The pictures shocked many people in the audience, even the scientists who had examined their share of dead bodies. Many felt Omalu had crossed the line. “Some of us knew it was in poor taste,” Nowinski said. But Omalu felt this was the nature of his business and an effective way to convey his message. It would not be the last time he showed pictures of dead players in a public setting.
When Nowinski gave his presentation, he used the name for football-induced brain damage that he and Omalu had settled on for the time being: neurofibrillary football linked dementia—NFL dementia.
By then, the newly formed Sports Legacy Institute had its sights on the brain of another player: Justin Strzelczyk (pronounced STREL-zik), yet another former Steelers offensive lineman. Strzelczyk had died two and a half years earlier at age 36 after leading police on a 37-mile chase on Interstate 90 through central New York. The chase concluded with Strzelczyk driving his pickup truck across a median at 100 miles per hour and colliding head-on with an oil tanker. He was killed instantly in the explosion. Strzelczyk had experienced a Webster-like transformation. He had played 133 games over nine seasons in Pittsburgh, retiring in 1998, but by the time of his death had become nothing like the free-spirited, goofy, intelligent man who had been beloved by family, friends, and teammates. Instead, he was paranoid and delusional, devastated by financial troubles and a failed marriage.
Bailes had been with the Steelers when Strzelczyk played; his death, like Webster’s, had stunned him. He remembered Strzelczyk as a “fun-loving guy” who would tool around on a Harley, play the banjo, and carry around a bag of candy to distribute to kids “like some modern Santa Claus.”
“His death really troubled me,” Bailes said.
Now, as the Sports Legacy Institute sought brains, Bailes had a hunch. He wondered if any of Strzelczyk’s brain tissue had been preserved during his autopsy. That led to a call to the medical examiner, who confirmed that he had kept some of the tissue.
Two months later, Schwarz had another story, this one on the front page of the Times’ sports section announcing that Strzelczyk had signs of “brain damage that experts said was most likely caused by the persistent head trauma of life in football’s trenches.” Among the experts quoted were Omalu, Bailes, and Ron Hamilton, Omalu’s mentor, who had played such a critical role in the validation of Omalu’s original work. Hamilton, the story said, had confirmed Omalu’s findings on Strzelczyk. He told the newspaper: “This is extremely abnormal in a 36-year-old. If I didn’t know anything about this case and I looked at the slides, I would have asked, ‘Was this patient a boxer?’ ”
That story also became the forum for Nowinski, Bailes, and Omalu to formally announce the creation of the Sports Legacy Institute. They couldn’t have done it better with a press release. Nowinski described his plan for a nonprofit organization based at a still-unidentified university.
“We want to get an idea of risks of concussions and how widespread chronic traumatic encephalopathy is in former football players,” Nowinski told the Times. “We are confident there are more cases out there in more sports.”
To date, the NFL’s efforts to shoot down the theory that football caused brain damage had not gone well. Those efforts included—but were not limited to—demanding a retraction from leading experts in neurodegenerative disease, making public statements in an attempt to discredit independent researchers, and convening a Concussion Summit in which the cochair of the NFL’s concussion committee mocked one of the nation’s top neurosurgeons in front of the new NFL commissioner as he showed slides of diseased former players.
The NFL needed a new strategy. Ira Casson and his colleagues on the league’s concussion committee decided to bring in their own independent expert to examine Omalu’s work—if, of course, he was willing to subject it to further scrutiny. The cases already had been validated by numerous researchers, including Bailes, who had been dispatched by the American Association of Neurological Surgeons. Bailes continued to be shaken by what he had seen. These weren’t just case studies that Omalu was presenting; they were human beings Bailes had known personally during his days with the Steelers, people who had spent time with him and his family.
The night of the memorable meeting with Maroon—“Bennet, do you really understand what this means?”—Bailes’s wife, Colleen, found him in his basement office, still staring at the slides of Webster’s brain.
“This is a sad day for the NFL,” Bailes told her.
