The NFL had rejected these guidelines. They weren’t supported by research, Pellman said in 2000.
Rejected the recommendations of the American Academy of Neurology? Bennet thought. Who was this Pellman guy? Rejecting existing science and choosing to start over with “a novel approach”? That is not in the spirit of scientific inquiry, Bennet thought.
In essence, Pellman had said team doctors knew better than independent scientists. They were, after all, team doctors. They would use “the art of medicine” to determine what was best for their players. As for research, that’s what the MTBI committee was for. They were looking into this problem, accumulating data, and publishing their findings frequently, paper after paper in Neurosurgery.
Bennet worked on his own paper and thought, wow, talk about a stranger walking into a roomful of blabbermouths. It was as though the established scientists were in there saying one thing and the NFL was talking over them, ignoring them, saying another thing. And here comes some guy from Nigeria who had never even heard of football, here comes this man from nowhere saying, “Hey, guys! Look what I found!”
And: “Guys! My surname is Onyemalukwube. It means, ‘If you know, come forth and speak.’ ”
—
Bennet studied the data the MTBI committee had accumulated. Most of it had to do with biomechanics studies and advances in helmet technology. They were using crash test dummies and measuring the impact of blows to the head. They were talking about inventing a super-helmet to protect the head, and they provided many charts and graphs and formulas:
Concussion risk functions were computed by using the logist function in the Statistical Analysis System program developed by the SAS Institute of Cary, North Carolina. This function relates the probability of injury, p(x), to a response parameter x on the basis of a statistical fit to the sigmoidal function p(x) = [1 + exp(α − βx)] −1, where α and β are parameters fit to the responses from the laboratory reconstructions of game impacts. The goodness-of-fit was quantified with the −2 log-likelihood ratio parameter, p value, and correlation coefficient (r).
Gee whiz, Bennet thought. Helmet technology? Why are you people even going there? He thought about Italian physician Jacopo Berengario da Carpi in the early sixteenth century. He thought about da Carpi and those hundreds of human cadavers, all those skulls, and the notion that “brain commotion” was caused by the thrust of the soft structure of the brain against the solid part of the skull. He thought: the sixteenth century. What good does a helmet do? It protects the skull from cracking, sure. But basic laws of physics told you that the brain sloshing around inside that skull was going to bash into the skull walls no matter how much padding you nestled the head in. Plenty of scientists had proved that one several times over.
Didn’t these NFL doctors read?
Moreover, Bennet found one particularly glaring hole in the research the MTBI committee had done thus far. It was an area of research missing from the work of the independent scientists, too:
Autopsy. None of these scientists had ever examined an NFL player’s brain in autopsy. They were missing the whole area of research Bennet was about to offer them.
Pathological findings were irrefutable. Concrete evidence, right there on the slides. Images. Splotches. Sludge. You could see for yourself exactly what had happened to Mike Webster’s brain. It would help these established scientists finally get through to the NFL. It could act as a bridge!
He thought everyone would welcome a discovery as important as this: pathological evidence that showed that the kind of repeated blows to the head sustained in football could cause certain and specific debilitating brain damage in certain and specific regions of the brain. He figured the MTBI committee would be able to make use of his finding. It could help them course-correct the direction of their own research.
But I did not simply want to report it as a case report. I had to give my finding a name, a sexy name that was scientifically sophisticated but with a good acronym that could easily be recalled by a third-grade student. I had to come up with a comprehensive name that would mean something but at the same time would not mean anything, in case I was eventually proven wrong. There was a possibility, although minimal, that I could be wrong. I researched and researched on descriptive names and terminologies that had been used in varying combinations in the past and I decided I liked Chronic Traumatic Encephalopathy. Chronic stood for something that took long to develop; Traumatic stood for something related to or associated with trauma; and Encephalopathy stood for a sick brain. I thought CTE was a very sexy acronym, and it was easy to remember.
