Tracking the slow or fast decline of American football, as driven by public health concerns, involves following the science, of course — in addition to following the deaths, the money, and the sound bites. Bob Costas went all lofty on us last night at halftime of NBC’s Sunday Night Football while addressing the Jovan Belcher murder-suicide. As Costas would have it, football safety is the background of this story. The foreground is gun control. I disagree.
With good timing, a new chronic traumatic encephelopathy study by the Boston research group makes the publicity rounds today. This one has numerosity, 85 donor brains, and Dr. Robert Cantu correctly observes that anyone who still doubts the discrete pathology of CTE no longer should.
When it comes to the risk thing, Chris Nowinski reminds us that predictions are fraught, “a gambler’s game.” This layman would like to pursue that line for a moment, and again advance the idea that the two interconnected components of traumatic brain injury study tend to get glibly atomized, when they should be integrated.
One component is the sports injury known as concussion. This is now understood to come in both detected and undetected varieties: observable loss of consciousness as well as less easily identified symptoms. One of the costs of the new concussion awareness has been the evolution of the term “concussion” into virtual catchall status.
The other component of football TBI is subconcussive accumulation, with CTE-associated long-term effects. At the far end of this scale, we find dementia and cognitive impairment in ex-athletes who were much too young.
“The dots are really about total head trauma,” Cantu tells The New York Times. This leads him to emphasize such things as reduced contact in practices, hit-sensor technology in helmets, and — to be fair to his boldest and most admirable point — recently articulated support of the camp advocating elimination of tackle football below age 14.
But what I’d like to ask is whether the football safety debate properly stops at “total head trauma.” Cantu’s colleague, Dr. Ann McKee, summarizes the same study similarly but differently, saying that “If individuals play football — especially if they have concussions that aren’t properly managed — they can develop areas of brain damage.” The italics are my own, underlining what I think these hard-working researchers themselves might not fully appreciate about the dissonance of their message.
For it seems to me that football serves up more than one TBI problem. There’s a “total” problem, in the form of concussions-cum-subconcussions. And there’s an entirely “random” but nonetheless systematic problem, in the form of reported catastrophic injuries and unreported chronic ones. The latter problem is less conducive to hard science. It suggests that this subject is, at root, social; non-disciplinary, or at least “multi-disciplinary.” No one is lining up to hand out grants for that.
The “dots,” in my view, are not some still-undeveloped quotient of hits-per-brain-cell-per-age, as the Cantu crowd maintains. Take a look at the recent interview by USA Today of Dr. Richard Ellenbogen, the National Football League’s brain injury co-chair. Ellenbogen spent most of his energy warning against snap visual diagnoses by press box-level consultants or even ad hoc sideline neurologists. He argued that the team medical and training staffs, those with the most knowledge of individual players’ baselines and histories, are still the best equipped to manage the fallout of in-game collisions.
Ellenbogen may be right, but my point is that the whole discussion shows how much more artistic than scientific the concussion-management game is. It leads to the question of whether America’s parents are truly, consciously, prepared to put their son’s futures, and broader national male mental health, in the hands of people who, for all intents and purposes, are making up the rules as they go along.
Last night NBC, an NFL broadcast partner, in a halftime segment Dan Patrick had hyped as “must-see TV” (not that he or his bosses care about ratings or anything, mind you), made sure not to go there. Costas firewalled his Belcher civics lesson at gun control. Speaking as someone who has never owned or even fired a gun, I don’t think that approach moved the chains. Indeed, it may have had the effect of shortening the shelf life of the tragic weekend news, rather than extending our collective memory of it.