Category Archives: News Analysis

NFL Deaths Reflect Inept Care and Record-Keeping

Since 1960 at least 16 NFL players have died of injury, a game-related condition or a possible link to football, impacted by inadequate medical management. Meanwhile, “public football” stokes a hot Q&A with Irv Muchnick, the iconoclastic sports journalist whose new book chronicles fall of the game as we know it.

By Matt Chaney

Posted Saturday, February 28, 2015

Copyright ©2015 by Matthew L. Chaney

In 1960 America, a football player was not only exposed to lethal injury and illness of the extreme sport. Once a casualty, he was vulnerable to shoddy medical response as well, beginning in professional football.

A worst-case scenario unfolded October 9th in the new American Football League, amid a sweltering Sunday on the Texas seaboard, where the Houston Oilers hosted the New York Titans—the NFL’s Tennessee Titans and New York Jets franchises today, respectively.

Air temperature topped 90 degrees with dense humidity for the 1 p.m. kickoff at Jeppesen Stadium, and early in the game Howard Glenn, an offensive guard for New York, was struggling to stay on his feet.

Teammates thought heat was affecting Glenn in the first quarter, when he complained repeatedly in huddles. Titans offensive tackle Ernie Barnes urged Glenn to stay in the game since coaches wouldn’t allow him to stop and sit. Team trainers would support the coaches, Barnes reminded his buddy, and no doctor made the road trip from New York.

Collisions on the field were viscous, meanwhile. Football’s head-on contact had steadily increased since advent of hard plastic helmets during World War II. Face bars became standard by the mid-1950s, when physics, technology and human will converged to make head bashing commonplace in the game.

In 1960, Howard Glenn donned a double-barred face mask on his helmet. The muscular 6-foot-2, 245-pounder fired low into foes at scrimmage, neck forward and face-first—in the law of modern football—and sometime around halftime at Houston, two opposing linemen smashed Glenn between them.

Clearly injured, Glenn rose unsteadily. No stretcher was available on the Titans sideline so a teammate helped him off the field, but head coach Sammy Baugh ordered Glenn back to the huddle, witnesses later told The Houston Chronicle.

Accounts vary whether Glenn played in the second half, which he basically spent on the sideline. A spectator recalled seeing Glenn wandering near the Titans bench in a daze, unattended.

No one realized Glenn’s neck was broken, with a fractured cervical vertebra just below his brain.

Trainers helped Glenn to the locker room after the game. He undressed and sat nude on a metal folding chair, clutching a towel and quivering in labored breaths. A teammate, Art Powell, yelled at the trainers: “Why in hell don’t you get a doctor to him?”

Glenn deteriorated rapidly. The Associated Press would report he became “belligerent in the clubhouse then hysterical” as he fell from the chair, convulsing.

Two Houston doctors were summoned and Glenn was finally taken to a local hospital at 5:30 p.m., while rest of the New York team headed for the airport.

Within an hour Titans players learned Glenn had died, as their plane sat on a runway, and tackle Ernie Barnes wept in his seat. The two young black men had bonded as friends in Glenn’s short time with the team, especially for art, a mutual love. Now Barnes remembered their final scene together: Glenn stricken on the locker room floor as teammates rushed out from showers, dripping wet.

“The news shook my heart,” Barnes later wrote. “The hurt deepened and all I could see in my mind was Glenn’s body lying in the water on the cement floor. He died a lonely death. It took time and reasoning for me to get over Howard’s death… it enters my mind often.”

Authorities were perplexed for Howard Glenn’s case, initially. According to a Houston team doctor “Glenn wasn’t hurt in the game or… his injuries were not serious enough to be noticed,” reported The AP.

Some Titans officials readily discounted football as a factor, speaking with media that first night, and many observers believed heatstroke caused the fatality, Barnes among them.

But the next day an autopsy revealed Glenn’s neck had crumbled apart in the hours after injury, primarily because Titans staff failed to recognize or diagnose. Harris County medical examiner Dr. Joseph Jachimczyk said “the fracture was very near Glenn’s brain and did happen during Sunday’s game,” reported The AP. “He said death was not instantaneous because the edges of the fractured bone had to cut the spinal cord before death occurred.”

Jachimczyk remarked, “The unusual thing about these cases is not the quickness of death but that the victims even live at all.”

Glenn was buried at Louisville Cemetery in Mississippi, his native Winton County. Besides AFL experience, Glenn played for the New York Giants of the NFL and the Hamilton Tiger Cats in the CFL. Earlier, at Linfield College in Oregon, Glenn starred in football and track and field.

Following the tragedy, Barnes requested his release from Titans brass. “I told them I didn’t want to play on a team like this,” he said. Barnes retired from professional football in 1965 and his career as an artist blossomed; he died in 2009.

Contemporary blogger Bill McCurdy concluded that Glenn in 1960 was “a victim of the times and what can happen to those who play football under the worst of circumstances—or even the best of conditions.”

*******

In American football today, detection and treatment of heartbeat arrhythmias and more cardiac malfunctions in young players remain inadequate, most experts agree. But football was primitive about managing cardiac risk during the Vietnam War era.

The NFL was no exception for lax action despite exploding revenues and expanding resources over TV rights and its merger with the former AFL. No uniform policy for cardiac management existed, basically.

League and franchise officials certainly knew young athletes suffered “heart attack,” in the catch-all term. Medical literature was plentiful by 1970 while sports pages and television reported cardiac incidents from multiple activities, regularly, led by basketball and football. Historically, two NFL players had died after games, Stan Mauldin and Dave Sparks, in the decade following World War II.

Moreover, the Detroit Lions had experienced recent cardiac fatalities off the field. Promising Lions tackle Lucien Reeberg, 21, died in the 1964 offseason [see below] while free-agent line prospect Ed Schreck, 23, was briefly under contract before he succumbed during heart surgery in 1968.

Yet the Detroit franchise stood unprepared for a third event, in 1971, and this time on national television. Chuck Hughes, 28, a 6-foot, 180-pound wide receiver for the Lions, was naturally gifted to catch a football. But a genetic heart defect stopped the blonde Texan on Oct. 24, apparently triggered by physical exertion.

Nearing end of the Sunday NFL telecast, Chicago at Detroit, Hughes dropped face-down after a pass pattern, “twitching uncontrollably,” a witness said, as a crowed of 54,419 “silently watched.”

Television viewers were horrified. “They turned the TV cameras on him [Hughes] for us until the spirit left him,” Barnard Collier would write for Esquire magazine, “and then they turned away.”

Time was precious for Hughes but Lions doctors had to be waved onto the field, by Bears linebacker Dick Butkus, because of a silly league rule. Then they could only roll Hughes over, pound his chest and deliver mouth-to-mouth resuscitation, unsure about his distress. An off-duty anesthesiologist charged out of the stands, like he could help.

While the Lions had prepared meticulously for playing the Bears, down to practicing Sudden change! for a turnover, no medical procedure was in place for sudden cardiac collapse of a player.

The impromptu treatment of Hughes was crude, futile, pathetic. Apparently there was no electronic defibrillator machine, state-of-art treatment for cardiac victims, on the premises at Tiger Stadium.

The football player was dying, his wife Sharon realized from the stands, and she began screaming. “After what seemed forever, Hughes was placed on a stretcher,” spectator Richard Bak later recalled.

An ambulance came onto the field and Sharon Hughes was summoned from the stands for ride to the hospital. But with everyone loaded, ambulance drivers groped for the misplaced ignition key. At this point Sharon figured it was too late for her husband.

“She stared at what the doctors were doing and she watched as Chuck’s ear turned slowly black and blue,” Collier recounted for Esquire. “Now she knew that Chuck was beyond reviving. After that, time slowed so much that hurrying did not matter. She kept thinking about their marriage and how much Chuck was in love with football.”

At the hospital, defibrillator shocks were administered but no heartbeat restored. Machines kept Hughes alive until he was pronounced dead at 4:41 p.m., an hour after the Lions game ended.

Team doctors still couldn’t pinpoint cause of death, whether it occurred at the heart or brain. “I’ve never seen anything like it in professional football,” said Dr. Edwin Guise, Lions physician.

Franchise owner William Clay Ford expressed bafflement. “I’m horrified and shocked. He [Hughes] was a great player and a great person,” Ford said.

An autopsy confirmed hardened arteries caused the coronary malfunction in Hughes, who had family history of heart disease.

In fact, Hughes had been tested for heart trouble months before his death, by cardio specialists at Henry Ford Hospital. Hughes was hospitalized again for chest pains in the preseason, after being crushed by tacklers in an exhibition game, but tests were negative and he returned to the football field.

Sharon Hughes, widowed with a toddler son, ultimately won a settlement of undisclosed amount from Ford Hospital. Her lawsuit against the facility and unnamed doctors alleged a heart problem had been detected but “they willfully and wantonly” failed to inform Chuck.

“The defendants well knew that Hughes was a professional athlete and as such was required to engage in strenuous physical activity not advisable for one who had suffered heart damage,” the complaint stated.

Sharon Hughes also won a $43,250 claim for workman’s compensation. Insurance representatives of the Lions, bound to indemnify the franchise for court losses and costs, had argued the death of her husband was unrelated to football.

*******

From 1960 to 2010, at least 16 active or contracted NFL players died of a) football injuries, b) game-related conditions or c) possible link to the sport.

The annotated cases below are deaths of those players in the NFL and former AFL, collected in my ongoing review of news reports on casualties in football history. The incidents are harvested largely through electronic search of news databases.

I make no medical claim of the information and little for its scientific value. This qualifies as raw data, news content, comprising case leads in need of expert follow-up by multi-disciplinary specialists of medicine and science, particularly for establishing or dismissing a football link in the majority of incidents.

No qualified epidemiological team has ever been assembled and funded to reliably assess fatality rates of vast American football—none—despite a purported entity at the University of North Carolina, the so-called National Center for Catastrophic Sports Injury Research,  funded by the American Football Coaches Association, the National Collegiate Athletic Association, the National Federation of State High School Associations, and the National Athletic Trainers’ Association.

The NCCSIR has no facility of street address on campus. Officials have declined to answer my email queries since 2011.

Presently, 8 of 16 NFL cases below are omitted from “total” football statistics self-published by the sports academics representing UNC in Chapel Hill. None of the cases involves cancer, drug overdose or suicide. Likely some omitted cases can be verified as game-related, still, by credible researchers. Others probably cannot be accurately assessed for a football link, either way.

Deaths of NFL and AFL players in the last 55 years include the following cases available in news reports:

1960: Howard Glenn, 26, a 6-foot-2, 245-pound offensive guard for the New York Titans, of the AFL, died on Oct. 9 of a broken neck sustained in a game with the Houston Oilers. [See story above.]

1960: Ralph Anderson, 24, a 6-4, 225-pound wide receiver for the San Diego Chargers, was a rising star in pro football and subject of a “tampering” lawsuit against his AFL team by the Chicago franchise of the NFL. But the talented athlete was diabetic, challenged to stay in the lineup, and in early November he missed a Chargers game. Anderson came back with big performances but was stricken again as he lay down on Friday night, Nov. 25. Anderson was found dead the next morning, and an autopsy ruled diabetic seizure as the cause. The athlete was survived by a 3-year-old daughter, and when the Chargers later played in the AFL championship game, the team voted that Anderson’s share of player proceeds be presented to his girl. Head coach Sid Gillman also gave his share to the child. Sources: Associated Press and United Press International.

*The death of Ralph Anderson was either missed or deemed unrelated to football by game-funded reviewers. His case is not included in 1960 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

1961: John Sherer, 20, a 6-3, 240-pound defensive tackle on the inactive list of the New York Titans, had foregone college football at the University of Miami after being drafted by the AFL. Sherer was a schoolboy legend in his native Pennsylvania, where he led a team of prep all-stars to victory over a squad of standouts from other states. Sherer barely missed making 1961 Titans roster, cut on the last day in training camp, so he played semipro football in hopes of getting a call from New York during the season. But on Sept. 26 Sherer collapsed and died following a gym workout in Philadelphia, of a reported heart malfunction. Sources: New Castle News and Associated Press.

1963: Stone Johnson, 23, a 6-1, 180-pound running back for the Kansas City Chiefs, AFL, was touted as one of the fastest men in pro football. Johnson had been a sprinter for the U.S. Olympic team in Rome and a football player for Grambling College. He left college football after being drafted by the AFL, but he suffered a broken neck as a Chiefs rookie, trying to tackle in an exhibition game against the Houston Oilers on Aug. 31. Emergency surgery stabilized fracture of the C5 vertebra and Johnson was placed in traction, but the spinal-cord nerve bundle was damaged and he died on Sept. 8. Some in football alluded to individual fault for the tragedy. Game officials were touting “head up technique,” their new theory for headless hitting, and the Football Coaches Association’s anointed death researcher chimed in, Floyd R. Eastwood. As a PE professor who went by “Dr. Eastwood” with the press, this college teacher held only a PhD in education, far short of a medical or science doctorate and follow-up certifications. Nevertheless, Eastwood routinely promoted untested concepts for casualty prevention in football—parroted widely by sportswriters—that placed responsibility primarily on individuals, not the system. Following Johnson’s death in 1963, Eastwood said “degree of skill” could dictate mortality of a football player, without mentioning the field physics of forward colliding in shatterproof headgear and pads. “Most injuries are sustained while blocking or tackling and if more players were trained properly in these respects, fatalities would take a sharp decline,” Eastwood declared. Sources: Associated Press and United Press International.

1964: Lucien Reeberg Jr., 21, a 6-4, 300-plus offensive tackle for the Detroit Lions, NFL, was a rising star publicized as the “baby-faced giant” of pro football. But Reeberg was unhealthy, ballooning as high as 317 pounds. Hospitalized in Detroit, Reeberg died of cardiac arrest caused by chronic kidney disease on Jan. 31, 1964. Reportedly the Lions had wanted Reeberg evaluated for weight loss when he mentioned blood in his urine to a nurse. Team physician Dr. Richard Thompson said, “The disease [uremia] will crop up one day and not the next, and as a result of this, the young people tend to ignore the disease.” Reeberg, a native of Bronx, N.Y., had played college football for Hampton Institute, which he left after being drafted by the NFL. In 2011, blogger Bill Dow interviewed Reeberg’s old roommate, former Lions linebacker Ernie Clark. “Lucien was Christmas morning,” said Clark. “I think about him all the time, and after he passed away my heart really wasn’t into football and I’ve never been the same.” Sources: Jet magazine, Blog.DetroitAthletic.com, Newspaper Enterprise Association, Associated Press and United Press International.

*The death of Lucien Reeberg was either missed or deemed unrelated to football by game-funded academics. His case is not included in 1964 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

1965: Mack Lee Hill, 25, a 5-11, 235-pound running back for the Kansas City Chiefs, averaged 5.2 yards a carry over two seasons in the AFL. Nicknamed “The Truck,” Hill suffered torn knee ligaments in a game and underwent surgery on Dec. 14. Complications developed, spiking Hill’s temperature to 108 degrees and causing respiratory distress and convulsions. Hill died on the operating table of a pulmonary embolism, blood clotting blocking lung circulation, attending doctors told the AP. But differing expert opinion followed, regarding a football link or none, as in hundreds of player deaths since the 1960s. The Kansas City Star reported that an autopsy by hospital pathologist Dr. O. Dale Smith involved “interesting speculation” to blame a rare form of heatstroke unrelated to football. Smith noted further research was needed, but he concluded “that the very strength of young Hill, especially his powerful musculature, contributed to his vulnerability to a temperature crisis in his body” during anesthetic and surgical stress, The Star reported. Football-funded analysts like Eastwood, however, apparently classified the Hill case as game-related of “indirect” cause.

1969: Frank Buncom Jr., 29, a 6-2, 235-pound linebacker for the Cincinnati Bengals, was a three-time all-star in the AFL and looking forward to the new season. Then blood clotting lodged in his lung arteries early on Sept. 14, Sunday morning of the opening game. Buncom’s gasping rousted his roommate in the team hotel, but the athlete died before medical help arrived. The linebacker and his wife Sarah had an infant son, Frank Buncom III, and an education trust fund for the child was established by players of the Bengals and the San Diego Chargers, Buncom’s former team. Decades later, 2015, the late AFL star’s grandson, Frank Buncom IV, committed to play college football for Stanford University. Sources: UTSanDiego.com, Associated Press and United Press International.

1971: Charles “Chuck” Hughes, 28, a 6-foot, 180-pound wide receiver for the Detroit Lions, died of a coronary attack suffered during a game against the Chicago Bears on Oct. 24. [See account above.]

1979: James Victor “J.V.” Cain, 28, a 6-4, 225-pound tight end for the St. Louis Cardinals, was “a perfect physical specimen” who passed a preseason physical “in great shape,” reported The Associated Press. But Cain collapsed in humid 85-degree weather the night of July 22, after running a pass pattern without contact at training camp in St. Charles, Mo. Team doctors and trainers administered cardiopulmonary resuscitation to Cain, working without a defibrillator machine. “When [75 players] saw that CPR was started, it just got dead silent,” said Cards spokesman Steve Curran. “At one point, Coach [Bud] Wilkinson had the players on a line in prayer. They kept yelling, ‘Come on, J.V., come on, J.V.’ There were tears. It was very emotional.” Cain, a 6-year team veteran, was pronounced dead at a local hospital 90 minutes after he was stricken on the football field. A pathologist concluded the cause of death was cardiac arrest from an “extremely rare congenital condition” known as myocardial fibrosis. Sources: Associated Press, United Press International and Washington Post.

*The death of J.V. Cain was either missed or deemed unrelated to football by game-funded academics. His case is not included in 1979 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

1980: Melvin Johnson Jr., 25, a 6-foot, 175-pound running back for the Kansas City Chiefs was an undrafted prospect the team had a penchant for signing and developing, like Mack Lee Hill before. Unfortunately, Johnson ended up mindful of the Hill tragedy [above] when he too died during routine surgery in Kansas City, in his case for a wrist fracture of football. Surgeon Dr. James Whitaker said cardiac arrest caused the death. Johnson had ranked among the nation’s fastest teenagers during high school in Louisiana, and he played college football for the University of Colorado. The Chiefs signed Johnson as a free agent in 1979 but he spent the season on the disabled list, never appearing in an NFL game. “We had very high hopes for him,” said Chiefs spokesman Doug Kelly. “He had good ability and a great deal of speed. We thought his chances of making the team [in 1980] were very good.” The deceased athlete’s younger brother, Troy Johnson, later played four seasons in the NFL. Sources: United Press International, Salina Journal, Thibodaux Daily Comet and HoumaToday.com.

