On February 17, 2011, former Chicago Bears safety Dave Duerson, one of my childhood heroes, shot himself in the chest. In a text message to family, he strongly implied that he committed suicide in this way in order to preserve his brain for research into the long-term effects of traumatic brain injury. In May of the following year, legendary linebacker Junior Seau did the same. Both Duerson and Seau were found to suffer from chronic traumatic encephalopathy, a progressive brain disease found in some athletes who have suffered repetitive brain trauma. Of course, brain damage is not unique to professional athletes; it can affect any of the 1.2 million high school students who play football each year (such as Kort Breckenridge).
In a book to be published tomorrow, two veteran investigative journalists detail not only how the National Football League failed its players, but also how it downplayed and covered up evidence of the long-term health consequences of blows to the head. Accompanying the book is a PBS Frontline documentary that will air Tuesday night. The authors have released excerpts of the book and are speaking publicly about its contents. Among the more interesting tidbits to emerge thus far:
The NFL over-relied on unqualified “experts” and insiders. The chairman of the first NFL committee convened in 1995 to study the issue – Elliott Pellman – had not once published a scientific paper on concussions or brain injuries. He was, in fact, a rheumatologist who eventually served as former Commissioner Paul Tagliabue’s personal physician and who had told Sports Illustrated in 1994 that concussions were unavoidable in football, simply an “occupational risk.” Nearly half of the committee members were the very team doctors that for years had been sending players with concussions back into the game. One member was an equipment manager. Some committee members eventually distanced themselves from the committee’s findings.
The NFL attacked scientists whose research was demonstrating the consequences of repeated head trauma, and misused the scientific journal Neurosurgery to create its own false scientific narrative. The book authors write that when presented with this research, the league “used its economic, political and media power to attack pioneering research and try to replace it with its own”:
For years, the NFL would co-opt an influential medical journal whose editor-in-chief was a consultant to the New York Giants. The league used that journal, which some researchers would come to ridicule as the “Journal of No NFL Concussions,” to publish an unprecedented series of papers, several of which were rejected by peer reviewers and editors and later disavowed even by some of their own authors. The papers portrayed NFL players as superhuman and impervious to brain damage. They included such eye-popping assertions as “Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.”
The NFL’s committee had cherry-picked data. The first two papers published in Neurosurgery by the committee were well-received. But the third, fourth, and fifth ones were not (the fourth paper in particular was published despite significant concerns during peer-review). Bill Barr, a former New York Jets neuropsychologist, believes that the committee—which was named the Mild Traumatic Brain Injury Committee, perhaps foreshadowing its conclusions—had chosen data that would suggest that concussions did not have significant impact, ignoring other data that showed the opposite. According to Barr, the researchers knew that additional baseline data had been collected, but didn’t ask for it. Speaking at a 2007 meeting convened by NFL Commissioner Roger Goodell, Barr pointed out the flaws in the original research:
“I said that the data collection is all biased,” Barr said. “And I showed slides of that. Basically I pointed out that we had been obtaining baselines on players for 10 years, and when you look at the study it only included a small amount of data. My calculations were that their published studies only included 15 percent of the available data. Let’s put it this way: There were nearly 5,000 baseline studies that had been obtained in that 10-year period. And only 655 were published in the study.”
When faced with evidence of brain damage, the NFL denied the research and called for future studies. At the 2007 meeting, top neurosurgeon Julian Bailes of the Northshore Neurological Institute presented images of chronic traumatic encephalopathy that was almost certainly caused by repeated blows to the head. Ira Casson, the new head of the NFL’s Mild Traumatic Brain Injury committee, rolled his eyes. The league said it would do its own study. “You have to look at their entire medical history,” said Commissioner Goodell. “To look at something that is isolated without looking at their entire medical history I think is irresponsible.”
Two years later, when presented with additional research at a meeting by Boston University’s Ann McKee, Dr. Casson was equally dismissive. “He was …at times mocking,” said Colonel Michael Jaffee, the national director of the Defense and Veterans Brain Injury Center, who was at the meeting. “I didn’t think [Casson] was really making an honest assessment of the evidence.”
Companies subsequently misled the public on what the science said about the safety of children’s football helmets. At the request of Senator Tom Udall (D-NM), the Federal Trade Commission found that helmet manufacturer Riddell falsely represented that one of its products intended for high school football players reduced concussions by 31 percent. The claim was derived from a faulty study in the journal Neurosurgery. The threat of helmet regulation inspired Riddell to spend tens of thousands of dollars on lobbying in Washington, DC.
The NFL tried to silence those who wanted to tell the story. After pressure from the NFL on the Walt Disney Company (which owns ESPN and ABC and a whole lot more) regarding the editorial direction of the documentary project, ESPN pulled out less than two months before the special was to air. ESPN has broadcast rights to many NFL games, leading some to suggest that the journalistic side of ESPN had been influenced by the financial side. It doesn’t seem that the final product will be any different, but the pressure from the NFL and the subsequent withdrawal is still troubling.
Science Leads to Informed Decisions
So what is the takeaway? The consequences of these actions are significant, not only for the affected players and their families but also for the millions of parents and coaches who face decisions about what risks children should take. Can we develop helmet technology and best medical practices that make football safe(r)? Should my own kids play football some day? The NFL’s actions to limit knowledge about the impact of collisions make these actions and decisions considerably more difficult.
This isn’t unique to football. When the information we receive is incomplete or misleading, we can’t make fully informed decisions about the risks of various activities. Science can help make many of our daily decisions better—from the chemicals we use to clean our houses to the food we eat to the safety devices we want in our cars. When science is squelched or misrepresented, we don’t bring all of our cards to the table.
And that’s but one reason why we should continue to fight to protect the integrity of science.
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