League of Denial (36 page)

He said he never compared ImPACT to a religion. “I would never use that language. That makes it sound like a cult; it’s creepy.” He said he merely told Barr that people gravitated to ImPACT “because it works.”

In many ways, the confrontation had been building for years. It was a product of jealousy over ImPACT’s wild success; the tension over the perceived conflicts involving Lovell, Collins, the NFL, and Riddell; and, of course, the allegations over the missing data first aired the year
before by ESPN’s Keating. Lovell even believed that his long-ago victory over Barr in the recruiting battle over Collins was a factor.

Regardless, the NFL’s Concussion Summit already had featured an ethics probe and a near brawl involving two neuroscientists.

And it was only lunch.

Bailes presented in the afternoon, standing in for Omalu. The topic was “Does Concussion Lead to Pugilistic Dementia and Alzheimer’s?” Also presenting were Maroon and Casson. They made quite a trio: Bailes, the genteel and brawny southerner; Maroon, the diminutive triathlete (and Bailes’s former boss); and Casson, brimming with certitude.

The presentation was unusual in that Bailes was effectively describing someone else’s work. This, too, provided a stark contrast. Omalu—a graduate of the Cyril Wecht School of Theatrical Pathology—was every bit the showman; love him or hate him, you couldn’t take your eyes off him. Bailes, by comparison, was a plodding presenter.

It was nonetheless an extraordinary moment. As the NFL commissioner and the league’s medical hierarchy looked on, microscopic images taken from dead football players appeared on the screen. Bailes explained that the brown splotches represented brain cells strangled by the tau protein. The almost certain cause, Bailes said, was repetitive head trauma related to football.

As Bailes went through one slide after another, he described the devastating symptoms produced by the disease: depression, dementia, even suicide. It was hard to imagine—the images seemed so benign, like flecks of paint on white marble. It was hard to connect the images to a man drinking antifreeze or knocking himself unconscious with a stun gun. Bailes didn’t talk about that. He showed the slides and described what he thought was the cause. “The facts spoke for themselves,” he said. “There wasn’t really very much editorialization that I had to do. I tried to stay narrow and focus on just what the findings were. Having taken care of brain-injury patients for the previous two decades or more, I knew that the only cause that was known in medical science was this exposure” to head trauma.

As he spoke, Bailes scanned the audience for a reaction. He was
feeling the weight of the moment. The conclusions he was delivering to the NFL and its new commissioner, he felt, were “extremely profound”: Their game was causing brain damage. How much wasn’t clear. But the results, combined with his own studies on depression and dementia in living players, were ominous. Bailes’s gaze fell upon a man seated in the first few rows. As sobering as the news was, he seemed to be … 
smirking
. Bailes looked more closely. The smirker wasn’t looking at him but at Casson, who was standing off to the side.

Bailes turned to look at Casson. “I saw him rolling his eyes,” said Bailes. He was stunned. As Bailes delivered his sobering presentation, the cochair of the NFL’s Mild Traumatic Brain Injury Committee was mocking him! Bailes had presented dozens of papers and had never witnessed anything like it. Struggling to describe what he felt in that moment, he called Casson’s reaction “unprecedented, totally unprofessional, egregious.… What other word can I say? It was unbelievable, inappropriate, unbelievable.”

Bailes kept going. When he got to the end, he was met with silence. “There were maybe one or two questions,” he said. “It was a lack of interest, a lack of intellectual scientific medical curiosity. And absolutely no line to, ‘What’s the next step?’ ”

Casson was now questioning Bailes’s conclusions, which, of course, were Omalu’s. Casson brought up his own experience with boxers and said these cases were definitively not dementia pugilistica as he understood it. The buildup of tau protein could have been caused by many factors, he said, including substance abuse and steroids. “He was really digging in and just totally unwilling to budge, and that was really their view on everything,” said Barr, who was back in the audience. “They were like, ‘Okay, I’ll listen to you, but you’re wrong. We gave you a chance to talk today, but you’re wrong.’ ”

“I’m a man of science,” Casson declared.

Years later, that was the line that stuck with everyone. Casson repeated it throughout the afternoon as a response to conclusions with which he seemed to disagree.