*The death of Melvin Johnson Jr. was either missed or deemed unrelated to football by game-funded academics. His case is not included in 1980 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

1983: Larry Gordon, 28, a 6-4, 230-pound linebacker for the Miami Dolphins, was a highly regarded player who helped lead his teams to playoff victories and a Super Bowl, flashing brilliance throughout his seven-year career. Dolphins coach Don Shula still expected greatness from Gordon, his former No.1 draft pick from Arizona State gifted in athleticism and physique. On June 25, amid desert heat at 6 p.m., Gordon was jogging in preparation for upcoming NFL training camp when he collapsed near a relative’s home in Arizona, said police. Gordon, a Florida resident married with two children, was pronounced dead at a Phoenix hospital. An autopsy by medical examiner Dr. Heinz Karnitschnig identified the cause as congenital heart disease, idiopathic cardiomyopathy. “His coronary artery was in perfect shape. He didn’t have a heart attack,” said Bob Edwards, of the Maricopa County morgue. Toxicology exams found no drugs in the body; specifically, no cocaine was detected in a gall bladder sample. In 1986, as cocaine toxicity killed athletes in the NCAA and NFL, the question arose publicly regarding Gordon’s case. His brother Ira Gordon, a Phoenix drug counselor and former NFL player, told The Arizona Republic that evidence of cocaine use was found in a bedroom that Larry occupied at time of his death. Ira said he had personally requested the autopsy and toxicology assays that tested negative for narcotics. Sources: Arizona Republic, Miami Herald, Associated Press and United Press International.

*The death of Larry Gordon was either missed or deemed unrelated to football by game-funded reviewers. His case is not included in 1983 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

1998: Leon Bender, 22, a 6-5, 300-pound draft pick at defensive tackle for the Oakland Raiders, suffered fatal mishap at his agent’s home in Atlanta on May 30, following team mini camp. An epileptic, Bender died on a bathroom floor at some point before a scheduled workout. Autopsy results were inconclusive while toxicology results were negative for drugs and alcohol. Bender had talked on the phone to family members until 3 a.m., including his wife Liza, before being discovered dead about noon. Bender’s epilepsy wasn’t lethal in itself, and a single episode couldn’t be detected postmortem—neither could some forms of cardiac malfunction. What was known, a grand mal epileptic had no body control in a seizure, which Bender’s family members believed he experienced in the bathroom then suffocated for his landing position and obstructions. Leon and Liza Bender had a 2-year-old daughter at time of his passing. Source: Associated Press.

*The death of Leon Bender was either missed or deemed unrelated to football by game-funded academics. His case is not included in 1998 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

2001: Korey Stringer, 27, a 6-4, 335-pound offensive tackle for the Minnesota Vikings, reported to training camp as an All-Pro from the previous season. Oppressive heat enveloped most of the country as the Vikings opened workouts on Aug. 1 in Mankato, Minn. Several players struggled through drills and Stringer faltered and vomited, having to sit out. Next morning, Stringer was back on the field in full pads until collapsing amid 98-degree temperature and stifling humidity. By the time Stringer was transported to a hospital he was comatose with a body temperature of 108 degrees. Organs began failing, including both kidneys, until finally the heartbeat stopped, unable to be revived. Stringer was pronounced dead about 2 a.m. on Aug. 3, and public debate erupted. Vikings coaches met with media while Stringer’s teammates were kept off-limits for interviews. Head coach Dennis Green suggested the players preferred public silence. “It’s a private thing and they deserve their privacy,” said Green, who snapped at a reporter for questioning whether team medical personnel should be available. “We chose not to,” Green replied. “I’m not going to discuss that… so you can step back.” Offensive line coach Mike Tice said a newspaper photo spurred the tragedy, not decisions of the coaching staff, by shaming Stringer when camp opened, picturing him doubled over at the sideline, looking weak. So the prideful Stringer came back the next day “out to prove to people that he was a leader and that he wasn’t going to let anybody embarrass him like that,” Tice said. “It’s very unfortunate that he worked himself to death.” Elsewhere, football’s anointed death researcher, exercise professor Fred Mueller at UNC, withheld blame of Vikings staff when pressed on CNN by news anchor Carol Lin. “I just heard about this… I don’t really know any of the details,” said Mueller, demurring as the so-called expert who’d agreed to discuss the case on international television. Despite heavy evidence of heatstroke and negligence on part of the football system, “Dr. Mueller”—funded by football organs, with his PhD in education—speculated about the individual, Stringer, saying “there’s a possibility it could be attributed to some other health problems.” But Mueller would have to include this highly publicized death in his next “study” from Chapel Hill. Postmortem investigation including autopsy left no question that heatstroke killed Stringer, driven by lack of policy and prevention on part of the Vikings and NFL. Heat illness plagued every football level, contributing to deaths of an arena player, college player and a high-school player the same week as Stringer, and critics assailed the sport. Football officials had promised since 1960 to eliminate heat illness that experts declared was completely preventable—but practices and games had only come to start earlier in hot weather, over decades, and necessary measures weren’t standardized such as sideline ice bath in a kiddie pool. In August 2011, Kelci Stringer settled her final lawsuit against parties found culpable of her husband’s death, including the NFL and helmet maker Riddell. That same summer at least seven high-school football players and one coach collapsed and died from July 22nd to September 1st.  Lawsuits followed, targeting schools and personnel for wrongful death of football heatstroke—a decade after Korey Stringer in the NFL. Sources: St. Paul Pioneer Press, New York Post, Associated Press, CNN, CBS News, ESPN.Go.com., Carlisle Sentinel, Reading Eagle, South Florida Sun-Sentinel, WSVN-TV, Miami Herald, Florence Morning News, Rivals.Yahoo.com, KDAF-TV, WTEV-TV, Atlanta Journal-Constitution, WSB-TV, WXIA-TV, Arkansas Democrat-Gazette, KLRT-TV, KRIV-TV, ABC News and Dallas Morning News.

2005: Thomas Herrion, 23, a 6-3, 315-pound offensive lineman for the San Francisco 49ers, collapsed and died on Aug. 20 following a night exhibition game amid cool weather at Denver. An autopsy determined ischemic heart disease caused the death, blockage of a coronary artery. Greg Aiello, NFL spokesman, said Herrion “may be a case of an unfortunate hereditary condition that is not easily detected, even by the regular and thorough cardiac screening used by NFL clubs.” Herrion was clinically obese by criteria of the Body Mass Index, like a horde of NFL athletes, and controversy flared again over his death. So league officials changed their story regarding the plethora of 300-pound players, upwards of 500 behemoths in training camps every year, compared to less than 10 on record prior to 1970.  Earlier in 2005, year of PED hearings in Washington, NFL commissioner Paul Tagliabue and cohorts told Congress the herd of mammoths wasn’t because of widespread doping, drugs like anabolic steroids and synthetic growth hormone, but for a modern wave of “fat” athletes. They told politicians like senators John McCain and Henry Waxman that drug abuse producing artificial specimens in the NFL was an epidemic of the past resolved by “steroid testing.” Pot-bellied players had taken over, said league and union officials. But their excuse flip-flopped months later, when media criticized obesity in the league that impacted health of Herrion, as chronicled in my book, Spiral of Denial: Muscle Doping in American Football: “Now officials contended the NFL primarily featured muscled specimens with low body fat, so the league could argue BMI standards were an invalid application for its athletes. League medical liaison Dr. Elliot Pellman said the question of obesity among players still had to be answered by research. The league was commissioning its own studies. ‘There’s a 1-in-200,000 chance that an individual the age of Mr. Herrion will suffer a sudden death,’ Pellman said. ‘It happens, and no one knows why it happens.’ Pellman said obesity was a cultural problem, not football’s. Officials dismissed a study, based on the BMI, that concluded virtually all NFL players were overweight or obese. Bears nutritionist Julie Burns said NFL players were abnormally muscular humans. Taglibue said, ‘We have athletes that are fitter than most people in society, bigger than most people in society, and doing things that are different and more demanding than many people in society.’ PEDs, meanwhile, did not apply. ‘Huh?’ remarked Sam Donnellon, the Philadelphia Daily News, on mixed messages from the league.” Additional sources: Contra Costa Times, Associated Press, NBC News and CBS News.

2007: Damien Nash, 24, a 5-10, 220-pound running back for the Denver Broncos, knew well about cardiac disease. Nash’s close older brother, Darris, 25, had a heart transplant for dilated cardiomyopathy, discovered for his cardiac episode while playing basketball. So Damien, training during the offseason at home in St. Louis, hosted a local fundraiser for the Darris Nash Find A Heart Foundation. Damien played a portion of the charity basketball game featuring his NFL and college friends then greeted people in the crowd. Festivities moved to Nash’s home in Ferguson, Mo., but he suddenly collapsed. Damien Nash was pronounced dead at a hospital, and initial autopsy results were inconclusive. Family members suspected a cardiac problem, but cardiomyopathy like his brother’s normally wasn’t genetic, said doctors. Such damage likely would have emerged already in Damien, for his life and job in elite athletics. And he passed several heart screens by NFL teams that his agent trusted as thorough. Damien did not drink nor use drugs, said family members, and toxicology results came back negative. Cause of death remained “undetermined” in the final report, issued by the St. Louis County Medical Examiner’s Office. “It was a natural death of cardiac origin,” said a spokesman, “but we were unable to determine an exact origin.” Nash and his wife, Judy, had a 7-month-old daughter at time of his death. Sources: Associated Press, Denver Post and NPR.org.

*The death of Damien Nash was either missed or deemed unrelated to football by game-funded academics. His case is not included in 2007 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

2010: Gaines Adams, 26, a 6-5, 258-pound defensive end for the Chicago Bears, was an athletic specimen who had been drafted No.1, fourth overall in his college class, by Tampa Bay. Traded to Chicago midway through the 2009 season with 13.5 career sacks, Adams wore the label of “bust” but kept potential intact, like a 4.55-second speed in the 40, with no serious injuries or apparent heath issues. But weeks following season’s end, on Sunday morning, Jan. 17, 2010, Adams collapsed at home in Greenwood, S.C., and was pronounced dead at a local hospital. Autopsy found that cardiac arrest of an enlarged heart killed the athlete, who had no such family history. Relatives and friends were shocked. “I am honored to have been able to know [Gaines Adams] and to have been his teammate,” said Bucs center Jeff Faine. “A truly bright soul.” Sources: Sarasota Herald Tribune, St. Petersburg Times, Associated Press and ESPN.com.

*The death of Gaines Adams was either missed or deemed unrelated to football by game-funded academics. His case is not included in 2010 football fatality data posted without scientific vetting on a website from UNC-Chapel Hill.

*******

Football’s on-field tragedies of Howard Glenn, in 1960 at Houston, and Chuck Hughes, 1971 at Detroit, framed the period’s dangerously inferior medical planning and response for players of all ages.

During the Vietnam War era, America’s sparse emergency-care system led to more football deaths than any other factor, according to my review of severe casualties appearing in news. I’ve collected thousands of fatality and survivor cases, including about 350 player deaths from the 1960s and about 275 from the 1970s.

The subsequent reduction of football fatalities isn’t measurable in close terms, much less absolute numbers, say independent experts. Undoubtedly, however, the trend is due primarily to society’s widespread establishment of EMT crews, modular ambulances, life flights, emergency rooms and trauma surgery.

Within the game, the NFL has improved its own medical management—but not to the point of effecting “safer football” like officials claim today.

“Anyone with two eyes on a Sunday afternoon [in season] can see that’s not so,” said Irv Muchnick, the investigative journalist and independent blogger with cunning for exposing dark underbellies of sport-entertainment conglomerates.

Muchnick thoroughly dissects football ugliness, amid contemporary crisis for the game over brain injuries. He focuses on ill-resourced outback levels below the NFL, particularly the public schools and municipal “youth” leagues with millions of juveniles colliding in helmets and pads. Many American kids play tackle football on public property before they enter first grade, while they cannot legally drive a car until age 16 nor buy cigarettes until an adult.

Change looms, as Irv Muchnick chronicles in his new book, Concussion Inc.: The End of Football As We Know It, published by ECW Press of Canada. In an email Q&A for ChaneysBlog, Muchnick addresses football problems and more, notably his current co-investigation, with independent journalist Tim Joyce, of sexual assault in U.S. Swimming:

Q1. Discuss your new book, the circumstances drawing you into the football issues by 2010.

Basically, it went like this: In late 2009 my book on the Chris Benoit murder-suicide came out. The book immediately got inserted into the 2010 U.S. Senate race in Connecticut between Democrat Richard Blumental and Republican Linda McMahon. Blumenthal is a liar who claimed military service “in Vietnam,” when in fact he had a cushy stateside Reserves stint during Vietnam. McMahon is the wife of Vince McMahon and the former CEO of WWE. She poured $50 million of their wealth from this publicly traded company into the failed race against Blumental, and $50 million more into another failed Senate race two years later, against Chris Murphy. Such sterling choices in our democracy!

Alerted by the fine early work on football by Alan Schwarz in The New York Times, and aware that I had a unique perspective on and reportorial resources for the concussion crisis story, I waded in, and by late 2010 I had “rebranded” my blog, naming it Concussion Inc. I answered only to a crazy boss: me.

Benoit had been the first CTE study announced in 2007 by Chris Nowinski’s Sports Legacy Institute and Center for the Study of CTE in Boston. (The Benoit study was done by Bennet Omalu — now coming to the silver screen, but back then being written out of the story not just by the NFL but also by Schwarz, Nowinski, and Cantu, the Northeast Gold Dust Trio.) Chris Benoit’s father and now my good friend, Mike Benoit, had insisted throughout my research for Chris & Nancy that I was underplaying brain disease and overplaying drugs and other generic explanations for his family’s tragedy, and I came to see how right he was.

From there, all the connections flowed—principally Dr. Joe Maroon of UPMC … and WWE, and the NFL, and anti-aging huckerism, and the goofy hype for resveratrol supplements, and his proximity (at minimum) to the steroid/HGH abuse on the multiple-champion Steelers.

There was no major publisher market for the book I was writing, so like the late Red Smith, I undertook my “daily spelling lesson” at what I jokingly call ConcussionInc.net LLP. The topics and the obsessions were spontaneous responses to the news of 2010-11-12. My main narrative interest was in exposing the interlocking ecosystem of problems and commercial “solutions.” I hope that readers come away convinced that safe tackling, better helmets, better mousetraps are the filtered cigarettes of the 21st century. I credit a little-known fellow native Missouri writer by the name of Chaney with a game-changing insight on how state “concussion awareness” laws are not just bullshit, but jiu-jitsu bullshit— magically creating new private profit centers from the public trough, principally our public high schools.

Along the way, I jousted a couple of times with Bob Costas, an acquaintance-friend from the St. Louis sports mafia. The book collects and reorganizes all this material the way books are supposed to do: to put the author over.

In all seriousness, there’s some stuff there that I’m very proud of. No other journalist has gone deep with the story of Dave Duerson’s role on NFL-NFLPA disability benefits board. No one else has called out the Congress of Neurological Surgeons for giving Roger Goodell a standing ovation before his lame speech at their convention. No one else documented how the Centers for Disease Control accepted unprecedented private funding from the NFL for the federal government’s “concussion education campaign,” or how the National Institutes of Health helped Maroon and his cronies develop their phony, for-profit ImPACT program to the tune of millions in research subsidies.

Q2. What is “public football”?

There is an answer, perhaps not as flip as it sounds, that all of football is truly “public” football—up through and including the NFL, a phony nonprofit that gets municipal subsidies for stadiums (plus other things). Since this situation will probably get worse before it gets better, as the industry has both the federal National Institutes of Health and the Centers for Disease Control in its pocket, I expect that within a few years the Super Bowl will be coordinated with the Presidents’ Weekend national holiday: the regular season and playoff schedule will have expanded yet again, so that fans don’t have to go to work the Monday after the game.

The thrust of what we mean by public football, however, is taxpayer-funded programs at the professional sport’s feeder levels. I say go ahead and allow all the fools who want their sons to play club and private school football. But let’s get our public school systems out of it. “Death of football” ideology is wishful thinking, but with new levels of “awareness” of traumatic brain injury—and with the failed prevention costs and litigation flowing from that awareness—the goal of stamping out public football in this targeted way is achievable.

Q3. Furthering this point, you’ve been characterized as bent on banning football. But isn’t that a simplistic view of, or strategic response to, your argument in the debate?

I’m not out to ban football. Prohibition of just about anything is too blunt an instrument. It’s not fair to the zealous and it doesn’t work.

But adult statecraft involves more than simply rambling about personal choice. I find it amusing that many of those who accuse people with my viewpoint of “having an agenda” are blind to their own as they grasp at commercial rearguard initiatives, such as helmet technology, more “professional” coaching of kids, or tail-chasing Zackery Lystedt state laws. We don’t ban boxing, but it has a somewhat saner footprint on our culture than it used to have. We don’t ban tobacco, but cigarette marketing is curtailed and kids are protected.

Last rejoinder to this straw-man argument: I refuse to play the game of having to prove my bona fides before I can join the football debate. Put your guns down and let’s talk about football as an activity, not as a religion. I’m not an expert—thank God. But it’s better to have common sense than no sense at all.

Q4. Compare the “blogosphere” with traditional daily news media, when it comes to reporting and analyzing public issues in sport.

Let’s stipulate that new media and mainstream media types are simply blaring their bugles from different formations of the same march against human folly. I know that, minus the filter of an editor, I’ve shown my own ass plenty of times. It doesn’t matter if the public learns the truth about football from me or The New York Times or Professor Hieronymus Buttocks. And if Schwarz hadn’t started doing what he was doing in 2007, you and I are not even having this conversation today.

But did Schwarz and The Times take anything close to the number of shots downfield they should have? Give me a break. When Schwarz wrote about his buddy Chris Nowinski getting a $1 million NFL grant, the story all but giggled like a schoolgirl. After Bennet Omalu fell out with Bob Cantu, Schwarz basically blacked the former out of coverage, while quoting the latter in the venture-capital hype for Xenith, a space-age helmet company. In his account of the fed investigation of Riddell’s promotional claims, Schwarz treated the lying Joe Maroon with kid gloves. Schwarz’s takeout disclaimer on the death of the Cincinnati Bengals’ Chris Henry was cringeworthy; The Times quoted NFL’s latest consulting face, Dr. Richard Ellenbogen, to the effect that sometimes bad behavior is just bad behavior, and Schwarz reminded readers that nice white quarterbacks, like Steve Young and Troy Aikman, who also had sustained concussions, were not “on C block.”

