Tag Archives: American Medical Association

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.

King Football Infests Institutions, Misleads Public

Medical Associations Avoid Confronting Injurious Sport

Dissident Doctors Threaten Medicine’s Football Bonanza

Incalculable Debilitating Injuries Annually in Football

By Matt Chaney

Posted Friday, October 3, 2014

No American of driving age and eyesight should feel revulsion over tackle football anymore, the widely corrupt, incessantly violent, powder-keg culture for players and people around them.

There shouldn’t be shock when cavalier football officials, led by NFL commissioner Roger Goodell, mislead individuals, families, and the entire public.

Yeah, the football suits lie, obviously, and when this week already.

So while King Football may be shorter on time to heed criticism and reform fundamentally, it isn’t facing apocalypse. The game hasn’t reached the cliff’s edge yet in America, forced to choose between falling or turning complete about.

Football remains our premier entertainment, the shark among shows, playing perpetually in-season from local fields to palatial stadiums and throughout millions of video screens,  audio feeds, and print pages.

It is our nationalized religion, the Church of Football, with media, municipalities, schools and colleges readily hosting worship, indoctrinating players and consumers, young and old. “We couldn’t live without the NFL,” gushes Leslie Moonves, CEO of CBS Corporation, paying billions for broadcast rights, operating within his situational ethic for our free press.

And nothing will change fundamentally in near future, regardless whether Goodell goes down (he won’t leave willingly, hauling $37 million annually in his job for the non-profit NFL). The frontman is interchangeable for this model. If Goodell cannot outlast political storm, league owners will substitute “another boilerplate-spewing lawyer… tobacco executive avatar for their bloodsport,” observes Bruce Arthur for The Toronto Star.

Football cult will carry on, and not only for its conniving leaders but because society is thoroughly vested too—or caught—virtually every institution and individual is beholden, some way or another, to the gridiron.

Our football universe thrives on cultural Spiral of Denial, as a costly, dangerous, and revered social setting marked by recurring crisis since the 1880s. Revelations emerge periodically against the blood sport, along with recriminations, debates, promises—and, ultimately, no legitimate reform undertaken, ever.

Foremost because tackle football is incorrigible for deadly violence.

Then, crucially, King Football has pimped vital American institutions over some 135 years, namely through mutual marketing, a profit-sharing synergy. No partner institution can react forcefully on football issues.

Historically and shrewdly, the good ol’ gridiron officials and advocates have infested government entities such as the CDC and Public Health, schools, colleges, municipalities, police and courts, and legislatures and Congress, along with the private domains of news, medicine and religion.

“And that is just it,” surmises essayist John Branch for The New York Times.  “The N.F.L. is buttressed by so many parties with a stake in its continued success… that no amount of exasperation will topple it.”

“The N.F.L. put itself in this position. But the tougher spot may belong to all the rest of us, bound to the N.F.L. with the nastiest of knots, looking for ways to be outraged in practical and meaningful ways.”

Officials of our institutions certainly bumble because of their toxic allegiance to brutal football, financially and politically. The NFL  wields more power in this country than government, staining if not benefiting all it touches, as we heard three decades ago from Howard Cosell, late iconoclast of TV sports. Cosell was the famed boxing announcer who moonlighted for Monday Night Football, in the booth with Frank Gifford and “Dandy” Don Meredith on early collaborations between the NFL and ABC.

Cosell would appreciate the pathetic comedy these days, as officials of institutions try camouflaging their conflicting interests over football, or just ignore that they’re gripping a wolf by the ears—collision DumbBall, imperiling millions of young minds and bodies.

Military boldly calls out NFL for mutual problem

Pentagon brass vow to reexamine relationships with the NFL on a moral basis, and they cite, of all things,  domestic abuse among football players.

Nervy move by military officials, projecting blame for predatory assaults on females, given their deplorable record for the same violence in the Armed Forces.

