Barr worked as the Jets’ neuropsychologist for nearly 10 years, at which point he ran afoul of Pellman and the NFL’s concussion committee. On December 11, 2004, he appeared at a sports concussion conference at Madison Square Garden. He spoke about his own research, including his role in a two-part series he had recently coauthored with Guskiewicz and others in JAMA. One of the major findings was that one concussion increased the risk of another—the exact finding the NFL was trying to refute. Barr told the audience he was preparing another study on the optimal time to administer neuropsychological testing, which he concluded was 5 to 10 days after an injury. That, too, diverged from NFL policy, which under Pellman and Lovell was 24 to 48 hours.
A week later, Barr said he got a call from Pellman, who had not attended the conference. Pellman, as the NFL’s medical director and Jets doctor, oversaw Barr’s work as the neuropsychologist for the team. Pellman said he heard that Barr had been “bad-mouthing” the NFL, according to Barr.
Barr told Pellman that he had merely described his own research. Pellman, according to Barr, responded by advising him that he’d have to clear all future concussion research through him, regardless of whether it was related to the NFL. Barr refused. He told Pellman that would compromise his integrity as a scientist and a faculty member at NYU.
“Then your time with the Jets is over,” Pellman informed him, according to Barr. Pellman later would vehemently deny Barr’s account to Peter Keating of ESPN, calling it “ridiculous.”
Barr was still fuming a few months later when he heard that the NFL was about to release a paper based on data from the NFL neuropsychology program. His first thought was: “Are you kidding me? You’re doing what? I haven’t heard anybody talking about this data for years and now you’re almost done with the paper?” Barr had accumulated hundreds of baseline tests while working for the Jets. He said neither Pellman nor Lovell asked him for the data. Barr said he contacted Pellman, who told him he excluded the Jets because of Pellman’s role as team doctor. That made no sense, Barr protested, telling Pellman that leaving out the data would bias the study. “He kind of blew me off,” said Barr. “He was like, ‘No, no, no, I don’t need the data. We’re okay, we’re gonna do it.’ ” Pellman later denied this conversation to ESPN’s Keating, the first journalist to explore the NFL’s adventures in concussion research. “Bill Barr was a consultant for the Jets who tested individual players to help us make decisions,” Pellman told Keating. “I did not discuss the committee’s research with him.”
When Paper Number 6 came out, Barr thought something stank, particularly the statistics that Pellman and Lovell used to support the conclusion that everything was right with the NFL’s world. The study reported that only 22 percent of concussed players—143 athletes—had submitted to neuropsychological testing. For a five-year study, that was an extremely low number. Why? Part of it was that the tests were voluntary; not all players were participating. But Barr knew that his own data for several years weren’t included. Then, three months later, the New York Times published its report that Pellman had attended medical school in Guadalajara, not New York, as he had told Congress. The Times hadn’t connected Paper Number 6 and the credentials flap, but when Barr saw the story, he decided to dig deeper into the mystery of what had happened to his data. His central question was whether Pellman, with Lovell’s assistance, was embroidering the NFL’s science in the same way he had embroidered his résumé.
Barr began to contact other neuropsychologists from Lovell’s network to see if he could find out whether their data had been excluded from the study.
On March 30, 2005, the day the Times published the Pellman piece, Barr wrote an e-mail to Rick Naugle, the neuropsychologist for the Cleveland Browns. “You might have seen this story in today’s news,” Barr began, attaching the link. He continued: “I have actually had some questions about the NFL study on neuropsychological testing that was published by Pellman and his colleagues last year in Neurosurgery. The number of reported baselines and injured players doesn’t match up with what I would expect for the five year study period from 1996 to 2001.”
Naugle replied that he sent Lovell data on “2 or 3 players.” He added: “I have a few hundred baselines. Mark does not have those data.”
Barr also wrote to Chris Randolph, a neuropsychologist for the Chicago Bears. Randolph said he had collected baselines for 287 players. No one from the committee had requested his data.
He wrote to John Woodard, the neuropsychologist for the Atlanta Falcons. Woodard had collected baseline tests for 173 players. He too was never asked for his data.
By the time Barr was done canvassing neuropsychologists from Lovell’s network, he calculated that at least 850 baseline tests—and perhaps thousands more—had been excluded from the NFL’s results. Barr was concerned that Pellman and Lovell had cherry-picked the data to reinforce the league’s argument that the impact of concussions was negligible and players recovered quickly. Barr said Pellman called him one year before the paper came out looking for information on three former Jets: Kyle Brady, Fred Baxter, and Keyshawn Johnson. None had been with the team in years, but they had come back quickly from their concussions, and that fit the profile of the players who were reported on in the NFL’s study. “I think they had an agenda on what they wanted to find in the research before they conducted the research,” said Barr. Pellman later told Keating this was false: “Team doctors talk to specialists and ask them for results all the time,” he said. “It’s part of their job.”