Eventually Schwarz became associate producer of a documentary funded by the billionaire developer of the King-Devick Concussion Test.

I don’t want anyone to think I’m picking on Schwarz. Jim Litke, the national sports columnist for the Associated Press, has done some great stuff on how Roger Goodell co-opted Mommy sports bloggers with cornball clinics on “safe tackling.” But AP analysis of how state Lystedt Laws “lack bite”—thank you very much—are just playing “gotcha.” Nowhere do I see a single passage about how these laws were designed, in the first place, to offload football industry liability onto the public sector.

In an age of rampant advertorial, you’re daft if you don’t acknowledge that bloggers, social media, what have you, can be a useful check and balance.

Q5. Discuss your co-investigative series with Tim Joyce on sexual predator coaches and athletes in U.S. Swimming.

Swimming is the right next book in several respects. Because it’s a niche sport, Tim and I have more of the field to ourselves (though outlets like ESPN, of course, which for the most part ignore the story, do manage to “big foot” us from time to time).

Just as a large segment of our boy population is getting systematically brained in football, disturbing numbers of girls are getting raped at all rungs of our Olympic sports system. As with concussions, we are less interested in being designated cops than in following the money. The profiteers of so-called amateur sports and the nonprofits of “Child Abuse Inc.” play defense much faster than the public realizes or perhaps cares.

But to get down to business: 400,000 kids, 12,000 coaches — you don’t need an advanced degree in statistical analysis in order to extrapolate from the scores of known and under-reported cases; to factor in the forms of denial and cover-up; and to conclude that this is, bar none, the largest-scale molestation narrative outside the Catholic Church. It makes Penn State look like a garden party by comparison.

The hardest part to explain is that every institution has its own sick dynamic. In swimming, it’s not willy-nilly opportunistic pedophiles. Rather, there is a unique power imbalance. Most often it’s a 30-something male coach and an early or mid-teens star girl swimmer, who is emerging from the physical and emotional changes of puberty, and is desperate for adult approval, college scholarship, Olympic glory. Parents are asleep at the switch; they are totally invested until something bad happens to their own kid.

The rippling societal costs, in terms of life-long cases of eating disorders, substance abuse, and broken relationships and families, are incalculable. Yet all we see above ground is NBC’s feel-good patriotic package for a fortnight every leap year summer.

With the Rio Games upcoming, Tim and I are going deep with the story of Brazilian national Alex Pussieldi, who is the Rowdy Gaines of swimming coverage on the country’s SporTV network. Two years ago Pussieldi fled South Florida, where he had gotten his start in American coaching under the recently deceased Hall of Famer Jack Nelson, whom Diana Nyad credibly accuses of molesting her for years at the Pine Crest School in Fort Lauderdale. In the course of reviewing thousands upon thousands of pages of discovery documents USA Swimming tried to suppress, Tim and I told the full story of the cover-up by that organization as well as local police, city government, and the Ft. Lauderdale Sun-Sentinel, of Pussieldi’s 2004 physical assault and Peeping Tom practices against a Mexican boy who was swimming and being boarded by him. Pussieldi was a major creep and international human trafficker, and his rise to prominence was aided by former USA Swimming president and conflicts-crazed consultant Dale Neuburger, who steers contracts with foreign national teams to coaches like Michael Phelps’ guy, Bob Bowman. Neuburger also was an architect of swimming’s scam offshore insurance subsidiary, the “United States Sports Insurance Co.” in Barbados. ESPN’s Outside the Lines still won’t tell its viewers, but all this is under investigation by the FBI and the Government Accountability Office.

Q6. The U.S. Swimming scandal is monumental with much yet to uncover and untold victims in need of light. So it doesn’t sound like you’re returning to football analysis anytime soon, not in your former diligence that produced the new book.

That is correct. The football follies are now out there for all to see and interpret. Geez, our friend Bennet Omalu is about to be portrayed by Will Smith. I’ll continue to comment on a connection or two as we move along–and of course I reserve the right to change my mind–but the focus of my energy is swimming and Rio ’16.

Q7. For what may be called the “genuine iconoclast” writer in sports issues, it appears there’s often little competition on reporting a problem, however terrible, because few media are willing to probe and pay the price to do so. Correct?

Yeah, no doubt I’m a little bit nuts, and I don’t have the excuse of having played football. Maybe I should have gone straight and gotten a real job, but it’s way too late for that. My name is on a Supreme Court case involving writers’ rights in new media, and Concussion Inc. is my third book, and I’m proud of those things. They’re not rewarding financially, but they’re rewarding.

Matt Chaney is a writer, editor, teacher and restaurant cook in Missouri, USA. Chaney’s 2001 MA thesis at the University of Central Missouri involved electronic search for thousands of news reports on performance-enhancing drugs in American football, a project inspired by his experience of injecting testosterone as a college player in 1982 (Southeast Missouri State). Email him at mattchaney@fourwallspublishing.com. For more information, including about Chaney’s 2009 book Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

Football Officials Alerted to Brain Damage, Concussion—80 Years Ago

Contemporary experts of law and medicine in sport discuss an historical news period, 1928 to 1933, when football officials learned of brain risk to players, understood research questions—and even devised a sideline concussion test

By Matt Chaney

Posted Saturday, January 31, 2015

Copyright ©2015 by Matthew L. Chaney

During football season in 1928, late October, American sports pages headlined ominous findings of fledgling research on brain damage in boxers:

“’Punch Drunk’ May Apply in Other Sports”

“American Medical Association Publishes Article Raising Question”

The accompanying news report quoted Dr. Harrison S. Martland, of Orange, N.J., whose newly published case studies of deceased boxers revealed a “punch drunk” syndrome to become known as “chronic traumatic brain injury.”

Utilizing microscopic pathology, Martland had identified diseased brain cells of boxers “due to single or repeated blows on the head or jaw,” he said, warning that likely all athletes of contact sport were at risk.

Research avenues were obvious and urgent for football leaders and officials of more activities in America.

“The condition can no longer be ignored by the medical profession or the public,” Martland said, long ago—and wowing experts today.

“Dr. Martland’s observation was spot-on,” said Bob Fitzsimmons, legendary sports attorney, during an email exchange this week. “Unfortunately it took over 80 years to follow his advice, even though the problem was right before us all the time.”

“If only the stakeholders in football would have heeded Dr. Martland’s warnings in 1928…,” said Paul D. Anderson, sports-injury lawyer and professor, “the science of football-related brain injuries would have been exponentially advanced and numerous lives could have been protected.”

“Instead, the stakeholders and guardians of football were willfully blind.”

Here is full text of the 1928 Associated Press report published in Sports sections nationwide:

NEW YORK, Oct. 20 (AP)–The “punch drunk” condition of boxers has stepped into the medical field for determination whether others than boxers get it.

The American Medical Association has issued in its Journal an appeal by Harrison S. Martland, M.D., of Newark, N.J., to find out the nature and extent of this state, which he says fight fans describe as “punch drunk, cuckoo, goofy, cutting paper dolls or slug nutty.”

The symptoms in slight cases are a “very slight flopping of one foot or leg in walking, noticeable only at intervals, or a slight unsteadiness in gain or uncertainty in equilibrium.” In severe cases “there may develop a peculiar tilting of the head, a marked dragging of one or both legs, a staggering, propulsive gait.” Finally, marked mental deterioration may set in.

“I am of the opinion that in punch drunk there is a very definite brain injury, due to single or repeated blows on the head or jaw. I realize that this theory, while alluring, is quite insusceptible of proof at the present time.”

Dr. Martland suggests that if punch drunk exists in the form he suspects [then] it afflicts others than boxers and that establishment of the facts is important to courts and labor compensation boards in handling head injury cases. He foresees disadvantages in the field which may be opened for “so-called expert testimony” and says:

“While most of the evidence supporting the existence of this condition is based at this time on the observations of fight fans, promoters and sporting writers, the fact that nearly one-half of the fighters who have stayed in the game long enough develop this condition, either in a mild form or a severe and progressive form, which often necessitates commitment to an asylum, warrants this report. The condition can no longer be ignored by the medical profession or the public.”

The Martland story is a “great” artifact, said Fitzsimmons, who represented family members of Mike Webster, the deceased, brain-damaged NFL lineman at center of landmark court action a decade ago. The Webster estate won $2 million in retroactive disability payments from the league and players union, setting legal precedent for claimants of brain injury from football.

Harrison S. Martland paved the evidential path. The pioneer sport neuro-pathologist, longtime medical examiner of Essex County, N.J., was also known for identifying disease states in workers of radium processing. Martland compiled boxing case studies until his death in 1954, and authorities of football like Fitzsimmons feel indebted.

“Much still needs to be done but I am encouraged by the numerous doctors and scientists who are now studying and researching CTE,” Fitzsimmons said. “Advances are being made and hopefully treatment is not far off.”

Two modern pathologists are prominent for their postmortem series on football players, beginning with former Pittsburgh ME Dr. Bennet Omalu, a friend and colleague of Fitzsimmons who’s now a county medical examiner in California and subject of a feature film in production.

Following Webster’s death at age 50 in 2002, Omalu delivered the groundbreaking micro-autopsies identifying chronic traumatic encephalopathy, or CTE, in brain tissue of the Steelers icon and more deceased NFL players.

At Boston University, Dr. Ann McKee has found brain disease in 78 of 82 NFL players analyzed postmortem, damage of impacts including hallmark tauopathy. “We have known about CTE since the 1920s, when it was first associated with boxing,” McKee said, speaking recently in Texas.

“CTE results in memory loss, mood swings, change of behavior, and sometimes suicide.”

Dr. Lester Mayers, a New York physiatrist and author of journal reviews, is versed in the literature lineage of brain trauma in athletes dating to boxing’s earliest. “Dr. Martland cautiously pointed out that evidence of [the boxing] affliction was anecdotal at that time,” Mayers stated this week in email.

“Since then, many studies of professional and amateur boxers utilizing a variety of [research] techniques have found that greater than 50 percent suffer substantial brain damage and disability. The significance of these findings is that the extent of brain damage correlated best with the number of non-concussive impacts experienced by the fighters over their careers.”

“There seems to be an obvious parallel with the current experience unfolding in football.”

Mayers knows the football maw close range, as former medical director for athletics at Pace University, where he treated casualties of all games. Mayers doesn’t see much if any wiggle room for football and its inherent violence, regarding improvement for so-called safety.

“Anyone who watches football games at any level from the sidelines, junior through professional, will observe the constant occurrence of head impacts intrinsic to the game—500 to 1,000 per season according to Helmet Impact Technology,” Mayers observed.

“I believe that when the extent of resulting brain injury and disability is better documented in future studies that football participation will decline substantially, placing the future of the game at risk.”

Some researchers, typically funded by football interests, say more studies are needed to draw conclusions about collision risk for the brain. They note longitudinal studies have yet to be performed on living players—without adding that football organizers have avoided exactly that research since Martland’s call 87 years ago.

Central New York clinical psychologist Dr. Don Brady, PhD, PsyD, NCSP, researches sport concussion and provides consultation for NFL retirees, their families, and other athletes. Brady has studied the literature of sport-related concussion for three decades, devouring Martland but taking his review deeper, back to 19th century research. Dr. Brady rebukes the notion that accumulating discovery isn’t documenting football danger.

Information such as the 1928 Martland news “serves to further thwart attempts by concussion revisionists and manufacturers of doubt to ignore, deny, minimize and sanitize the existence of adverse medical history accounts…,” Brady stated in email, “that pertain to brain injury or concussion in sports and other life aspects.”

“Concussion history literature of the 1800s and early 1900s is rich with documentation on the adverse effects of both sport and non-sport-related concussion.”

Attorney Paul Anderson concurred, discussing historical information in context of present-day lawsuits by thousands of former NFL players and families.

“Dr. Martland’s [1928] statement is another bullet in the plaintiffs’ chamber when they seek to prove the NFL knew or should have known about the long-term, devastating effects of repeated blows to the head,” Anderson, representing family of late college player Derek Sheely in an NCAA lawsuit, wrote for ChaneysBlog.

For more regarding what football organizers have known about brain trauma, and when, see below the annotated timeline of news articles from 1982 to 2001, first posted at ChaneysBlog in 2012.

*******

Public fallout for Dr. Martland in 1928 emanated primarily from boxing circles.  “His brains are scrambled from taking them on the chin,” cracked a dim pugilist, unwittingly affirming Martland theory [and, no, the doctor wasn’t a boxer].

Martland won more support than opposition for his conclusions about chronic TBI in boxers. A powerful opinion leader in Martland’s camp was Dr. Morris Fishbein, widely known official of the AMA, for his four decades in spotlight as editor of Journal of the American Medical Association.

Fishbein endorsed the boxing research in this installment of his syndicated newspaper column, “Daily Health Talk”:

Punches in Prize Ring Often Injure Brain

By Dr. Morris Fishbein

Pugilists know the condition that results from a terrific pounding in the prize ring in which the recipient of the mauling suddenly finds himself unable to move his legs, dizzy, or as it is commonly expressed, “out on his feet.”

Dr. Harrison S. Martland recently read before the Pathologic society of New York a discussion of the condition called “punch drunk,” which the fighters themselves all characterize by the terms “cuckoo,” “goofy,” “cutting paper dolls,” or “slug nutty.”

He points out that the condition usually affects fighters of the slugging type who are usually poor boxers and who take considerable head punishment, seeking only to return a knockout blow.

It usually takes the fighter one or two hours to recover from a severe blow on the head or jaw. If he has been “punch drunk,” he may notice later a flopping of one foot or leg in walking, and sometimes mental confusion lasting several days.

Dr. Martland is convinced that the condition called “punch drunk” results from a definite brain injury due to a single or repeated blows on the head or jaw which cause multiple small hemorrhages in the deeper parts of the brain.

In the late stages, therefore, the disease resembles the condition known as shaking palsy or Parkinson’s disease.

He has presented microscopic studies of the brains of persons who have developed this condition, showing the pathologic changes which occurred in the brain, and which substantiate his point of view.

Furthermore, he presents the names of 23 fighters who have been “punch drunk,” and their present condition indicates the permanence of the physical changes.

The AMA and JAMA already stood opposed to boxing at outset of the Depression Era, and membership immediately adopted Martland studies for accruing argument.

AMA ethical policy then and now essentially outlines Hippocratic creed of Do no harm, or When in doubt, protect the patient. To recommend avoidance of pugilism, especially for children, amounted to simple rationale for America’s leading medical body.

But AMA and JAMA simultaneously supported dangerous football, curiously or hypocritically [see news timeline below for the dichotomy in recent decades].

Fishbein himself publicized perhaps the first sideline concussion test, apparently referencing a 1933 NCAA publication detailing the protocol, Medical Handbook for Schools and Colleges: Prevention and Care of Athletic Injuries.

Fishbein addressed traumatic brain injury in football and symptoms to watch for, reporting the following in newspapers:

Most serious of all [football] injuries are those affecting the brain and the skull. A concussion of the brain means that the brain tissue actually has been bruised, with possible small hemorrhages in the tissue.

The first sign of such injury is loss of memory for recent events. The least important sign is a slight dizziness. But coaches and trainers should not, however, be unimpressed when a player comes out of a sudden impact with another player merely slightly dizzy or dazed.

The first thing to do in any such accident is to put the player immediately at rest, to determine extent of the injury. When a player has had a head injury, he should be put into a reclining position, questioned as to the headache and dizziness and given the test as to his memory for recent events.

If he cannot remember the names of his opponents, which side is on the offensive, the score, the day of the week, or similar matters, it is not safe to permit him to play again. If, however, he merely is dizzy, he should be permitted to stand and move about, to determine whether he has lost his sense of balance.

Any sign of a loss of sense of balance is serious, and the player should be removed from the contest.

Fishbein was channeling the NCAA publication, undoubtedly.

Kansas City attorney Paul D. Anderson has studied the 1933 NCAA document. And he keeps seeing perfect fits of additional information, then and now, like the historic news items about Martland, the AMA, and brutal sports.

“The doctors [from 1928 to 1933] clearly identify a causal link between football-related head blows and punch-drunk syndrome,” Anderson surmised.

*******

A 2007 episode of Friday Night Lights on NBC centered on a lawsuit against a high-school football coach, for failure to instill “proper tackling” in a player who ended up paralyzed by a helmet hit. This TV show was based on fact, not fiction.

Heads Up, football coaches and wives, because you’re legally liable for the theory of “head up” or headless hitting by players, the alleged “technique” and accompanying rules proven inapplicable and unenforceable since at least 1976.

Yes, coaches are legally responsible for ensuring that headless hitting is applied in tackle football, which is, lest anyone forgets, a forward-colliding frenzy that pits large, helmeted combatants to ram each other. No one can actually teach and instill Heads Up nonsense, of course, revived by NFL commissioner Roger Goodell and league offspring USA Football.

Nevertheless, coaches of all levels are integral to the show of “proper technique.” The vast majority serve public lip service, promoting Heads Up for every gullible news reporter, of the legion.

Meanwhile, the unfortunate few coaches—and their families—become legal shields for King Football, as targets for lawsuits. Individual  homeowner’s insurance becomes exposed for paying potential settlement or damage award, among liabilities.

Since 1971, coaches, colleges, schools, youth leagues, local government and helmet makers have been sued over “head up” or “proper contact”—and with no backing of the prime purveyors like Goodell, who quickly acknowledge lacking scientific proof for Heads Up when pressed.

Lawsuit plaintiffs—from whom Goodell effectively insulates—are player casualties of football’s predictable severe injuries, calamities occurring much more frequently than reported by game-funded “studies” posted on a website from University of North Carolina in Chapel Hill.

Contemporary plaintiffs include a former NAIA college player, Nathaniel Seth Irvin, whose lawsuit alleges he suffers concussion damage “as a result of bad coaching and improper helmet use” during the 1980s, reports The Chicago Tribune.

In California, the mother of a quadriplegic former Pop Warner player is suing coaches, their wives, and youth-league organizations. Crystal Dixon alleges in the court complaint that her son, Donnovan Hill, was paralyzed in Pop Warner football for “a negligent tackling technique he was taught and instructed to use by his coaches.” Hill was 13 when paralyzed during a game in 2011.

Defense attorneys replied: “To encourage aggressive play in football is simply to encourage participants to play the game as it should be played.”

Such lawsuits could also target football players and referees.

I played and coached in college football 30 years ago, when the so-called anti-butting rule of the NCAA and national high schools—supposedly banning the striking of a helmet facemask for initial contact—was already a joke.