Bailes had met Colleen in Pittsburgh when he was working for Maroon and she was working as a cardiothoracic nurse in the intensive care unit at Allegheny General Hospital. He knew she would understand. As they sat in the basement, Bailes first showed his wife a slide of a normal brain, then one of Webster’s, splotched with the tau protein that had caused him so much pain.
“Here’s Mike, our dear friend. Here’s his brain,” Bailes told Colleen.
She, too, was crestfallen. “For me, it was just really sad to have it come down to a slide of somebody who I knew,” she said. “There it was: on a slide. It was just sad. And then he was the first. Little did we know others would follow.”
But the NFL still wanted its own opinion. Casson set out to find an independent expert. He didn’t have to look far. Casson had an affiliation with Long Island Jewish Medical Center, part of the North Shore–Long Island Jewish Health System. He was aware that North Shore–LIJ recently had opened an Alzheimer’s Center. Its director was Peter Davies, a leader in Alzheimer’s research. Davies was also recognized as an expert in tau, the protein at the heart of the CTE debate.
Casson contacted Davies and asked if he would assess Omalu’s research and report back to the NFL committee. Davies agreed and soon afterward met with the committee at the NFL’s headquarters on Park Avenue. Davies told the doctors he couldn’t tell much from Omalu’s papers in Neurosurgery; they showed just one picture from one slide that revealed one neurofibrillary tangle. Davies was baffled and annoyed; he never would have published a paper with so little evidence. He needed to see multiple regions with multiple stains of brain. Davies was skeptical of the finding, and it was clear to him that he wasn’t alone.
“I think there was a really high level of skepticism” on the committee, Davies said. “And in fact, you know, the thought of real exaggeration that [Omalu] was making a mountain out of one picture of a tangle.”
“I need to see the tissue that Omalu took the pictures from,” Davies told the committee.
Maroon, who had been added to the committee amid the turmoil, volunteered to serve as a liaison. That made sense: He lived in Pittsburgh, knew all the players, and had seen the slides.
Casson offered to pay Davies, but Davies declined. He wanted to avoid even the appearance of a conflict. “If you want my opinion, you’ll get what I think, not what you pay for,” he told Casson.
A few weeks later, Davies found himself seated in a large conference room at West Virginia University with Maroon, Bailes, and Omalu. By that point, Omalu had obtained brain tissue from six NFL players and two professional wrestlers. Omalu was wary. He saw Davies as a researcher, not a real-world forensic pathologist. He was a scholar, not a doctor. At that point, Omalu wouldn’t have trusted anyone sent by the NFL. For his part, Davies saw Omalu as an overzealous coroner slightly out of his depth. The role of a medical examiner was to determine cause of death, not identify new diseases. He thought Omalu’s research and staining were crude, not up to his standards. Later, he noted that Omalu, of course, wasn’t a neuropathologist. When informed that in fact Omalu was, Davies exclaimed: “Wow, that’s surprising! I didn’t know that.” It wasn’t necessarily a recipe for agreement.
Yet the more Davies analyzed the slides, the more astonished he became. It was clear that Omalu was on to something big. Davies confirmed that what Omalu had found was definitely not Alzheimer’s or any other disorder he had seen. The pattern of tau was unique, the tangles everywhere.
“It was obvious there was something there,” he said. “I knew t
here was something going on.”
Davies wanted to take the tissue back to his lab. He told Omalu that his lab could provide a more exacting level of staining. Omalu panicked. Should he really give up tissue to someone who had been hired by the NFL? But he agreed, telling Davies he would get him whatever he needed.
“I knew if they destroyed my slides, that was a good opportunity for me to sue them and become a multimillionaire,” Omalu said.
