By Matt Chaney, for ChaneysBlog.com
Posted Tuesday, May 7, 2019
II. AMA Confronts Brutal Football, Condemns Boys Game
III. JAMA Editor is Heavyweight of Football Debate
IV. Fishbein Sells Safer Football, Safer Cigarettes for AMA
Copyright ©2019 for original content and historical arrangement by Matthew L. Chaney, Four Walls Publishing
American medical organizations are prone to fumble the issue of tackle football, to chop-block Hippocratic Oath, by shielding the injurious game from criticism and accountability—including for brain damage of players.
The American Medical Association was ally of King Football through recurring controversies of the 20th century. JAMA, prestigious journal of the AMA, protected the collision sport in debates from the Depression Era through Vietnam War.
During the 1950s and ’60s, AMA publications and rhetoric were overrun with authors and theorists of sports medicine. Their safety claims proved critical in preserving youth football from abolition.
Football friendliness of the AMA turned hypocritical in the 1980s, blatantly exposed. JAMA editor Dr. George D. Lundberg called for a ban on boxing, citing brain trauma, while simultaneously deeming the gridiron acceptable, including for juveniles. Lundberg, a closet football fan, argued that boxers intentionally inflicted TBI while gridiron harm was incidental, free of malicious intent.
The AMA convention backed Lundberg as critics responded from America and abroad.
“Their position is almost laughable,” Dr. Ferdie Pacheco, boxing physician and TV commentator, said in 1985. “I think people need to remember a few things about the AMA. It represents less than 50 percent of doctors in the country. It’s not a scientific [research] group. It’s a politically oriented lobbying group.”
“If the group really cared about safety in athletics, it would have picked on other sports—football, for starters… They picked on a flea when there are some real elephants out there.”
“The only problem the AMA encounters in this mission is one of discrimination,” stated Melvin Durslag, news columnist. “If, in the interest of life and health, it asks for the abolition of boxing, how can it explain auto racing and football?”
“In [an NFL] game the other day between Dallas and Philadelphia, Tony Dorsett was rammed head-on by a tackler clad in the conventional helmet of iron-like plastic. Tony was knocked colder than Duluth, Minnesota. Does the AMA feel this was helpful to his brain?”
Lundberg and AMA associates clung to their position into the 2000s, until overwhelmed by emerging evidence of brain damage in football players, chronic traumatic encephalopathy, or “CTE.” Lundberg came to acknowledge mistakes, sort of.
“Over the years, many physicians have asked me why I was so avid in my condemnation of boxing and completely quiet about the hazards of American football,” Lundberg commented for Medscape.com in 2016. “After all, blows to the head damage the brain, whatever the sport and whether or not the person delivering the blow is paid. I have always considered the moral difference between boxing and football to be stark.”
“Until today, I have never answered those critics. I am biased. I have been in love with American football at least since Harry Gilmer led Alabama’s Crimson Tide to a 34-14 victory over the University of Southern California in the Rose Bowl on January 1, 1946… I never stopped loving the Tide. I was a skinny kid but I was fast and I could catch any ball thrown near me. Three broken arms later, I gave up playing.”
“So, my huge bias delayed confessing reality,” Lundberg continued. “Football blows to the head damage the brain. We now have so much evidence, both clinical and, especially, from autopsies… Just as in boxing, it is not only the knockout-defined concussions but the multiple, repetitive sub-concussive blows that tear small blood vessels and brain fibers each time the movable brain bounces around inside the rigid skull.”
Dr. Lundberg still believed boxing should be outlawed but amended his stance to endorse banning football for ages 12 and under. The former JAMA editor also still believed football officials, their repetitive pledge to devise safe contact sport.
II. AMA Confronts Brutal Football, Condemns Boys Game
By turn of the 20th century, football advocates had their talking points together for recurring debate over field brutality. In 1900, football’s latest “reform,” officials touted new rules, modern equipment, medical supervision, and trained coaches to instill “proper tackling.”
Officials and associates promised “safe football” would finally materialize, fulfilling the stated mission since 1887. They said common transportation killed more than the gridiron, citing accidents of horsepower, bicycles, boats and railroads.
Self-anointed “football experts” dismissed publicized death counts as inaccurate and exaggerated by newsmen. The experts conducted their own surveys and announced more research was needed, from in-house, to determine true risk and outcome of playing fields.
