by Irvin Muchnick
Where we left off this grim story, a little more than a month ago, is that I declined a New York newspaper editorial page editor’s offer to resubmit later an op-ed essay questioning whether this 14-year-old’s sudden death, on the second day of football practice at Mount Saint Michael Academy, would turn out to be another underreported example of ECAST (Exertional Collapse Associated With Sickle Cell Trait) in the largely black youth football population.
The editor explained that he was “uneasy about publishing a speculative diagnosis if we’re going to get a definitive, official medical judgment.”
For my part, I explained my own unease over waiting dozens, scores, or hundreds of news cycles, until long after the Bess death had faded from local, let alone national, consciousness, before being offered such a platform — and even then, if and only if Bess were ultimately found to be a sickle cell trait carrier, the death were definitely attributable to this syndrome in some measure, and the New York City medical examiner were persuaded to state as much in the autopsy. “Definitive, official medical judgments” can be funny that way.
Instead, I chose to publish the piece immediately here at Concussion Inc. Today I am reproducing that text, one day shy of six weeks since the incident. I believe the point is made, again. (See the bottom of this article.)
As for the facts — was this or wasn’t it ECAST? — here’s what is known publicly so far.
I submitted a public information law request for a copy of Dominick’s autopsy. The New York M.E.’s office had estimated to two New York journalists that pinning down the findings would take two weeks. We are four weeks and counting past that.
Reportedly, one of the victim’s relatives told journalists that Dominick did not carry the sickle cell trait. This may turn out to be so. However, this relative’s word is hardly dispositive, since there is a lot of confusion between the condition of sickle cell anemia and the genetic sickle cell trait. A carrier of the latter doesn’t have the disease, but a risk — an eminently manageable one — of ECAST during exertion. New York State birth records are supposed to notate whether a newborn carries the trait (and Dominick, whose mother is from Montserrat in the Caribbean, was born in New York). To date, I am not aware of documentation of the young man’s sickle cell trait status.
Similarly, until there is a finding by the coroner, and one that exhibits a thorough weighing of the ECAST possibility, I continue to believe that responsibly labeled speculation should be part of the public dialogue in the immediate wake of yet another death in American youth football.
If Dominick indeed proves to have died “only” from a heart attack or heat stroke, then football’s apologists will be able to take all the comfort they can muster from that.
Which is to say, in this corner’s view, very little.
The death [on August 22] of 14-year-old Dominick Bess at a Bronx high school football conditioning session is a reminder that, while traumatic brain injury gets most of the headlines, the lethal dangers of this sport, in which no kid should be participating for public schools or on public fields, are multiple.
Though the medical examiner has yet to speak on the cause of death, and episodes like this one are usually written off as generic cardiac arrest or heat stroke, there is considerable circumstantial evidence that young Bess was the latest unacknowledged victim of one of football’s biggest killers: ECAST, which stands for Exertional Collapse Associated with Sickle Cell Trait.
Medical journal research spearheaded by Dr. E. Randy Eichner, a former University of Oklahoma football team physician, and Scott Anderson, still the Oklahoma head athletic trainer, shows that there have been at least eight ECAST deaths since 2010 in high school and college football. With more rigorous accounting of sickle cell trait and with better reporting of the many more youth football practice deaths, the number of confirmed ECAST incidents would certainly be higher. Critics believe that ECAST may account for as many as half of all non-traumatic injury football deaths — which makes sense when you consider that around 1 in 12 African-Americans carries sickle cell trait.
This trait should not be confused with sickle cell disease, a form of anemia or blood disorder triggering chronic health crisis. Those with the trait can lead normal lives but need to be vigilant for the onset of episodic sickling attacks during extreme exertion. Lay people can easily mistake these for ordinary heart failure.
ECAST is, literally, a political football. Despite mounting data that it is a leading cause of football and, to some extent, military training deaths, sickle cell disease advocates and fundraisers don’t want to call attention to the trait. They likely feel that, in a society where racial discrimination is pervasive, they shouldn’t be promoting factors that could stigmatize blacks. This is especially challenging because sports and military service may be the closest things in American life to pure meritocracies.
Unfortunately, the taboo reinforces annual and preventable loss of life. Last year Eric Goll died suddenly during an offseason football workout at Chadron State College in Nebraska. The school said it was not aware that Goll had sickle cell trait, even though he should have been screened for it when he was a freshman two years earlier.
But even when a school knows, the competitive and commercial pressures of the college football industry can eclipse safety measures. Such was the case at the University of California-Berkeley in 2014, when Nigerian-American player Ted Agu, who was known to the football and medical staff to be a sickle cell carrier, perished during a bizarre offseason punishment drill overseen by athletic trainer Robert Jackson and strength and conditioning coach Damon Harrington. The university withheld crucial information from the county medical examiner, whose initial autopsy ruled the incident a coronary. But discovery and deposition testimony during the Agu family’s subsequent wrongful death lawsuit against Cal persuaded the coroner to make an almost unprecedented revision of his findings.
The Agus settled their lawsuit for $4.75 million. I am currently suing the university in state court, under the public records act, for release of internal documents that would allow taxpayers to better understand the background. (The parties have jointly asked the court to pause the litigation docket while we explore a possible settlement.)
Trainer Jackson had also been a responsible party in the 2008 sickling death of a Haitian-American football player, Ereck Plancher, at the University of Central Florida. Jackson is now out of the football industry. Incredibly, however, Cal conditioning coach Harrington has moved to the same post at Grambling State, where the squad is nearly 100 percent black.
In the case of Dominick Bess, his mother had immigrated from the Caribbean island of Montserrat, where estimates of sickle cell trait among the population there of African ancestry run as high as 15 percent. Heat stroke, another common false flag in deaths of this sort, was unlikely, as it was only 79 degrees last Tuesday morning in the Bronx.
What we do know is that on this second day of football conditioning at Mount Saint Michael Academy, Dominick was made to sprint repeatedly. A teammate said he was overworked and tired, and that Dominick himself said he was tired and asked for water. His father said he was described as “gasping for air.” The alleged response of the supervising coach was that age-old exhortation: “One more lap.”
Concussions and chronic traumatic encephalopathy — the slow-moving brain deterioration probably caused by accumulation of subconcussive hits — are plenty scary by themselves. So are spinal cord injuries and internal organ devastation. But the ECAST factor deserves to be amplified as American parents ponder the fraught future of football. And as with every aspect of the football debate, it should gain intensity and moral clarity at the sport’s non-adult and non-professional levels.
Concussion Inc.’s ebook THE TED AGU PAPERS: A Black Life That Mattered — And the Secret History of a Covered-Up Death in University of California Football is available on Kindle-compatible devices at http://amzn.to/2aA2LDl. All royalties are being donated to sickle cell trait research and education.
Op-ed article for the Daily Californian on my Public Records Act lawsuit: http://www.dailycal.org/2017/04/25/lawsuit-uc-regents-emblematic-issues-facing-college-football/
“Explainer: How ‘Insider’ Access Made San Francisco Chronicle and Berkeley J-School Miss Real Story Behind Death of Cal Football’s Ted Agu,” https://concussioninc.net/?p=10931
Complete headline links to our Ted Agu series: https://concussioninc.net/?p=10877