by Steve Almond
The first wave of media coverage, two decades ago, focused narrowly on the impact of concussions. As doctors gathered more data, and shifted focus to the risks posed by the smaller collisions that occur every single play, the story evolved from a practical question—how to minimize big hits?—to an existential crisis.
It’s useful to recall here the manner in which the public outcry over violence reshaped football a century ago. Back then, the President of the United States felt duty-bound to help speed reforms. The game was killing and maiming college and high school players. It was a moral problem.
The moment football became a business, violence was no longer just a moral problem. It was a money problem.
This, of course, is the big dance of capitalism: how to keep morality from gumming up the gears of profit, how to convince people to make bad decisions without seeing them as bad. We have whole industries devoted to this voodoo, the dark arts of advertising, marketing, public relations, lobbying. Every day, an army of clever men and women are devising new ways to get us to enjoy tobacco and animal flesh and petroleum and corn syrup without suffering the harsh aftertaste of guilt, without dwelling on the ethical costs of these pleasures. Oftentimes, you will hear some academic type marvel at the American capacity for self-delusion. Here’s our secret: we’re soaking in it.
I mention all this not just to get my socialist jollies, but to emphasize the larger system within which modern football operates. From the perspective of its governing body, the NFL, the game is a multi-billion-dollar product. And those of us who love it are not innocent fans rooting for our teams to prevail. We’re consumers. Our money and attention are what subsidize the game.
This is true of all pro sports. But it’s especially true of football. Consider this factoid. In 1948, nearly nine-tenths of the revenue earned by the NFL’s best team, the Philadelphia Eagles, came from ticket sales. The share from radio and TV rights was 3 percent. Hardcore fans kept the league afloat, the ones who braved stadiums so cold that players sat bundled in hay to keep warm on the sidelines.
This season, the NFL will receive $5 billion in TV rights alone, nearly half its total revenue, and three times more than Major League Baseball earns. This money is generated by the tens of millions of casual fans engaged in what we might call “passive consumption” (i.e., watching a game on your couch while inhaling Cheetos).
But the league’s ascendance has had unintended consequences. Stars now qualify as national celebrities, and their physical deterioration is front-page news. Television coverage renders each game as both epic and personal. Back in the seventies, the camera angles were limited and the images often grainy. The players remained obscure under their bulky exoskeletons, more like superheroes than human beings. Today, we see the game in high-def. Slow motion replays show us the unnatural angle of a broken ankle, and a quarterback’s contorted face at the precise moment he is concussed. We hear the impact thanks to tiny microphones affixed to player’s uniforms. It’s gotten harder and harder for even casual fans to deny the cruelty of the game.
The standard rationalization hauled out at this point is that the NFL will clean up the game. As fans, we want to believe that league officials will choose the righteous path over the profitable one. This is nonsense and always has been.
From the beginning, the NFL has sought to obscure the most disturbing aspects of the game. This is why Bertie Bell, the first great commissioner of the NFL, wrote a stipulation into the contracts the league signed with TV networks prohibiting them from showing injuries or fights. “In the matter of television and radio we are doing a job for the public,” he explained, “a job of showing them the best football in the world.” In a more candid moment, Bell explained the appeal of the sport this way: “You knock my brains out this Sunday and I knock your brains out the next time we meet.”
So football’s guardians have always tried to walk this absurd line, between selling violence and disavowing it. The best way to gauge how league officials will respond to safety concerns is to consider what they have done thus far.
The first commissioner to issue a public statement on concussions was Paul Tagliabue, who succeeded Pete Rozelle in 1989. His statement: “On concussions, I think this is one of those pack journalism issues, frankly. The problem is a journalist issue.” He cited steroids, drinking, and other injuries as more pressing matters.
Having served as the league’s lead counsel before becoming commissioner, Tagliabue eventually adopted the same activist strategy employed by the tobacco industry. He sought to shape public debate by flooding the market with junk science. The NFL created a “research body” called the Mild Traumatic Brain Injury Committee. (If you believe, as I do, that language is essentially an instrument of truth, we might pause here a moment to linger upon the spooky propagandistic frisson produced by the juxtaposition of those two words: mild, traumatic.)
Tagliabue chose a man named Elliot Pellman to chair the committee. Pellman was a rheumatologist with no experience in brain research. He worked for the New York Jets and was Tagliabue’s personal physician.
Members of the committee published sixteen papers in a medical journal called Neurosurgery, whose editor-in-chief was a consultant to the New York Giants. These papers invariably reached the same conclusion: NFL players were, if not impervious to brain injury, unlikely to suffer long-term effects. The authors, many of whom had worked in and around football for years, seemed at times almost touchingly naive about the fundamental nature of the game. (“Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.”) A number of these papers found a home in Neurosurgery only after being rejected by other editors and peer reviewers. Some were later repudiated by their own authors. Still, the committee provided crucial cover for Tagliabue. Every time some pesky reporter brought up concussions, he could point to the MBTI and its reams of exculpatory data.
