League of Denial

by Irvin Muchnick

The most revealing quote in League of Denial: The NFL, Concussions, and the Battle for Truth — Mark Fainaru-Wada and Steve Fainaru’s page-turning game-changer of a book — comes early on from Dr. Ann McKee, the central casting blonde-bombshell laboratory coat face of chronic traumatic encephalopathy. She replaced Dr. Bennet Omalu, the original sprightly African lab coat face of CTE.

Musing aloud to the Fainarus a year ago, McKee says, “[H]ow come I just don’t say, ‘Let’s ban football immediately?'” She answers her own question: “I think I would lose my audience.”

Yes, League of Denial is a book about science in the sense that, along the way, CTE earns classification as a discrete pathology. This is because, under a microscope, a dead brain that was impaired by the disease exhibits the strangling tau protein accumulations also found in Alzheimer’s, but in different parts of the brain and without the beta-amyloid residue also attendant to Alzheimer’s. The Fainarus explain it all concisely, brilliantly, for a general readership — with more diligence than I do, for example, in The Concussion Inc. Files, which will be published next year by ECW Press.

It’s important to bear in mind, however, that LOD is not only, or even primarily, about science. For whenever public health collides with ingrained, commercially successful social customs, hard science gets you only so far. Moreover, what the world recognizes as pure science is often only slightly less elusive than art.

And that problem is the tangled web the Fainarus weave: a chaotic, improvisational dance of academic egotists, corporate butt-coverers, bad timing, and juicy intrigue, all with an unmistakable overlay of inevitability. Anyone who hasn’t been playing football without a Riddell Revolution helmet knows how this story will end … at some indeterminate point in the future, with a whimper, after all the books have been written and read. What remains to be known are just a couple of details — how long it will take to get there and precisely what will constitute the tipping point.

With its bickering ensemble, mixing crude politicos and earnest pointy-heads, and its long, truth-bending narrative arc, LOD is in the tradition of The Best and the Brightest, David Halberstam’s 1972 opus on how Team McNamara came — if I may be permitted to exploit a gridiron term — to “put the ball on the ground” in Southeast Asia. From my perspective, the Fainarus’ final product has foibles, and I’ll get to some of them. But don’t let those cloud what, in the round, is a huge achievement in sports journalism. In journalism journalism.

In coming years, literature will further concentrate the American mind on the gross national cognitive product-decimating insanity that our billion-upon-billion-dollar football industry has become. These forays have to combine good writing, good reporting, good analysis, and, finally, “bona fides”; like Ann McKee said, you mustn’t lose your audience! The authors of LOD, who work at ESPN, have delivered on their end. They found Goldilocks’ sweet spot: their verbal porridge is not too hot, not too cold, just right.

*****

In a few places the book tips its cap to ConcussionInc.net, for which I am grateful. LOD goes deep with the tragedy of Dave Duerson, a retired defensive back and fallen business tycoon who joined in stonewalling old colleagues’ brain injury claims on the Bert Bell/Pete Rozelle NFL Retirement Plan board — virtually up to the moment Duerson shot himself to death while admitting that he, too, was a victim of the syndrome. In the wake of that 2011 episode, Rick Telander and Paul Solotaroff wrote a fine article for Men’s Journal chronicling Duerson’s tormented last days, and Alan Schwarz of The New York Times raised the question of whether the deluded Duerson’s presence on the disability review board tainted its body of work. But so far as I know, only Alex Marvez of FoxSports.com and I have persisted in digging into the Duerson case files with an eye toward correcting injustices.

League of Denial also quotes my friend, Missouri-based writer Matt Chaney, calling Kevin Guskiewicz “Gus Genius” (a jab at that worthy’s MacArthur Fellowship), plus me tagging him “Dr. No. Jr.” (a reference to the senior “Dr. No,” Ira Casson, who once chaired the NFL’s Mild Traumatic Brain Injury Committee). These sallies appear in the epilogue, where the Fainarus ably bring their story home.

Heretofore, Guskiewicz had been part of a group of researchers the authors refer to as “The Dissenters,” since they pecked away at stubborn denial in the higher councils of the league and even in the scientific research the league’s well-connected consultants manufactured for publication in the most prestigious “peer-reviewed journals.” But like just about everyone in LOD at one time or another, Guskie shows his own ass once he becomes an ultimate insider, apologizing for the health toll of the football system and nitpicking at others’ more aggressive extrapolations of concussion-related findings.

In contrast, other figures in the book come off better at the end than in the middle. One is Dr. Robert Cantu, who had signed off on corrupt NFL research and bizarrely lax editorial standards when he was sports section editor of the journal Neurosurgery (whose jocksniffing editor-in-chief, Dr. Michael Apuzzo, was also a team physician for the New York Giants). At least Cantu came around to clearly opining that no one under age 14 should play tackle football, period.