And we coaches at Southeast Missouri State didn’t have to specifically instruct players to ram. We only lined them up to play the dumb game, which inherently dictates head-on collision between opposing players, clashing from opposite directions. This is a very simple matter of modern football covering law–ramming–because of natural physics and shatterproof head armor.

The idea of chest-bumping and “shoulder leverage” in football with modern helmets isn’t only impossible. It is quackery for the public presentation today. And every football official above low-informed knows it, especially coaches who played.

Yet cultural authorities like the American Medical Association have espoused “head up” versions first devised by a coaches association in 1961, then pumped by AMA press releases in 1967—despite medical literature’s lacking a peer-reviewed article on the concept, still, much less one credible researcher to sign his or her name.

No Heads Up theorist claims responsibility yet, not academically, scientifically or legally.

That should say everything for anyone.

*******

This year’s Super Bowl City serves as ‘Cautionary Tale’ for subsidizing sports and more questionable entertainment ventures.

Read past the hype or rhetoric about being an “NFL City,” and Glendale, Ariz., is almost bankrupt for building stadiums and hosting events like the Super Bowl. And monetary shocks spread further, affecting greater Phoenix and taxpayers across the state.

“To fiscal conservatives, Glendale serves as a cautionary tale for suburban cities across the United States that want to throw public money at professional sports projects,” note Associated Press writers Josh Hoffner and Jaques Billeaud, for this week’s must-read analysis.

“Overall, it’s a bad move for cities,” said Kurt Altman, attorney for the Goldwater Institute. “As much as they say it’s going to make the city a destination, it just doesn’t.”

A mathematical reality confronts any region for public giveaways to the NFL and other sports like the NHL (the garage league utterly underwritten by American taxpayers):

There can be no public payoff unless a sport franchise imports new consumers and industry from out of state. But that never happens.

The glittering civic toys of subsidized stadiums and entertainment districts merely steal in-state customers from local businesses, those paying full taxation and operating without government aid.

Even a region’s temporary injection of Super Bowl fans, corporate sponsors and major media produces negligible return for public coffers—or just more red ink.

In Glendale, the tax-paying citizenry will lose millions this week over the Super Bowl, says Jerry Weiers, the mayor tasked with sorting out a sports mess left by predecessors in city government.

The municipality is dropping “huge amounts of money on overtime and police and public safety costs associated with hosting the Super Bowl but getting very little in return,” report Hoffner and Billeaud.

Elsewhere, Missouri, does Gov. Jay Nixon get it about public subsidy for the NFL?

Jay Nixon proposes dropping a half-billion dollars in state resources on yet another football stadium in St. Louis—only 20 years after taxpayers opened a new dome for the Rams, a project still carrying millions in debt.

Does the Missouri governor need help, or logic, to ascertain necessary and priority need for appropriating public assets?

Supplement: News Timeline on Brain Trauma in Boxing, The NFL and NCAA

Articles from 1982 to 2001

By Matt Chaney, 2012

1982, Dec. 4:  “Dangerous Games That People Play,” by Ira Berkow, New York Times. News commentary discusses risk and injury of hazardous sports and activities in the United States, citing a report of the American Medical Association [AMA]. Berkow notes, with boxing under renewed threat of elimination in America, that brain injuries are well-known in football too, comparing the gridiron’s “almost casual list of the maimed… those [players] suffering the routine concussions, neck injuries and assorted broken segments of the anatomy.” Berkow writes: “There are more deaths occurring in college football and in motorcycle racing and in sky-sailing than in boxing. Relatively few [authorities], it seems, have vigorously propounded abolishing any other sport besides boxing since 1905…”

1983, Jan. 14:  “Physicians’ Journal Calls For a Ban on Boxing,” by John Noble Wilford, New York Times. News analysis discusses JAMA editorials urging ban of boxing in America, CAT-scan studies of living boxers revealing “brain damage,” and response of boxing officials, including their proposals to reduce risks. “Editorials in today’s issue of the Journal of the American Medical Association urged the banning of boxing in light of new evidence suggesting that chronic brain damage was prevalent among fighters,” Wilford writes. In Britain, a study of living boxers, professional and amateur, determines chronic brain damage is “most predictable” for a career in the ring.

1983, Feb. 15:  “The Ring Commission Hearings,” by Jim Lehrer, Monica Hoose, and Peggy Robinson. MacNeil/Lehrer Report [transcript]. PBS Television show addresses congressional hearings on boxing in Washington, with replays of day’s lawmaker questions and witness testimonies on Capitol Hill. Discussion includes boxing deaths and more notorious beatings of the 1970s-80s, arguments on potential ban or government regulation of a continued sport, so-called safer boxing conducted as “a science,” and an AMA doctor’s pointing to tackle football in America for producing severe head injuries as well. “I think a similar kind of injury occurs in any contact sport,” says Dr. Russell H. Patterson, Jr., neurosurgeon and AMA official. “Football is a good example, and we’ve seen some serious head in juries in football. … The blow is the same whether it’s in boxing or in football. It’s just in boxing it’s small, repetitive blows but maybe spread over many years and almost daily in its occurrence.” Robert Lee, U.S. Boxing Commission president, says, “The past year, 1982, has been filled with controversy with all too many people calling for a ban on boxing. Yet how many of these same people call for a ban on high-injury sports such as skiing, football, hang-gliding, auto racing, scuba diving or mountain climbing?”

1983, June 12:  “Boxing and The Brain,” by David Noonan, New York Times. News analysis discusses the following: boxing hearings and debate; medical literature since 1928 and physiology of brain injury; child fighters such as a 13-year-old who died of brain injury; concepts of safer boxing like “body punching”; noticeable speech difficulties of boxing great Muhammad Ali, age 41; and Dr. Ira R. Casson, a Long Island neurologist conducting a study series on boxers who would later work for the NFL. The known permanent brain damage of boxing includes “a clinically diagnosed condition called dementia pugilistica, also knows as chronic encephalopathy of boxers and best known as punch-drunk syndrome,” Noonan writes. “As the information about chronic encephalopathy in boxers has accumulated over the years, several distinct clinical symptoms and their apparent pathological causes have been identified.” Casson—who someday would lead NFL studies on brain injury—views radiological imaging of Ali’s brain, for Sports Illustrated, and says, “That’s the kind of CAT scan that I’ve seen in a number of former and long-term boxers.”

1983, June 20:  “Doctors Debate What To Do About ‘The Sweet Science,’ ” by Brenda C. Coleman, The Associated Press. News report discusses AMA proposal to eliminate publicly funded boxing, convention debate over the proposal, a new study that finds repeated blows causes brain damage in boxers, and similar research on college football players. “Any sport whose objective is to injure another human being is an abomination,” says internist Dr. William F. Dowda. “There’s absolutely no moral justification for a sport that condones a brain concussion.” Differing viewpoints were heard on convention floor, including from Dr. Russell H. Patterson, Jr., AMA official and chairman of the American Association of Neurological Surgeons [AAN], who says research shows brain damage is “not a problem” among amateur boxers. “Patterson also pointed to a study of 11 Eastern colleges that showed the incidence of accumulated head injury in football was at least as high as in boxing,” Coleman reports.

1983, June 23:  “AMA Delegates: Ban Amateur Boxing,” no byline, Washington Post. News report discusses debate over the formal AMA call to eliminate boxing in municipal leagues, schools, colleges and more government entities such as the military, along with establishing federal regulation of professional boxing. “The AMA’s action comes at a time of increased interest in boxing regulation following the death last November of South Korean fighter Duk Koo Kim of head injuries…,” The Post reports. “I think their [AMA delegates’] position is unreasonable,” says Sig Rogich, chairman of the Nevada State Boxing Commission. “I think if they’re going to categorize risk factors in boxing as a professional sport, then they should use the same philosophy with other sports.”

1984, May 7:  “Concussion Routine in Other Sports; Boxing Safety Praised,” by James Christie, Toronto Globe and Mail. Commentary discusses the following: growing outrage over boxing, led by doctors who want downsizing or bans in America, Canada and Britain; Canadian measures for “reasonably safe” boxing, including sidelining knocked-out fighters for 30 to 60 days; and need for concussion protocol in other sports, particularly tackle football. “This is one of the biggest problems we’ve had at the university level,” says Dr. Bruce Stewart, neurologist and medical director of the Ontario Athletics Commission. “People get knocked out routinely in football, get revived and could be back in for the next series of plays. What this does is demonstrate to me that in boxing we’re being properly cautious about the welfare of our athletes.”

1986, Nov. 7:  “Johns Hopkins Begins Boxing Study,” no byline, The Associated Press. News report discusses pending research, a four-year study of amateur boxers and football players in select cities, for assessing brain damage among control groups and evaluating neuropsychological [NP] testing for possible method of early detection. “A 14-member research team will travel to three or four cities in the South, Southwest and Eastern seaboard to locate boxers, football players and youths in the same age group as the athletes who do not play contact sports and can serve as controls in the study,” The AP reports. “Col. Don Hull, the president of the USA Amateur Boxing Federation, said information gathered from the study will be important to all amateur sports.” Dr. Walter Stewart, epidemiologist at The Johns Hopkins School of Public Health, says, “We are going to collect data and let the chips fall where they may.”

1986, Nov. 10:  “The Agony Must End,” by Paul Zimmerman, Sports Illustrated. News analysis discusses NFL injuries that “continue at an unacceptable rate,” including “fractures, concussions and bruises that play havoc with America’s No. 1 sport.” While some football-funded researchers claim a safer tackle game at hand, designed to reduce head and spinal injuries in particular, the armored, high-speed violence of pro football—collisions administered and absorbed, impacts head to toe, and other physical stresses that discombobulate—is unprecedented danger for the SI writer Zimmerman, a former college player and game historian, and Miami Dolphins head coach Don Shula. “Some of the collisions I’ve seen are really severe,” Shula says. “I’ve been happy for quite a while to be on the sidelines.” Zimmerman has interviewed numerous muscle dopers in the NFL and NCAA, and blames anabolic steroids and other powerful prescription drugs, like pain-killing shots and pills, for bloodshed in the modern game. “The result is higher-speed collisions by larger people, a ferocity of hitting never before seen in football or any other sport,” Zimmerman writes.

1987, Feb. 26:  “Boxing Doctor Says Peril Exaggerated; Other Sports Said Riskier as Brain Study Launched,” by Al Sokol, Toronto Star. News analysis discusses the following: boxing controversy as medical associations recommend  downsizing or banning the sport; measures for less risky or safer amateur boxing; danger of tackle football, and a Johns Hopkins longitudinal study on young boxers that includes American football players as a control group. “The stand against boxing taken by both the AMA and the Canadian Medical Association comes partly from the intuitive sense that getting hit in the head by a punch is not healthy and partly from a growing body of scientific evidence,” Sokol writes. Dr. George Ginter, a Kentucky anesthesiologist and pro boxer, says, “I totally disagree with the American Medical Association’s stand regarding the neurological damage resulting from boxing. College and pro football rank higher than boxing in terms of causing long-term disabilities.” But Boston neurosurgeon Dr. Robert Cantu supported the AMA perspective, as vocal opponent of boxing and staunch football advocate himself, promoting ideas and rhetoric of “safer” tackle football in America—and destined to someday lead an NFL-funded research team verifying brain damage in deceased football players, teens and older. Commenting on boxing in 1987, Cantu dismisses touted measures of “safer” pugilism. “A doctor at ringside is like a priest at a hanging,” Cantu says. “Neither improves the safety of the event.”

1989, March 9:  “Boxing Causing Dozens of Military Hospitalizations Yearly, Study Finds,” by Brenda C. Coleman, The Associated Press. News report discusses debate over injuries in Army boxing and research, which finds head injuries responsible for 68 percent of hospitalizations in the military sport. “Evidence that boxing produces irreversible brain damage is now as indisputable as the link between cigarette smoking and lung cancer,” the researchers state. Navy boxing coach Emerson Smith disagrees, as chairman of a safety committee overseeing amateur fighting. “Since they have mandated gloves and headgear that we did research on for all boxing programs in the United States, the injury statistics are far, far less than probably all your contact sports,” Smith said. “In football, you have the kids that are paralyzed, the kids that die. I don’t believe there’s any high school or college… where you have contact sports where you’ll eliminate all serious injury.”

1989, March 10:  “Boxing Safety Studies Disagree,” by Steve Woodward, USA Today. News report discusses conflicting outcomes in studies on brain risks of young boxers, with results of research commissioned by the U.S. Amateur Boxing Federation portraying the sport in “safer terms” than the Johns Hopkins study, published by JAMA. Boxing advocates questioned the number of brain injuries cited in the JAMA article, suggesting it too high and wondering if many study subjects were unfit to box in the first place. Johns Hopkins researcher Dr. Walter Stewart responds thusly: “Clearly I would say that some people should not be boxing, just as some should not be playing football.”

1990, May 22:  “Head-High Tackles: How Long Can Footy Have Them?” no byline, London Herald. News analysis discusses Britain’s boxing controversy and increasing concern for brain injuries across contact sports, particularly rugby or Australian Rules football, where some clubs already employed “baseline” NP testing. “Boxing people, when confronted with the claim that their sport is unreasonably dangerous, inevitably point the finger straight at [rugby] football as a sport more likely to give an athlete brain damage,” The Herald states. Rugby officials rebuke the allegations, noting their safety measures and declaring relative few concussions occur. An anonymous neurosurgeon, identified as a former rugby player, says high hits were the single threat and could be outlawed by new rules. “The real problem in Australian Rules is not the normal game; it’s the excessive violence and shirtfronts. As long as everyone does things sensibly and the king-hits are kept out of football, the risks are minor.”

1991, Jan. 19:  “Jabs Cause The Brain Damage,” no byline, South Australian Advertiser. Aussie news commentary discusses the following: boxing as gladiatorial sport in western civilization, violence as public spectacle or popular culture; apparent Parkinson’s symptoms in Muhammad Ali; crystallizing medical consensus that repetitive, sub-concussive blows cause long-term cognitive impairment; and injury comparisons, boxing and other activities such as American football. “The controversy over boxing is fueled more by emotional and moral questions than by any overwhelming death toll,” the Advertiser piece opines. “Even though more than 300 professional boxers have died in the past 20 years, a recent American survey put its fatality rate at .13 boxers per 1,000 participants—compared with .3 for college football [players], 1.1 for scuba divers, 5.1 for mountaineers, 5.6 for hang gliders, 12.3 for sky divers, and 12.6 for horse racing [jockeys]. The recorded [boxing] injury rate also is low. In the United States a two-year study of 6,000 amateur boxing bouts revealed an injury rate of 1.43 percent, compared to a rate of 4.75 percent for professional boxing and 46 percent for high school football, a figure which would probably translate quite comfortably to Australian Rules or rugby in Australia.”

1992, December 7:  “Toon Out,” by Albert Kim, Sports Illustrated. News report discusses sudden retirement of NFL receiver Al Toon and his “postconcussion syndrome,” other cases of severe brain injuries in pro football, and ever-increasing awareness within the sport of potential long-term dysfunction for casualties. “Although there is no evidence to show that concussions [in football] can lead to permanent brain damage, most medical experts believes that repeated blows to the head can have dire consequences,” Kim reports. Richard Weiss, team doctor for the Buffalo Bills, says, “Think about boxing. Suffering a large number of concussions over a period of years more than likely leaves some permanent residue.” The “normally articulate and quick-witted” Toon, as Kim describes, is subdued, groggy and suffering memory loss a few weeks following his ninth diagnosed concussion in eight NFL seasons. “There are some inherent dangers in playing football…,” Toon says. “But when you get something like this [concussion syndrome], you’ve got to take it more seriously. You’ve got to think past just, Can I play on Sunday?”

1994, Jan. 28:  “Neurologist Discusses Concussions on The Gridiron,” by Noah Adams, All Things Considered[transcript]. National Public Radio show discusses growing attention to concussions football as Super Bowl nears, including public speculation of long-term brain damage to players, with interview of Dr. Peter Tsairis, team neurologist for the New York Giants. “Are there retired players who… have permanent damage because they had too many concussions?” Adam poses to Tsairis, concluding the show. “I don’t know how many of these players go on to develop dementia,” replies the Giants doctor, “which is a term that we use where there’s permanent structural change on a molecular level to the—to the brain that they cannot remember certain things, when they lose their memory. And you see this a lot in boxers who’ve gone on after their years in boxing and developed dementia problems. We don’t have that much experience with football players who’ve had multiple concussions. I don’t know of any article that’s been written on the subject. I know it’s been done with boxers, but not with football players.”

1994, Jan. 28: “That’s Enough for Buffalo Linebacker Cornelius Bennett,” no byline, Agence France Presse. International news report discusses injuries for Super Bowl teams, including Dallas quarterback Troy Aikman’s widely publicized memory loss of a concussion sustained during the previous week’s NFC title game. The report states: “When told a boxing trainer would suggest six weeks of rest after a concussion, Aikman said, ‘Did you tell him I have a Super Bowl to win? I’m not given the luxury of waiting til then.’ ” Jim Kelly, Bills quarterback, admits “second thoughts” about his brain injuries, especially given the decades of publicized concussions to NFL quarterbacks. “I’ve had six or eight of them and it’s a scary, scary feeling,” Kelly says. “You don’t know where you are at. The emptiness in your mind, let alone your gut, comes when you wake up trying to figure out why everybody is staring at you. It makes you wonder, ‘Is the game worth it?’ But it is.”

1994, Oct. 29:  “Illinois Firm Gives Aikman New Protection,” by Lorraine Kee, St. Louis Post-Dispatch. News commentary discusses star names who’ve suffered concussions in NFL, past and present—including Toon, Merrill Hoge, Roger Staubach, Harry Carson, Joe Montana, Aikman—and a doctor’s linking football to boxing for brain trauma and damage. “Of course, concussions aren’t news to these guys [NFL players],” Kee writes. Aikman says, “You have to be somewhat concerned by concussions, but it’s something you just have to deal with. I don’t want it to get out of hand. I want to live a normal life after pro football.” Dr. Kenneth R. Smith, neurosurgeon at St. Louis University Hospital, says, “It’s kind of like boxing injuries; if you get knocked out a lot of times, your brain will eventually have some diseased process going on. Usually, when the natural nerve cells die, they do not recover.” The specialist adds that multiple impacts to head and spine “could produce a permanent injury and a whole series of these could lead to a possible degeneration later on in life.”