Football policymakers had stock claims for preventing “concussion of the brain,” rampant in their forwarding-colliding sport. Traumatic insanity of head blows, linked postmortem to microscopic hemorrhages of brain tissue, wrought mental disorders recognized in clinical literature. Some families and doctors, communicating in public, believed traumatic brain injury had spurred violence and suicide in their athletes of football and boxing.
To quell concern, football coaches and trainers hawked new helmets, their creations of patent leather and pneumatic rubber. Headgear was trial-tested on players, and promotional text for a leading model, 1900, stated: “The head harness was formerly of felt, but of late years a solid leather headpiece has been invented. It is made of the heaviest English oak-tanned leather… This headgear is ventilated and is made with a double crown to protect the entire top of the head; it breaks the force of any blow received.”
Personnel pledged “open play” and rules enforcement would eliminate cerebral concussion. The 10-man flying wedge had been banned years ago, they reminded, and smaller “mass” formations were under control.
Officials touted “low tackling” for headless hitting, teaching players to strike with shoulder and chest, eyes up, to avoid cranium shots. “The best way to learn tackling is with a dummy with head thrown to one side. That saves your head,” said Dr. R.C. Armstrong, coach-physician in Brooklyn, 1899.
Football advocates from all walks rallied for game preservation. They said criticism was groundless, repetitive, heard from jealous wimps with no grasp of manly sport.
Theodore “Teddy” Roosevelt, fervent football fan, railed against game adversaries. The rising politician and Harvard alum vowed his sons would play football and build character from injury experience. Roosevelt enjoyed the grandstanding, such as cheering from sidelines at games, highly visible, fist-pumping like a player he wasn’t in college. Shrewdly, Roosevelt reaped political capital in votes and favors, because millions loved football like him.
Anybody could claim anything, really, in defense of beloved football. Hardly anyone tracked the reform phases and failures in some 25 years of American blood-letting. Indeed, headless contact had been tried for a decade already, fixing nothing, along with more theoretical concepts.
Football spectacle was a national institution, economically, socially and ideologically. Casualties were acceptable price for the preferred entertainment, and many if not most physicians cared nothing of “football hurts.” Many had played the game.
In 1900 JAMA endorsed the football word of leaders like Walter Camp, who argued brutal play was isolated and “unsupervised,” existing only at small schools, clubs and sandlots. The AMA Journal qualified university football as milder than “gladiatorial combat” and poked at naysayers, editorializing: “Aside from its apparent dangers, which are probably less real than might be thought, it has its merits as an athletic exercise, and evidently demands more than mere muscle.”
“There is a chance for more thorough research into the effects of football on [human physiology],” JAMA stated, “but so far as the evidence is in, the particular charges made seem hardly justified.”
Football carnage continued, predictably, including for elite programs like the Yale juggernaut of Camp. Emergency response and trauma care were primitive, useless to save victims of severe brain bleed or spinal dislocation, among football damages. Infection ravaged injured athletes in this era before penicillin antibiotics. Football death occurred of bone fracture, organ trauma and skin laceration, sometimes years after mishap, for lack of treatment.
Today’s football by comparison—some five million players, majority juvenile—produces tens of thousands of bone fractures annually. Higher numbers of variously wounded enter surgery. Incidents of brain trauma, largely undiagnosed, likely reach millions. The contemporary American gridiron would kill and maim like warfare, massively, if relying on medicine of a century ago.
In 1902 JAMA staffers collected football reports and analyzed casualties. “Thus far the returns give 12 deaths, several fatally injured and over eighty seriously injured,” editors announced in December. “Among the serious casualties of the game this year we have fractured skulls, injured spines, brain injuries resulting in insanity, as well as broken legs, ribs, collar-bones, etc. To be a cripple or lunatic for life is paying high for athletic emulation.”
The AMA editors weren’t condemning football itself, just human factors. JAMA called for officials to revise rules, once again, and to ensure enforcement by field referees. Editors opined “it would seem that something might be done by those in charge of college athletics at least, to modify the roughness of the game and somewhat reduce its risks… brutality is utterly needless and deserves the severest condemnation and consign punishment.”
But brutality was not incidental of head-on football, only inherent. Danger element could not be attributed to inept rules, bad technique, poor coaching and medical response. Vicious hits and harm were DNA of the sport, explicitly. “It is a mere gladiatorial combat; it is brutal throughout,” said Karl Brill, Harvard All-American tackle who quit football. “When you are opposed to a strong man you have got to get the better of him by violence.”