So in August 2004, nearly two years after he first met Mike Webster on the slab, Bennet put the finishing touches on his paper, “Chronic Traumatic Encephalopathy in a National Football League Player.” He listed as coauthors Ron Hamilton and three geneticists from Pitt who had helped him with some of the science, and he put DeKosky’s name last. The last name on a scientific paper was the big one. It was like saying: here’s my mentor, here’s the fancy one, here’s who made this research possible.
“What the fuck?” Wecht said, when he saw DeKosky’s name there. If anyone was the father of this endeavor, surely Wecht was. He had set the ball in motion. “Bennet, what the fuck?”
So Bennet tucked DeKosky’s name into the list of others and put Wecht’s name in the honored spot, even though Wecht had not been involved in the research beyond his crucial decision to allow Bennet to keep Webster’s brain from disappearing forever into a grave.
Bennet stuffed the paper in an envelope and he licked the flap and then he addressed it to the editors of Neurosurgery and dropped it into the mailbox.
It would be three months before he would hear anything back.
—
Prema understood long before Bennet did what was happening in their relationship. She never said it out loud but she knew full well. Mie-Mie didn’t say anything, either, even though she, too, understood—as did Uche and Father Carmen and most of the people at church. It seemed Bennet was the last to know what was going on in his own love life. He had shut that part of his life down; he had tried it in the past, tried valiantly, and it hadn’t worked, so never mind. Just like deciding whether or not to be smart when he was a kid; it was something you put your mind to. You could turn different parts of yourself on and off like that, simple as flicking a switch. Well, his depression had put a hole in that theory. But still. He was done with romance. He was writing papers and studying and working his butt off on Wecht’s private cases. He didn’t need a relationship.
He worked on Wecht’s cases on Sundays, after brunch. He and Prema would go to church together, then eat, and then he would have to drive out to some godforsaken county morgue in some town in Pennsylvania or Ohio or West Virginia and do an autopsy for Wecht and Prema would go with him. She worried about his being alone; she had taken to staying with him at the morgue in Pittsburgh when he would work until two and three o’clock in the morning. “You can’t go there alone.” A few times on the Sunday outings she watched him do autopsies, but she couldn’t take the smell, so she would just find an office or someplace to sit. She brought books.
On New Year’s Day 2005, they were in Bennet’s condominium and the phone rang. It was Bennet’s father calling to say happy New Year. Then he said: “This is the year you will marry, son.”
“Sure, sure, Daddy,” Bennet said. “Also, did I tell you I have applied to get my master’s degree in public health?”
His father responded to this news with extended silence. “Why do you need that?” he said finally. His booming tuba voice brought Bennet back to Enugwu-Ukwu and kola nuts. He felt instantly small.
“If I want to open a clinic some day,” Bennet said, “it will be useful to learn.”
“Do you want to open a clinic some day?”
“No, but—”
“Then get married,” his father said. “You are thirty-six years old, Bennet. It is time to have a wife.”
“I know, Daddy.�
�
“Remember I told you, marriage is not about love. Marriage is a business arrangement. You are picking a life partner. The love comes later.”
“Okay, Daddy.” He was so sick of the nagging. Everyone was nagging him about getting married. At church, people seeing him with Prema on Sundays, they would talk about wedding bells, Bennet ignoring their silly chatter. At the lab at Pitt one of the nurses had pulled him aside and asked him if he was gay. She said people were wondering. “Why aren’t you married?” Wecht, too, was on him about it. “It’s part of your professional profile,” he told him. “It gives you clout politically. You need a wife, Bennet.”
“Also I have applied to get my MBA at Carnegie Mellon University,” Bennet told his dad that New Year’s day on the phone. He was going to do that after the master’s in public health.
“These degrees. Are you doing this for selfish reasons?”
“No.”
“For self-aggrandizement and to inherit the world?”
“No.”
“Will you use your God-given talents, blessings, and opportunities to make a difference, to enhance the lives of others?”
“Yes.”
“Good,” his father said. “And I would like for you to get a wife.”