1994, Nov. 1:  “Not Just Boxers [Who] Can’t Answer The Bell,” by Stephen Brunt, Toronto Globe and Mail. Canadian news commentary identifies hypocrisy in supporters of tackle football, including American neurologists, who condemn boxing for brain damage while claiming to see little or none in their nationalistic collision sport. “Professional boxing exists on the verge of extinction…,” Brunt writes. “What is thriving, though, is the greatest sports-entertainment complex in the world, the game that owns Sunday afternoons, NFL football. … What’s the difference between that and being knocked out in a boxing match?” Brunt notes lengthy layoff for concussed athletes in boxing, unlike football, where “after a quick whiff of smelling salts” the injured return to contact, then the writer poses: “Does a 300-pound lineman making full, head-to-head contact have as much brain-jarring impact as a perfectly timed blow delivered with a gloved fist? You’d have to think so. Does the football helmet offer sufficient protection? Obviously not sufficient to prevent players from routinely having their bell run… And when that same helmet becomes the top of a projectile hurtling through space, it also contributes to the damage done.” Football supporters criticized boxing for intent to injure, implying sanctity of their sport, but “watch [NFL lineman] Bruce Smith bearing down on [quarterback] Joe Montana,” Brunt intones, “and then try to convince anyone that his purpose is anything other than doing as much damage as possible. Just as in boxing, there is a direct reward for disabling a foe…” In conclusion, Brunt heckles American medicine and science for obvious see-no-evil perspective regarding NFL dangers: “So where is the AMA now, why isn’t professional football being cast as the last refuge of barbarianism, the way boxing is? Probably because football is not a fringe activity run by the Don Kings of the world, but a mainstream colossus. Probably because football is so tied to corporate and academic institutions and is run by bright, white lawyers. … Probably because the same people who would be doing the condemning have a brother or father or son who has at some level been involved in the game. In other words, probably because of divisions of taste, and class, and money—not [violent] content.”

1994, Nov. 5:  “Staff Is Ready for Severe Hits: Impact of Concussions Isn’t Lost on Vikings Doctors,” by Curt Brown,Minneapolis Star Tribune. News report discusses concussion awareness in an NFL franchise, including for symptoms like headache, blurred vision and memory loss, knowledge expanding among medical staff, coaches and players of an NFL team in 1994—tumultuous year of publicized brain-injury cases for the league, especially of star quarterbacks flattened on television. “If I could give players any advice, I’d say don’t ignore the signs,” says Hoge, a year after retiring for multiple concussions, such as the re-bleed or “second impact” brain injury that rendered him comatose, hospitalized in ICU. A concussion “can clear up and you can function normally,” Hoge continues. “But that doesn’t mean you’re right. This is messing with your brain. You can damage your life. You can go into a coma. You can even die from it.” Longtime Vikings team physician Dr. David Fischer says: “Perhaps awareness has been heightened with fans and players, but our medical staff has always been fairly sensitive to post-concussion syndrome.” Research remains fledgling regarding long-term effects of brain impacts football, with the NFL just committing itself to studies, but some 65 years of medical literature continues documenting brain damage of boxing, like “chronic encephalopathy,” through cellular pathology of deceased athletes and longitudinal study of the living—and the Vikings doctor knows as much, among several NFL team physicians speaking publicly. “In boxing, surely we’ve seen how repetitive head trauma can cause all types of long-term problems,” Fischer says. “But how many blows it takes, what severity over length of time, we don’t know. Dennis Green, Vikings head coach, says, “Concussions are not new to football, but we have a fair understanding of when a guy is safe to return and when he isn’t. It’s up to the doctor if he can or can’t go.”

1994, Nov. 20:  “Dazed and Confused: Merril Hoge and Other Veterans Are Finding Out Why Concussions Have Become Serious Head Games,” by Jerry Crasnick, Denver Post. News analysis discusses the following: brain concussion as “the most highly publicized injury of the 1994 season”; NP testing’s employ around the league, along with balance assessment of players, more intuitive methods to detect concussion symptoms; widespread concern, or talk, for guarding against dreaded “SIS,” second-impact syndrome; rhetoric on brain damage of tackle football; NFL concussion tracking and data compiled annually at the University of Iowa; and insider agreement that modern football is highly dangerous, with large, helmeted athletes sprinting and colliding in open field. “Sometimes the damage the brain sustains is permanent…,” Hoge says. “Twenty years down the line they can’t come in and give you a new joint. It’s irreversible.” Cris Collinsworth, former NFL player turned TV commentator, says: “Once you get out of football, you look back and say, ‘I can’t believe I ever did that.’ It’s insane. My wife tells me all the time that she’s glad I don’t play anymore.” Greg Aiello, NFL director of communications, says league rate of concussions isn’t changing despite public spotlight on the issue. “Obviously, it’s something we’d like to reduce,” Aiello says. “But if all the media attention suggests there’s been a sudden increase in concussions, that’s inaccurate.”

1994, Dec. 19:  “The Worst Case—Doctors Warn That Repeated Concussions Can Lead to Permanent Brain Dysfunction,” by Michael Farber, Sports Illustrated. This news analysis of the time’s most-read sports magazine discusses football brain trauma and potential or known brain damage in players of the American game, particularly in the NFL. “People are missing the boat on brain injuries [in football],” says neurologist Dr. James P. Kelly. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.” Farber writes: “Some [NFL] veterans have gone through the neuropsychological sideline drills so often that even new concussion can’t make them forget.” Farber reports: “On Dec. 9, [Jets team internist Dr. Elliot] Pellman, Dr. Andy Tucker of the Cleveland Brows and Dr. Ira Casson, a New York neurologist, met with league officials, including commissioner Paul Tagliabue, to discuss concussions and suggest ways to cut down on their frequency.” Elsewhere, Dr. Cantu, neurosurgeon and NCAA-funded researcher of catastrophic brain and spinal injuries in American football, blames players who do not employ “proper contact” or “proper technique” for impacts—or Cantu’s controversial theory for colliding in the modern game without using heads, by avoiding contact of high-tech helmets built for ramming without skull fracture, but incapable of preventing brain trauma: “We know that people who have a concussion tend to have more concussions,” Cantu says. “Why? Two logical reasons. The first is that certain people can take a blow better than others; you see that in boxing all the time. But of equal, if not more, importance is how you play the sport [football]. If you keep playing like a kamikaze, if you tackle with your head, there’s more of a chance of being concussed than if you block or tackle with the shoulders.” Neuropsychologist Ken Kutner, PhD, says lingering “postconcussion syndrome” is more widespread among active and former players than is generally believed: “I counsel several [New York] Giants, past an present, but they don’t want their names known,” Kutner says. Meanwhile, Dr. Joe Maroon, Steelers surgeon, sees the possibility that football players could suffer “cumulative effect” from concussions, but Dr. Joe Torg doesn’t, Eagles doctor: “I know of no football player who has had residual neurological impairment from repeated insults to the head,” Torg says.

1995, March 4:  “Don’t Ban Boxing—Just Make It Safer,” by Joan Ryan, San Francisco Chronicle. News commentary discusses tenants of so-called safer boxing designed to save the blood sport from extinction or banishment, including “scientific” or finesse punching, larger gloves, stringent selection and review of referees, and stringent medical restrictions for fighters, assuring their fitness. “Don’t let them in the ring if they don’t belong there. You’d reduce about 85 percent of the problems,” says neuropsychologist Matthew Bowen, who boxed as an amateur. Former heavyweight champion Mike Tyson doesn’t care about a person he faces in the ring: “I try to catch my opponent by the tip of his nose,” Tyson says, “because I try to punch the bone into his brains.” Ryan, the pundit and confessed boxing fan, comments that “in the wake of yet another fighter leaving the ring on a stretcher with a blood clot in his brain, as happened to Gerald McClellan a week ago, I’m having a tough time arguing against those calling for drastic reforms or an outright ban of the sport.” However, “banning boxing altogether is unrealistic,” Ryan writes. “Plus, if we ban boxing for being too violent, we’d have to consider banning football, too. The incidences of flagrant violence have risen so high in the NFL that agent Leigh Steinberg recently gathered some of the country’s top brain doctors for a seminar with quarterback Steve Young, Troy Aikman, Warren Moon and other football clients who have sustained multiple concussions.”

1995, April 3:  “Information That Should Make Their Heads Spin,” by Bill Plaschke, Los Angeles Times. News commentary discusses new NFL initiatives and proposals, fostering “increased research and awareness of football head injuries,” that include the following: establishing a league committee of experts for brain-injury research and recommendations for prevention; reviewing helmet technology and banning dangerous models; mandating all rookies undergo “baseline” NP assessment for concussion monitoring throughout their careers; and establishing a league-wide “concussion grading scale” and “testing” so injured players can be diagnosed and sidelined until recovery. “If boxing can have these worldwide standards and rules that can keep certain fighters out of danger, it would seem that football could, also,” says Dr. David A Hovda, neurosurgeon and consultant on boxing’s health reforms. “This is a problem that needs to be addressed and studied now.” Another neurologist agrees, Dr. Janet Chance, who says: “Head injuries [in football] are a huge problem, and a poorly understood problem. There are some questions here that absolutely need to be answered.” But Dr. Elliot J. Pellman, Jets team doctor and chairman of the new NFL concussion committee, is unsure about for rapid progress because of monetary expense, time constraint and internal resistance: “Players run the show. If they don’t want to do something, it’s not going to happen,” Pellman says. “We suggest these things and owners are going to look at us like, What difference does this make?” Plaschke states: “It is this sort of attitude that may eventually drive an ex-player to his grave from Alzheimer’s disease. Many doctors now believe this occurs more frequently in those who have suffered multiple concussions.” The writer concludes: “The players still don’t scare and the owners still don’t care. You wonder what has to happen before they do.”

1995, Oct. 20:  “A No-Brainer: Football Leads to Concussions: Al Toon Will Attest That Symptoms Can Remain for Years,” by T.J. Simers, Los Angeles Times. News profile discusses life for former NFL receiver Al Toon with post-concussion syndrome, three years after football retirement, as he still experiences problems such as “emotional volatility.” Toon, a successful businessman, says, “There was a time when I thought of suicide. The act itself was never considered, but life was very frustrating.” Toon says there are more former players like him: “Very, very commonplace. You play the game of football, people get hit in the head. It’s no fluke.” Dr. Daniel Kelly, neurosurgeon at UCLA, believes that concussion management, if effective, would likely sideline many more players than what occurs, and for longer: “There are a lot of things we do not know yet, but the simplest thing would be to have [diagnosed concussed] players sit out a month,” Kelly says. “Of course, if you did that, you would probably have the quarterback, the running back and the tight ends sitting on the bench.” Leigh Steinberg, sports agent, says: “We won’t know for years what that impact of this will be. We may have an epidemic of Alzheimer’s and attendant problems 20 years from now with some of these players.”

1996, July 9:  “Concussion Potentially Most Dangerous Sport Injury: Blows to The Head Cause Brain Damage and The More Hits an Athlete Takes The More Chance of Permanent Injury: Little Research Conducted on Returning After Concussions,” by Shaun Powell, Newsday, New York, reprinted in Canada by The Vancouver Sun. In-depth news report discusses problems of concussion and more brain injury among athletes, young and old, including the following: no “firm” RTP protocol among various approaches for treating the concussed, disagreement marked by no consensus in defining the condition, and wide opinions regarding length of time needed for complete recovery; woeful injury reporting in American football, all levels, especially for subpar concussion diagnosis and recording overall; skull-preserving helmets that cannot prevent brain trauma while likewise encouraging head-on collisions; brain disease such as Alzheimer’s and Parkinson’s in former athletes of contact sports; mounting adverse research findings for contact sports, especially tackle football. “The attention given head injuries in recent years has put the sports world on alert and confirms the fears of medical experts. The concussion finds itself at the forefront of sports injuries,” Powell reports. “We are years behind when it comes to brain injury and what we can do to diagnose it and take care of it,” says Jets internist Dr. Elliot Pellman, chairman of the recently minted NFL Committee on Mild Traumatic Brain Injury. For Hall of Fame quarterback Roger Staubach, concussions figured “in my decision to retire,” he says, estimating he sustained 18 to 20 in football from high school to the NFL.

1996, Oct. 31:   “Experts Warn of Brain Damage,” by Sabin Russell, San Francisco Chronicle. News analysis discusses concussions suffered by the 49ers’ star quarterback Steve Young, growing medical opinion that football’s brain dangers are underestimated, and continued speculation on brain damage of postconcussion syndrome and/or multiple concussions in football. “The risk of serious brain injury with a concussion is very, very low. But when it does happen, it is very severe,” says Dr. Gordon Matheson, Stanford professor of sports medicine. “In the scheme of things, they [concussions] may be very minor. But they may also affect a player over the long haul,” says neurologist Dr. Janet Chance. Russell reports: “Dr. Lawrence Pitts, a University of California at San Francisco neurosurgeon, said ongoing neuropsychological surveys of athletes will ultimately determine whether or not repeated concussions cause permanent damage. Although there is ample [research] evidence that boxers can be permanently damaged in their sport… no one can claim football players have a similar problem. ‘It is very uncommon to see a football player knocked unconscious,’ he said. ‘In boxing, it’s a different matter.’ ”

1996, Nov. 15:  “Concussion Policy Should Be A No-Brainer,” by Paul Woody, Richmond Times Dispatch. News analysis discusses controversial segment of concussion “return to play” protocols, length of layoff for the injured athlete, a sidelining that could be minutes in football or months in boxing. Woody notes that 49ers quarterback Steve Young suffered two diagnosed concussions within 15 days, prompting the question whether the NFL star came back too soon, or dangerously, following the initial brain trauma, continuing: “In boxing in Virginia and most states, a fighter who even takes a technical knockout must wait 30 days before boxing again. If there is a knockout [unconsciousness], the boxer’s waiting period is 60s days.” But the NFL dismisses such boxing RTP protocol for the concussed in pro football, while apparently speaking for football at-large, juvenile and college levels that will follow same philosophy: “We have a committee of team and outside doctors who have been meeting and studying concussions for the past two years,” says NFL spokesman Greg Aiello. “They say it doesn’t make sense to have a rule to keep a player out for a specified period of time. Concussions are too complex. They have to be considered on a case-by-case basis.” An independent analyst disagreed, Dr. Michelle Miller, Virginia Commonwealth University Medical School, who believed boxing RTP parameters should be adopted by football: “I don’t know that it’s coming any time in the future, but it’s needed,” she says.

1996, Dec. 1:  “Heady Concerns: Concussions No Longer Comedic Material in NFL,” by Jonathan Rand, Kansas CityStar. News analysis discusses multiple concussions to star NFL quarterbacks Troy Aikman and Steve Young, and insider perspective on potential brain damage of football players, related to boxing, by Dr. Joseph Waekerle, Chiefs team physician, member of NFL concussion committee, and renowned trauma-care specialist. “It’s a big problem because football has approximately 250,000 concussions every year,” Waekerle says. “One in every five high school players has a concussion on a yearly basis. Now, we’re beginning to understand the potentially serious effects of concussions, especially repeated concussions.” Noting conclusions about second-impact syndrome or brain re-bleeding and susceptibility for multiple concussions, Waekerle says: “The third [vulnerability] is the chronic thing—all this becomes cumulative. A great example would be a boxer. That may occur to other professional athletes who suffer many concussive syndromes.”

1996, Dec. 20:  “Heads, You Lose: Football Concussions Hit Players at All Levels,” by Angelo Bruscas, Seattle Post-Intelligencer. News analysis discusses concussion debate in football, talking points to endure decades into future, including in regard to cultural awareness, modern helmets, risk-taking athletes, soft concussion definition, and gigantic athletes. “The whole subject of concussions has been taken way too lightly,” says Leigh Steinberg, sports agent who’s organized educational seminars for players and encouraged media to cover of the issue. “When Monday Night Football opens with two helmets crashing together and when videos of hardest hits are huge sellers, there’s a level at which concussions are glamorized and the subject is treated as fun without a consciousness of real ramifications.” Pediatrician Dr. Stephen Rice believes football’s ever-increasing sizes and modern equipment create action of terrible risks and casualties, by emboldening players to act as missiles like never before: “Did all this happen before and we were just missing it all? … Now you could run into a steel wall and nothing would happen to you. … In the days when players wore only leather helmets without facemasks, no one struck people with their heads. There was no protection.” Rice notes the fact modern helmets do not prevent concussion “because the helmet doesn’t stop the brain from moving around inside the skull.”

1997, Jan. 1:  “QB Concussions: A Heady Issue,” by Thomas Boswell, Washington Post. News commentary discusses NFL brutality ravaging quarterbacks, suggesting football stars could end up punch-drunk permanently, and endorses controversial countermeasure to arbitrarily monitor tackler intent and punish “cheap-shot” or “dirty” hits. “This season, football’s been getting its bell rung with regularity,” Boswell writes. “Every time a popoular quarterback gets his brain scrambled the game suffers a blow, too. As our gridiron heroes reach middle age, do we want them to remind us of addled boxing pugs? Do we want Troy Aikman to tremble like Muhammad Ali or Danny Wuerffel to be as bizarre and bitter as Joe Frazier?” Boswell reports a coach’s allegation of bounty-type hits on Wuerffel, star quarterback at University of Florida: “Obviously [Florida State] had some late hits [on Wuerffel],” says UF coach Steve Spurrier. “Obviously they could have pulled off. The intent of the hits was a little different than the other teams we play. Obviously somebody told them to try to knock him out of the game.” Spurrier suggests responsibility lies with the Florida State “coaching staff.”

1997, June 10:  “Carson’s Crusade Begins, Puts Focus on Head Injuries,” by Randy Lange, Bergen Record. News profile discusses cognitive and emotional struggles of former All-Pro Giants linebacker Harry Carson, who’s become one of the first players, like Al Toon, to openly discuss his post-concussion dysfunction and dark thoughts such as suicide. “A lot of players are hesitant to talk about the brain and being brain-damaged. It’s one of those things you don’t want to be associated with,” Carson says. “I think probably there are a whole bunch of players walking around who are experiencing mood swings and sensitivity to bright lights and loud noises, who are having headaches, and a whole host of other symptoms. … There was a time where I was depressed about it, and bad thoughts came to my head. I didn’t know what was going on, and I didn’t have anybody to talk to. Suicide? I thought about it. I was living but I didn’t have a life. My head was kind of in a fog. My daughter Asia kept me up. I told myself, ‘You do that, what’s going to happen to her?’ ”

1997, July 13:  “‘Iron Mike’ Webster Works on Strategy for Health Since Retirement; He Has Struggled With Troubles,” by Terry Shropshire, Akron Beacon Journal. News profile discusses the Hall of Fame lineman’s descent into increasingly publicized problems after retiring from the NFL, including poor health, debt, pending divorce and homelessness. “As good as times got, they got bad,” says Pam Webster, estranged wife of the Steelers great. “We’ve gone through times where we didn’t have enough money for toilet paper. There were times we didn’t have heat in the house. … Mike has always been a loner by nature. But there were times that people should have been there for him.” Mike Webster says: “I lived in the car for about a year and a half out of the last five years. … My issues are my issues and I’ll handle my issues.” Doctors speculate Webster suffers from congestive heart failure, but he and others worry about his brain, possible symptoms of post-concussive syndrome or Parkinson’s. “He’s really had trouble concentrating and focusing on certain things in order to function at an optimum level,” says Dr. Jerry Carter, personal physician. Webster acknowledges mind disturbances: “Some of the things I think about, horrify me,” he says.