Rather, an independent party should probe the “partnership” between the NFL and Pentagon that is publicized as “a long-term program to care for and prevent concussions… as well as other health issues.” Hear Goodell spin dramatically, conjuring heroism for the collaboration, proclaiming the NFL-Military mission is to help the world:

“We’ve had an impact on the military,” bleats the highly paid yak. “Traumatic brain injury is a big issue for our [football] veterans and our military personnel. The information we have and we’ve learned, the research we have, we have shared with the defense department.”

“Those changes are going to make not just football, not just sports, but I think our world safer,” Goodell says.

But the military doesn’t want to know about casualties or pay for them, beginning with soldiers who suffer brain damage and mental disorder, just like the NFL.

And we know the qualification of NFL “research” sometimes means, according to this League of Denial, in-house data specially cooked, CYA against lawsuits and more damage claims.

That’s what common interest of the NFL-Military partnership smells like, nothing about “making a difference” or an altruistic “sharing” of reliable study and valid conclusions, as Goodell bluffs.

Dissident doctors defy Medicine’s gridiron allegiance

No American institution should precede Big Medicine in dissolving its current relationship with football, for industry ethics and substantive empirical evidence that qualify the game as a public health menace, especially for children.

Yet medicine has been twisted by football money and politics to becoming largely an endorser of the beloved carnage since the 1950s. “Sports medicine” has gerrymandered the industry to generate growth and profit—while eschewing traditional health values and standards.

Recently in California, two sports-med specialists entered public debate with a former NFL lineman on the following question:

Would you let your 8-year-old son play Pop Warner football?

The physicians, with commercial interest in the game, notably steady patients, agreed they would allow sons to play. One doctor offered a familiar tinny explanation.

“If someone [or small boy, per the question] really wanted to play a sport [of collision], I wouldn’t stop him from playing,” said Dr. Ty Affleck, physician of athletics for two colleges. “There are so many benefits derived from playing.”

Ben Lynch took exception, the well-compensated NFL player.

Lynch is among former athletes who scoff at this talking point, the abstraction of Football benefits outweigh risks for kids!—stock answer today of medical professionals with no tangible reason but personal income, which they won’t mention.

Football-boosting doctorate-holders are hard-pressed to prove their positives cited, those so-called doses of discipline, teamwork and courage when a young person straps it on to collide beneficially with others.

Heck, for my college football experience, I just say we were student-athletes roaming the field in educational manner, knocking the shit out of each other.

Because a football player should “target” every incoming opponent, or think “bounty,” whatever it takes to get vicious. The game’s covering law is primitive: Be predator or prey; avoid becoming the “cart-off” carcass.

Bad intent on a football field is survival, not “dirty” play. Head-ramming is a player’s “proper technique” to merely compete, period.

Every person inside the sport gets this reality, too, starting with medical professionals in denial.

So man bites dog anytime medicine’s football parrots—the accredited flock of MDs, ScDs and PhDs—come up against honest, informed challenge from a layman.

That was the hulking Lynch and sports docs, a most curious exchange.

The football gladiator, ex-NFL center of a dozen diagnosed concussions and eight surgeries, schooled the MDs on simple health and ethic. They would’ve had to pass-block him to match it.

“I think it’s safe to say it’s not a good idea to hit your head on something,” Lynch had to remind the doctors. “I think most people would agree with that.”

“I don’t have a son,” Lynch continued. “But if I did, I wouldn’t let him play football—at any level. There’s still so much we don’t know about concussions. There’s so much unknown. This is just my opinion.”

Study findings, critics threaten Medicine’s football bonanza 

Football-friendly specialists and researchers cannot deny mystery persists of brain trauma and recovery, especially for children.

But they slyly flip Hippocratic ethos, the keystone Do no harm—or When in doubt, protect the patient—to follow medical-biz credo of Protect football until no doubt, cha-ching.

They cluster together in public events and news stories to play word games, claiming lack of “evidence” exists to denounce the blood sport, even for small children who can include girls.

