Concussion

Concussion Crop

The National Football League has been in crisis mode of late, accused of mishandling the Deflategate cheating scandal and several domestic violence cases involving players, but the greatest threat to the future of America’s brutal, beloved sport involves damage to the bodies on the field itself. Amid mounting evidence of the dire long-term consequences of repeated head trauma, participation in youth leagues is on the decline, and even President Obama has said that if he had a son, he wouldn’t allow him to play pro football.

Jeanne Marie Laskas’s new book, Concussion, grew out of her 2009 GQ article, “Game Brain,” about Bennet Omalu, the largely forgotten forensic pathologist who discovered the degenerative brain disease chronic traumatic encephalopathy (CTE) in a number of former football players. Omalu fought to publicize his findings despite the NFL’s efforts to discredit him. The upcoming film Concussion also grew out of Laskas’s article, and it arrives in theaters right on the heels of the book. With Will Smith in the lead, Oscar-baiting role of Omalu, it seems certain both that the concussion controversy will receive renewed attention and that the word forgotten will not be attached to the doctor’s name going forward. (As this review was posted, Omalu’s Op-Ed piece about the dangers of allowing minors to play football was published in in the New York Times.)

The GQ piece opens with Omalu, who worked for the Allegheny County coroner’s office in Pittsburgh, being assigned the autopsy of Mike Webster, the Hall of Fame Steelers center who died in 2002 at age fifty, after years of mental deterioration and homelessness. In Concussion, that pivotal moment comes more than a third of the way in, after chapters describing Omalu’s upbringing in Nigeria, his struggle with depression during medical school, and his move to the United States, which he idealized. The lead-up to Omalu’s breakthrough feels overly long, but these early chapters do provide insight into the doctor’s fascination with the human brain. He yearned to find a scientific explanation for a question that preoccupied him: in Laskas’s words, “Why do some depressed people commit suicide, and some, like him, do not?” This interest led him, on a hunch and at his own expense, to preserve slices of Webster’s brain for microscopic study, despite the cause of death having been declared a heart attack.

Webster was a legend in Pittsburgh, but Omalu hadn’t heard of him before his death. It’s estimated that “Iron Mike” took as many as 25,000 hits during a lifetime of playing football, and in his final years he wandered Pittsburgh and its environs in a haze, trying to Super Glue his rotting teeth into his mouth and stunning himself with a Taser in order to fall asleep. When Webster’s slides returned from the lab, Omalu discovered a buildup of tau proteins, “neurofibrillary tangles” that, as Laskas puts it, are “like sludge, clogging up the works, killing healthy brain cells — in this case cells in regions of the brain responsible for mood, emotions, and executive functioning.” Webster’s brain looked similar to that of an Alzheimer’s patient or a boxer afflicted with dementia pugilistica, also known as punch-drunk syndrome.

Omalu published his findings in the scientific journal Neurosurgery. The NFL pressured the journal to retract the article, but it refused and instead published a follow-up by Omalu, who had found evidence of CTE in the brain of a second player, former Steelers offensive lineman Terry Long, who committed suicide in 2005. The discovery of new cases continued apace (several former players, including Dave Duerson and Junior Seau, have committed suicide by shooting themselves in the chest in order to preserve their brains for study) while the NFL continued to keep its head in the sand. The league’s Mild Traumatic Brain Injury committee — headed by a rheumatologist — derided Omalu’s research and questioned his motives. Meanwhile, infighting over strategy and resources intensified as other doctors, lawyers, and advocates entered the fray, pushing the politically inexperienced Omalu to the sidelines.

Much of this story was covered in last year’s League of Denial. Concussion will most interest those who wish to understand events through Omalu’s eyes. Long “passages of introspection” that he wrote appear throughout the book in italics. These can bleed disconcertingly into Laskas’s own prose, as she at times writes as if she were inside her subject’s head. Still, a clear portrait of Omalu emerges. A devout and spiritual man, he speaks to the dead and believes they speak back; for him, Webster’s lab results are urgent messages his spirit is sending through his brain tissue. Concussion also captures an immigrant’s dawning understanding of the America he had long romanticized: Omalu’s naive faith that the NFL would welcome his findings is replaced by a growing sense that racism played a part in the league’s attempt to damage his reputation. Despite this more clear-eyed view of his adopted country, at book’s end he is on the verge of becoming naturalized, and “if he is proud of one thing in his life,” Laskas writes, “it is that he is about to become a citizen of the United States of America.” Omalu remains true to his heritage, too; after all, his full surname translates to “If you know, come forth and speak.”

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