The problem was that the number of former players showing signs of cognitive damage kept growing. They also began committing suicide in rather flamboyant ways. Steelers lineman Terry Long drank anti-freeze. His teammate Justin Strzelczyk led police on a high-speed chase before crashing into a tank truck at 90 mph. Long was forty-five, Strzelczyk thirty-six.
By the mid-2000s, a group of neurologists unaffiliated with the NFL had begun examining deceased players and finding incontrovertible evidence of brain damage that explained the disturbing symptoms of dementia reported by family members. In 2007, new commissioner Roger Goodell listened to a number of these doctors present their findings at a conference he convened on brain injuries.
His public response subtly undermined the link between football and brain damage. “I’m not a doctor, but you have to look at their entire medical history,” he said. “To look at something that is isolated without looking at their entire medical history I think is irresponsible.” The league also released a carefully worded pamphlet whose ostensible purpose was to inform players of the risks associated with concussions: “Current research with professional athletes has not shown that having more than one or two concussions leads to permanent problems if each injury is managed properly … Research is currently underway to determine if there are any long-term effects of concussions in NFL athletes.”
The league had entered its official Obfuscation Phase.
It didn’t last long. Two years later, an NFL spokesman told a reporter this: “It’s quite obvious from the medical research that’s been done that concussions can lead to long-term problems.” By this time, larger media outlets—The New York Times and PBS in particular—had begun piecing together the NFL’s systematic cover-up. Players had begun to speak out and to consider legal remedy.
In 2011, a former Atlanta Falcons safety named Ray Easterling sued the NFL, an action eventually joined by more than 4,500 other former players. The suit accuses the NFL not only of negligence but fraud, a “concerted effort of deception and denial” that includes “industry-funded and falsified research.”
In 2013, the NFL agreed to pay a settlement of $765 million, along with an estimated $200 million in legal fees. The presiding judge deemed this sum insufficient to cover the anticipated medical costs of the 20,000 players who eventually may qualify for payment.
Anybody with even a rudimentary sense of how corporations regard liability will understand why the NFL is so eager to make a deal. First, a settlement would guarantee that league officials never have to answer questions under oath regarding what they knew, and when, about the link between football and brain damage. Second, they would avoid the discovery phase, which would make public the grisly medical histories of former players. Presumably, some of these players and their family members would testify. It would be a public relations disaster.
And that’s what matters, in the end, to NFL officials, and what makes their conduct so transparent. Roger Goodell and the men who work for him are not stupid. They’ve looked at the mountain of medical data and come to the same reluctant conclusion that Big Coal and Big Meat did decades ago. The business they run is unsafe for their workers.
The moral decision in this situation isn’t very complicated: you stop playing the game until you learn more. You explain the dangers to your players (and the public) and you apologize for gambling with their health.
Goodell has made business decisions. He’s done just enough—purged the deniers, tweaked the rules, funded research—to allow us fans to pretend that the league gives a damn. He’s placed his faith in our capacity for self-delusion.
The second big rationalization in the NFL Fan Survival Kit is that players knowingly choose to incur the game’s risks and are paid for doing so. You hear this line all the time on sports talk radio, often in that pitched, contemptuous tone characteristic of men who resent moral contemplation.
Okay. Let’s start with the issue of what constitutes informed consent. Here’s what seems fair: On NFL Draft Day, Roger Goodell can call the number one draft pick to the stage and give him his jersey and hat. But the commish will also have to hand the kid a waiver, the text of which would be printed onscreen:
I, __________, the undersigned, am aware that the average age of death of an NFL player is, according to the Players Union, up to two decades shorter than normal life expectancy. Furthermore, I recognize that playing in the League, even in the absence of formally diagnosed concussions, may cause brain damage leading to the loss of cognitive function, depression, disorientation, and suicidal ideation.
A copy of this waiver will be distributed to the draftee’s family. They will then be required to watch a brief video of former players, such as the late Pittsburgh Steeler Mike Webster, describing—or attempting to describe—what life is like with CTE. Then the player and his family will be given a week to consider the matter.
That would be informed consent.
Most of those kids would sign. They would sign not just because they’re twenty years old and believe they’re bulletproof, but because their talent for football is the single attribute upon which they have been judged for most of their lives. Football isn’t just what they do. It’s who they are.
NFL players are members of an elite fraternity that knowingly places self-sacrifice, valor, and machismo above medical commonsense. Football is the one major American sport that selects specifically for the ability to inflict and absorb physical pain. (We don’t judge baseball or basketball players on how well they can take a hit.) The ultimate badge of honor for a pro football player is not that he play fair or that he play hard but that he play hurt.
In January of 2014, ESPN asked 320 NFL players, anonymously, if they would play in the Super Bowl with a concussion. Eighty-five percent said yes. More recently, a linebacker for the Jacksonville Jaguars named Russell Allen revealed the reason for his unexpected retirement: he suffered a stroke after being hit during a game last year. Allen refused to leave the game or inform medical personnel because he feared he might lose his starting job.