A favorite PhD guy for King Football is neuropsychologist Gerald Gioia, who forbids cheerleading for his daughter because “risks exceed safety” in the activity.

But football is fine for kids, says Giola. He recommends boys and and presumably girls to play because, of course, science hasn’t proven the gridiron dangers.

Gioia repeats the hysteria claim for football brain injury, children in the maw notwithstanding, saying fear-mongering pushes “people over the edge.”

“Importantly, science and reason must drive our action-oriented approach to safety in youth sports, maximizing participation and safety efforts together,” Gioia testified before Congress last spring. “We must avoid responding to opinion and anxiety in setting the proper course.”

Gioia operates looser for his tangled business and politics regarding athletics, which provide him income streams from the public and private sectors.

Among connections, Gioia works with teams of the NFL, NHL, public schools, private academies, “and numerous youth sports organizations in the Baltimore-Washington region,” boasts his bio-page for Children’s National Medical Center, where he heads pediatric neuropsychology.

Gioia is one of those usual sports “experts” at hearings and conferences in the United States and abroad, including the wacky 2012 Zurich confab that declared no research yet links football to brain damage—while panelists like him espoused quackery “technique,” Heads Up, as valid prevention of concussion.

A pleasant professor, the audacious Gioia co-authored Heads Up policy for the government CDC while also advising for the NFL’s front organ in “youth” athletics, USA Football.

The non-profit USA Football generates and promotes the 47-year-old false hope behind Heads Up, known by various refresher names over decades, like “proper technique,” “form tackling” and “head up” contact. Allegedly, it’s headless hitting for football.

The NFL is pouring $45 million into retreading and reselling this time-proven invalidity, and millions of children and adults buy the lie, Heads Up, believing in “safe” tackling.

Plaintiff attorneys now target coaches, officials, schools and local governments for lawsuits, alleging negligence for failure to instill headless hitting. A court test is bound to  materialize and finally blow apart the fallacy.

Modern football yaks think they aren’t liable. The NFL disavows legal responsibility for Heads Up, along with USA Football, with officials’ acknowledging there’s no proof the theory is sound—after nearly a half-century of folly, and their constant claiming it does work.

Back to Giola, what’s credibility to really matter for a guy like him, embodying conflict of interest wrapped within conflict of interest? Many prestigious citizens are bound to football samely, and the opinion-leading breed anoints the game as vital public entity, as it’s already financed.

“You don’t know what the world would be like if we cut out these activities!” Giola says on website of the American Psychological Association.

Actually, many medical professionals envision a better America without dangerous sports in schools and parks, especially DumbBall.

This side believes a wealth of empirical evidence supports placing unprecedented restrictions on football, perhaps banning it, at least for prepubescent kids.

“The literature is clear. This is a dangerous game for children to be playing,” Dr. Paul Butler, retired physician and former college player, said two years ago at forefront in the neo-wave of medical outcry against tackle football.

Retired internist Dr. James Harris took up the cause last year in Texas, urging his local school board to consider dropping football, as had Butler in New Hampshire.

“It is my medical opinion that there is already sufficient medical evidence available to warrant cessation of tackle football, period,” Harris says. “In all age groups, especially for goodness sake in children.”

“I would not let my grandsons play football. … I feel guilty because I love football and I encouraged one of my boys to play. Shoot, I played; thank goodness I wasn’t any good and I’m still okay. Or am I? Are you? Your kids? How about your dad?”

Dr. Harris is convinced microscopic examination has established evidential connection between brain damage and football impacts. He cites research of teams led by sport-neuropathologist Drs. Bennet Omalu and Ann McKee.

“Chronic traumatic encephalopathy, or CTE, is a degenerative disease caused in large part by repetitive head trauma, like you get butting heads in football,” Harris says. “I’m talking about routine hitting that is part of football, sub-concussive, any position.”

Valid and reliable pathology links trauma harm to athletes, by McKee, Omalu and Dr. Harrison Martland, dating to the latter’s postmortem cases of boxers with “dementia pugilistica” in the 1920s.