1997, Sept. 22:  “Use Your Head,” by Joan Ryan, The Sporting News. News analysis discusses NFL forces keeping brain-injured players on the football field, beginning with competitive intent of both the player and his team, such as the controversial case of 49ers quarterback Steve Young. “It’s tough for someone like Steve to sit out when he feels fine,” says Leigh Steinberg, the star’s agent. “But you don’t know how much long-term damage you’re causing by continuing to play. Maybe it’ll cause Alzheimer’s. Maybe senility.” Dr. Larry Bedard, of the American College of Emergency Physicians, doubts effectiveness of so-called concussion management and RTP in sports: “[Concussions] tend to be misdiagnosed and minimized. Athletes are trained to tough it out. But there may be no such thing as a mild concussion.”

1999, Nov. 21:  “NFL players roughed up to know it hurts,” by Bill Gleason, South Bend Tribune. News commentary discusses postconcussion syndrome and the multiple concussions suffered by “punch-drunk” NFL players, while quoting football writer Jerry Magee, who recently endorsed boxing’s lengthy layoff for such athletes in his column for Pro Football Weekly. “It also must be said that boxing, for all its abuses, is more mindful of the well-being of its participants than is the NFL,” Magee states. “In Nevada a boxer who is knocked out cannot fight again for at least 45 days. In the NFL quarterbacks or players at any position who suffer concussions can play again within days. On a recent Monday evening, there was Troy Aikman quarterbacking the Dallas Cowboys only eight days after suffering the sixth concussion of his year. Many people who cover the NFL for newspapers, radio, and TV are around NFL players who are suffering through ‘post-concussion syndrome.’ ”

1999, Dec. 10:  “A Hard-Headed NFL Makes for Soft Skulls,” by Tim Green, USA Today. Guest news commentary by former NFL player discusses regular concussions in the league and endorses mouthpieces for helping prevent brain trauma, while noting longtime nicknames for head-injured players include “cardboard head” and, for those exhibiting lasting impairment and susceptibility, “paper head.” Green writes: “I’m not such a paper head as to think that mouthpieces will eliminate concussions. They help. And, if the NFL is as serious about safety as I think, there will be fewer… cardboard heads.”

2000, May 15:  “Trying to Leave Concussions’ Dark Ages: Neurologists start to take sports hits more seriously,” by James C. McKinley, Jr., New York Times. News analysis discusses continuing problems of non-uniform concussion diagnosis and return-to-play protocols in the NFL and sport at-large, noting that only in “the past 15 years” are neurologist beginning to understand brain trauma and “how multiple concussions can lead to permanent damage.” Mark R. Lovell, a Detroit neurologist serving on the NFL concussion committee who designs NP testing for teams, dismisses concussion guidelines by the American Academy of Neurology: “We don’t know whether being knocked out briefly is any more dangerous than having amnesia and not being knocked out,” Lovell says. “We see people all the time that get knocked out briefly and have no symptoms. Others get elbowed, go back to the bench and say, ‘Where am I?’ ” League committee chairman Dr. Elliot Pellman dismisses standard guidelines for all cases as nonsense amid hype about brain injury in football: “You really have to hope that the doctors who deal with this have a lot of experience with it, use the tools available and are not affected by the outside din,” Pellman says.

2000, September:  “Lower Cognitive Performance of Older Football Players Possessing Apolipoprotein E4,” by Kenneth C. Kutner, David M. Erlanger, Julia Tsai, Barry Jordan, and Norman R. Relkin, Neurosurgery. Clinical study discusses possible genetic link to brain trauma and long-term damage in control groups involving 53 active “professional football players,” presumably of the NFL, and provides direction for priority research questions such as whether football impacts, both concussive and subconcussive, cause cerebral disease or what is known from boxing cases as CTBI, “chronic traumatic brain injury.” In review of literature available, the authors state: “To our knowledge, no previous published study has systemically evaluated the cognitive status of professional tackle football players. At least two different mechanisms may contribute to the development of chronic cognitive dysfunction in football players. First, cognitive impairment secondary to concussion may be cumulative. Football players occasionally experience concussive events through typical contact sport collisions, i.e., head-to-head, head-to-body, head-to-ground, and head-to-goal post collisions. Second, football players may experience subconcussive events through these same collisions during play and practice/training sessions. For professional boxers, CTBI has been associated more strongly with career length than with the number of knockouts and concussions, suggesting that subconcussive blows are an important primary environmental mechanism of neurological dysfunction.”

2001, April 17:  “Concussions Make Stars See Retirement,” by Jonathan Rand, Kansas City Star. News analysis discusses retirement of Cowboys quarterback Troy Aikman, who sustained 10 diagnosed concussions in 12 NFL seasons, and includes comments by league medical officials on state of league knowledge or study in brain trauma of players, which the NFL contends typically clears in days to a week, outside exceptional cases like Aikman and fellow quarterback Steve Young. “For whatever reason, they take much longer to get better,” says Dr. Elliot Pellman, Jets internist and head of league brain committee and research. “You also notice the injuries they are getting are the result of lesser blows. … Why are these individuals more susceptible to post-concussion syndrome? You look at them and there’s no long-term damage. There’s no scientific evidence that can tell you they shouldn’t go back and play. Others say, ‘Even though I can’t prove it, intuitively there’s something wrong. You shouldn’t go back.’ What you see publicly is that debate going on.” Dr. Joseph Waeckerle, Chiefs physician and league committee member, says: “There’s no gold standard to diagnose concussions or predict whether someone will have another concussion.” Leigh Steinberg, agent for Aikman and Young, expresses frustration with the NFL’s “slow” pace for research and answers. “I think the years have not brought any greater focus. The denial by the NFL continues,” Steinberg says, urging standardized NP testing and development of concussion-resistant helmet technology. Pellman responds to Steinberg: “That’s a lawyer talking about medicine. I don’t think it’s ever that easy,” Pellman says. “I’d like to see better helmets and better equipment, and that’s the kind of work we’re trying to do now and are actively promoting to helmet manufacturers. But neither we [researchers] nor the NFL are helmet manufacturers.”

Matt Chaney is a writer, editor, teacher and restaurant cook in Missouri, USA. Chaney’s 2001 MA thesis at the University of Central Missouri involved electronic search for thousands of news reports on performance-enhancing drugs in American football, a project inspired by his experience of injecting testosterone as a college player in 1982 (Southeast Missouri State). Email him at mattchaney@fourwallspublishing.com. For more information, including about Chaney’s 2009 book Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

Experts: Football Death Reports Aren’t Valid Epidemiology

The University of North Carolina’s self-published football casualty statistics are deemed ‘unverified’ and ‘unreliable’ while its claim of zero deaths in 1990 is debunked by two case finds

By Matt Chaney

Posted Monday, January 12, 2015

Copyright ©2015 by Matthew L. Chaney

When sportswriters report 17 football players died in America during 2013, and medical writers and researchers cite the same figure, everyone’s common information source is the National Center for Catastrophic Sports Injury Research (NCCSIR) at the University of North Carolina in Chapel Hill.

The annual UNC numbers on football fatalities have been quoted worldwide since the 1970s and include statistical framework back to 1931, the year football organizations assumed control of annual recording. Reports are posted at the NCCSIR website and everyone presumes the data meet epidemiological standards for charting mortality risk in American football.

But the numbers do not qualify as epidemiological research, not remotely, say two experts who have monitored faults and recurring issues in UNC postings for three years.

“There is no independent verification of the data,” said Don Comrie, the CEO of PanMedix, a New York company that designs statistical analysis protocols for medical and pharmaceutical research. “When we look at the UNC data, there is no reliability.”

Epidemiologist Charles E. Yesalis says NCCSIR reports fail to pass muster for his discipline. Yesalis, author of epidemiological studies, journal articles and books on sports, identifies an historical misstep by UNC workers who lack medical and scientific credentials—their reliance on limited news content for casualty assessment of millions of football players, the vast majority being juveniles.

“When you’re dealing with (information) as what might get reported in the news, versus trying to identify accurately what’s reported in emergency rooms, or hospital records, that’s problematic,” said Yesalis, professor emeritus of public health for Penn State University, with his doctorate of science from Johns Hopkins University in 1975.

“It’s tough, it really is,” Yesalis said, empathizing with the football academics at UNC. “You’re trying to glue this all together, which is what it appears they’re doing. And they’re not the first people to do this on a variety of disease states, ER conditions, injuries and all that.”

Yesalis and Comrie have followed my email updates and blog critiques of UNC football publications since 2011, when I began collecting news reports of catastrophic player casualties found online.

For fatalities, I’ve located more than 1,400 deaths among active football players from 1960 to 2014, cases both confirmed and still suspect for links to the sport. And when comparing to the approximate 1,050 deaths UNC logs in the timeframe, methodological holes emerge for the NCCSIR.

Center officials refuse to answer my inquiries but an overriding fact is clear: more people die from football than the game-funded “studies” convey to the public.

Faults beset six decades of UNC football data, with inconsistent classifications and case omissions exposed by contemporary electronic search. Missing are deaths caused by football collision, defined as “direct” fatalities of the sport, along with likely hundreds of “indirect” or game-related fatalities—particularly for cardiac arrest, its various mechanisms that can include delayed attack from previous chest blows, according to a recent study.

Casualties omitted from 2011 UNC statistics, for example, include 13-year-old Kansas school player Alec Mounkes, who died of blood clots following an ankle injury. Kishon Cooper, 8, collapsed and died in Florida while training at home for “youth league” football. Two young men succumbed, Marcellis Williamson and Andy Collins, of blood clots and cardiac arrest, respectively, as free-agent hopefuls for professional football.

During 2012, Pennsylvania semipro player Willie Mims collapsed at football practice and later died, as did prep player Temoc Castellanos, 15, stricken during off-season conditioning for his school team.

An aspiring player in Texas, 15-year-old Jacob Gatlin, collided heads with another on a football field at school. The boys were participating in a “7-on-7” passing drill without helmets during “athletics class” directed by coaches, school officials told media, and Gatlin suffered a skull fracture and fatal brain hemorrhaging.

None of these deaths is recorded by UNC.

Several high-school players died of cardiac arrest in 2012, during exercise and restive state like sleep, including: Anthony Vaeao, California; Austin Lempera, Illinois; Cody Stephens, Texas, David Widzinski, Michigan; and Tyler Miller, New York. Such cases require specialized postmortem applications for diagnosis and determining a possible link to sport, according to a host of experts worldwide.

None of these deaths is included in UNC “research.” Many more of possible football ties since 1960, found online, require proper scientific evaluation.

Errors likewise dog UNC’s recorded cases, such as the 2010 death logged in the wrong year. Youth player Quadaar White, 15, died of a broken neck in Philadelphia on Aug. 31, 2010, but the NCCSIR recorded his case for 2011.

I repeatedly emailed then-center director Frederick Mueller. Instead of correcting his mistake, Mueller—a lifelong football man with a PhD in education who goes by “Dr. Mueller”—demanded that I cease contacting him. Mueller has since retired as an exercise professor, after co-authoring football surveys at UNC from the 1970s to 2012.

The error on Quadaar White remains standing in NCCSIR reports at the website.

1990 Collision Deaths, Retrieved Online, Nullify Old UNC Claim

Now a substantial mistake has emerged involving Mueller, his inaccurate declaration publicized for three decades from Chapel Hill, such as it reads here, typos intact, on Page 1 of the UNC report for 2013 football deaths:

The 1990 report was historic in that it was the first year since the beginning of the research, 1931, that there was not a direct fatality in football at any level of play.(Mueller & Schindler 1991)  This clearly illustrates that data collection and analysis is important and plays a major role in prevention.

Wrong, at least on the first point.

Minimally two direct football deaths occurred during 1990, both of violent “sandlot” incidents, according to reports I recently retrieved from NewsBank database.

One case occurred merely 80 miles from Chapel Hill: Jamarl Gentry, 17, died on Nov. 7, 1990, of a broken neck suffered in a pickup tackle game at Winston-Salem, reported The Greensboro News & Record.

The second 1990 football death retrieved from NewsBank is Christopher Mock, 19, a college student from Bluffton, Ind. Mock died on Dec. 1 of a brain injury suffered in sandlot tackle football, reported The Fort Wayne News-Sentinel.

During December I forwarded these cases to Mueller, NCCSIR medical director Dr. Robert Cantu in Boston, and other officials like Kristen Krucera, PhD, the athletic trainer who’s replaced Mueller as center director. I requested their comments, repeatedly.

Only one person replied, Mueller, by email: “I told you to take me off of your mailing list,” he griped.

Modern Emergency Care Dramatically Cuts Football Deaths Since 1960s

NCCSIR officials argue that their dubious football statistics and recommendations like Heads Up “safe contact,” the latest version of stale “head up” theory, have reduced player deaths by as much as two-thirds since the 1960s.

Historical news shows no such evidence. Rather, the major reason for fewer reported football fatalities was faster, better medical care that kept seriously injured players alive, with an assist from modern helmets.

Most football fatalities in the 1960s were connected to inadequate medical care, based on news reports. Players died of brain bleeding, spinal fracture, chest impact, ruptured spleen, lacerated kidney, blood clotting, heat stroke, cardiac arrest and more maladies that became better managed in America by end of the Vietnam War.

“By the early 1970s, many influential members of medical society (in the United States) believed that lessons learned on the battlefields in Korea and Vietnam in terms of triage, rapid transport of trauma patients to definitive care centers, and standardization of pre-hospital and in-hospital care could be applied effectively to civilian patients,” recounts a Canadian medical review.

The 1970s advancement of emergency medicine in America—led by widespread establishment of EMTs, modular ambulances, life flights, emergency rooms and trauma surgery—saved countless athletes who would have died previously without it.

The steel head-and-neck brace or “halo cast,” breakthrough technology available nationwide by 1973, stabilized vertebral fractures that previously killed people. Numerous tragedies were averted in football and all walks of life, with immobilization techniques for spinal casualties and treatment like the halo brace.

Even Mueller admits emergency response has cut football deaths from brain injuries, compared to a half-century ago. “The line is going down with fatalities. I think that’s related to kids getting better medical care on the field,” Mueller told HealthDay.com, after reviewing news reports of two-dozen players who survived catastrophic brain bleeds in 2011. “They’re not dying, but they’re having permanent brain damage.”

Left unsaid? I had forwarded Mueller those cases, or he probably would’ve missed most.

UNC Changes in Death Definitions Trim Football Numbers Since 1960s

Factors beyond emergency care and improved helmets also have reduced football deaths in UNC records since 1960. Based on available information, numbers have been shaved as much as one-fifth since 1960 just by altering definitions to qualify game fatalities.

Background begins in 1931, when the American Football Coaches Association hired Floyd R. Eastwood, a college professor with a PhD in education, to record yearly football casualties—formerly the task of media entities like The Associated Press. News accounts describe Eastwood’s method for collecting cases and defining types of football death.

“Dr. Eastwood” analyzed news reports of deaths among football players for 35 years, working for both the coaches association and the NCAA, groups which continue to fund the NCCSIR today. Relying heavily on the NCAA’s “clipping service” of major newspaper and wire-service articles, Eastwood gathered stories of casualties and looked for football causes or possible links, sometimes basing a case decision on news content alone.

Eastwood had to track national football casualties while grounded on campuses where he taught PE pedagogy and gym classes. Limited in information access and funding, he tried to assimilate medical protocol despite a personal résumé far short in education and training for the mission.

Eastwood followed up many football incidents he learned of, making phone calls and mailing information forms to witnesses and authorities. But their responses likely varied in substance and it was difficult and costly to obtain medical files and death certificates from across the country. Moreover, Eastwood surely understood that official information was frequently tainted by simple incompetence and/or football allegiance among local authorities.

“Keep in mind…,” intoned Comrie, who has compiled football casualty data, “many doctors in many parts of the country don’t want to blame football. So on those death certificates, is that information reliable? I don’t know. We don’t have a clue.”

Most significantly, Eastwood defined and qualified several types of football death differently than his present-day successors at UNC.

For example, Eastwood believed that football exertion and impacts could trigger congenital brain bleeds in players, caused by “AVM” and Chiari arterial malformations since birth. Medical opinion was divided, but many doctors determined that football spurred these cerebral vessel ruptures of natural origin, and Eastwood embraced the stance.

UNC researchers dismiss these incidents today, meanwhile, like the 2010 death of college player Ben Bundy, killed by his genetic brain-artery malformation that launched a blood clot during a team workout. Bundy wasn’t counted in the annual NCCSIR report.

Eastwood included meningitis fatalities among players and field deaths of referees for his 1960s football statistics. Neither type of incident figures into current UNC data.

Eastwood counted players dead of blood clots originating from leg injuries, classifying them as indirect fatalities of the game. In recent decades, however, UNC publications include only an occasional death via non-cerebral blood clots; many additional cases are omitted without explanation, like Mounkes, the aforementioned schoolboy, and Ben Jordan, 16, a South Carolina prep player dead of a pulmonary embolism in 2012 after he was hospitalized for blood clots during successive football seasons.

Altogether, the types of deaths counted by Eastwood but not counted by UNC comprise as much as 20 percent of the 350 football fatalities from the 1960s that I’ve collected.

And the “sandlot” classification has become the biggest area of NCCSIR shell games that produce smaller numbers, over time, and inspire the rhetorical mirage of “safer” football today.

UNC Qualifies Few ‘Sandlot’ Fatalities for Football Statistics Since 1980s

Erstwhile PE professor Floyd Eastwood held a broad view of what constituted a “sandlot” death, qualifying any person who died from injuries suffered while playing any type of football: organized or informal; tackle or “touch”; games in vacant lots, flag leagues and PE classes; and even passing and catching during school recess. In 1962, for example, Eastwood counted a young father who died of striking a telephone pole during a backyard touch game with family as one of the professor’s 19 direct football fatalities that year.

Eastwood also logged indirect or game-related sandlot deaths, numerous cases in his 1960s data, for causes such as cardiac arrest and heat stroke.

