1 Neal Pfeiffer English 200 T R 12:30-1:45 The Hidden Cost of Football For many people in the U.S.

, the coming of the fall months is an exciting time. It means the National Football League season is upon us. As football fans, we love the superstars, the touchdowns, and the hard hits. We especially love the hard hits; they thrill us. We love the hits so much that we boo players who fall or go out of bounds to avoid them. We clap for those players who get hit hard, leave for a few plays, and then come back in the game. We assume they’re okay, since the medical staff and the coaches let them come back. Besides, if they were really hurt, there is no way they’d be back playing, right? As fans, we assume that team medical staffs are familiar with concussions and other injuries and their effects, and they would never let a suffering player go back in the game. Every so often we hear of our favorite NFL players from years past who have died. We take note of their young age at death, but for whatever reason we don’t think about it too much. What if there was a link between the way these players played the game, and their early deaths? The NFL gives out the idea that they are doing everything they can to protect their current players, but what about their retired players? As reported in studies on concussions headed by Dr Pellman and the NFL Subcommittee on Mild Traumatic Brain Injuries (mTBI’s from here on out), players are not at risk for secondary, more serious head injuries very soon after receiving a concussion. The subcommittee also has found in most instances, it is okay for players to be sent back into the game, even after being knocked out. Through a discussion of case studies of retired NFL players, the

2 opinions of the mTBI committee, and the leagues position on player disability claims, the reader will see that the NFL has known about the major long and short term effects of concussions for a long time, and has tried to explain them away because player injuries are expensive to teams in terms of their wins and losses and because the league is not interested in paying retired players pensions under the disability pension plan. They have written this disability plan in such a way that, as one player pointed out, you’d have to be physically dead before the doctors under the plan qualified you as disabled (Bruton). Out of the almost 2000 living retired NFL players, many of whom need their disability pensions; only a few over 200 people have actually qualified for the pension. If the NFL’s mouthpiece, the mTBI subcommittee, continues to knowingly go against what experts say on concussions and head injuries, injured players will continue to be sent back into games, and the language in these retired players’ plans will never be changed, and these injured and sick retired players will live their lives in pain, constantly worried about their next operation, while their money slowly trickles away. Some retired players in need of their money have already filed suit, and more are to come. A case in point is Mike Webster. In his time, the mid 1970’s into the 1980’s, Mike was known to have one of the best work ethics in all of sports. It was that work ethic that impressed the Pittsburgh Steelers to draft this under sized Center who displayed a lot of heart. He was picked in the fifth round of the 1974 draft, and would later become the 4th Hall-of-Famer taken by the Steelers in the first five rounds of that draft. When Mike Webster retired from the game after 17 years, he was a shell of his former self. Years later, he would die, homeless, alone, and out of his mind. He lived his last day barely hanging on to his sanity. The injuries he acquired from playing the game plagued him. He

3 suffered crippling depression, and later, after his death, his autopsy, performed by Dr Bennet Omalu, showed he had been suffering from a severe case of Alzheimer’s disease. In Webster’s playing days, medical experts didn’t know very much about concussions, and even if they did, it is doubtful that Webster would have reported them to the doctors, so there is no way we will ever know how many he sustained. We do, however, know he played through many injuries. When Webster finally retired 17 years later, Greg Garber, an ESPN.com columnist, says that that his wife had already started noticing signs of change. Pam Webster explains that it was, "small things. Anger at inappropriate times, a sense of disorganization, personality changes with no warning, getting lost, getting easily distracted.” What she didn’t know was that he was literally “losing his mind” explained Garber. Less than two years after his retirement, Mike separated from Pam. He was not paying his bills anymore and he would leave for days at a time. Separation hit Mike hard. He was homeless for the next five years of his life. He tried many business ventures that fell apart quickly due to mismanagement. He was clearly not thinking right and was losing a lot of money in these failed ventures (Garber). In 1999, he filed for NFL disability, and was denied. The NFL cited his failed business ventures as proof that he had at least been trying to hold down a job and live normally, and said he didn’t qualify for a disability pension. Chris Nowinski, the author of a book which examines the effects of concussions on athletes, knows about concussions from personal experience. As a professional wrestler, he was kicked in the head by his 300 pound counterpart during a match and

