Concussion Inc. (17 page)

The break is clean — I am no longer, officially or unofficially, part of the Sports department. Of course I will contribute things here and there, as I do to other sections — for example, the essay about my son, and the obit on John Mackey. But I have moved — ­mentally and physically, given my new desk on the third floor — to National Education.

It is not for me to say what the Sports department will do regarding concussions and other head-injury/football matters in the future. Mine was never any sort of concussion “beat” — I just did the work and pursued it with my superiors' support and guidance, like dozens of other reporters at the paper. You'll notice I did a lot of other work (baseball, Paralympics, etc.) interspersed during my four years; concussions was my prime focus when it made sense, which was obviously rather often. I am extremely confident that the subject will be ­covered just as skillfully in my ­absence.

My leaving Sports was a promotion, not an exile — it was my decision alone, facilitated by a masthead that wanted to reward my work with the prestigious challenge of National Education. They couldn't have been nicer about it.

Hope this helps. Take care.

— Alan.

I responded:

Alan,

Thanks. I'll post your statement. Happy trails. Whether it's known as a beat or anything else, I hope the
Times
carries forward well the important work you pioneered.

Irv

10 August 2011..........

Yesterday I asked Chris Nowinski, head of the Sports Legacy Institute, and Dr. Robert Cantu, Nowinski's co-director at Boston University's Center for the Study of Chronic Traumatic Encephalopathy, to comment on the wildly propagandistic statement by Dr. Joseph Maroon that the incidence of kids' injuries in car accidents is “significantly higher than playing in sports.”

Nowinski and Cantu have not responded. That is both disappointing and revealing.

Talking about the new collective bargaining agreement between the NFL and its players, Nowinski has said that it is good if the professional athletes got what they wanted, and now there are additional questions of whether amateur athletes and their families will get what they need in terms of a sports system that protects them from undisclosed risks of permanent and disabling brain trauma. (I am paraphrasing.) There is no problem with Nowinski's stance, so far as it goes. But it doesn't go far enough, and he, more than anyone, should know that.

The NFL has given Nowinski's center a $1 million grant, but with each muted and equivocal public statement by the guiding light of contemporary concussion reform, the tacit strings attached to the league's discount generosity are showing.

Nowinski realizes — and he used to articulate this powerfully — that the NFL doesn't merely set the tone for the incentives and style of play in high school and youth football. It also buys and sells them. No example is starker than the thoroughly tainted Maroon and his ImPACT “concussion management” system. So when Maroon spews more public nonsense, as he did this week, it is Nowinski's responsibility — not just his job description — to rebut it.

Nowinski bristles at the charge that NFL money has compromised his mission. He says the steps initiated in recent years by Commissioner Roger Goodell and the owners have been “game-changers” in the national concussion narrative. Maybe so — but if one of those changes was to squelch the voice of Nowinski and his Boston group, then it was a bad bargain for the rest of us.

17 September 2011..........

On September 8, National Public Radio's
Talk of the Nation
with Neal Conan featured a discussion of the concussion issue by guests Alan Schwarz of the
New York Times
and Buzz Bissinger, author of
Friday Night Lights
.
7

It's an excellent dialogue, though also an incomplete one from my perspective. In addition, it provides some important interpretation by Schwarz of his groundbreaking and, unfortunately, now past-tense coverage.

Schwarz and Bissinger trade topping each other with the points that define the debate over the future of football. Schwarz gets to the heart of the unacceptable risks of traumatic brain injuries for pre–legal consent amateurs, and even the impossible real-world task of helmets in protecting against them. Often he does so with quite a bit more clarity than he achieved in his published news reports and analyses.

Bissinger, I think, effectively presses Schwarz on the bottom-line futility of changing football rules to address the problem. (Bissinger comes to a different conclusion than I do on whether the upshot is that tackle football should continue to be part of the public high school agenda — let alone its 900-pound gorilla.)

Now, back to Schwarz and what I have found so inadequate about the
New York Times
on concussions. Or was, before the
Times
moved Schwarz to the position of national education reporter and became just another pack outlet on a story he and they had made.

It's a shame so much of Schwarz's intelligence is used for caginess instead of communication. For example, on the subject of the spate of lawsuits against the NFL, he says on NPR, “I think the question is, you know, what did you know, and when did you know it? And that's very debatable. I think those of us who have spent a long time studying not only the evidence but the history of the unfolding of the evidence, there's a point at which it becomes reasonable to think that the employer should have told the employees. However, a lot of people want that to start a lot earlier than I think is reasonable. So we'll see. It's for a jury and a judge to decide.”

That is certainly one hermetically impenetrable way to put it. But is an underlined disclaimer about how the lawyers are going to slug it out, while we all sit back and watch, the most illuminating way? In my own interview on a Toronto radio station the very day the first of these lawsuits became news, I acknowledged that the specifics of that case needed more scrutiny. But I also emphasized that litigation, this one and others, collectively and inevitably, would drive the public's better understanding of the NFL's responsibility for a tobacco-like public health tab.
8

This is the difference between someone employed by the
New York Times
and someone employed by himself.

Generally speaking, Schwarz devotes a lot of verbiage to his skepticism about the strongest claims of the links between football and traumatic brain injury. I think it's mostly a matter of style — but again, at a point the style becomes less about projecting credibility than about being disengaged and unhelpful. He says on NPR, “I think all we were certainly trying to do at the
New York Times
was give people the information, whether they were professionals or the parents of kids, on which to base their decisions of whether to take a risk — that particular risk or not. They can take whatever risks they want. We don't care.”

