[GQ]Game Brain

Ok. This is a long article. Really long, but also interesting and dramatic.

Obviously, the title of the article isn't very descriptive, so the following is the summary from the redit entry so that you can decide whether it sounds interesting or not before spending a few minutes reading the article:

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A lone scientist uses his own time and money to find massive brain injuries in people who are dying young. The problem is they're ex- NFL players and the NFL's doctors deny the claims to avoid huge payouts...

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The source of the article is GQ.


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Game Brain




Let’s say you run a multibillion-dollar football league. And let’s say the scientific community—starting with one young pathologist in Pittsburgh and growing into a chorus of neuroscientists across the country—comes to you and says concussions are making your players crazy, crazy enough to kill themselves, and here, in these slices of brain tissue, is the proof. Do you join these scientists and try to solve the problem, or do you use your power to discredit them?

On a foggy, steel gray Saturday in September 2002, Bennet Omalu arrived at the Allegheny County coroner’s office and got his assignment for the day: Perform an autopsy on the body of Mike Webster, a professional football player. Omalu did not, unlike most 34-year-old men living in a place like Pittsburgh, have an appreciation for American football. He was born in the jungles of Biafra during a Nigerian air raid, and certain aspects of American life puzzled him. From what he could tell, football was rather a pointless game, a lot of big fat guys bashing into each other. In fact, had he not been watching the news that morning, he may not have suspected anything unusual at all about the body on the slab.

The coverage that week had been bracing and disturbing and exciting. Dead at 50. Mike Webster! Nine-time Pro Bowler. Hall of Famer. “Iron Mike,” legendary Steelers center for fifteen seasons. His life after football had been mysterious and tragic, and on the news they were going on and on about it. What had happened to him? How does a guy go from four Super Bowl rings to…pissing in his own oven and squirting Super Glue on his rotting teeth? Mike Webster bought himself a Taser gun, used that on himself to treat his back pain, would zap himself into unconsciousness just to get some sleep. Mike Webster lost all his money, or maybe gave it away. He forgot. A lot of lawsuits. Mike Webster forgot how to eat, too. Soon Mike Webster was homeless, living in a truck, one of its windows replaced with a garbage bag and tape.

It bothered Omalu to hear this kind of chatter—especially about a dead guy. But Omalu had always fancied himself an advocate for the dead. That’s how he viewed his job: a calling. A forensic pathologist was charged with defending and speaking for the departed—a translator for those still here. A corpse held a story, told in tissue, patterns of trauma, and secrets in cells.

In the autopsy room, Omalu snapped on his gloves and approached the slab. He noted that Mike Webster’s body was sixty-nine inches long and weighed 244 pounds. He propped up the head and picked up his scalpel and sliced open the chest and cracked open the ribs. He took out the heart and found everything he expected of a man who was believed to have died of a heart attack, as was the case with Webster. Then he made a cut from behind the right ear, across the forehead, to the other ear and around. He peeled the scalp away from the skull in two flaps. With the electric saw he carefully cut a cap out of the skull, pulled off the cap, and gently, like approaching a baby in the birth canal, he reached for the brain.

Omalu loved the brain. Of all the organs in the body, it was easily his favorite. He thought of it sort of like Miss America. Such a diva! So high-maintenance: It requires more energy to operate than any other organ. The brain! That was his love and that was his joy, and that’s why his specialty was neuropathology.

Omalu stared at Mike Webster’s brain. He kept thinking, How did this big athletic man end up so crazy in the head? He was thinking about football and brain trauma. The leap in logic was hardly extreme. He was thinking, Dementia pugilistica? “Punch-drunk syndrome,” they called it in boxers. The clinical picture was somewhat like Mike Webster’s: severe dementia—delusion, paranoia, explosive behavior, loss of memory—caused by repeated blows to the head. Omalu figured if chronic bashing of the head could destroy a boxer’s brain, couldn’t it also destroy a football player’s brain? Could that be what made Mike Webster crazy?

Of course, football players wear helmets, good protection for the skull. But the brain? Floating around inside that skull and, upon impact, sloshing into its walls. Omalu thought: I’ve seen so many cases of people like motorcyclists wearing helmets. On the surface is nothing, but you open the skull and the brain is mush.