Thus far, NCCSIR officials decline to provide me with the names and locations for football deaths in their multi-decade collections. They decline to address inconsistencies in data classifications back to Eastwood’s tenure. They do not offer, or possess, a single peer-validated document incorporating detailed cases, formal literature review and a complete research method that identifies limitations.

UNC transparency isn’t needed, however, to deduce that Mueller et al. have basically counted only “youth league” players for sandlot fatalities since 1986, based on NCCSIR postings, cases found online, and public statements of Mueller and colleagues.

UNC no longer counts fatalities of flag football, “touch” games, PE classes, “athletics classes,” recess periods, and intramural competition at colleges; deaths from tackle sandlot games are no longer included—yet all types still load those numbers from the 1960s and ’70s.

It would seem “sandlot” deaths were disappearing by the 1980s, according to football-funded researchers. Indeed, UNC statistics from 1986 to 1998 do not list any direct fatalities in the category.

On the contrary, numerous deaths of impacts occurred in the period that Eastwood would’ve counted for sandlot classification, including the following cases I’ve located:

1986: Ervin Kolk, 27, died of “being kicked in the head during a touch football game” at Tukwila, Wash., reported The Seattle Times.

1987: Joshua Arruda, 12, died of “injuries he received when he fell and hit his head on a rock during a tag football game at school,” reported The Daily News of Los Angeles.

1988: An adult male, unidentified, died of “a severed aorta after taking a blow to the chest” in touch football at North Conway, N.H., reported The Sporting News.

1989: Walter Jackson, 27, died “as a result of the head injury he suffered” in touch football, reported The Buffalo News.

1990: Jamarl Gentry, 17 (aforementioned case), died of a broken neck sustained in pickup tackle football at Winston-Salem, N.C., reported The Greensboro News & Record.

1990: Christopher Mock, 19, (aforementioned case), died of head injuries sustained in pickup tackle football in Indiana, reported The Fort Wayne News-Sentinel.

1991: Timmy Hysinger, 29, died “of a head injury he suffered… playing touch football in the street” at Mauldin, S.C., reported The State newspaper.

1994: Chris Hart, 18, dead “from head injuries suffered in a flag football game” at Texas A&M University, reported The Houston Chronicle.

1996: Terry Crayton, 16, died after “being knocked unconscious in a gym-class collision… playing a game called ‘speedball,’ a combination of soccer and football” at a Milwaukee school, reported The La Crosse Tribune.

1996: Jason Boone, 19, died of “receiving a severe head injury… in a touch football game” at Maryville, Tenn., reported The Knoxville News-Sentinel.

1996: Derek McMillen-Morgan, 16, died of “massive spinal injuries (sustained) when tackled” during a pickup game at Canton, Ohio, reported The Akron Beacon Journal.

The following deaths also are omitted from UNC statistics that log zero “sandlot” collision fatalities in said years:

2000: Maurice Doty, 16, “died of cardiac arrhythmia due to blunt force impact of the chest” in a pickup tackle game at Dayton, Ohio, reported The Daily News.

2005: Kenny Luong, 19, “died from (head) injuries received during a UC Irvine fraternity football game,” reported The Orange County Register.

2005: Steve Lynes, 19, “died of (head) injuries suffered during a pickup football game” at Brigham Young University, reported The Associated Press.

2005: Robert Meza, 24, died of a brain injury sustained in flag football at Taylor, Mich., reported The Detroit News.

2006: Logan Honsinger, 10, “died after his diaphragm was ruptured, an injury authorities… suspect he received during practice” for his youth-league team at Hemlock, Mich., reported The Associated Press.

2006: Andre Thibault, 12, “died from injuries suffered… when he tripped and fell into a pole while playing football” at Halstead, Kan., reported The Kansas City Star.

2008: John Buzzard, 15, “died of heart and brain-related conditions” sustained “during a touch-tackle football game” at Brooklyn, N.Y., reported The Staten Island Advance.

2008: Coty Bluford, 14, died of injury sustained when he knocked “heads with another boy” in football play during PE class at school in Lenoir City, Tenn., reported The Associated Press.

2008: Dominique Edwards, 19, died of a ruptured kidney sustained “when he dove for a football… and struck his left side” in a pickup game at Macon, Ga., reported The Telegraph.

2008: A boy, unidentified, 11, died “after being struck in the throat during a recess game” at school in Lake Oswego, Ore., reported The Oregonian.

2012: Jacob Gatlin, 15 (aforementioned case), died of skull fracture and brain hemorrhaging after a collision during a 7-on-7 passing session in school “athletics class” at Hawkins, Texas, reported The Longview News-Herald.

2012: Alex Lott, 17, died of a neck fracture “received playing touch football” at Richton, Miss., reported The Jackson Clarion-Ledger.

Again, these cases require examination by accredited authorities for qualification in valid football research, but this news batch demonstrates the stark, unannounced change between 1960s record-keeping and modern death data from UNC.

“We hear, ‘Oh, football’s become safer,’ ” Comrie said. “I don’t know if it’s become safer. I’m hearing this but I don’t know. Because no one’s willing to sift through the (UNC) data, we don’t know how many kids died or what they died of. We don’t know how many football deaths were purely preventable.”

Comrie, who has consulted for the U.S. Air Force and NFLPA regarding brain injuries and assessment, sees professional incompetence for NCCSIR publications that claim to reduce football mortality rates.

“It’s certainly uninformed,” he said. “Science is about asking questions. If you have incomplete or inaccurate data, you’re probably asking the wrong questions. The lack of information is bad for everybody, including the NFL, the NCAA and the national high schools.

“Reliable data is the key to making strong recommendations about what to do, but decisions are being made in football based on nothing,” Comrie said. “Everyone should know the data is just crap, period.”

Like Eastwood in the past, UNC researchers erroneously announce football deaths in absolute numbers, never mind that their primary means of incident details–news content–remains inadequate. Any accuracy would be a lucky guess and unverifiable anyway.

The total for a given year “could be stone-cold accurate or it could be off by a million miles,” said Yesalis, the epidemiologist. “It’s all based on how you count the population at risk, football players. It’s how you count the death events, how you acquire information, with bias for relying on news reports. Even of a death, there could be an injury where the kid is taken from the field and dies maybe three weeks later. Well, how confident can you be that will be reported (in news)?

“Basically going by news media alone? No epidemiologist would say that’s ideal.”

Comrie believes enough information exists empirically to resolve deficiencies through collaborations among investigators like me, the UNC academics, and appropriate authorities from medicine and science. Amassing death certificates would be a scientific start.

Vital data on football mortality risk “probably exist somewhere, in some form,” Comrie said, but politics stymie progress. “They (game officials) have just made it as difficult to get and to analyze as they possibly can because they want no change in the status quo. I have my beef in all this, because I can’t make reasoned decisions because the data’s unreliable. And the scientific community just goes along.

“We’ve been operating in a world where no one’s ever checked to see if the (football) data are real or not,” Comrie said. “They publicize it, of course, under UNC, but what was their research method? How did they do it? But since the method, regardless, produced exactly what the media wanted to hear and the parents wanted to hear, no one’s ever questioned it.”

Modern Myth of Safer Football, Research Heroes and Saving Lives

In 1998, the United States Sports Academy gave Fred Mueller an award for “lasting contributions to the growth and development of sports medicine through practice or scholarship.”

A UNC-Chapel Hill press release heralded the university’s “Life-Saving Dr. Mueller,” stating:

Statistics he compiled, first with Dr. Carl Blyth, also of UNC-CH, on football injuries and deaths helped lead to rule changes and improved coaching credited with saving dozens of lives a year in the United States.

Comrie scoffs in New York, pondering what’s really happened around the so-called National Center for Catastrophic Sports Injury Research—which has no street address in Chapel Hill, no facility on campus, nothing of validated research.

It’s all a façade fronted by Mueller types and feel-good statistics, Comrie alleges, designed to lead naïve kids and parents along the Yellow Brick Road to Safer Football.

“It’s the mythology being confused for reality,” he surmised. “And the way to promote mythology is to make sure there are no hard facts or evidence.

“So we go through the curtains and we find out the great, mysterious Oz is not who he appears to be.”

Matt Chaney is a writer, editor, teacher and restaurant cook in Missouri, USA. Chaney’s 2001 MA thesis at the University of Central Missouri involved electronic search for thousands of news reports on performance-enhancing drugs in American football, a project inspired by his experience of injecting testosterone as a college player in 1982 (Southeast Missouri State). Email him at mattchaney@fourwallspublishing.com. For more information, including about Chaney’s 2009 book Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

Cardiac Death Foils Medical Tracking in Football, All Sports

Risk of Sudden Death Understated in Football, Say Experts

Information Barriers, Autopsy Limits Promote Short Data

Sample 31 Player Cases Led by Cardiac Deaths, 2014 To-Date

By Matt Chaney

Posted Friday, October 24, 2014

As concern spikes again for deadly injuries in American football, field collisions have killed from two to five teenagers thus far in 2014, pending further analysis, and an exact number may remain in question.

Actual football mortality constitutes a much bigger picture, meanwhile, through incalculable player deaths that are indirectly related to the game.

Minimally two dozen American football players have succumbed in sudden death this year. Most of the cases are perplexing, challenging for accurate diagnosis and impractical for linking to football, according to contemporary studies and authorities.

Record-keeping is stifled, resulting in significant under-reporting of deaths overall in American sport, especially for cardiac disease, say experts.

For American football, sudden cardiac death (SCD) has been marginally recorded over some 120 years of casualty reporting−while likely being the leading cause of mortality in the game.

And a particular, robust SCD class has been practically excluded, left undocumented: Those active football players who die without  physical exertion, in daily life outside game activities.

Actually, say experts, an athlete’s restful or normal state can combine with previous exertion to induce cardiac arrest in some variations.

“Yes…,” affirms Dr. Kimberly G. Harmon, of the University of Washington, a leading researcher in sudden death among athletes, “exercise can cause changes in the heart in some conditions that may make SCD more likely either at rest or at death.”

This year at least seven American football players have died during sleep and minimally five have collapsed at home, on campus, or while shopping. See their cases amid the 2014 summaries below, hyper-linked to news reports.

The dozen dead were schoolboys and collegiate players who participated regularly in training sessions and games. Each was hours or days removed from his last athletic exertion.

Nine more players have collapsed during football-specific activities, such as games and practices, then died.

Additional cases likely have occurred this year, sudden deaths of active football players, but information is hindered, leading to skewed recording and analysis−and weak prevention.

Privacy law is one limitation but the research field relies too heavily on inconsistent news media, which traditionally generate the lot of football’s catastrophic casualties to become recorded. Thus final statistics are short regarding millions of players, most prepubescent.

“Current methods of data collection underestimate the risk of SCD,” conclude Harmon et al., in the group’s landmark 2011 research on collegiate sports. “Accurate assessment of SCD incidence is necessary to shape appropriate health policy decisions and develop effective strategies for prevention.”

“Deaths in high school athletes may be even less likely to be identified by media reports as opposed to higher-profile NCAA athletes,” the researchers surmise in their article for Journal of The American Heart Association.

Faulty U.S. Death Investigations Impact Medical Data on Sports

Proper postmortem exam is problematic for American SCD casualties in general, not only athletes. America’s current death-investigation system struggles with “widespread dysfunction,” as documented by government and media reviews in the past decade.

Only about 9 percent of all deaths are autopsied in this country, and cardiac disease can elude identification and diagnosis even under pathology exam.

“The coroner-medical examiner system in the United States is highly variable in quality,” says Harmon, the MD and professor of sports medicine and family medicine at UW, via email. “Coroners are often elected or appointed officials with their only requirement being graduation from high school.”

“In many cases (of sport SCD) forensic pathologists are not performing the autopsies and most of the time cardiac pathologists are not involved.”

The basic mission of coroner and ME offices nationwide is to rule natural causes or foul play in a death, “and not necessarily the actual pathology,” notes Harmon.

Verifying a possible sport link is impractical, typically impossible.

“Often the training of the pathologist is limited and budgets to run (microscopic) histology−which is critical in making a correct (SCD) diagnosis−are limited,” notes Harmon, who encounters the issues in her review of college cases.

“Often experts will come to different conclusions as to etiology or not be able to make a definitive call on cause of death.”

Common thread is lack of evidence and sound conclusion, for SCD incidents in football players, like 2013 prep fatalities reported in Michigan and North Carolina. For the latter case, The Fayetteville Observer editorial board criticized state pathologists and procedures.

“When young football player Evan Raines died last year during practice at Seventy First High School, his family had to wait more than a year to find out why,” the newspaper editorialized on Oct. 5, continuing:

“But they weren’t singled out for what appears to be a glacial work pace at the N.C. Medical Examiner’s Office. … And they weren’t singled out, either, for an autopsy report that was vague and incomplete. That, we have learned, is the prevailing condition, too.”

In Missouri, a local coroner acknowledges knowing little but to declare cardiac arrest as cause in the recent death of 22-year-old international student Kazadi Mutombo. The ruling was based on hearsay that the fit and athletic young man collapsed in workout clothes after visiting the YMCA in Joplin.

Autopsy proved fruitless; the coroner’s consultant pathologist detected negligible evidence of harm to Mutombo’s heart, which “appeared to be in good shape.”

“There’s just certain things you don’t find out from autopsies, and you’ll never know,” says Newton County coroner Mark Bridges.

Accurate Death Analysis Crucial to Surviving Family Members

Researchers estimate almost a third of SCD cases in athletes under age 35 produce “negative autopsy” results for the different forms. State-of-the-art, costlier analysis is needed.

“Because electrical and other (cardiac) conditions will not be detected, it is not unusual for a routine autopsy to conclude that the cause of death was indeterminate,” states a Michigan study.

“In such cases, heritable conditions such as cardiac ion-channel disorders are suspect and genetic analysis could help to elucidate the cause of death and prevent future deaths in families at risk.”

The call is universal among experts, to overhaul SCD tracking in sports such as American football, foremost for preventing congenital health calamities among athletes and their families.

Genetically inherited cardiac conditions include most cardiomyopathies, like “enlarged heart” or HCM, and the “channelopathies,” heartbeat malfunctions caused by the organ’s electrical current, becoming increasingly detectable in advanced assays.

“In the past decade, the emergence of the channelopathies, in particular long QT syndrome and catecholaminergic polymorphic ventricular tachycardia, has transformed the importance” of advanced analysis, observes Dr. Mary N. Sheppard, of the Department of Histopathology at Royal Brompton Hospital in London.

“Sudden unexpected death during exercise particularly can, in many families, bring to their attention a hitherto unsuspected cardiac condition which is inherited and may be diagnosed by screening first-degree family members,” Sheppard writes for her 2012 analysis published in British Journal of Sports Medicine.

“Missed diagnoses (or) wrong diagnosis can have catastrophic consequences for families in which other members are at risk of sudden death because they carry the defective gene for that condition.”

31 Death Cases Among Football Players, 2014 To-Date

This collection of death cases among active American football players in 2014 is a sampling of public reports, online news. This analysis does not purport to present any  accurate number or estimation of deaths caused or related to football activities.

See 31 annotated cases below, including fatal casualties of brain bleeding, cardiac disease, heatstroke, and pulmonary embolism, culled from reports in Google banks since January.

Twenty-seven teenagers are among this sample 31 deaths, which are comprised of 1 youth football player, 2 middle-school students, 19 high-school players, 8 collegiate players, and 1 adult in flag football. Case capsules are wholly constructed of news content.

The information requires medically specialized followup, vetting by a multi-disciplinary team that would include accredited epidemiologists and a cardiac histopathologist, among experts, for scientific qualification beyond raw data, which is news content.

No such research team has yet been funded and assembled for American football.

Additional deaths among active football players appear online: suicides, drug overdoses, and more unexpected casualty.

Further deaths reported around the sport, including of coaches and referees, also do not appear below.

Cases are collected and filed by Matt Chaney, MA, at email: mattchaney@fourwallspublishing.com.

My condolences to family and friends of every deceased athlete.

Oct. 17:  Jamond Salley, 16, Virginia, a 5-10, 203-pound lineman for Park View High School in South Hill, complained of a headache after contact during a game. Salley collapsed on the sideline of a brain bleed and was pronounced dead at hospital. Cause of death was blunt force trauma, according to the medical examiner’s office. Sources: WTVR-TV and SoVaNow.com.

Oct. 12:  Trey Taulton, 18, Texas, a 6-foot-1, 210-pound receiver for Mesquite Horn High School, died during sleep of “natural causes,” reports The Mesquite News.

Oct. 1:  Tom Cutinella, 16, New York, a linebacker and offensive guard for Shoreham-Wading River High School, sustained a brain bleed during a game of contact, say police. Cutinella died later at hospital and no autopsy results were available at time of this posting. Source: WFAN-TV.

Sept. 29:  Isaiah Langston, 17, North Carolina, a lineman for Rolesville High School, collapsed during a game on Sept. 26 and died three days later at hospital. A family member says cause of death was linked to a blood clot at the brain, reports WTVD-TV.

Sept. 28:  Andrew Madrid, 14, Texas, a football player for Marfa High School, collapsed while playing soccer with friends at the school on this Sunday. He died later at hospital. Sources: Big Bend Sentinel and KWES-TV.

Sept. 28:  Demario Harris Jr., 17, Alabama, a cornerback for Charles Henderson High School, collapsed of a brain bleed after making a tackle during a game on Sept. 26. Harris died two days later at hospital of a brain hemorrhage caused by contact during the game, says his father. Sources: People, WSFA-TV, and Dothan Eagle.

Sept. 28:  Jeremiah Pierce, 12, New Jersey, a youth player in Penns Grove Midget Football, collapsed during practice on Sept. 23 and died five days later at hospital. Results of any postmortem examination were not available at time of this posting. Sources: New York Daily News and South Jersey Times.

Sept. 1:  Miles Kirkland-Thomas, 16, New York, a 6-2, 295-pound lineman for Curtis High School, collapsed during football practice and was pronounced dead at hospital. Cause of death was hypertrophic cardiomyopathy or HCM, and obesity contributed, according to the medical examiner’s office. Source: Staten Island Advance.

Aug. 25:  Walker Wilbanks, 17, Mississippi, a lineman for Jackson Preparatory School, collapsed during a game on Aug. 22. He died three days later at hospital of over-hydration, or hyponatremia, according to Dr. Joe Pressler. Source: Clarion Ledger.

Aug. 24:  Marquese Meadow, 18, Maryland, a 6-2, 300-pound lineman for Morgan State University, collapsed at football practice on Aug. 10. He died two weeks later at hospital of heatstroke, according to the medical examiner’s office. Sources: Baltimore Sun and Washington Post.