“I fail to see where the gray matter in a man’s head is exercised at all, nor am I able to see how football is the intricate game some proclaim it to be. Neither do I see how the game can be reformed or remedied.”
JAMA editors detected no safe football in 1903 and expressed chagrin for officials. “The fatalities and injuries… were probably not more numerous or more grave than in recent years,” the journal editorialized. “While we do not wish to be considered as opposing legitimate athletic sports, we believe that in this particular game the human wreckage far outweighs the good resulting from three or four months of athletic exercise and training.”
JAMA editors still hadn’t given up on football. They commended the game’s instilling campus pride and spirit, along with “honest rivalry in manly sports and athletic exercises.” The Journal backed President Roosevelt in 1905, who blamed brutality on “dirty” players and lousy referees, for his effort to cleanse football. The “open game” was Roosevelt’s solution, and scores of colleges jumped the bandwagon, trumpeting presidential reform and “safer football.” This faction, led by Teddy’s alma mater Harvard, was merely bureaucracy to mushroom, become known as the National Collegiate Athletic Association, NCAA.
“President Roosevelt is to be congratulated,” JAMA editors declared. “It was his vigorous protest and personal intervention which, more than anything else, brought the football rules committee to its senses.”
Optimism flattened in 1907. The Roosevelt reform hadn’t reduced risk of football, but did inspire scary colliding in open field, injurious as mass scrums. Critics howled, charging folly for so-called Debrutalized Football. “The revised rules of the game have not fulfilled the hopes of the framers… speed and combination plays have proved almost as hazardous,” observed a newspaper scribe. “The ‘reformed’ game has been abruptly ended in smaller cities in which players have been seriously injured or killed.”
Roosevelt blamed college leaders and referees for failing to stiffen code against “unnecessary roughness.” The president insisted “there is no real need for considering the question of the abolition of the game.” He said malicious players were culprit, not wholesome collision football, although he wished it “less homicidal.”
The AMA was souring on hocus-pocus about reforming football. “It was hoped that the open game, introduced by changes in the rules, would take away much of the stigma that has attached to the sport because of accidents, but that hope has proved illusory,” JAMA editorialized. “The question that naturally arises is whether the game is worth the candle.”
Tackle football wasn’t worth it for boys, said critics who denounced “junior” play emerging at schools, clubs and sandlots. The anti-movement included college coaches and players who disavowed boys football—and doctors of the American Medical Association, chirping up from hinterland offices to organization headquarters.
The AMA and its Journal comprised the most powerful entity in U.S. medicine, and likewise stood suspect for heavy handedness in health and trade. The curious relationship with gory football lent credence to allegations.
AMA honchos, editors among them, ruled agenda-setting, finances, and group communication from the non-profit’s headquarters in Chicago. The setup smelled like administrative “tyranny” to Kenneth W. Millican, who critiqued medical industry in 1906.
The AMA posed “a formidable body” in national membership and societal impact, Millican observed for Medical Record. “It can be powerful for good or for evil; in which direction its influence will be cast will depend entirely upon the character of the few men who from time to time must inevitably control its destiny.”
Millican noted, or warned, that a handful of officials could act in defiance of AMA thousands. “Issues will crop up in which the few… will dictate one course, while the majority will prefer another.”
Junior football didn’t divide the association, at least not in 1907. That December the AMA Journal, under editor Dr. George H. Simmons, condemned contact football for juveniles. The editorial, titled “Football Mortality Among Boys,” began: “We called attention early in the season to the fact that deaths and serious injuries were resulting from football, in spite of the claims made that the new rules would give comparative exemption from the dangers of the unreformed game of three years ago.”
JAMA reported football produced 14 fatalities in 1907. Twelve of the deaths were of schools and sandlots, “by whom the new rules are not so carefully followed.” Regarding college football, editors would withhold “final judgment” until further consideration.
“There need be no hesitation, however, in deciding that football is no game for boys to play,” JAMA proclaimed. “Of the whole fourteen killed the ages averaged something under eighteen years; none was over twenty.”
Editors alluded to a football belief that players had but shelf life in the maw, often rendering youths “used up” before collegiate competition. “If football were to be prohibited for students under eighteen and this weeding-out process stopped, then surely there would be more deaths among the older players!” the Journal cracked.