“I’m a man of science.”

The clear implication was that what Bailes had just presented was not science.

Even Collins, who thought Omalu’s research was over-the-top, was stupefied by Casson’s performance. “I just sat there thinking, ‘Why is Ira Casson such an asshole?’ ” he said.

Guskiewicz was apoplectic. It wasn’t that long before that he and Bailes were standing together on the Pittsburgh Steelers sideline—Bailes a young neurosurgeon, Guskiewicz an apprentice trainer. As much as anyone, Bailes had helped launch Guskiewicz’s career as a neuroscientist. Together, they had started the Center for the Study of Retired Athletes at a prestigious institution, the University of North Carolina, with the explicit goal of assisting and conducting research on former NFL players. Since then, they had surveyed and examined thousands. Many of the players were fine, Guskiewicz knew. Many were not. Now here was Ira Casson essentially heckling his partner and dismissing all of their work.

Guskiewicz thought the NFL’s Concussion Summit had the makings of a
Saturday Night Live
skit, with Casson as the parody of a man in denial.

“Oh, my gosh, as long as I live I’ll never forget that day,” Guskiewicz said. “I use that as a teaching point with my students. I’m like, ‘The day that you have to stand up in front of a group and tell them that you’re a man or woman of science, your credibility is shot, especially when you have nothing to put in front of people to convince them.’ That was a bad, ugly, ugly day for the NFL.”

When the doors flew open, the league tried to put a positive spin on it. A dialogue had been opened. Further research was needed. The league was planning its own study on retired players, which it predicted would bring clarity. “
You’re looking for an answer,” Pellman told Schwarz. “And the answer is there is no answer.”

Apuzzo, speaking to a motley collection of football writers and broadcasters, described a concussion as a little-understood “ephemeral kind of event” traceable to prehistoric times, “when people would have a concussion, appear to be dead, and then rise. And what this did was to lead our ancestors in medicine 12,000 years ago to begin to bore holes in dead people’s bodies thinking they were going to bring them back to life. So it’s a very dramatic thing when that happens.” As the editor of
Neurosurgery
, Apuzzo told the sports media, “I really am privileged to feel that I’m a journalist and a part of your family.” But he was also the
“principal neurosurgical consultant” to the New York Giants: “I triage the Giant players,” he explained.

The NFL seemed to draw a distinction between Bailes and Omalu. Bailes was a reasonable man, the league said. He was at least open to dialogue and debate. Omalu was “out there stating things unequivocally,” said Pellman.
Goodell also weighed in on Omalu’s assertions that the players had brain damage. “I’m not a doctor,” he said, “but you have to look at their entire medical history. To look at something that is isolated without looking at their entire medical history, I think is irresponsible.”

To Bailes, there was no distinction. He and Omalu were delivering the exact same message: Football causes brain damage. The NFL establishment appeared to have a problem not just with the message but with the messenger, too.

When Schwarz said he heard that the behind-closed-doors exchange got
a bit heated, Pellman replied: “I wouldn’t even use the word ‘heated.’ I would use the word ‘lukewarm.’ ”

In fact, the rancor spilled into the ensuing days. Dave Viano, the new cochair of the committee with Casson, tried to get Guskiewicz to sign on to a statement that doubts remained about the effect of repeat concussions. Guskiewicz said the statement was similar to one contained in a pamphlet released to NFL players that fall:

“How can you put out this statement? Do you really think you’re going to pull the wool over the eyes of these people?” Guskiewicz said he wrote Viano, referring to league medical personnel who had attended the summit. “And he spouted back to me something like, ‘That’s insulting to me and to our committee that you would suggest that we’re trying to pull the wool over anybody’s eyes.’ ”

“Really???” Guskiewicz said he wrote.

“I was just like, ‘Come on, get real. Who do you think you’re talking to?’ ” said Guskiewicz. “That was when I realized that he was all about protecting the company, its name, and not about his own integrity. And that’s where I lost respect for him. I thought he was one of the few true scientists on that committee.”