4 sustained a massive concussion. He couldn’t remember what his next moves were; he couldn’t remember who he was or what he was doing. Somehow he was able to finish the match, but he felt terrible right after it. His doctors told him he “might” have a concussion and to see how he felt the next night before his fight. He felt strange, but he went ahead with the match anyway, and was almost immediately overcome with terrible pain in his head. His doctor again told him he might have a concussion, but didn't think too much of it. The next night, he went ahead with, what would become his last televised match. Nowinski was told to take it easy for a few weeks, and in that time, he began searching the internet for symptoms such as his. He found several articles about high school football players dying after sustaining head injuries. He soon began to hear a new term called SIS, or Second Impact Syndrome. SIS says that an athlete can sustain a massive brain injury if they are hit on the head again very soon after a concussion. Nowinski's personal experiences continued to prove what he was reading online. He tried to make a comeback a few weeks later with a series of four scheduled matches over the period of a few days. He felt terrible during and after the first match, and even worse with the second match. The next morning he was in such terrible shape that, he says, “The WWE refused to let me perform on the third show that afternoon.” That night, he suffered a very serious setback. He was in a hotel with his girlfriend, and woke up on the floor to her screaming and surrounded by a lot of broken glass. He had been thrashing around and jumped off the bed on to his nightstand. He woke up on the floor a few seconds later. Chris would later find out that that phenomenon sometimes happens to people after very serious concussions. He went to his match the next day, and

5 after taking one look at him, Vince McMahon told him to go home. His doctors suggested that he take some more time off. Chris never wrestled again. Chris Nowinski’s post-concussion effects kept plaguing him, so he decided to do some research. He started talking to doctors who were experts in the field, and started to understand what was happening to him. He found that there was no official book or journal to read about sports related concussions, and other serious head trauma, and wondered why. He was especially interested in the way football head injuries were being dealt with, particularly in the NFL. It just so happened that the doctor he was visiting for massages and physical therapy was Dr. Bennet Omalu, the same doctor who conducted Mike Webster and Andre Waters’ autopsies. Andre Waters killed himself in December of 2006 after suffering a long bout of depression and Alzheimers that Omalu strongly believes was caused by concussions and repeated hits to the head following his retirement from the Philadelphia Eagles. Omalu’s autopsy found he had very serious Alzheimers and would have died within the next ten years had he not killed himself. In late 2006, with lots of help from Dr Omalu and several other accomplished doctors, Chris Nowinski published a book called Head Games. Head Games is basically the only “concussion handbook” available. It is the only book that details all the knowledge we have on sports related concussions so far. He also talks about the NFL extensively, and what it is and isn’t doing in regards to concussions. Since this book came out, the NFL has gone on the defensive, and has tried to discredit Chris Nowinski and his book. So what are concussions and how do we deal with them? The repercussion of head injuries has been a concern for well over one hundred years. In Nowinski’s book, he

6 talks about his friend who is a collector of Harvard football (where both Chris and the friend Brian Daigle were teammates) memorabilia. Daigle has a book that contains the diary of Bill Reid, who was the coach of Harvard football in 1905. At the time, Harvard was a powerhouse in college football and Reid was a very well respected head coach. Since he was doing research for his book at the time, he decided to search through Daigle’s book, called “Big-Time Football at Harvard, 1905: The Diary of Coach Bill Reid” for any mention of head injuries. It just so happened that Coach Reid kept a log of all the injuries that his team got during the season, and one injury caught Nowinski’s eye. Coach Reid explains that Dan Hurley, the team captain, had been acting very strangely for the last ten days of the season. The team doctor explains that he felt Hurley was “a little out of his mind.” Coach Reid didn’t want to believe it at first, but he promised the doctor that he’d check out Hurley for a few days. Two days later, Reid finally accepted that something was slightly wrong with Hurley. Reid saw that Hurley would repeat sentences that he had just said as if he had never said them. Hurley was also late to lunch, and Reid could not get him to eat any of it. He was sent to specialists who immediately told him to go to his bed and have doctors watch over him. He seemed to have some sort of “invisible injury.” It was because of Hurley that Coach Reid and his doctor set up a rule about concussions in the 1905 season. The rule said, “In case any man in any game got hurt by a hit on the head that he did not realize what he was doing, his team mate should at once insist that time be called and that a doctor come on to the field to see what is the trouble, also that every man on the squad must make up his mind in case he gets hurt, to have a friend with him from the time an injury occurred until noon of the next day, to prevent any serious results from beginning without anybody being around. Coach Reid and his doctor understood that whatever was happening to Hurley