Still others intersperse good deeds with manipulative self-promotion, such as the formidable activist and ex-WWE performer, Chris Nowinski, sometimes in concert with The Times‘ Schwarz, his veritable amaneuensis.

Without the spadework and high-end media access of the troika of Cantu and Nowinski in Boston, and Schwarz in New York, no tome as powerful as League of Denial would have had any hope of coming to light from a major publisher in 2013. Yet the Fainarus call out the vanity of these haughty Northeasterners, too. The climax of the process was a million-dollar NFL grant to the Boston University Center for the Study of CTE, which was accompanied by — and this is strictly my interpretation — a year or more of the Gray Lady’s compromised coverage of the age of “concussion awareness.” Dutifully, in the wake of the uncontrollable Omalu’s split from the Boston group, The Times and others blacked out this native Nigerian, who didn’t give a rat’s rear about football, in favor of the mediagenic McKee, a rabid Green Bay Packers fan.

*****

Commenting on the sister PBS documentary League of Denial, some have said the NFL Players Association is a missing character. After reading the more fully developed book (whose review here supersedes further comment on the television production), I agree. As noted, the Duerson angle is there, but not the dissenting work of disillusioned union activist Sean Morey. LOD doesn’t deal with the fault line between pre-1993 retirees and beneficiaries of the more recent collective bargaining improvements, or with the corruption and cronyism of the late NFLPA executive director, Gene Upshaw. I suspect the authors were just making economical storytelling choices.

The same might be said of another missing character: government at all levels. When the battle of the buzzards was on, between Nowinski’s Boston research group and Omalu’s, for the right to examine the CTE evidence in another celebrity suicide, Junior Seau, the NFL maneuvered the family to donate the brain, instead, to the National Institutes of Health. This was quickly followed by a $30 million donation to NIH, the largest charity check in league history. The Fainarus don’t bother pausing to underscore that NIH is an agency of the federal government, whose pursuit of the public interest gets warped by such levels of supposed corporate largesse.

LOD doesn’t get around at all to the NFL’s parallel eight-figure underwriting of a “public education” campaign under the auspices of another federal agency, the Centers for Disease Control. A pity, as this would have fit neatly into the too-short chapter so tastefully entitled “Concussion, Inc.” (And, guys, you know where to send the royalty checks.)

The Fainarus only briefly touch on the regime of state statutes known as “Zackery Lystedt Laws,” which add to the expensive and untenable “safety mandate” burdens of public high school football. LOD seems mostly uninterested in our theme, at least in this context, of how concussion awareness got vacuumed up by the NFL and its retinue — especially the developers of the ImPACT concussion recovery testing program — in ways that would not only protect Big Football’s interests, but also isolate new profiteering opportunities from them.

Which, of course, brings me to this blog’s bête noire and favorite punching bag: Dr. Joe Maroon of the Pittsburgh Steelers, the NFL, the University of Pittsburgh Medical Center, and ImPACT Applications, Inc. I could fill an ebook with Maroon material not covered in LOD. Come to think of it, I already did.

But Maroon does gets his, too, when he lies about the concussion history of ex-Steelers suicide Terry Long; when he feuds unproductively with pioneer researcher Omalu; when he issues a dingbat endorsement of a supplement called Sports Brain Guard; and when he co-authors the UPMC study that got hyped by the Riddell helmet company and drew the ire of Senator Tom Udall. (Curiously, and unreported by the book, Udall’s Senate Commerce Committee hearing on the subject didn’t name Maroon — one of many examples of the good doc’s Teflon treatment in government investigations and media accounts.)

LOD doesn’t mention Maroon’s position as WWE medical director, though it recounts the Chris Benoit double murder-suicide and has an extended passage on the meeting at the West Virginia Brain Injury Institute, arranged by Maroon, at which an independent researcher, Peter Davies, examined Omalu’s brain tissue slides and, much to the NFL’s chagrin, confirmed Omalu’s breakthrough findings.

I am perplexed by the Fainarus’ decision to bestow on Maroon a quote bearing the moral of the whole shootin’ match: “If only 10 percent of mothers in America begin to conceive of football as a dangerous game, that is the end of football.” Any of a dozen other folks, all with demonstrably superior sincerity, surely said something similar at one time or another; and, worse, Maroon to this day sticks with an outlandish sound byte about how more people die in automobile accidents than on football fields. Oh well. The Fainarus seem less convinced than I am of the centrality of Dr. Joe in concussion cover-up and opportunism, and they have a right to their own conclusions.

Generally, I would describe League of Denial as the definitive work on the top-down generation-long strangulation of pertinent brain injury data emanating from the NFL’s Park Avenue headquarters. If the worst things I can say about this book are in the mild dissents above — along with disappointment in LOD‘s poorly done back index — then that is very high praise. As we move forward, other writers will stand on the Fainarus’ shoulders and execute the next definitive work, on this sport’s bottom-up toxic culture.