Aug. 20:  Jason Bitsko, 21, Ohio, a 6-4, 280-pound offensive lineman for Kent State University, died during sleep at home. Final autopsy results are pending for public release. Sources: The Associated Press and WOIO-TV.

Aug. 16:  Will Wheeler, 17, Massachusetts, a 5-11, 165-pound defensive back for Central Catholic High School, died during sleep at home. Autopsy is planned, reportedly, but no results are yet available online. Source: Eagle Tribune.

Aug. 13:  William Shogran Jr., 14, Florida, a lineman for Sebastian River High School, collapsed at football practice then died at hospital. Heat illness possibly contributed, according to reports. Further information was unavailable at time of this posting. Sources: New York Daily News and WPTV-TV.

Aug. 11:  Zyrees Oliver, 17, Georgia, an offensive lineman for Douglas County High School, collapsed during football practice on Aug. 5. He six days later at hospital of over-hydration, say doctors. Further pathology results are pending but currently unavailable online. Sources: Atlanta Journal-Constitution and The Weather Channel.

Aug. 10:  Dan Malakoski, 36, Pennsylvania, collapsed while playing flag football and died at hospital, reportedly of cardiac arrest. Source: NewsItem.com.

Aug. 6:  Noah Cornuet, 16, Pennsylvania, a 6-2, 270-pound lineman for Burrell High School, collapsed at football practice then died at hospital. Reportedly, a non-cancerous heart tumor caused the death. Further information is unavailable online. Sources: WTAE-TV and Pittsburgh Post-Gazette.

July 21:  Shawn Afryl, 22, Minnesota, a 6-3, 310-pound offensive lineman for Winona State University, collapsed during a conditioning workout and died at hospital. Cardiac arrest reportedly caused the death. Sources: Chicago Tribune and Minneapolis Star Tribune.

June 30:  Sean Tillotson, 17, Vermont, a running back and tight end for Oxbow Union High School, died of a pulmonary embolism, a blood clot lodged in lung tissue, during an airport layover in Denver, Colorado. Tillotson was recovering from a second surgery on a knee that was injured the previous football season. Source: Valley News.

June 30:  Gage Meeks, 11, Louisiana, who was preparing to play football for Calhoun Middle School, became stricken at home and died at hospital. A doctor said cardiac arrest caused the death. Sources: KNOE-TV and Monroe News-Star.

May 21:  An unidentified boy, 14, New Jersey, collapsed while throwing a football during PE class and died at hospital. The incident occurred at Thomas E. Harrington Middle School. Source: Philadelphia Inquirer.

May 13:  MarQuavious Payne, 17, Georgia, a 5-11, 185-pound linebacker for Cedar Shoals High School, died during sleep at home. Pathology results are unavailable online. Source: Athens Banner-Herald.

April 27:  James Michael Creamer Jr., 15, New York, a lineman for St. Peter’s Boys High School, died in sleep at his home.  An allergic reaction or choking may have contributed to the death, say family members. Source: Staten Island Advance.

April 21:  Jaqwan Cephus McGill, 16, North Carolina, a 5-6, 155-pound running back for South Columbus High School, collapsed at a convenience store and was pronounced dead at hospital.  Autopsy was performed but results remain unavailable online. Sources: Fayetteville Observer and WECT-TV.

April 15:  Mekail Evans, 17, Alabama, a 5-10, 195-pound linebacker for Clay-Chalkville High School, collapsed and died at home following a workout. The teen had a heart condition that was previously undiagnosed, say family members. Sources: Trussville Tribune and Al.com.

April 6:   Ronald Cunningham, 19, North Carolina, a 6-2, 285-pound lineman for St. Augustine’s University, collapsed on campus, possibly of cardiac arrest, and died at hospital.  Cunningham had recently injured a knee in football practice and was awaiting surgery. Pathology results, if any, are unavailable online. Sources: WTVR-TV, WRAL-TV, Charlotte News Observer and Richmond Times-Dispatch.

March 25:  Will McKamey, 19, Maryland, a 5-9, 170-pound running back for the U.S. Naval Academy, collapsed of a brain bleed at practice on March 22 and died three days later in hospital, following surgery. No football contact distinguishable on video could be linked to the injury, say family members. McKamey previously suffered a severe brain bleed in football, 2012, when he was a high-school senior in Tennessee, but no surgery was performed after that incident and he returned to the sport. Sources: USA Today and TheDailyBeast.com.

March 8:  DaQuan Henderson, 15, South Carolina, a defensive lineman for Whale Branch Early College High School, died at a hospital. Henderson’s mother said her son had been diagnosed with irregular heartbeat and a coroner reportedly determined natural causes for the death. Further information is unavailable online. Sources: Beaufort Gazette and MarshelsWrightDonaldson.com.

March 2: Desmond Pollard, 17, Texas, a 6-2, 180-pound receiver for Gilmer High School, collapsed and died during a pickup basketball game. Pathology results, if any, are unavailable online. Sources: KLTV-TV and KYTX-TV.

Feb. 8:  Eddie Key III, 18, Nebraska, a 6-2, 270-pound lineman for Wayne State University, died in his sleep. Autopsy results reportedly list the cause as pulmonary edema, fluid buildup in the lungs caused by heart failure. Sources: KOLN-TV and Lincoln Journal Star.

Feb. 7:  Ted Agu, 21, California, a 6-1, 240-pound defensive lineman for the University of California-Berkeley, became stricken during a team conditioning session and died. Autopsy results released in spring reportedly listed the cause as hypertrophic cardiomyopathy, thickening of the heart, but the player’s family later filed a wrongful death lawsuit, alleging he had a known sickle-cell condition. Sources: The Associated Press, San Francisco Chronicle, and SFGate.com.

Jan. 17:  Joseph Cooks, 18, Florida, a 6-foot-2, 165-pound wide receiver for Southeastern University, died in his sleep. Pathology results, if any, are unavailable online. Source: Lakeland Ledger.

Matt Chaney, with a MA in electronic media studies, is an independent writer, editor, teacher, and restaurant cook in Missouri, USA. For more information, including about his book Spiral of Denial: Muscle Doping in American Football (2009), visit the homepage at www.fourwallspublishing.com. Email him at mattchaney@fourwallspublishing.com.

Brain Bleeds Among American Football Players, 2014

By Matt Chaney

Posted Monday, October 13, 2014

Last week a Texas boy became another severe brain casualty among American football players this year.

Details are sketchy for what led Clay Carpenter, 12, to collapse twice during football practice at Eustace Middle School last Tuesday night.

Carpenter was transported by ambulance to a local emergency room then flown by helicopter to a major trauma center in Dallas.

The boy was responsive following emergency brain surgery at Children’s Medical Center in Dallas, said his mother. “We’re just thankful he’s awake,” Leticia Carpenter told The Athens Review.

Leticia Carpenter said the injury “didn’t appear to have occurred after a collision with another player.”

As young Clay Carpenter remains hospitalized, at least six additional survivors of severe brain bleeds among American football players are known publicly, based on online reports thus far in 2014.

Recovery continues for all seven. See the annotated brain-bleed cases at bottom, along with capsules on one stroke victim and more casualties among football players in 2014.

Additional severe brain injuries have likely occurred and some will become public in future calendar years, beyond 2014, as demonstrated by cases from years such as 2013, 2012 and 2011, emerging still in reports.

Regarding football of 2011, for example, several critical brain injuries were later revealed in locales such as California, Alabama, and North Carolina. Even the brain-bleed case of an NFL player, caused by congenital artery malformation and possibly related to football, was “kept quiet” for two years.

Further types of head injuries for football 2014, reported in Google banks thus far, include an orbital-lobe fracture of a college football player and  blindness of an eye for a prep.

Severe Brain Bleeds Reported Among Football Players in 2014

Cases require medical review for scientific qualification above raw data, which is news content. Cases are reported online by news media then collected through electronic search by Matt Chaney; email him at mattchaney@fourwallspublishing.com.

Oct. 7:  Clay Carpenter, 12, Texas, a football player for Eustace Middle School, collapsed of a brain bleed during football practice. Surgery was performed and the boy remains hospitalized, reports The Athens Review.

Sept. 26: Brandyn Flores, teenager, Texas, a senior football player for Tornillo High School, sustained a brain bleed during a game. Surgery was performed and Flores remained comatose for six days. He has been released from hospital and recovery continues. Sources: KVIA-TV, El Paso Times and Facebook.com.

Sept. 12:  James McGinnis, teenager, Kansas, a senior football player for Olathe East High School, collapsed of a brain bleed during a game. Surgery was performed and McGinnis continues recovery at a rehabilitation center, reports KMBC.com

Sept. 12:  Robert Back, teenager, a junior football player for Belt High School, sustained a brain bleed during a game, reportedly of impact. Surgery was performed and Back remains hospitalized.  Sources: Great Falls Tribune and GoFundMe.com.

Aug. 28:  Dillon Fuller, 16, Wisconsin, a running back for Hartford Union High School, sustained a brain bleed of contact during a game. An initial surgery has been followed by a second brain operation and recovery is promising. Sources: WTMJ-TV and WDJT-TV.

Aug. 14:  Parker Scott, 16, Nebraska, a football player for Millard West High School, sustained a brain bleed during practice, reportedly of contact. Surgery was performed and recovery is promising, reports The Omaha World-Herald.

April 5:  D’Ondre Ransom, adult, California, a semipro football player for the Sacramento Wildcats, sustained a brain bleed during a game, reportedly of contact. Surgery was performed and Ransom remained comatose for weeks, at last report. Sources: KXTV-TV and Sacramento.CBSLocal.com.

Cerebral Stroke Reported Online Among Football Players, 2014

Sept. 3:  Nathaniel Brumett, teenager, West Virginia, a freshman football player for Coal Valley High School, sustained a fractured cervical vertebra during practice that led to a stroke, blood clotting in the brain. At last report, Sept. 5, Brumett was hospitalized in ICU with spinal surgery pending, reports The Ironton Tribune.

Additional Brain Cases Reported Among Football Players, 2014

Sept. 26:  Andrew Buzynski, teenager, Iowa, a sophomore football player for Wapsie Valley High School, sustained a concussion during a game and was hospitalized for one week. Buzynski has returned to school and recovery is strong. Sources: Waterloo Cedar Falls Courier and KWWL-TV.

July 16:  Max Haddad, 17, California, a football player for John Burroughs High School, sustained a brain bleed of collision during a scrimmage without pads and helmets. Within hours doctors determined swelling had subsided and Haddad was released from hospital after one day, reports LosAngeles.CBSLocal.com.

Matt Chaney is an independent writer, editor, teacher, and restaurant cook in Missouri, USA. For more information, including about his book Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com. Email him at mattchaney@fourwallspublishing.com.

Cardiac Arrest Likely Kills Most in Football 2014

American football’s possible role in a player’s sudden death is difficult to assess, particularly in a case of cardiac arrest outside physical activity. But athletic exertion is presumably contributing to many player fatalities this year, among the sampling 21 cases in this review. 

By Matt Chaney

Posted Wednesday, August 20, 2014

American football, with but one player’s death of field collision so far in 2014, might be poised to inspire proclamations of “safer” play. Last year, eight players died of football contact, all teens.

But the violent game is only beginning its regular season, traditionally the deadliest calendar stretch. In 2013, for example, the second collision death did not occur until Aug. 16, opening a run of seven direct fatalities in 12 weeks of prep football.

And more young football players are dying unexpectedly in America—especially this year—amid circumstances such as collapsing during a workout, succumbing while asleep, and developing blood clots. These fatalities are largely unverifiable for solid link to the sport that poses bodily stresses beyond physical battering.

A 2014 sampling is below, 21 deaths of active players through Aug. 16, mostly teens, culled from reports online. Death investigation continues for many of these casualties while other cases have concluded without pathology exam.

When cause isn’t field contact, death investigation of an American football player meets obstacles for objective establishment or dismissal of a game link. Medical specialization is required for accurately diagnosing illness like cardiac arrest, for its varied forms, and the process optimally involves experts of multiple disciplines.

Postmortem analysis of a football player, however, is often left to unqualified officials who are merely available, such as a general physician or elected coroner—or no autopsy at all.

Bottom line, no research entity can accurately determine the true number of football-related deaths, and notably not the “National Center for Catastrophic Sports Injury Research” at the University of North Carolina in Chapel Hill. No party has succeeded despite a century of published statistics, incomplete yet widely repeated, because case-collecting cannot properly access and assess the sport’s vast domain.

The football data’s entire history is fault-ridden, in need of redefining and reclassification for disjointed and limited collecting since the Victorian Era, by parties such as news media, game-funded groups like the NCCSIR, and this reporter.

The problem is apparent in overview of football deaths to-date in 2014, particularly the select 21 cases below.

Cardiac arrest likely caused the majority of these deaths, which also include cases of heatstroke, apparently, but information is lacking in public reports.

Conjecture even lingers over the single collision fatality, Navy running back Will McKamey last spring, based on statements by his parents that seemingly absolve football for culpability.

Certainly, evidence of football’s role in many of these casualties will pass undetected, whether missed, lost or ignored.

Epidemiological study remains a lofty goal, therefore, on mortality risk and outcome in American football. Valid and reliable numbers on catastrophic casualties, including survivors, must be harvested from a injurious environment hosting four to five million players scattered over 50 states, with about 95 percent of the population being juveniles.

Such research, unforeseen at this time, would necessitate a massive commitment of money and expertise, along with extraordinary cooperation by athletes, families, and football officials.

The 2014 death cases below are compiled strictly of information available in Google banks, primarily news reports, and require qualified, specialized follow-up for medical designation.

Not included are the deaths of active football players such as suicides and drug overdoses.

My condolences to the families of deceased players.

 

21 Fatality Cases of American Football Players in 2014

From Google reports through August 20

By Matt Chaney

Email: mattchaney@fourwallspublishing.com

Jan. 17:  Joseph Cooks, 18, Florida, a 6-foot-2, 165-pound wide receiver for Southeastern University, died in his sleep. Pathology results, if any, are unavailable online.

Feb. 7:  Ted Agu, 21, California, a 6-1, 240-pound defensive lineman for the University of California-Berkeley, became stricken during a team conditioning session and died. Autopsy results released in spring reportedly listed the cause as hypertrophic cardiomyopathy, thickening of the heart, but the player’s family later filed a wrongful death lawsuit, alleging he had a known sickle-cell condition.

Feb. 8:  Eddie Key III, 18, Nebraska, a 6-2, 270-pound lineman for Wayne State University, died in his sleep. Autopsy results reportedly list the cause as pulmonary edema, fluid buildup in the lungs caused by heart failure.

March 2:  Desmond Pollard, 17, Texas, a 6-2, 180-pound receiver for Gilmer High School, collapsed and died during a pickup basketball game. Pathology results, if any, are unavailable online.

March 8:  DaQuan Henderson, 15, South Carolina, a defensive lineman for Whale Branch Early College High School, died at a hospital. Henderson’s mother said her son had been diagnosed with irregular heartbeat and a coroner reportedly determined natural causes for the death. Further information is unavailable online.

March 25:  Will McKamey, 19, Maryland, a 5-9, 170-pound running back for the U.S. Naval Academy, collapsed of a brain bleed at practice on March 22 and died three days later in hospital, following surgery. Football contact linked to the injury was indistinguishable on video of the practice, said family members. McKamey previously suffered a severe brain bleed in football, 2012, when he was a high-school senior in Tennessee, but no surgery was performed after that incident and he returned to the sport.

April 6:   Ronald Cunningham, 19, North Carolina, a 6-2, 285-pound lineman for St. Augustine’s University, collapsed on campus, possibly of cardiac arrest, and died at hospital.  Cunningham had recently injured a knee in football practice and was awaiting surgery. Pathology results, if any, are unavailable online.

April 15:  Mekail Evans, 17, Alabama, a 5-10, 195-pound linebacker for Clay-Chalksville, collapsed and died at home following a workout. The teen had a heart condition that was previously undiagnosed, said family members.

April 21:  Jaqwan Cephus McGill, 16, North Carolina, a 5-6, 155-pound running back for South Columbus High School, collapsed and died. Autopsy was performed but results remain unavailable online.

April 27:  James Michael Creamer Jr., 15, New York, a lineman for St. Peter’s Boys High School, died in sleep at his home.  An allergic reaction or choking may have contributed to the death, said family members.

May 13:  MarQuavious Payne, 17, Georgia, a 5-11, 185-pound linebacker for Cedar Shoals High School, died during sleep at home. Pathology results are unavailable online.

May 21:  An unidentified eighth-grade boy, 14, New Jersey, collapsed while throwing a football during PE class and died at hospital. The incident occurred at Thomas E. Harrington Middle School.

June 30:  Gage Meeks, 11, Louisiana, who was preparing to play football for Calhoun Middle School, became stricken at home and died at hospital. A doctor said cardiac arrest caused the death.

June 30:  Sean Tillotson, 17, Vermont, a running back and tight end for Oxbow Union High School, died of a pulmonary embolism, a blood clot lodged in lung tissue, during an airport layover in Denver, Colorado. Tillotson was recovering from a second surgery on a knee that was injured the previous football season.

July 21:  Shawn Afryl, 22, Minnesota, a 6-3, 310-pound offensive lineman for Winona State University, collapsed during a conditioning workout and died at hospital. Cardiac arrest reportedly caused the death.

Aug. 5:  Trey Aldrich, 16, Kentucky, a senior football player for Allen Central High School, died in his home. An autopsy was planned but further information is unavailable online.

Aug. 6:  Noah Cornuet, 16, Pennsylvania, a 6-2, 270-pound lineman for Burrell High School, collapsed at football practice then died at hospital. Reportedly, a non-cancerous heart tumor caused the death. Further information is unavailable online.

Aug. 10:  Dan Malakoski, 36, Pennsylvania, collapsed while playing flag football and died at hospital, reportedly of cardiac arrest.

Aug. 11:  Zyrees Oliver, 17, Georgia, an offensive lineman for Douglas County High School, died of over-hydration a few hours after football practice. Further pathology results are pending but currently unavailable online.

Aug. 13:  William Shogran Jr., 14, a lineman for Sebastian River High School, collapsed at football practice then died at hospital. Heat illness possibly contributed, according to reports. Further information was unavailable at time of this posting.

Aug. 16:  Will Wheeler, 17, Massachusetts, a 5-11, 165-pound defensive back for Central Catholic High School, died during sleep at home. Autopsy is planned, reportedly, but no results are yet available online.