Further literature piles on, for brain mayhem of collision football, and doctors who dissent from sports-med group-think contend that anti-football findings now constitute a neural research trend moving steadily toward consensus: Collision football is too dangerous for the human brain, particularly in developing children, and has no remedy for the impacts.

But many football-friendly professionals blather on, claiming need of more evidence for brain risk and outcome. One of those is Dr. Gillian Hotz, a specialist of pediatric sports neuro-trauma at the University of Miami.

“We don’t know enough to say kids shouldn’t play football,” Hotz says. “Everyone around the athlete needs to be educated on this subject.”

Especially doctors like Hotz and her colleagues. So here’s a primer lit review, study findings that include some research funded by football organs like the NFL since December 2012:

Football leads school sports in diagnosed concussions with prep players nearly twice as likely to suffer cerebral injury than college players… concussed children may need break from schoolworksingle concussion may result in long-term disease…  youth athletes may suffer emotional and behavioral dysfunction in months following concussion… physical fighting can lead adolescents to IQ loss equivalent to missing a year of school… football impacts to the head measure same G-forces for children as adults… depression may beset children with brain trauma… no evidence football helmets reduce concussion risk… brain injury often causes vision problems.

An onslaught of football-adverse findings have emerged the past nine months, studies in journals of 2014 to-date, with some replicating previous results, such as… deceased college football player diagnosed with severe CTE…  18 college football players and 4 prep players diagnosed with CTE postmortem… concussed teens sensitive to light or noise more prone to anxiety or depression… brain changes can persist two years beyond sport participation… teens with history of concussion more likely to suffer depression… concussed hockey players exhibit micro-structural brain change in advanced MRI… brain injury may be present even without clinical symptoms… concussion during school year means much longer recovery… brain injury may stunt childhood social skills… football players may not recover from brain trauma over the offseason… concussed teens more likely to commit suicide… football may shrink the hippocampus brain region, affecting memory and emotion… chemical response to brain impact can worsen injury or disorder… brain injury common among female criminals… college football players sustain six undiagnosed concussions for every concussion diagnosed… and concussed children should rest and avoid schoolwork post-injury.

Perhaps the biggest bomb was recently unleashed in documents of the pending NFL concussion settlement–the league’s historic acknowledgement that about 30 percent of former players suffer brain disease at earlier age and nearly double the rate of the general population.

“I think we have underestimated the link between traumatic brain injuries and degenerative diseases,” says NFL researcher Dr. Bruce L. Miller, neurologist and director of the Memory and Aging Center at the University of California-San Francisco. “There is a huge, important link related to brain trauma even early in life and degenerative diseases later in life.”

Acute traumatic brain injury and chronic disease kill 50,000 Americans every year, with 235,000 hospitalizations and 80,000 disabled. Total cost for care hits $76 billion, according to Miller.

Many of the injured dwell outside diagnosis and treatment, including football players and combat veterans . “A lot of people who suffer from TBI go under the radar,” says Miller, a candid NFL researcher.

“Ten to 23 percent of the troops returning from Iraq and Afghanistan have TBI. That is a huge number of people. We have 1.8 million troops serving in these conflicts.”

“I would argue that head trauma is one major risk factor for dementia in our society,” says Miller. “We have reached only the tip of the iceberg when it comes to understanding what the dementia is following a TBI.”

Another earnest researcher funded by the NFL is Dr. McKee, famed pathologist who has confirmed the most cases of brain damage in deceased football players.

McKee disturbs the NFL with her frank comments on football dangers, and league officials no longer steer brain donations her way. McKee’s accumulating evidence is startling, especially of pro football.

New data were released Tuesday from the Massachusetts brain bank McKee directs, revealing almost 80 percent of football cases she’s examined have tested positive for CTE, or 101 of 128.

McKee has found brain damage in 76 of the 79 NFL-player cases she’s investigated postmortem. The sampling isn’t random but biased, since most the men and families suspected brain damage and wanted to confirm.