7 was very serious. While they didn’t have the full capabilities to know what was actually wrong with him, they saw something that worried them. Coach Reid and his doctors were not far off on what they thought about concussions. Nowinski explains that an accepted description of what a concussion is is a “trauma-induced alteration in mental status that may or may not involve a loss of consciousness.” The death of Mike Webster worried former Pittsburgh Steelers fullback, now current ESPN analyst, Merrill Hoge. His career had ended prematurely because he sustained too many concussions. It was during a six week stretch in 1994 when he suffered the concussions that changed his life. It took Merrill almost four years to be able to write his name again. He would often walk around his neighborhood in a daze, not knowing where he was or where he was going. Hoge would have to keep his phone number in his pants pocket since he was not able to remember it (Garber). In Nowinski’s book, Hoge explains what happened to him right after the concussion. Hoge was hit so hard in the head; his facemask had bent and cut him in the chin pretty badly, so he went to the sidelines. His doctors suggested he better go to the locker room and get some stitches. What the doctors didn’t know was that Hoge was acting purely on instinct at that point, as the hit had knocked the consciousness from him. As they were stitching him up, he explains, “I stopped breathing for about fifteen seconds, I lost all my vital signs. They took me to intensive care. I stayed there for two days. I basically had to retire after that” (Nowinski 11). Now, over 10 years later, he is still sensitive to bright light, which makes it hard to be an analyst on ESPN surrounded by all the studio lights. If you watch his segments, you’ll see him squinting more than the other people around him. Even though Merrill is

8 still young, he was one of the lucky ones. What did the NFL really know about concussions and what were they doing to find out more information? They hired Dr. Elliot J Pellman – a rheumatologist, not a neurologist – to be chairman of the NFL Subcommittee on Mild Traumatic Brain Injury (mTBI). In 2005, while working as Major League Baseballs’ medical advisor on steroids, Dr. Pellman was caught embellishing his resume. In his resume, he said he went to State University of New York at Stony Brook, but really he graduated from medical school in Guadalajara, Mexico. He also said he got a medical degree from Stony Brook, but records say he did not (Wilson). Also, while he was working as the MLB’s doctor on steroids, he vigorously defended them. After interrogation during a Congressional hearing, it became completely clear to the Congressman at the hearing that he had no idea what the steroid policies were. Ironically, two years before being hired by the MLB, Pellman was asked about steroids, he responded by saying, “the players and the team owners have sold their souls to the devil with steroids, and I know, because I’ve treated professional athletes since 1986” (Nowinski pg 91). Appointing Pellman to a committee on concussions for the NFL is very telling, since it shows that the NFL was very interested in hiring a yes-man to never deviate from the party line. Dr. Pellman once wrote a paper where he said “that the mTBI sets off intracranial processes that result in worsening cognitive functioning over the first twenty-four to fourty-eight [sic] hours after the injury” (Nowinski 89). It would appear he went against that advice in the case of New York Jets wide receiver Wayne Chrebet. At the time, Dr Pellman was the team doctor for the Jets, and through his actions as team doctor, may have seriously endangered Chrebet’s life, and quite possibly sped up his early retirement