“Okay, Daddy.”
Shortly after he hung up, the phone rang again and it was his brother Theodore. He told Bennet he had called to say happy New Year and then he said, “Bennet, this will be the year for you to marry.”
“Okay, Theodore.”
Then again his phone rang and this time it was Chizoba saying happy New Year and then, “This will be the year for you to marry.”
“You had some emergency family meeting about this, Chi Chi?” Bennet asked.
“Well—”
“Tell the rest not to bother calling,” Bennet said. “I’ll handle it.”
And with that amount of forethought, Bennet turned to Prema, who had brought her laundry over. She was standing behind the couch, folding a blue blouse with embroidery on the sleeve.
“Let’s get married,” Bennet said.
“Oh. Are you sure?” she said.
“Yes.”
“Okay,” she said, flattening the blouse and smoothing out the wrinkles.
“We can learn to love each other,” Bennet said.
“Okay, Bennet,” she said.
Why was it so difficult for him to admit that he already loved her? She would never understand his reluctance to surrender his heart in this one simple way, the simplest act in the world to her, to him so complicated and fraught.
In the coming weeks Bennet told Father Carmen about the engagement and Father Carmen made the announcement at church and everyone more or less acted as if they had not seen this painfully obvious thing coming; they put their hands in front of their widened mouths, saying “Oh!” and “Ooh!”
“Happily ever after!” Bennet said, giving everyone what they seemed to need, and soon Bennet himself came to believe in it and need it, too. Wecht and Sigrid took Bennet and Prema out for an engagement dinner at a ritzy downtown restaurant. Wecht barked orders at Sigrid about what kind of wine she should try and she shot back with lessons about salad dressing and Prema looked on somewhat aghast at the way that couple interacted. Bennet loved all of it. He felt proud of Prema for looking so smart in the winter-white suit he had bought her. He felt proud of all the ways in which he believed he had made Prema beautiful and he wanted to keep doing it more. “My wife,” he practiced saying. “My wife.”
“We will now go to the movies,” Wecht said that night after dinner, because he loved movies, and he ordered people around exactly that way. “The show is at nine thirty, so let’s get going.” They went to see Hotel Rwanda, hardly a celebratory movie, but it was playing at the Squirrel Hill theater, Wecht’s favorite, the one place on earth where he found he could relax, and the two couples sat next to each other and Wecht passed the popcorn, which Bennet dutifully munched—a boy with his dad and his mom and his girl, except now all grown up. He felt as if Wecht was treating him like a son, and he loved that feeling. He felt more like a son with Wecht than he ever did with his dad, and he did not experience sadness or conflict but instead focused on the warmth of family and the comfort of knowing he had found a home, in this city, with these people, living this life where optimism filled you without effort, just regular oxygen you breathed and there was plenty of it for everyone.
In a blink he realized how strange it was to feel so peaceful while watching people flee from the ravages of the Rwandan genocide. That was horrible. But that was no longer reality. That was just a movie. This was his new reality, this moment here, America and popcorn and people suffering atrocities on a screen in front of you. That was something you now stood back and watched. It was no longer the reality you inhabited.
—
At home one morning, on television, the bishops and the cardinals were dressed in their finest robes, crimson, gold, and silver shimmering in the sun, and they were chanting and praying:
“Follow me.” The risen lord says these words to Peter. They are his last words to this disciple chosen to shepherd his flock. “Follow me.” This saying of Christ can be taken as the key to understanding the message which comes to us in the life of our late beloved Pope John Paul II. Today, we bury his remains in the earth as a seed of immortality.