“We may not be able to stop the game, even if it were desirable to do so, but we can prevent some of its evil results,” editors concluded. “It is clear that persons of delicate build or of immature development should not be allowed to engage in football. If we must have this gladiatorial ‘sport,’ would it not be better to adopt gladiatorial methods and have the game played only by fully-developed men who had passed a severe physical examination before beginning the course of training?”
The JAMA bomb invigorated foes of kids football—doctors, lawmakers, educators, parents, college coaches, players, journalists—on their crusade that fell short of establishing legal bans before World War I.
But AMA hierarchy wouldn’t threaten King Football again, for the century and beyond, child combatants notwithstanding. On the contrary, AMA brass and publications would demonstrate unseemly patronage for “youth football,” wholly inappropriate per medical standards and juvenile law, in time ahead.
III. JAMA Editor is Heavyweight of Football Debate
Organized tackle football for boys and adolescents grew rapidly after World War I, expanding through the Depression Era at schools, clubs and parks. Casualties rose in relation. “Injuries on the football field are a major concern,” Pennsylvania doctors observed in 1937. “While there are about 70,000 college students playing football this fall, there are 700,000 high school boys.”
“Authorities of the game have endeavored to make it safer for the players,” added the medical society, noting historical failures. “Despite whatever may be done to minimize football injuries, there will be more than 70,000 injuries on gridirons of the United States this fall.”
Then medical sarcasm:
“Get that ball!”
“Hit that line!”
“Let’s go, team!”
Many skeptics of cleansed football turned cynical by the 1940s, and debate blew up in public. Juvenile participation was flash-point topic, football’s growth sector, and supporters dug in. Questions loomed regarding medical ethics, child protection and education policy in America. Many doctors proposed to ban tackle football for youths under driving age.
The fray drew star physicians of mass media, debating youth football. The three biggest medical names of print and radio proffered opinions: Drs. Logan Clendening and William Brady, syndicated newspaper columnists, and the AMA heavyweight, Dr. Morris Fishbein, Journal editor, print columnist, and recognized czar of the monolith association.
Dr. Logan Clendening analyzed tackle football from a medico-legal perspective, finding gross negligence, malicious disregard on part of game organizers. “What is the excuse for all this death, suffering and disability that compares with war?” Clendening posed, insinuating blame for medicine, government and education. “It doesn’t ‘make men’ as the coaches argue. It isn’t good sport. It has become one of the stupidest games on earth for the spectator.”
Clendening, who collected injury cases from newspapers, paid a clipping service for the 1941 football season. Thousands of casualty reports were harvested, immense news data for medical follow-up. “Note once more the preponderance of high-school injuries,” Clendening emphasized in his column, “which supports my contention that boys of high school are not physically matured enough to stand the gaff, at least until they are seniors.”
Clendening, proponent of forensic medicine, attributed 23 deaths to football in the year, including 14 schoolboys and 8 sandlot players. For disabling injury, he detected high rates. “The chances are one-to-four [a schoolboy] will receive an injury sufficiently serious to lay him up. The chances are one-to-five that he will receive a permanent injury that will last through life.” An estimated 1.2 million school days were lost by injured players every year.
Like many physicians, Clendening logically associated brain damage of pugilism, known as “punch drunk” disorder in literature, to the same likelihood for football colliding. “The condition is not confined to boxers, and may occur in football players or to anyone who receives a severe blow on the head,” he observed.
Dr. William Brady agreed, having linked brain damage to school football for years in his columns, since Harrison Martland’s microscopic study of deceased boxers. Brady had written for newspapers 35 years, a trailblazer among medical columnists. He regularly ripped boys football, inciting hate mail from schoolchildren and adults.
Brady challenged any ethical physician, acting objectively, to deem tackle football suitable for youths. Brady identified schools as football dens of bully recruitment, where faculty and students groomed boys to play. Anti-football administrators concealed sentiments from local football hordes, Brady alleged, and parents avoided interceding for sons.
“It is bad enough for college freshmen to attempt to train for football,” Brady commented in December 1949. “It is absurd and shameful to permit the ‘sports’ of the community to use growing boys of high school age as stooges in the football burlesque.”
“Football is a grown man’s game, and high school boys, even lanky ones, are not full-grown men.”