Guskiewicz detected a faint glimmer of hope right after he left the meeting. He ran into Jeff Pash, the league’s general counsel and the number two executive at the NFL. Pash, much to his surprise, was complimentary. “Keep doing what you’re doing,” he told Guskiewicz.

Guskiewicz came to believe the Concussion Summit was “the game changer, the turning point,” but not for the reasons the NFL would cite in the statement he had refused to sign. Guskiewicz realized that Goodell and Pash “were in the back of that room saying, ‘I’ve got a freaking train wreck on my hands here.’ ”

Although neither was invited to Chicago, Omalu and Nowinski had loomed large over the Concussion Summit. It was Omalu’s findings, after all, that Bailes had presented. By then, Omalu had linked football to neurodegenerative disease in three dead NFL players: Webster, Long, and Waters. Nowinski had helped put the issue on the national agenda by feeding the Waters story to the
New York Times
. With the league scrambling to regain control over the crisis, Nowinski and Omalu moved to formalize their partnership.

The plan had begun to take shape in January 2007, shortly after the Waters story was published in the
Times
. When things settled down,
Omalu wanted to travel to Florida to meet with Waters’s family to compile a complete clinical history for his next paper. Nowinski set up the meeting and made plans to join him. Amazingly, the two men still hadn’t met face-to-face. They decided to link up at the airport in West Palm Beach and then make the 45-minute drive to Belle Glade to see Waters’s family.

Nowinski had seen a picture of Omalu that had run with the story, but the photo was taken from the waist up, Omalu wearing a white lab coat over a tailored light blue dress shirt and a striped tie. He was posed in the middle of a long hallway at the coroner’s office in Pittsburgh, staring seriously at the camera. He easily could have passed for 50. When Nowinski saw him in person for the first time, he was taken aback.

“You look much younger than I thought,” Nowinski told him. “You look smaller. You look like a college kid.”

As they strode through the airport, they made quite a pair: the 28-year-old former Chris Harvard from suburban Chicago, tall, blond, and muscular, and a short, loquacious 38-year-old Nigerian doctor who had earned three degrees and five medical certificates and believed he could talk to the dead.

Nowinski found he enjoyed Omalu’s energy and youthful personality. Omalu referred to his faith several times and seemed at ease with his new friend. He discussed a book he was beginning to write about his own experiences with the concussion issue and his battle with the NFL. He asked Nowinski if he would be willing to write the introduction.

As they drove west on U.S. 98, Nowinski broached the idea of forming a partnership with Omalu. He imagined a nonprofit organization based at a research institution that would seek to acquire the brains of dead athletes—primarily football players—and determine if they had CTE. Nowinski, like Omalu, believed the prevalence of the disease was extensive. He had become disgusted by what he viewed as the NFL’s pattern of denial. In researching his own book, he had read all the
Neurosurgery
papers and, channeling his mentor Cantu, ridiculed “the NFL’s tobacco industry–like refusal to acknowledge the depths of the problem.”

Nowinski wanted to fight back against what he saw as a dangerous message. “I knew that if people trusted the NFL implicitly and the NFL leads the sports culture and the NFL didn’t take concussions seriously, no one could take concussions seriously,” he said.

He wanted to be an advocate for the athletes. He needed someone to carry the science. That would be Omalu’s role. Nowinski thought that he and Omalu, along with respected older colleagues such as Cantu and Bailes, could compel the NFL to confront a reality it had spent years dodging. Omalu thought it was a good plan. He, too, liked the idea of directly challenging the NFL, which had tried to discredit him, but he thought the work also was consistent with his faith and a chance to bring some degree of peace and hope to former players and their families.

A few weeks after returning from Florida, Nowinski e-mailed
a two-page document to Omalu. It was titled:

PROPOSAL TO INSTITUTIONALIZE NEUROPATHOLOGICAL INVESTIGATIONS ON PROFESSIONAL ATHLETES BY AFFILIATING WITH A UNIVERSITY RESEARCH CENTER

The proposal began with a summary of the current state of the research: three cases of former NFL players diagnosed with the “first indisputable evidence” of brain damage caused by football. “This has created a media storm, and may provide the needed momentum to force multiple sports to increase safety measures for athletes, especially at the youth level.”