More than four million mourners gathered in Rome for Pope John Paul II’s funeral on April 8, 2005, just a few months after Bennet and Prema’s engagement and the announcement of happily-ever-after. The couple stayed home from work to watch the funeral, both of them holding rosaries, rolling the beads and praying in accordance with the pattern. Prema was stoic, while Bennet said the prayers under his breath and wept openly. Oh, Bennet. He loved that pope. He had a framed photo of John Paul II on a bookshelf and he had all his books. The pope stood up for Africa when no one else did. The pope was in Nigeria when Bennet was giving up on Nigeria. “Respect for every human person,” he said, “for his dignity and rights, must ever be the inspiration behind your efforts.” The pope before that cheering crowd in Abuja, the pope calling for the release of Abiola. All those people cheering in thanks, and then the police, and then whips made of electrical wire. Get back, damn you, get back!
Bennet felt that the pope was his friend, his soulmate, which is sort of the point of the pope, and Bennet was a true believer. Saying his rosary that day, he was thinking Thank you for trying to help Nigeria, most Holy Father, and Good luck in heaven, and Pope, please tell God I’m sorry for my sins, and Thank you, Pope, and A special thank-you to Jesus, he was praying and his phone was ringing and he didn’t want to answer it because he was praying along with more than four million mourners, and Prema next to him, and the bishop at the altar on the TV saying “When you were younger, you used to dress yourself and go where you wanted.” But the phone kept ringing and so finally Bennet reached over and picked it up.
It was work. He heard strange cries from familiar voices at the morgue. A tech talking, and then another tech talking over her, and they were saying, “Bennet! Something is happening! Bennet!” Bennet held the phone, still momentarily locked in his prayer trance.
And he said to him, “Lord, you know everything. You know that I love you.” Jesus said to him, “Feed my sheep.” Amen, amen, I say to you.
Bennet could not understand what the techs were screaming about but it had to do with the FBI and the FBI was at the morgue ripping through boxes—and, hold on, what? That day of the pope’s funeral, having nothing to do with the pope’s funeral, a world away, in downtown Pittsburgh, a dozen FBI agents were storming into the Allegheny County coroner’s office, and simultaneously into Wecht’s private office, and they were grabbing boxes, logbooks, hard drives. Guys wearing FBI jackets, loading boxes and books and computers, and the TV news was there, cameras, Wecht arriving late from a talk he did at Fox Chapel Area High School, leaping out of a car, microphones in his face. “I just came in! I have to find out what’s hap
pening!”
“What is happening?” Bennet said, after he hung up with the tech and finally reached Wecht, who was standing in his office, mid-raid, watching these men in their jackets carrying boxes of autopsy records out to their vans.
“It’s bullshit,” Wecht said. “It doesn’t concern you, Bennet. It’s fucking bullshit like these cocksucking motherfuckers did to me before. It’s nothing.”
“But, sir, if you’ll pardon me, it sounds like something,” Bennet said, and he thought, Wow, fathers are falling. In one day, fathers are dropping like flies.
“Forget about it, Bennet. It will amount to nothing. They tried this before.”
“But when you grow old, you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.” He said this signifying by what kind of death he would glorify God. And when he had said this, he said to him, “Follow me.”
CHAPTER 9
ATTACK
Bennet’s paper about Mike Webster’s brain was published in the July 2005 issue of Neurosurgery. When it arrived in the mail, he held it gently in his hands, like it was parchment, like it was the original of the Declaration of Independence or something. Page 128. It was so handsome. “Chronic Traumatic Encephalopathy in a National Football League Player.” It had his name and all the others in bold stacked on the left above their dignified bona fides in fine print. The words SPECIAL REPORT appeared in a red banner across the top, the letters bleeding to a fade as if they were moving, as if they had just zoomed in on a top-secret mission. It was hard not to feel proud of something like that.
We herein report the first documented case of long-term neurodegenerative changes in a retired professional NFL player consistent with chronic traumatic encephalopathy (CTE). This case draws attention to a disease that remains inadequately studied in the cohort of professional football players, with unknown true prevalence rates….Our case represents an extremely rare scenario whereby a complete autopsy was performed on a retired NFL player with a comprehensive neuropathological examination, which revealed changes consistent with CTE….Our report therefore constitutes a forensic epidemiological sentinel case that draws attention to a possibly more prevalent yet unrecognized disease.
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