Meanwhile, a national audience awaited Dr. Morris Fishbein of the AMA, expressing his view of boys football hyped for release 24 hours after Brady’s from Chicago.
Fishbein was an impact leader of American opinion for three decades, a voice of reach rivaling the president’s in any year. Fishbein was known as editorial pen of various AMA publications he founded, and synonymous for JAMA. But Fishbein fame was culturally ingrained for his popular press. His syndicate columns ran weekly in newspapers and Reader’s Digest. His medical encyclopedias stood ready in countless homes, revered as gospel. Fishbein’s voice was heard through every radio on AMA broadcasts, and the indefatigable personality visited thousands of locales, a celebrity on speaking circuit.
Presumably Dr. Fishbein would judge collision sport for kids in medico-scientific manner, given his reputation and so much at stake. Presumably Fishbein of the AMA, trusted by millions, would act free of bias or politics favoring King Football. Presumably Fishbein was fully informed for his grid proclamation, having premiere access to football files, medical literature and contacts surrounding the sport. He had written extensively of football risks, ranking brain “concussion” as the game’s No. 1 problem.
IV. Fishbein Sells Safer Football, Safer Cigarettes for AMA
JAMA Editor Dr. Morris Fishbein knew Dr. Harrison Martland as colleague, having published the pathologist’s landmark study on “punch drunk” in 1928. Fishbein knew of “traumatic insanity” of the 1800s, or should have. Such brain damage was visible under microscope following the Civil War, in full autopsy of dead sufferers. Dr. John W. Perkins characterized brain matter as egg yolk during injury, jolted by inertia, bashing into cranial walls. Perkins discussed “traumatic cerebral lesions” attributed to “old injury,” different than gross destruction of acute subdural hematoma. And Journal of the American Medical Association published Perkins—in 1896.
Fishbein saw a host of doctors link brain damage to tackle football after Martland’s boxing revelations, among them Irving S. Cutter, James A. Barton, Edward J. Carroll, Jr., and Ernst Jokl. A particular medical term was established in 1940, chronic traumatic encephalopathy—yes, CTE—coined by Drs. Karl M. Bowen and Abram Blau. Football referee Dr. Eddie O’Brien said excessive contact caused punch drunkenness. Coach Jim Crowley, one of the legendary Four Horsemen, reduced full-contact scrimmages for his Michigan State players, blaming “punch drunk” risk. Countless sportswriters made the connection.
Regardless, Fishbein himself would not associate traumatic brain disorder with football, not publicly, and microscopic autopsy wasn’t yet performed on a deceased player to impress him either way. Fishbein’s clout could’ve made that happen, his demanding football pursue obvious research in wake of Martland findings—examining a) brain damage in deceased players and b) cognitive deficit in the living—but he kept quiet.
Fishbein identified mental illness as endemic in America but blamed “high-tension” society and factors such as child labor, which he labeled “a great menace to future citizens.” The possibility of a nationalized head-knocking dogma, perpetuated through rites like head-ramming football, sanctioned violence, wasn’t broached by Fishbein.
Dr. Fishbein also schmoozed around football types since his days at University of Chicago, then featuring great teams of Amos Alonzo Stagg. Fishbein had known late coach Knute Rockne, who joked to Collier’s about a punch-drunk lineman for Notre Dame. Fishbein was friend of George Halas, NFL owner and Bears coach who designed a football helmet. Fishbein welcomed doctors of fledgling “sports medicine” to JAMA pages, having published their articles and letters since taking over editorial around 1920. A socialite, Fishbein enjoyed football games even though the sport had been dropped at his college alma mater.
During holiday season of 1949, Dr. Fishbein watched a high-school football game in Chicago then informed a reporter of his stance on juvenile participation. His comments hit news wires on Dec. 20, the day following remarks of Dr. William Brady.
Fishbein of the AMA believed tackle football should be preserved for the Boomer Generation, including juveniles. “The number of deaths and permanent injuries do not warrant the elimination of the game from a high school athletic program,” he said. “In reality, basketball and boxing are much harder on youths than football. I believe boxing should be banned in high schools.”
“Football, in my opinion, is not too dangerous a sport for high school boys.”
Fishbein parroted classic talking points of football advocates. He said play was safer because of rule changes, sound coaching, trained athletes, and, of course, modern equipment. Fishbein said plastic hard-shell helmets, joint creation of football and the military, were finally preventing head injury. “Formerly, helmets were actually a weapon,” he reasoned. “Now they are a protective piece.”