McKee, however, believes she’s helped establish irrefutable link of football battering to brain damage, or exactly what game-sycophant researchers keep harping about. She says that “playing football, and the higher level you play football and the longer you play football, [means] the higher your risk.”

The football-funded researchers McKee and Miller are echoed by an independent medical dissident on the game.

Dr. Jeff Ritterman also contends war and contact sports “are leading to significant number of serious brain injuries” among Americans. “We are literally knocking ourselves senseless,” Ritterman states, disgusted with the military and violent athletics.

“Take a moment to reflect on your own store of cherished memories,” the doctor writes for HuffingtonPost.com. “Imagine not being able to retrieve them, or not being able to lay down new ones. In addition to memory loss we are causing violent outbursts, depression, aggressive tendencies and even death. Is this the legacy we want to impart to our boys and young men?”

Incalculable numbers suffer debilitating football injuries annually

Contemporary tackle football physically maims thousands every year, from head to toe, possibly reaching a six-figure number in fractures and tears that require surgery. Most cases are juvenile players in school and youth leagues.

Football-pandering experts who cry for evidence of public health menace can simply delve into the deep store of player casualties found online. Brain injury constitutes but a segment.

Even I, humble ex-sports reporter with MA degree and operating on my dime, have collected more than 1,000 cases of critical football casualties since 2009.

Minimally hundreds suffer severe to catastrophic injuries annually, per online reports and other data, and likely most would die if not for high-tech helmets and emergency response.

An overlooked category is players with internal injuries that years ago would have killed routinely, for lack of modern treatment that include powerful antibiotics. Indeed, organ ruptures, non-cerebral blood clots and infection combined to kill most a century ago, when football action moved in masses of clawing players who ripped and crushed each other, in contrast to the high-speed, head-on collisions in open space today.

Today more than a hundred football survivors of lethal injuries surface online, every year, quite predictably. The cases involve impacts to torso, extremities, head and neck, absorbed from other players and ground contact, and most patients require emergency surgery. The hits inflict damage to brain, spine, eyes, heart, lungs, liver, spleen, kidneys, pancreas, and circulatory system.

Countless additional cases occur without reaching an internet posting.

Limitations on information include privacy law, with some families quashing or controlling public mention. Independent analysts like myself, along with football-funded researchers and news media, are hopeless for documenting all severe injuries in football. A likely majority of cases are missed.

The problem is illuminated by gaping holes in annual case collections of the so-called National Center for Catastrophic Sports Injury Research at the University of North Carolina. The entity, funded by football organs, isn’t a facility on campus and manifests primarily as a website full of erroneous data, trend claim and projection. The staff is unqualified for compiling epidemiological study, the complex discipline no one is capable of achieving for football in near future.

The annual UNC reports miss numerous catastrophic football injuries publicized in Google banks, including severe brain bleeds, spinal fractures, and cardiac collapses. Another problem is many cases aren’t publicized within the calendar year and only surface in subsequent periods, including reports of permanent brain impairment and quadriplegia. I’m still finding cases of 2011, for example, previously unreported.

Moreover, the UNC material doesn’t cover many classes of grid catastrophe found online, including: internal bleeding of the torso led by spleen-rupture cases galore; blood clotting launched from wounded extremities; “compartment syndrome” or rhabdomyolysis; artery rupture; peripheral paralysis of shoulder, arm and leg; and infection like deadly MRSA.

And while tackle football kills fewer players in collisions anymore, the differences are modern skull-preserving helmets and trauma-care infrastructureand not, as UNC literature purports, the musty concepts of “head up” contact and unenforceable “anti-butting” rules.

Besides, football’s contemporary death tolls should be unconscionable for the medical industry to support, given its professed values. Instead, officials characterize annual collision deaths in single digits as somehow acceptable, indicative of “safer” play.

Eight teen boys are known to have died of football contact last year at public schools and stadiums, and despite high-tech armor and modern medicine.