So Omalu carried Mike Webster’s brain to the cutting board and turned it upside down and on its side and then over again. It appeared utterly normal. Regular folds of gray matter. No mush. No obvious contusions, like in dementia pugilistica. No shrinkage like you would see in Alzheimer’s disease. He reviewed the CT and MRI scans. Normal. That might have been the end of it. He already had a cause of death. But Omalu couldn’t let it go. He wanted to know more about the brain. There had to be an answer. People don’t go crazy for no reason.

He went to his boss, pathologist Cyril Wecht, and asked if he could study the brain, run special tests, a microscopic analysis of the brain tissue, where there might be a hidden story.

There was nothing routine about this request. Another boss might have said, “Stick with the protocol,” especially to a rookie such as Omalu, who had not yet earned a track record, who was acting only on a hunch. But Wecht was famously never one to shy away from a high-profile case—he had examined JFK, Elvis, JonBenét Ramsey—and he said, “Fine.” He said, “Do what you need to do.”

A deeply religious man, Omalu regarded Wecht’s permission as a kind of blessing.

*****​

it was late, maybe midnight, when Bob Fitzsimmons, a lawyer working in a renovated firehouse in Wheeling, West Virginia, got a call from the Pittsburgh coroner’s office. It was not unusual for him to be at the office that late; he was having a bad week. He struggled to understand the man’s accent on the phone, jutted his head forward. “Excuse me? You need what?”

The brain. Permission from the Webster family to process Mike Webster’s brain for microscopic examination.

Oh brother was Fitzsimmons’s initial thought. As if the Webster case wasn’t already complicated enough.

Fitzsimmons had first met Webster back in 1997, when he showed up at his office asking for help untangling his messed-up life. Webster was a hulk of a man with oak-tree arms and hands the size of ham hocks. Fitzsimmons shook his hand and got lost in it, mangled fingers going every which way, hitting his palm in creepy places that made him flinch. It seemed like every one of those fingers had been broken many times over. Mike Webster sat down and told Fitzsimmons what he could remember about his life. He had been to perhaps dozens of lawyers and dozens of doctors. He really couldn’t remember whom he’d seen or when. He couldn’t remember if he was married or not. He had a vague memory of divorce court. And Ritalin. Lots of Ritalin.

“With all due respect, you’re losing your train of thought, sir,” Fitzsimmons said to Webster. “You appear to have a serious illness, sir.” Not a pleasant thing to tell anyone, and here was a hero, a famous football player Fitzsimmons once bowed to, as did all young guys worth the Terrible Towels they proudly waved in the 1970s. The Dynasty! The black and the gold! It fueled optimism here, up and down the rivers, mill towns held tight in the folds of the Allegheny Mountains. And here was Iron Mike himself.

As a personal-injury lawyer, Fitzsimmons thought what he saw in Webster was an obvious case of a man suffering a closed-head injury—the kind he’d seen plenty of times in people who had suffered through car crashes and industrial accidents. No fracture, no signs of physical damage to the skull, but sometimes severe psychiatric problems, memory loss, personality changes, aggressive behavior.

“Please help me,” Mike Webster said.

It took Fitzsimmons a year and a half to hunt down all of Webster’s medical records, scattered in doctors’ offices throughout western Pennsylvania and West Virginia. He sent Webster for four separate medical evaluations, and all four doctors confirmed Fitzsimmons’s suspicion: closed-head injury as a result of multiple concussions.

Fitzsimmons filed the disability claim with the NFL. There are several levels of disability with the NFL, and Mike Webster was awarded the lowest one: partial, about $3,000 a month.

Fitzsimmons said, “Oh, please.” He said if ever there was a guy who qualified for the highest, it was Mike Webster. The highest level was “total disability, football-related,” reserved for those who were disabled as a result of playing the game. It would yield Webster as much as $12,000 a month. Fitzsimmons said to the NFL, “Four doctors—all with the same diagnosis!”

The NFL said no. Four doctors were not enough. They wanted Webster seen by their own doctor. So their own doctor examined Webster…and concurred with the other four: closed-head injury. Football-related.

The NFL pension board voted unanimously for partial disability anyway.

Fitzsimmons said, “You have got to be kidding me.” He filed an appeal with the U.S. District Court in Baltimore, where the pension board is headquartered. The judge reversed the decision of the NFL pension board—the first time in history any such action had been taken against the NFL.

And yet still the NFL fought. They took the case to federal court. They said Mike Webster—who had endured probably 25,000 violent collisions during his career and now was living on Pringles and Little Debbie pecan rolls, who was occasionally catatonic, in a fetal position for days—they said Mike Webster didn’t qualify for full disability.