A few days after the meeting, Maroon, now seemingly a convert, sent Omalu an e-mail of thanks: “The personal effort you made to meet with us is deeply appreciated. Like Socrates, you have been a major ‘gadfly’ (in a complementary sense) in stimulating and provoking a more detailed examination in the underlying pathophysiology of TBI in sports.” One day later, Davies wrote to Omalu: “I remain convinced that you have discovered something, a new phenomenon.… This discovery could prove of great importance to the field of neurodegenerative disease research.”
Davies kept the NFL committee informed of his progress, forwarding his correspondence with Omalu to Casson and Maroon. At one point, Omalu suggested that he and Davies pursue research together, a suggestion that Davies encouraged. Casson tried to warn him off: “I would suggest great caution regarding Dr. Omalu’s proposed paper.”
Once back in New York, Davies received the tissue from Omalu. His lab began to process it. The NFL and Casson were eager to hear the conclusions of Davies’s study. “Do you have any information regarding your staining of Dr. Omalu’s material yet?” Casson wrote. “We are all very anxious to hear about your findings.” A few weeks later Casson checked in again: “How is your analysis of the slides going? I am very interested in hearing about your findings.” And then, a few days after that: “Dear Peter, I am really looking forward to your report.” Omalu, too, was on pins and needles. The early signs had been positive, but he wasn’t sure what would come back now that Davies had the material to himself. “Should we expect the results soon?” he wrote.
As Davies peered into his microscope, he couldn’t believe what he was seeing.
“I remember that day, you know, it’s one of those days where you’re just so blown away by what you see: What on earth am I looking at?” Davies said. “I’ve never seen anything like it. With the best stains around, we’re seeing far too many tangles. Way too many. More than I’ve ever seen in anything else before.”
The results were so off the charts, Davies thought his technicians had botched the staining. He had them do it again. That was part of the reason for the delay. When the slides came back, the results were the same.
On January 28, 2009, Davies sent an e-mail to Omalu, beginning to lay out his findings. He was perplexed by one thing. There seemed to be two distinct groups: one with unprecedented widespread disease and the other also with numerous tangles, but not nearly as prevalent. He wondered if there might be a reason other than head trauma for the differences. He began to speculate that perhaps steroids were a factor. Nevertheless, Davies was convinced. The following day he wrote Omalu: “This is amazing stuff: you really have opened a major can of worms!”
Two days later Maroon, still acting as a liaison between Omalu and the NFL, wrote Davies: “I have been asked to comment on this and wondered if you could coach me a little on just where we stand on this. ANY input is appreciated.”
Davies wrote back 38 minutes later:
I am forced to consider at least three different scenarios:
1. That Bennet is right, and that repeated head injury produces this pathology, in certain (genetically distinct?) individuals resulting in a very aggressive disease.
2. That some systemic factor (steroid abuse?) causes the pathology.
3. That the two factors interact such that those abusing steroids become much more sensitive to head injury. Steroids may “prime” neurons for tau pathology following head injury, and render vulnerable whole populations of neurons that otherwise would not show signs of damage.
When Maroon informed Casson, the cochair of the NFL committee indicated that he thought the findings still didn’t implicate football: “WOW!!! Amazing,” he wrote Davies. “This seems to raise more questions than it answers. Is it fair to say that something is going on here but it is not clear exactly what that something is?” He again cautioned Davies against collaborating with Omalu and Bailes “until your further studies are completed.”
The NFL had brought in its own independent expert, but that expert had muddied the waters further. Davies had validated the magnitude of Omalu’s findings. When he issued his final report, he differed only in that he thought some of the cases might have resulted from “either a toxicological or pharmacological cause, rather than traumatic events.” That was scientific conjecture; there was no evidence that steroid abuse led to neurodegenerative disease (later, a Bailes study would show that it didn’t). Davies also thought genetics might play a role. In light of the extensive history of mental illness in Webster’s family, that certainly seemed plausible.
None of it was good news for the NFL. Davies was essentially telling the league it had two issues on its hands: head trauma and steroids.