9 the next year. The sportswriter, Peter Keating, a columnist for ESPN the Magazine was the first to shine the light on Pellman and his actions causing Pellman to step down from his subcommittee post. Keating’s ESPN.com column and Chris Nowinski’s Mind Games helps explain what Pellman did. Wayne Chrebet sustained a concussion and was told to go back in the game by Pellman. Chrebet had suffered many concussions in his career, and in a game in November of 2003, he was hit particularly hard on one play, and fell to the ground unconscious for about a minute. Pellman immediately took him out of the game and talked to him. He asked Chrebet if he was okay, and being the athlete who didn’t want to let his team down, Wayne said yes, he was fine. Pellman then said to Chrebet, “There’s going to be some controversy about going back to play.” He then let Chrebet go. Pellman later said that he hadn’t second guessed himself by letting Chrebet go back to play because he hadn’t seen any risk. It is difficult to believe Pellman when he says that, because he had published a paper about that very topic not too long before the Chrebet incident in which he acknowledged the effects of head injuries on the brain. Nowinski figures that Pellman knew what he was doing with regards to Chrebet. If doctors over one-hundred years ago knew to confine a player to his bed and to keep him monitored, then for Pellman to do what he did with Chrebet is hard to understand, even for him (Nowinski p120-123). It is interesting to note that in a the medical journal, Neurosurgery, where some of the country’s top experts on sports related concussions explain their findings on mTBI’s, Pellman and the subcommittee wrote about their findings, which contradicted the other studies. Nowinski believes that their conclusions were hastily made. He said “[…] the

10 conclusions they drew from the data went against just about every study on sports medicine in the last twenty years […]” Peter Keating’s findings agree with Nowinski’s. Keating’s article entitled “Doctor Yes” explains that Pellman’s and the committee’s findings deviate from those of other top doctors. He found that, according to the committee, about 52% of players who exhibit symptoms of concussions, or get knocked out for any length of time, end up going back in the game. Pellman feels that it is okay, and cites that most judgment in the NFL thinks it is as well. According to Keating, that is completely untrue in every way. In a conference on sports related concussions that met in Prague, they found, “"When a player shows ANY symptoms or signs of a concussion ... the player should not be allowed to return to play in the current game or practice[…]”, in direct contradiction to the NFL’s party line. Peter Keating thinks he knows the reason why Pellman and the committee have repeatedly gone against experts. One of the people who reviewed Pellmans findings in Neurosurgery explains that, “They're basically trying to prepare a defense for when one of these players sues. ... They are trying to say that what's done in the NFL is OK because in their studies, it doesn't look like bad things are happening from concussions.” Pellman and the committee were appointed by the NFL to praise their tactics, not to find fault in them. Pellman knew exactly what he was getting in to, and if this expert is right, then he is doing exactly what a yes-man should do. He learned from the master, former NFL commissioner Paul Tagliabue. Famous sports agent Leigh Steinberg was quoted in Nowinki’s book as having heard Tagliabue reply to a question about concussions, saying “Worrying about concussions is a function of pack-journalism.” Dr. Elliot Pellman

11 learned from the best. Dr. Pellman stepped down from his job as head of the NFL’s concussion committee on February 28th, 2007, after the heat from Keating’s articles and Nowinski’s book proved to be too much for the NFL to handle. It appears had he not decided to voluntarily step down, he would have been fired in the near future, as the pressure from his critics was proving to be too strong. Mike Ditka, former coach and player of the Chicago Bears is unhappy with NFL policy. He looks at people like Mike Webster, who died alone and in terrible pain, and Andre Waters, who suffered from crippling depression brought on from Alzheimer’s disease possibly as a result of playing football. He looks at the state of the league that gave him his glory, and vice versa, and how it is now a billion dollar industry, and wonders why a league with that kind of money refuses to give back to the players who gave so much to it. Ditka and others believe that there is something the NFL does not want you to know. Former players who are now disabled are not receiving the disability pension that they deserve, and the NFL would like to keep it that way. Ditka says, "It's a disgrace, the owners ought to be ashamed of themselves. The owners are financiers, and they are all about making money. They don't care about the history of the game.” Players nowadays are making millions of dollars, but back in the glory days of the NFL, that was not the case. He goes on to explain, “All we are saying is we got a lot of guys that started this game that have a lot of problems health wise and mental wise. I say help them out. Help them out. Let them die with a little dignity and a little respect.” (Wetzel). So far, Ditka’s concerns are not being addressed adequately, but soon these things could change due to a lawsuit brought by former NFL player, Mercury Morris. Morris sued the NFL a