Well, I for one care which risks are undertaken — by the parents of other kids as well as my own — in heavily funded and promoted activities run by the gatekeepers of our educational system. Because those risks will affect all of us in maintaining national mental hygiene and a civil society.

12 October 2011..........

Minus Alan Schwarz,
New York Times
football concussion coverage has evolved from “flawed” to “missing in action.”

Since Schwarz was promoted to national education reporter, the
Times
has not run a single story about the National Football League's relation to the national concussion issue that was not prompted by a press release.

I think it's fair to interpret this as showing that Schwarz was exiled, not promoted.

8 November 2011..........

I appreciate the fact that Chris Nowinski doesn't perceive his mission to include making the case against public high school football. But someone should tell Nowinski that the public conversation doesn't begin and end with making the case for chronic traumatic encephalopathy, either.

Right now the hockey community is pushing back at the Boston research group's finding that retired player Rick Martin had early onset CTE when he died earlier this year of a heart attack at 59. Even though the face of the sport, Sidney Crosby, continues to sit out the aftereffects of his nearly year-old concussion, and other recent hockey deaths do clearly link in some fashion to contact-induced brain degeneration, doctors and journalists from points north are right to be noting holes in claims by the Center for the Study of CTE. To oversimplify only a little, tau protein buildup in brains is like plaque buildup around hearts — further study will surely show that it affects individuals with different intensities and at different rates.

That a debate so narrow should be bogging down general understanding of the sports concussion crisis is a crying shame — and also so unnecessary. Sadly, Nowinski, not long ago one of the great public health advocates of his generation, seems to be devolving into a Concussion Inc. bureaucrat as he stubs his toe in defense of the research turf of Dr. Robert Cantu and colleagues. What we all could really use from Nowinski is a little less “peer review” pomposity and a little more common sense.

The hype that Martin's so-called stage 2 CTE would have led to Martin's eventual dementia (“no question,” Nowinski said in one ­credibility-crippling sound bite) is “incomplete … fragmented,” neuro­surgeon Dr. Charles Tator told Randy Starkman of the
Toronto Star
, adding, “We need more science and less grandstanding.” The intellectual rift between hockey doctors and the Boston group was further explored in a very good three-part series by
Yahoo Sports
' Nicholas J. Cotsonika.

Let me be clear about my own position. I think the pattern of CTE — that new and more all-encompassing nomenclature for what once was known only in ex-boxers as “punch-drunk syndrome” — is unmistakable in football players especially. But in the course of chasing research dollars (including the National Football League's not-so-­unrestricted $1 million gift to the Boston center), Nowinski has pushed the envelope in the Martin case and undermined the larger cause.

My view is that we don't need this non-scientific spokesman, with his own scary brain-sloshing experience and testimonials from college football and WWE, fronting for narrow institutional interests. We need him leading from the bully pulpit on the heart of the matter: ending the annual carnage of disability and death — including but not limited to traumatic brain injury — in the football programs of our public high schools.

To reduce the whole shootin' match to “CTE or no CTE?” is to give away the game just when the good guys' team was building momentum. There is a known heavy toll in other injuries sustained by young people in pursuit of American gladiatorial blood sport: strokes, seizures, aneurysms, brain bleeds, subdural hematomas, and, lest we forget, spinal injuries, as well as garden-variety concussions. (Never mind steroid abuse: that horse is so far into the next county that the barn door has petrified.) These add up to a significant public bill, whose significance would be even better grasped if Nowinski's mentor, Cantu, would compile catastrophic injury reports as comprehensively as my colleague in independent journalism, Matt Chaney.

It would also help if the Boston crowd stopped giving aid and comfort to the fiction that football safety measures and baseline neurocognitive testing were real solutions at the Pop Warner and prep levels. The former undoubtedly can reduce the volume of serious injury and death at the margins. The latter is part of a sham, preying on football mania, to turn the whole crisis into a marketing opportunity for frauds like the pushers at UPMC.

6 December 2011..........

If the
New York Times
' superb three-part series by John Branch on the death of 28-year-old hockey player Derek Boogaard had only added vestigially to what's being called “concussion awareness,” then it would rate no more than a gentleman's C. I'm happy to be praising Branch for accomplishing so much more — putting chronic traumatic encephalopathy in the context of what I have called the “cocktail of death” in contact sports and entertainment. Give the Gray Lady and its reporter an A+.

Give credit, also, to the Boston University Center for the Study of CTE and to concussion go-to guy Chris Nowinski for coming back from the credibility hit they took for overhyping the CTE findings of another recently deceased ex–National Hockey Leaguer, Rick Martin.

The hockey establishment had scored a TKO in its debate with Nowinski over the claim that Martin, a non-brawler in his late fifties, had “stage 2” CTE, from which the public was asked to extrapolate that he “definitely” would have faced hockey-related dementia had he not died first of a heart attack. As I argued at the time, that was a stretch — more about the Boston group's territorial claims to concussion research than about deepening public understanding.

But I try to call 'em as I see 'em, and I see the Boogaard story, as sketched by the
Times
, very differently. Here I think the hockey mavens' attempts to disclaim its implications come off not as healthy skepticism but, rather, as classic and unfortunate defensiveness in the face of facts.

The key difference rests with the word “story.” Branch doesn't present bloodless, atomized lab reports and expect general readers to accept them as the teachings of the priesthood. Instead, he weaves a compelling narrative of Boogaard's violent life and work, leading to episodes documenting his mental deterioration.

As a result, the story has no need to choose or champion any single cause of the player's specific and final demise. Was it the concussions? The booze? The painkillers? The clinical depression, somehow divorced from all of the above?

Correct answer: it was all of them, as it almost always is, in different measures in different people.