One of the more despicable arguments put forward by the MBTI committee was that the rigors of football weeded out the weak. Those who made it to the pro level were less susceptible to concussions and quicker to recover from them. The proof of this claim was that so many players returned to the playing field so quickly after suffering concussions, which was a little like claiming that the dangers of black lung weren’t that serious because so many coal miners returned to work after bouts of respiratory illness.
What an unbiased examination of the data suggests is that concussions have been under-reported, under-diagnosed, and under-treated for decades. When doctors describe symptoms to an older player—dizziness, seeing stars—they often identify these as routine. The linebacker Bill Romanowski, by all accounts one of the nastiest players in league history, estimated that by these standards he’d suffered five hundred or more concussions during his career. “I saw stars every day for sixteen years. I saw stars in college.” He was diagnosed with twenty concussions.
The NFL’s research wasn’t gauging the resilience of players’ brains, but the toxic convergence of its own reckless cupidity with the macho culture that prevails among its employees.
What happens to a player who rejects this culture?
Consider the case of Ted Johnson. During his ten-year career, the hard-hitting linebacker helped the Patriots win three Super Bowls. In 2002, he suffered a concussion and briefly blacked out during a pre-season game. He returned to practice four days later, expecting he would wear a red jersey for “minimal contact.” A blue “full contact” jersey was hanging in his locker. Johnson confronted a trainer, who told him there had been a mistake, that he wasn’t cleared for contact. Johnson put on the red jersey. Out on the practice field, as the team prepared for a contact drill, an assistant trainer brought him a blue jersey. Coach Bill Belichick had directed him to do so. Johnson was incensed.
Here’s where things get truly messed up.
Johnson put the jersey on anyway. Almost immediately, he suffered a second concussion and was rushed to the hospital. When he confronted Belichick privately, Johnson says the coach admitted that he’d screwed up and apologized to him.
Belichick’s public response to the incident was considerably different: “If Ted felt so strongly that he didn’t feel he was ready to practice with us, he should have told me.”
This is part of what makes Bill Belichick a great coach. He knows how to “get the most out of his players,” which is a kinder way of saying that he knows how to manipulate them. He knows that a tough guy like Johnson would rather risk his health than risk losing face by refusing to put on that blue jersey. “They weren’t going to beat me,” is how Johnson put it.
Instead, Belichick got Johnson to beat himself.
Johnson played three more seasons for the Patriots. He estimates that he suffered half a dozen more concussions, though he reported only one of them because he wanted to avoid being labeled soft. He was already suffering from symptoms of neurological damage, which have worsened.
If you follow football, especially in New England, you hear a lot of talk about the so-called “Patriot way,” a dignified, stoic approach to the game. One of its central tenets is extreme secrecy when it comes to injuries. And yet here is how one team official summed up Johnson’s medical condition to a Boston Globe reporter: “Ted Johnson is a very sick young man. We’ve been aware of the emotional issues he’s had for years. You can’t blame all of his behavior on concussions.”
The Patriot Way: When a player receives serial brain traumas trying to honor your code, suggest in print that he is mentally ill.
Of course, it’s easy to blame ruthless coaches and venal owners and foolhardy players, and much harder for us to see our own role in all this.
Most football players begin life with limited socioeconomic options. They may love football for its inherent virtues. But they also quickly come to see the game as a path to glory and riches. These rewards aren’t inherent. They arise from a culture of fandom that views players as valuable only so long as they can
perform.
We might pay lip service to health issues, but we’re much less forgiving when the injury report comes out. Scroll through the Internet message boards, or listen to the provocateurs on sports talk radio. A frequently hurt player is not to be pitied, but suspected. In these kangaroo courts, “injury prone” has become synonymous with cowardly or weak-willed. The explosion in steroid use is partly a response to this mindset. The drugs help speed recovery from injuries.
Then again, according to a lawsuit filed in May, scores of ex-players were fed pain pills by team doctors and trainers—the pills were “handed out to us like candy,” in the words of one retired lineman—and pressured to soldier on despite severe injuries. One of the named plaintiffs (there are more than five hundred in all), former Pro Bowl quarterback Jim McMahon, claims he incurred a broken neck and ankle during his career, never received proper diagnoses, and played through both. Like other former players, McMahon wound up addicted to painkillers, and now suffers from the early stages of dementia.
We worship players for bravery and excoriate them for vulnerability because we wish to see masculine ideals on display. But I think here also of Cicero, who speculated that the loathing for timid gladiators wasn’t a function of their diminished entertainment value but the fact that they forced spectators to confront the profound heartlessness of the games.
If you want to know what the current state of the research is on NFL players and brain damage, one of the best people on earth to consult is Dr. Ann McKee, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University and chief neuropathologist for the National Veterans Affairs ALS Brain Bank in Bedford, MA. McKee is the person who cuts up the brains of former players and determines if they have CTE. Because so many brains have been coming in recently, and because (as her titles suggest) she is a very busy person, she is perpetually “about thirty brains behind.”