Mike Webster and Bob Fitzsimmons grew close during those days. In fact, Mike Webster clung to Fitzsimmons like a baby to his mamma. He took to sleeping in the parking lot, waiting for Fitzsimmons to show up for work. He would stay there all day, just watching, waiting, and when Fitzsimmons would go home, Mike Webster would go back to his truck and write him letters. Hundreds and hundreds of letters. “Dear Bob, Thank you for helping me. We’ve got to keep up the fight. We have to see this thing through.” And then he would start talking about wars. And blood splattering. The letters would inevitably trail off into the mutterings of a madman.

And now he was dead.

Bob Fitzsimmons did not know what in the world to say, in 2002, to the man with the thick accent who called from the Pittsburgh coroner’s office, four days after Mike Webster died of a heart attack, asking to study Webster’s brain. Fitzsimmons was, in truth, grieving his client’s death deeply; Mike Webster had been living for nothing but the case, the appeal, the last victory against a multibillion-dollar entertainment industry that seemed to have used him, allowed him to become destroyed, and then threw him away like a rotten piece of meat.

And now he was dead.

“Yes,” Fitzsimmons said. And he gave Omalu the brain.

*****​

Days and nights went by. Weekends. Slicing, staining, ordering slides. It got so Omalu was embarrassed in front of his co-workers at the morgue. “He’s gone mad!” he imagined them reasonably thinking. “He won’t stop looking at that brain! He’s here at 2 a.m.!”

So Omalu put Mike Webster’s brain in a plastic tub and took it home to his condo in the Churchill section of Pittsburgh. He put it in the corner of his living room, where he set up a table, a cutting board, some knives, and a microscope, where he could work without shame as long as he wanted and as hard as he wanted, no one looking over his shoulder except Prema, his sympathetic wife. “What the mind does not know, the eye cannot see,” he would say to her, explaining the piles of books and journal articles cluttering the house, the sheer volume of research on trauma, on football, on helmets, on Alzheimer’s disease, on concussions, on impact, on g-force, on protein accumulation, on dementia pugilistica. He had to learn more so he could see more so he could learn more so he could see. For months it’s all he thought about. It became for him a calling. He was after all a spiritual man, and he came to know Mike Webster in the most personal way. “Help me” is what he heard Mike Webster say.

One day he started on a new set of slides, prepared for him by a lab at the University of Pittsburgh where he had ordered specialized staining. He was ordering so many slides, he had to start paying for this out of his own pocket. He put the first slide from the new set under his microscope and looked in.

“What is this?” he said out loud. “Geez. Gee! What is this?”

Brown and red splotches. All over the place. Large accumulations of tau proteins. Tau was kind of like sludge, clogging up the works, killing cells in regions responsible for mood, emotions, and executive functioning.

This was why Mike Webster was crazy.

Omalu showed the slides to Wecht and to scientists at the University of Pittsburgh. Everyone agreed: This was a disease, or a form of it, that no one had ever seen before. Omalu wondered what to call it. He wanted a good acronym. Eventually, he came up with CTE, chronic traumatic encephalopathy. He wrote a paper detailing his findings. He titled it “Chronic Traumatic Encephalopathy in a National Football League Player” and put it in an envelope and sent it to the prestigious peer-reviewed journal Neurosurgery. He thought NFL doctors would be pleased when they read it. He really did. He thought they would welcome a finding as important as this: scientific evidence that the kind of repeated blows to the head sustained in football could cause severe, debilitating brain damage. He thought they could use his research to try and fix the problem.

“I was naive,” he says now. “There are times I wish I never looked at Mike Webster’s brain. It has dragged me into worldly affairs I do not want to be associated with. Human meanness, wickedness, and selfishness. People trying to cover up, to control how information is released. I started this not knowing I was walking into a minefield. That is my only regret.”

*****​

Nothing was welcoming, nothing was collegial, about the NFL’s reaction to Omalu’s articlethat appeared in the July 2005 edition of Neurosurgery. In a lengthy letter to the editor, three scientists, all of whom were on the NFL payroll, said they wanted Omalu’s article retracted.

“We disagree,” they said.

“Serious flaws.”

“Complete misunderstanding.”

The scientists, Ira Casson, Elliot Pellman, and David Viano, were all members of the NFL’s Mild Traumatic Brain Injury committee. In tone their letter to the editor struggled to remain calm, but everyone could read the subtext: We own this field. We are not going to bow to some no-name Nigerian with some bull**** theory.
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