Lovell denied that data were purposely excluded. He said that Naugle and Randolph had refused to provide data and that a “miscommunication” prevented Woodard from providing his. Barr, he said, later privately told the NFL that “we had all of his data on multiple occasions. So do we have it or do we not? I don’t know. He’s the only one who knows the answer to that.” Lovell believed that Barr had launched his attack to get back at Pellman for firing him and that Lovell wound up as collateral damage.
Lovell’s role in the controversy was bewildering. His pioneering research had helped expose the NFL’s concussion problem. Leigh Steinberg had featured him in his seminars to convince the NFL the world was round. He had taken the witness stand to accuse the Chicago Bears of ruining Merril Hoge’s career by failing to take his concussion seriously. Yet now many of his fellow neuroscientists suspected that Lovell was involved in the NFL’s effort to cover up its concussion problem.
Lovell denied that was the case. “I don’t think the NFL ever wanted to have a concussion problem. I don’t think anybody ever does,” he said. “But, I mean, the suggestion that there was some kind of grand conspiracy, I don’t think, honestly, knowing the people on the committee—that never happened. Or none of us would have been involved with it.”
Yet much of what the NFL believed about concussions was there in black and white, with Lovell’s name attached to it. Beyond the allegations about the missing data, Lovell had put his name to research that concluded, among other things, that (1) concussions are minor injuries and nearly all NFL players recover quickly and completely and (2) pro football doesn’t cause brain damage, ever. Oddly, Paper Number 6 even suggested that neuropsychological testing was at best of limited use in assessing football-related concussions and at worst useless. Was Lovell really bashing his own profession, the research that had come to define him? Even his partner Maroon seemed taken aback, noting in his review that “the authors seem to suggest that the role of neuropsychological testing is ‘minor.’ Such a strong statement does not seem to be justified.”
Lovell, backpedaling years later, argued that he was a victim of the inner workings of Pellman’s committee, which he said produced the more inflammatory assertions without his knowledge. When the MTBI committee wrote up its findings, he said, it was a collaborative effort. Each author wrote a section related to his work. The sections were then compiled by the lead author, which in nearly all cases was Pellman. Lovell claimed that he contributed sections on the history o
f neuropsychology and football, the evolution of the NFL Neuropsychology Program, and the methodology of the study. His name was on the paper as a coauthor, but he claimed he didn’t write the passages that produced the most controversy and, later, legal action.
Neuropsychology was of limited use in diagnosing concussions?
“Obviously I didn’t write that,” Lovell said.
Multiple concussions do not increase the risk of further injury?
“I didn’t write that.”
NFL players don’t get brain damage?
“I didn’t write that,” Lovell said again. He acknowledged he could have protested to the committee to try to get the passages changed. But there was already a lot of back-and-forth between the authors, he said, and he didn’t pay atttention to sections he didn’t write. Lovell said the language was “actually softened a great deal.”
“Could I have said, you know, ‘God dammit!’ ” said Lovell. “Probably. Didn’t.”
One former committee member said it was essentially revisionist history for Lovell to try to disavow responsibility for a paper that, after all, had his name on it. Versions of the papers were indeed passed around among all the authors, the committee member said, and changes were made constantly upon request. “I wouldn’t have any argument with someone saying, ‘Gee, looking back on it, I wish I hadn’t agreed to that,’ ” the former MTBI committee member said. “But to say, ‘They put something in there that I didn’t agree with’? Everyone had the opportunity to look at everything and had the chance to say, ‘I don’t agree with that, and I don’t want to be an author on it, let’s change it.’ And it probably would have been changed.”
It was an eventful four months for Elliot Pellman and his MTBI committee. Pellman had fired a neuroscientist who disagreed with the NFL’s concussion policies; his own credentials had been exposed as inaccurate and inflated; and he had published a controversial study that was based on questionable data.
In April 2005, Barr sent a letter to his dean at NYU “to clarify the nature of [the] professional relationship I have had with Dr. Pellman since the early 1990s and to review the series of events that ultimately led to the abrupt termination of this relationship.”
He described how Pellman, after Barr refused to clear all research through the NFL, not only fired him but “threatened me with a lawsuit” if Barr ever tried to publish research related to his work with the Jets.
“The idea that someone would attempt to restrict my academic activity and prevent the communication of my research findings, as a precondition for continued employment, was most disturbing,” Barr wrote. “I would appreciate it if you could keep this letter on file in the event that I have any further encounters with Dr. Pellman.”
Barr would have future encounters with the NFL; that was certain.