With Fishbein’s blessing, high school football counted as AMA Approved—a real trademark that was household cliché, recognized everywhere. The AMA granted its “seal of approval” to institutions, groups, products and services. Supposedly each was vetted for promoting health in some manner. Most significantly, every vendor or organization bought advertising in AMA publications, with collections payable to Fishbein’s office in Chicago.
AMA approval was displayed and broadcast everywhere, adorning medical schools, hospitals, practices, skin lotion, milk, food, cod liver oil, funeral homes and motorcycle helmets, among the array. Wheaties cereal was AMA-approved, “Breakfast of Champions,” as an advertiser with Fishbein.
Critics were legion with many from inside the AMA. Columnist Dr. Brady ridiculed the association for decades as a member, focusing his ire on Fishbein, bitter rival on issues like football and cigarettes. The two exchanged editorial putdowns, squabbling over scientific standards and news ethics, among topics. Brady honed in on dark “approval” business of the AMA, naturally.
“Doctors on the Make,” Brady headlined his national column in early 1950, following Fishbein’s overdue departure from the AMA. Brady had dropped membership a few years before. “I couldn’t stomach the way the nominal officers of the AMA permitted the dictator, now deposed, to insult them,” he stated.
Brady derided Fishbein as the “Great Pooh-Bah” formerly in charge of the “comic weekly” Journal. Brady charged corrupt trade and communication, “a racket whereby the American Medical Association ‘accepts’ and grants its seal of approval or acceptance to the thousand and one medicines, foods, gadgets, methods, processes and even patents. This racket beats any similar scheme of popular magazines as a means of assuring a huge advertising revenue.”
Cigarettes weren’t exactly AMA-approved, not explicitly. But Fishbein valued tobacco advertising for his Journal, exceeding $100,000 in annual revenue after World War II. Cigarette makers appreciated him likewise. The rhetoric of Dr. Fishbein, a public-relations specialist with medical doctorate, effectively shielded Big Tobacco—a JAMA cash cow along with drug companies—through controversy of the early 20th century.
Doctors increasingly recommended against smoking, citing potential risks and conservative ethic of Do no harm. Many were smokers themselves, one form or another.
In 1939 an expectant mother was advised to halt cigarettes by her physician, so she wrote a medical columnist for his opinion. Dr. George W. Crane answered in print, stating no definitive evidence yet existed of smoking’s harm during pregnancy. “On the other hand,” he added, “there is no clear-cut evidence to prove that use of tobacco may not exercise injurious effects on the unborn baby.” Dr. Crane affirmed the recommendation a pregnant mother shouldn’t smoke.
Dr. Fishbein rationalized differently in his column, lending benefit of doubt to cigarette use, not human health, in the matter of smoking during pregnancy. While Fishbein acknowledged harm to the unborn “seems certain” he attached the caveat: “Many additional studies, are required, however, to determine whether the harm is sufficient to prevent smoking in moderation by prospective mothers.”
And so it went according to Fishbein of the AMA, in a quarter-century of addressing tobacco use, until 1949. He didn’t deny risks but wouldn’t condemn the popular activity, always conjuring positives for smoking, always advocating more research. Fishbein suggested casualties were negligible with millions of adults puffing billions of cigarettes. He hit the fact thousands of doctors smoked cigarettes, right in sync with the focus campaign of Big Tobacco.
A blitz of cigarette advertising made buzz for the theme of doctors in love with cigarettes. Physicians in photos and illustrations were featured lighting up at work and leisure. “More Doctors Smoke Camels Than Any Other Cigarette” was a slogan indelibly stamped in American conscious of the period. Print pages, placards and billboards were plastered for years of ridiculous images.
Fishbein blamed excessive smokers for any harm documented. He maintained extremists grew ill for their own abuse of cigarettes and cigars. In contrast “safer smoking,” by the blossoming term, was an innocent pleasure for adults to indulge. Clinicians theorized smoking comforted users with beneficial “psychological effects,” Fishbein told audiences.
Fishbein said cigarettes in moderation could relieve anxiety and hunger pangs, or serve as mental stimulant. Fishbein advised smokers purchase only fine processed tobacco, avoiding the “hard, coarse, commoner varieties” that certainly didn’t advertise in JAMA. Fishbein quoted an expert who said, “Speaking generally, tobacco smoking in moderation is not injurious to grown-up people.”