12 few years ago, and may have started a precedent for change. Eugene “Mercury” Morris played on one of the most celebrated teams in sports history; the 1972 Miami Dolphins. That Dolphins team went undefeated during the regular season, a feat that hasn’t yet been repeated, and then won the super bowl. Mercury was tackled hard by a Pittsburgh player, and landed awkwardly on his neck, breaking it. After the game, he had an x-ray taken of his neck, and the doctors told him it was sprained, and that he could keep playing. After the season was over, he had a physical, and was told he had two cracked vertebrae in his neck. He was told he should have immediately gotten a halo put on his neck after the injury occurred, but since it had been many weeks since the injury happened, he needed to wear a neck brace. If he didn’t wear the neck brace, he could sustain very serious damage to his neck. When Morris returned to Miami, the team doctors told him the other doctors overreacted; there was no need for a neck brace. Almost six years later, he had surgery on his neck, but by then it was too late, the damage was permanent. Now Morris has to deal with that damage. He gets devastating headaches in the middle of the day that are so bad that he can’t be near any light and he has to put wet towels on his head for hours. Doctors say he gets those headaches because some very important nerves in his neck were destroyed. The author, Les Carpenter, says about Morris, “He is 60 years old, and football has left him with a spine that had to be fused together with piece of a dead mans bone.” (Carpenter). When he is not suffering from horrible headaches, he is devoting all of his energy to fighting the NFL and the disability pension plan that he believes is working against the very people it is supposed to be helping. He says that the plan is working against retirees

13 by making it impossible to actually collect money under the disability plan. According to Morris, 50-60% of players who leave the game do it because of disability, but for some reason, only 1.7% actually collects disability benefits. When he went to a plan approved doctor, he was told that he didn’t qualify for a “line-of-duty disability.” The plan says he must have had a “surgical removal or major functional impairment of a vital bodily organ.” He feels they left out a major phrase, “or part of the central nervous system.” He argues that the neck is a part of the central nervous system, and an injury to it qualifies him for benefits. He has argued many court cases in the NFL, and may have started a precedent for change, because before Morris, no other player had ever tried legal action over this issue. His most current case was dismissed, but he will soon file another suit against the NFL. (Carpenter). Greg Aiello, the NFL spokesman, sees the NFL’s treatment of retired players quite differently. In a Yahoo! Sports article entitled “A steep price to pay,” by Dan Wetzel, Aiello defends the benefit package that former players are getting now. Aiello says, […] guys who played years ago, the economics of the league weren't as great. Therefore their benefit package isn't what the benefit package is for the players today." Wetzel says Aiello is right, he finds that the NFL “[…] currently pays out $61 million in pension, but most of that goes to post-1977 players.” The Players Association ups the amount paid to the older, pre 1977 players every few years, but Mike Ditka and his people still think that isn’t enough. Aiello disagrees with people like Ditka, however, and in Wetzels’ column, says, “Every collective bargaining agreement we've negotiated with the players has included improvements in the pension plan for retired players, which is unusual in industry for the bargaining unit to go back and improve the benefits."

14 Wetzel also feels that some of the problems the older players had after football are not the NFL’s fault. He names some startling problems, such as that after less than a year of retirement, two out of three players will have “emotional problems,” and before the end of four years, 80% of those two-thirds will be divorced. People on both sides know that something should be done, but actually deciding what needs to be done and actually getting it done is the problem. Sure, the NFL is worth six billion dollars, but, Wetzel explains, if well over one thousand people suddenly were qualified as severely disabled, even a business as rich as the NFL wouldn’t be able to pay both current and retired players all the money they need. What can be done about this? Sadly, if you are looking for an answer in this paper, it will not come from here, and it probably will not come in the real word soon either, as both sides are not backing down. A lot has happened as this was being written. The NFL took a big step forward in causing Dr. Pellman to step down. They have hired a more competent person in his stead, and perhaps the subcommittee is now more than just a mouthpiece for the league; maybe soon it will follow other experts. It all hinges on new NFL Commissioner, Roger Goodell. He has been commissioner for over a year now, and he has made needed strides in player conduct policy in the last few months. In an April 27th, 2007 article entitled “NFL Considers 17th Regular Season Game,” sportswriters Mark Maske and Cindy Boren explain that commissioner Roger Goodell is making steps in protecting his current and former players. Maske and Boren say that Goodell plans to have players better understand how to use their chinstrap and to have coaches “be more careful in dealing with players who have suffered concussions.” In the article, Goodell was quoted as saying “"I've been very clear to coaches that at no time should competition issues take

