up and went in to the office and lost myself in my work. I tried not to think about the paper.
The second morning, I woke up early, again, but just like the day before, I could not write anything worth keeping. The words I pecked out on the keyboard never formed a cohesive thought. This was very unusual for me. Mike Webster was not the first paper I had submitted for publication, nor would it be the last. In addition to writing academic papers, my job demanded that I write scholarly works on a regular basis for the courts or attorneys or Dr. Wecht. Never before had I struggled so much to put my thoughts into words.
When I had the same experience on the third day of writing, I knew this was more than a case of writer’s block. Suddenly the cause dawned on me. My spirit whispered to me, Bennet, give it a name. I could not force words onto the page because I was trying to describe a condition and a disease that remained nameless. In a way, the lack of a name kept this disease detached and distant. It was like a stray animal that comes to the house. When the animal is just a cat or a dog, it annoys you and you try to get it to leave. The moment you give it a name, that animal becomes part of your family. The nameless condition I tried to describe was no different.
Okay, I need to give it a name, I thought to myself. But what? I spent the next two weeks contemplating that question. In my mind, the name had to meet four criteria. First, it had to be intellectually sophisticated. Second, it needed to have a good acronym, which would help it stick and make it more likely to permeate society. Third, the name also had to be generic enough to give me some wiggle room if my concepts were proven wrong and yet specific enough to actually describe the disease I had observed.
Finally, I recognized this was ultimately an occupational disease, and being an occupational disease, it was only a matter of time before it ended up in a court of law. As such, it had to fulfill what is known in the American legal system as the Daubert standard.1 The Daubert standard states that for scientific evidence to be admissible in court, it must be a generally accepted principle and must have precedent. Therefore, I could not use any novel name I wanted, like dementia footballitica, because such a phrase had never been used in any medical literature.
My search for a name took me back to my original research. Going back to the time of Hippocrates, I identified thirty-seven descriptive terminologies that had been used to describe symptoms of permanent brain damage following blunt force head trauma. As I went through the list, two terminologies stood out above the others: Chronic Traumatic Encephalopathy and chronic traumatic brain injury. I quickly settled upon Chronic Traumatic Encephalopathy, or CTE. Chronic means “long term”; traumatic means “associated with trauma”; and encephalopathy means “a bad brain.” In other words, the terminology referred to a bad brain associated with trauma over a long period of time. That was exactly what I had observed in Mike Webster. I now had my name.
I chose Chronic Traumatic Encephalopathy to fulfill the purposes I laid out for my criteria in finding a name. I believe my efforts were very successful. Fifteen years ago, no one had ever heard of CTE. Today, nearly everyone who watches or participates in football is very aware of it, even down to the little children in my son’s kindergarten class. When I walk in the door of his classroom with him, the other students will ask me, “Are you the CTE doctor?” I believe that if I had used a totally novel name that had never been used in the medical literature, it would have made it easier for sports leagues to reject or deny CTE in the court of law based on the Daubert standard.
• • • •
Long before I sat down at my computer to write my paper describing CTE in Mike Webster’s brain, a flood of research into the dangers of concussions and head injuries related to football was already in full swing. I thought I had discovered something new—and the brain disease I named CTE was, in fact, a new diagnosis. However, the fact that so-called mild traumatic brain injuries incurred in football and other contact sports can result in long-term, life-altering, and potentially life-ending problems was already well-known, at least to the National Football League.
Football has always been known to be a violent, dangerous game. Congress nearly banned it in the early twentieth century when a rash of players died on the field, many from head injuries. Back then, the game was even more savage than it is today. If not for President Teddy Roosevelt’s intervention and his insistence that rules be changed to make the game safer, the sport might have ended in 1905. The changes that came as a result of Roosevelt’s intervention made the game safer, but it did not make it safe. Many rule changes were made—changes such as eliminating mass formations during play, creating neutral zones between the offense and the defense, and increasing the yardage needed for a first down from five yards to ten yards. The number of player deaths and serious injuries dropped and the game lived on, but it never became safe.
Head injuries were a problem from the start. Back in the days before helmets, players ran the very real risk of suffering a fractured skull. The sport adopted leather helmets in response to this problem. It was rather interesting for me to learn that the first leather helmet to be worn in a football game was created by a shoemaker in 1893 for Cadet Joseph Reeves, who wore it in the Army-Navy football game. Cadet Reeves had been advised by a Navy doctor that he would be risking death or “instant insanity” if he took another kick to the head.2 Obviously, a thin leather helmet offered very little real protection to the player, but it gave a sense of security that he had at least done something to protect himself.
Plastic helmets eventually replaced leather, and face masks were added in the 1950s to protect players’ noses and jaws. Unfortunately, the helmet that was implemented to protect players quickly became a weapon. No longer in fear of breaking their heads open, players could hurl themselves at one another fearlessly. As players began to use their helmets as weapons, head injuries moved from the outside of the skull to the inside. Even today, even after rule changes designed to minimize concussions and head-to-head contact, you can hear the pop of helmets colliding with one another on every football play, as offensive and defensive players slam into each other at the line of scrimmage.
In the early, middle, and late twentieth century, many papers were published in the medical literature stating that football players at all levels suffered brain injuries while playing football, and sizable proportions of football players suffered persistent and prolonged symptoms, such as headaches, nausea, vomiting, impaired vision, changes in behavior, loss of memory, inability to concentrate on tasks, etc. Yet none of these papers made waves within the football community, including a po
sition paper published in May 1957 by the American Academy of Pediatrics stating that any child who is twelve years of age or younger should not play high-impact, high-contact sports like football, wrestling, and boxing.3 A 2011 paper by the American Academy of Pediatrics and the Canadian Paediatric Society reaffirmed this position.4 Yet the game continued on as it had. Concussions and brain injuries continued to plague the game. We as a society chose to look the other way and keep silent in conformational cast of the mind and cognitive dissonance, because of our idolization of football. God remained number one; football became number two; and our children and their lives were relegated to number three. However, in the fullness of time, the light of the truth will shine upon us, in His time.
By 1994, the National Football League faced its most public brain and concussion crisis. Several of the league’s biggest stars, including future Hall of Famers Steve Young and Troy Aikman, went down with concussions. Aikman’s was so severe that he had no memory of the National Football Conference championship game in January 1994, the game that his team, the Dallas Cowboys, won to advance to their second straight Super Bowl. Merrill Hoge, a running back for the Chicago Bears, quit the game in the middle of the season after suffering his second major concussion in six weeks in October 1994. Many major news outlets, including the New York Times, ran front-page stories about football’s concussion problem. Sports Illustrated ran a three-part series in its December 19, 1994, issue, which focused on head injuries in the NFL. Other media outlets spoke out about the dangers of football. Even Congress took notice and talked of investigating the sport.