While willing to reach for positives about cigarettes, Fishbein downplayed studies linking maladies of heart, lungs and circulatory system, always suggesting invalid research. “From the available evidence there is no ground for any startling announcement about smoking,” Fishbein proclaimed in his newspaper column.
He approached tackle football same as tobacco use, conservatively guarding the activity if not human participants. At end of 1949 Dr. Morris Fishbein was popular for his football stance, but charade of safer cigarettes hastened his demise at the AMA. Fishbein resigned under pressure, primarily for his nasty opposition to group insurance and subsidized healthcare. That battle pitted Fishbein, “Medical Mussoli,” versus President Harry S. Truman, and the doctor went down.
Fishbein also took heat for posing as cigarette scientist, with the besmirching JAMA and the organization. “The stately American Medical Association finds itself on the spot about cigarette advertising. Its official Journal accepts cigarette company advertising—but it finds the medical claims rather embarrassing,” editorialized the Des Moines Register.
Fishbein and the AMA were guilty of “ardent promotion of cigarette smoking,” Dr. William Brady decried in column. “To be sure, Doctor Fishbein is no longer in the saddle, but it remains to be seen whether the organization will regain the prestige the AMA enjoyed before it went commercial.”
In 1953 cigarette advertising was dropped by the AMA, which acquiesced to angry members, public pressure, and mounting conclusions of tobacco risk. The association abruptly denounced cigarettes as dangerous, and the convention in San Francisco unveiled “startling” new research. “A team of medical experts reported that cigarette smoking shortens human life… and definitely causes higher death rates from heart disease and cancer,” media reported.
But the association didn’t deviate on collision football, maintaining status quo. The group continued to endorse tackle football for children and adults, promoting “benefits of sound health.” Simultaneously, the Journal crusaded against television for concern of child viewers; doctors said “horror shows” likely posed “adverse medical and psychological implications” for kids. JAMA, pulling major press, called on the television industry to fund valid research on risks. Meanwhile the AMA still avoided confronting football for essential brain studies, three decades after Martland on boxing.
JAMA instructed parents to closely monitor television for content harmful to young minds. In stark contrast, regarding football, the AMA wizards told worrisome parents to back off, lest they damage male psyche of sons.
“To anxious parents of sons who want to play football, the best advice is—let them. No, that is not enough. HELP them to play it safely,” declared Dr. W.W. Bauer, AMA-Approved health columnist for newspapers. “When a high-school boy wants to play football, this cannot be denied him without possibly doing injury which may be worse than he is likely to sustain on the properly supervised playing field.”
“A great many parents base their apprehensions on an overemphasis of the hazards connected with playing football,” Bauer commented. “Between the ages of 15 and 25, when most of the football activity occurs, accidents to pedestrians and motor-vehicle fatalities of the same age group are 15 times as frequent.”
“The relative safety of the game, despite its reputation for roughness, should prompt parents not to interfere with the athletic activity of their boys including football.”
Dr. Bauer talked the timeless points and promises of grid safety, echoing again nationwide. Anti-concussion helmets, “heads up” tackling, everything was in the offing once more.
And more doctors preferred football than any other sport, based on quotes and testimony flooding multimedia. Promoting doctor approval was a page from King Football’s playbook, merely replicated of late by Big Tobacco.
JAMA was establishing trend for journals by stabling sport doctors and academics, including Allan J. Ryan, Augustus Thorndike and Fred Vein. The MDs and PhDs, specialists of newly formalized sports medicine, melded right in at association publications and confabs. Football was AMA-approved like never before.
Dreams, concepts, gadgets, experts—all came stylish again in America. Anything seemed possible in the Space Age, including safe smoking and safe football.
“Football can be a killer and a maimer,” JAMA intoned, “but for the player it is also a wholesome and valuable experience that—like life itself—can be made safer.”
Matt Chaney is an author, editor, and consultant on public issues in sport, specializing in American football. Chaney, MA in media studies, is a former college football player and coach whose books include Spiral of Denial: Muscle Doping in American Football, 2009. Chaney’s study for graduate thesis, co-published with the University of Central Missouri in 2001, analyzed print sport-media coverage of anabolic substances in football from 1983-1999. Email him at firstname.lastname@example.org or visit the website for more information.
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