At the time, in light of the way baseball had been consumed by the BALCO steroids scandal while football had stayed under the radar, the steroids scenario wasn’t much better for the NFL. “Obviously this wasn’t really what the head injury committee wanted to hear,” Davies said. Interestingly, once the NFL realized that a steroids problem was in many ways preferable to the suggestion that the sport itself was to blame, committee members and league officials publicly latched on to the steroids theory as the possible cause of neurodegenerative disease.
Davies came away entertained by the experience. He wasn’t certain football had caused brain damage in all of Omalu’s cases, but it was clear that he had stumbled onto something huge. Casson hadn’t gotten what he and his committee expected out of Davies.
“Rightly or wrongly, the perception of that original head injury committee was that they were downplaying the long-term consequences of concussion,” Davies said. “Certainly, Ira Casson didn’t believe that Omalu was right. And I don’t think that anybody on that committee thought that Omalu would come out looking right. When he did, I think there was more of a panic mode, the realization that something was really going on here and it was very serious.
“I was kind of amused at the time. It was one of those things: Be careful what you wish for. You brought me in to find out if Omalu was right, and I said he was right in spades.”
When Goodell took over from Tagliabue, he couldn’t have foreseen how the concussion issue would overwhelm his tenure as commissioner and how damaging the discovery by an obscure forensic pathologist would be for his business. Omalu’s conclusion that Webster had brain damage—and the implications that grew out of it—was quickly turning into the defining issue of Goodell’s commissionership. After the precipitating event, the scandal continued to spin out in different directions, seemingly with a momentum of its own.
Omalu had become the fulcrum around which most of the action revolved. As the NFL continued to attack him, one of his closest friends, a Pittsburgh personal injury attorney named Jason Luckasevic, asked him one day: “What are you going to do about this?”
“I don’t know. What do you mean?” Omalu said.
“Shouldn’t you be doing something against the NFL, fighting back or whatever it takes?”
“I don’t know. You’re a good lawyer; you figure it out,” Omalu said. Jason Luckasevic was even greener than Omalu, a 30-year-old associate at the firm of Goldberg, Persky & White. He had a modest office near Duquesne University, where he had gone to law school. The two men had become friends through Luckasevic’s older brother Todd, a pathologist in training at the Allegheny County coroner’s office. The Luckasevics were from a sports-obsessed working-class family in the Monongahela Valley; their father was a machinist in a glass factory, and their mother worked at a credit union. Joe Montana had grown up down the street from their grandmo
ther. The Luckasevics had Steelers season tickets and were devoted fans of the Pirates and the Pens. The family loved Omalu—his Nigerian perspective on life, his obvious smarts and religiosity. The Luckasevics invited him over for Christmas every year.
As Jason Luckasevic and Omalu spent more time together, Omalu began insisting that he would make a great expert witness and that Luckasevic should hire him. Luckasevic was dubious, for obvious reasons. Omalu was black, baby-faced, and foreign, not exactly the prototypical expert to persuade a jury to award millions. But Omalu was persistent and persuaded Luckasevic to use him on a major asbestos case. By the eve of the trial, Luckasevic was in a panic. What was he thinking? Omalu had never testified in an asbestos case. The trial was in a predominantly white rural county 90 miles east of Pittsburgh. He would get creamed.
Luckasevic tried to prep Omalu the night before, but Omalu just wanted to go out for a beer.
“Don’t worry, don’t worry,” Omalu insisted
The next day, when Omalu took the stand, Luckasevic tried to lay the foundation to at least show the jury that his expert witness was qualified.
“Dr. Omalu, you are board-certified in anatomic pathology?” he asked.
“Yes,” said Omalu, impeccably dressed, as usual.
“And you are board-certified in clinical pathology?”
“Yes.”
“And you are board-certified in forensic pathology?”
“Yes.”
“And you are board-certified in neuropathology?”
“Yes.”
“And you have a master’s in epidemiology?”
“Yes.”
“And you’re currently attending Carnegie Mellon University to earn your business degree?”
League of Denial Page 28