For 2014, at least two teens are dead of football contact thus far, Navy walk-on running back Will McKamey and New York prep Tom Cutinella.

Further, for reports that show in Google, dozens of active football players die of causes with potential indirect links to the game, although challenging to determine either way.

Some 30 cases have emerged publicly during 2014 through this week. These players die suddenly, unexpectedly, on fields, in workouts, at home and elsewhere.

Cardiac arrest kills most, apparently, followed by causes that include heart attack, heatstroke, congenital arterial malformation such as “AVM,” cerebral stroke, and blood clots in lung and heart.

Victims are largely teenagers and America’s common death-investigation offices cannot reliably verify a football link in most cases, if not the vast majority.

Finally, suicides and overdoses of active football players also occur regularly, screaming for attention and resources hardly forthcoming. Football officials zealously distance the game from these incidents, in their news quotes and court defenses.

But many experts strongly associate brain trauma to violence such as domestic attack and self-harm, and suicide often ends the lives of boxers and football players later found with cognitive disease.

Painkiller abuse is traditionally rampant in the NFL, while college and schoolboy football players are increasingly associated through arrests and tragedies.

Football players at high schools and colleges die for overdoses of pills and heroin. Others are busted for use and distribution.

Some families publicly declare that football injury led their troubled athletes to opiate addiction. Coaches, trainers and doctors have been accused of involvement, from prep ranks to pros.

Medical associations traditionally avoid confronting football

The bedding of medical authorities with tackle football is a tawdry affair of overt, historic proportion, a conflict of interest longstanding.

American medicine’s ethical infidelity was obvious 30 years ago, for its illogical stance of condemning boxing because of brain injuries while simultaneously defending football, the golden cow, according to news reports available in the subscription database Lexis-Nexis.

By 1984, the American Medical Association led groups in Britain and Canada in calls to ban boxing for amateurs and to tightly regulate professional ranks. The AMA wanted boxing barred from public funding and facilities in the United States.

American medical professionals chided counterparts who defended boxing and talked of reform for “safer” pugilism.

“A doctor at ringside is like a priest at a hanging,” joked Dr. Robert Cantu, Boston sports neurosurgeon, speaking to The Toronto Star. “Neither improves the safety of the event.”

But Dr. Cantu heartily endorsed collision football at the time, including the struggling “safety” initiative billed as “form tacking,” or impossible “head up” hitting without helmet strike.

Today the table has turned. Cantu’s altered his gridiron opinion and come under fire himself, from game advocates led by doctors, for his contemporary recommendation that parents forbid tackle football for children before high school.

Cantu contends many doctors support him but are paralyzed to act because of their business ties to football. “Although doctors generally approve, they’ve had to tiptoe around the issue with young patients and their parents,” Cantu writes for Time Magazine.

Cantu recounts his conversation on the ethical dilemma with a pediatrician, who said, “You want to do what’s best for your patients. You also want to have patients.”

A recent survey by The Aspen Institute finds many doctors share Cantu’s concern for millions of kids in tackle football. Seventy-seven percent of medical professionals polled said they were “uncomfortable” with the activity for ages under 14.

The AMA and other associations, for their part, say nothing substantial yet. It’s status quo for Big Medicine’s political and business chicanery with DumbBall in America.

In October 2011, Roger Goodell was keynote speaker at convention for the Congress of Neurological Surgeons in Washington.

The NFL commissioner received a standing ovation from the 3,000 CNS members in assembly, and independent journalist Irv Muchnick wanted to know why.

Muchnick emailed 24 officials of the CNS, copying his query to president Dr. Christopher C. Getch, professor of neurosurgery at Northwestern University.

“The Congress of Neurological Surgeons is not supposed to be a cheerleader wing of the National Football League,” Muchnick reminded Dr. Getch. “I challenge the CNS to release the [Goodell] video and take public account of this incident for your group’s independence and credibility. I look forward to hearing back from you.”

Silence. None among the CNS officials responded to Muchnick.

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.