Despite the work of the Dissenters, the NFL’s concussion research machine was unstoppable. During one prolific stretch in 2004 and 2005, the league churned out five papers in as many months; the first four listed Pellman as lead author. The committee ultimately pumped out 16 papers on concussions, an extraordinary number for a single group of researchers publishing in one journal. Cantu, who commissioned the first paper for Neurosurgery, thought that it was overkill, that one or two studies would have sufficed: “For the life of me, to this day I don’t understand how it turned into that many papers.” But Apuzzo insisted on taking them all, he said. In February 2005, Maroon, one of the reviewers, wrote: “This article represents the seventh and final contribution by the NFL Committee on MTBI on the various aspects of head injury in professional football.” Yet a month later, without explanation, there it was: Part 8! Some concussion researchers began to mock Neurosurgery as the “Official Medical Journal of the National Football League” or the “Journal of No NFL Concussions.” No sooner would Guskiewicz review one paper than another would arrive in his in-box. Guskiewicz, of course, was rejecting the work. But oddly, Apuzzo would still call him, asking where his review was so that the paper could be published. “He’d say, ‘You know, I’d really like to get this paper out, because we’re delayed and we’re waiting on your commentary,’ ” said Guskiewicz. “And I’m like, ‘Mike, you just sent it to me 10 days ago. You know, I’ve got a life.’ ”
“We all talked about this often: Who was driving this?” said Guskiewicz. “Who was pushing him? We never knew. It was just odd. And very questionable.”
Whether it was Pellman who actually wrote the papers—9 out of 16 would list him as the lead author—also was unclear. Two former committee members insisted that none of the studies was ghostwritten, a not uncommon practice in the research community, but the idea that a rheumatologist with no experience in neuroscience could write that many papers on the subject struck many as unlikely. Pellman, after all, had never authored a paper on the topic before taking over as head of the MTBI committee, according to a search of PubMed, a database of scientific literature. Some seasoned researchers felt lucky to publish a paper or two a year. But the reassuring treatises kept coming. Pellman and the NFL now were saying that concussions were so minor that players were generally safe to return to the same game even if they had lost consciousness. Not only that, although the league had studied only NFL players, they wrote, “It might be safe for college/high school football players to be cleared to return to play on the same day as their injury.” The authors suggested that “rather than blindly adhering to arbitrary, rigid guidelines, physicians keep an open mind to the possibility that the present analysis of professional football players may have relevance to college and high school players.”
After a while, the Dissenters threw in the towel. If any assertion could be published unchallenged as peer-reviewed science in Neurosurgery, they reasoned, what was the point of peer reviewing the studies? “Quite frankly, people like Kevin and myself just quit reviewing these papers,” said Cantu. “We just said, ‘These are poorly written, you can’t use this data to make the claims they’re making, and we won’t even bother to write comments anymore because it’s just so flawed and so bad. We won’t be a part of this.’ ”
“We were like, ‘I’m outta here,’ ” said Guskiewicz. When Apuzzo sent him papers to review, Guskiewicz refused. Soon Apuzzo stopped asking. Cantu said Apuzzo’s solution to the peer review uprising was not to shut down the NFL’s research but to find other reviewers who were willing to chime in.
Lovell continued to argue that he was on the outside of this unruly debate and that except for the three papers that had his name on them, he barely paid attention to the literature the MTBI committee was churning out every month. “I probably only read five of the papers,” Lovell said. “Other than that I had absolutely nothing to do with the papers.” That argument avoided one important fact: As a body of work, the papers were an expression of NFL dogma. Over and over, they repeated the same essential themes, making it nearly impossible to disassociate oneself from the overall message. Lovell was a coauthor on NFL Papers 3, 6, and 12; all asserted that NFL players didn’t get brain damage from playing football and/or seemed to have superhuman qualities that limited their susceptibility to concussions. Paper Number 12 included the observation: “In our opinion, it is unlikely that athletes who rise to the level of the NFL are concussion prone.”
“That’s just kind of a stupid statement,” Lovell said when it was read back to him. “What do you mean by ‘concussion prone’? What does that mean? I didn’t write it, but it’s stupid either way.”
“Well, your name’s on it,” it was pointed out.
“No, no, no,” he said. “I mean, is my name on that sentence?”
The researchers associated with the NFL’s work would all take a hit to their reputations, but Lovell in many ways had the farthest to fall. By the time he arrived on the committee, he had spent years helping athletes understand the seriousness of head trauma. He had helped bring concrete measurements to an injury that team trainers and doctors had only guessed at. Now Lovell found himself accused of carrying water for
the NFL. Whether Lovell was a passive or an active participant in this stunning transformation was subject to interpretation. Lovell argued that he was merely swept up in the politics of the committee but played a very minor role. “I’m not a, you know, NFL company man,” he said. “Do I regret some of the things that were said that had my name on it? Yes. Would I say them again? No.” But others portrayed Lovell as a scientist caught in a web of conflicts that proved too lucrative, seductive, or both for him to disengage, if in fact he wanted to.
Lovell had come a long way. Back in 1993, when he and Maroon had come up with the idea to measure the Steelers’ brain functions, Lovell had started with just pencil and paper and 27 reluctant subjects. He had since refined that test and developed it for the computer. With financial backing from UPMC, the test was now being mass-marketed under the brand name ImPACT. Many brain scientists didn’t consider ImPACT much different from the alphabet soup of neuropsych tests that were out there, such as ANAM, which was used by the Army, and NEPSY, which was designed for kids. But ImPACT, through its association with the NFL, had come to be known as the football concussion test, an impression that Maroon, Lovell, and Collins constantly encouraged.
League of Denial Page 21