15 precedence over medical issues." Also, the article says that Goodell is figuring out ways to adequately offer medical care for former players at a realistic price, and is thinking about making “assisted-living facilities for needy former players.” This is definitely a step in the right direction. In the last few days, it appears he is on damage control, and is trying to help former players get their disability money. More and more stories are coming out about players dying or being severely hurt. Former New England Patriots player Ted Johnson was made to practice by the head coach only days after suffering a concussion and was forced into playing in the game the next week and Andre Waters’ brain had red flecks in it because brain cells died and turned into abnormal proteins. It has been only a few months since Pellman stepped down, and people all over the United States are starting to talk about the NFL’s policies regarding injuries. It may take some time, but as those stories, and more like them come out, change may happen. The NFL needs to make sure injured players are not being sent back in to play, and it needs to be more responsible towards former players who are in need of money. As the public gains more knowledge on what is going on, the NFL may be forced to actually do it. They are moving in the right direction as we speak. We just have to understand that even though it may seem like it, the league is not made of money, and they cannot pay everybody everything they need.

Works Cited
Bruton, Mike. "A sobering look at the NFL's disability program.(Knight Ridder Newspapers)." Knight Ridder/Tribune News Service. (May 22, 2001): K4890. Thomson Gale Library, Richmond, VA. 21

Feb. 2007 <http://find.galegroup.com/ovrc/infomark.do Carpenter, Les. "Long After His Retirement, Morris Still Making Claims." Washingtonpost.com. 28 Jan 2007. Washington Post. 4 Feb 2007 <http://www.washingtonpost.com Edholm, Eric. "Part warrior, part tragedy, Webster lived his life all the way to the end." Profootballweekly.com. 27 SEP 2002. 5 Mar 2007 Garber, Greg. "A tormented soul." ESPN.com. 24 JAN 2005. ESPN. 19 Feb 2007 <http://sports.espn.go.com/nfl/news/story?id=1972285> Garber, Greg. "Blood and Guts." ESPN.com. 25 JAN 2005. ESPN. 19 Feb 2007 http://sports.espn.go.com/nfl/news/story?id=1972286 Garber, Greg. “Man on the Moon.” ESPN.com. 26 JAN 2005. ESPN. 19 Feb 2007 http://sports.espn.go.com/nfl/news/story?id=1972287 Glauber, Bob. "Hoge warns, 'This is messing with your brain.'." findarticles.com. 31 OCT 1994. The Sporting News. 5 Mar 2007 <http://www.findarticles.com/ Keating, Peter. "Doctor Yes." ESPN.com. 28 OCT 2006. ESPN. 23 Apr 2007 <http://sports.espn.go.com/nfl/news/story?id=2636795>. Keating , Peter. "See no evil? The NFL won't face concussion facts." ESPN.com. 19 Jan 2007. ESPN. 12 Feb 2007 <http://sports.espn.go.com/nfl/columns/story?id=2736505&lpos=spotlight&lid=tab5pos1 MacMullen, Jackie. "`I don't want anyone to end up like me' Plagued by post-concussion syndrome and battling an amphetamine addiction, former Patriots linebacker Ted Johnson is a shell of his former self." Boston.com. 02 FEB 2007. Boston Globe. 26 Apr 2007 <http://boston.com>. Merrill, Elizabeth. "NFL: Risky business: Head trauma is a serious issue in the league, and the Chiefs will be cautious as their quarterback recovers.." Knight Ridder Tribune Business News 12 SEP 2006. Proquest. Cabell Library, Richmond, VA. Apr 16, 2007. Nowinski, Christopher. Head Games. First. East Bridgewater, MA: The Drummond Publishing Group, 2007. Wetzel , Dan. "A steep price to pay." Yahoo Sports. 30 Jan 2007. 5 Feb 2007 <http://sports.yahoo.com/nfl/news?slug=dwretiredplayers013007&prov=yhoo&type=lgns Wilson, Duff. "Medical Adviser for Baseball Lists Exaggerated Credentials." NYTimes.com. 30 MAR 2005. New York Times. 26 Apr 2007 <http://www.nytimes.com/

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