Roger Goodell’s youth advocacy: Details of legislative campaign came from a May 23, 2010, Associated Press story titled “Goodell Sends Letter to 44 Governors.” Details of meeting with Robert Cantu came from Caleb Daniloff, “Game Changers,” Bostonia, Fall 2010, and Peter Keating, “Coming to a Head,” ESPN The Magazine, January 10, 2011.
CTE cases involving younger brains: Details of Chris Henry’s story came from multiple news accounts, including “Ex-Bengal Is First in N.F.L. Known to Play with Brain Trauma,” New York Times, June 29, 2010. Details of Owen Thomas’s story came from multiple news accounts, including “In College Player’s Suicide, Signs of Disease That Haunts N.F.L.,” New York Times, September 14, 2010.
Hit-impact research: Background on studies of head impacts in college football players came from an interview with Kevin Guskiewicz, Ph.D. Details on his own research came from various articles and published studies conducted by his Department of Exercise and Sport Science at the University of North Carolina–Chapel Hill. Additional information came from various articles, including Malcolm Gladwell, “Offensive Play,” New Yorker, October 19, 2009, and “Safer Football, Taught from Inside the Helmet,” New York Times, November 6, 2010. Details of the 2010 study involving three NCAA football teams came from “For Head Injuries, a Problem in Practice,” New York Times, September 17, 2010. Details of the high school impact study came from Thomas M. Talavage et al., “Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion,” Journal of Neurotrauma, published early online in October 2010, and David Epstein, “The Damage Done,” Sports Illustrated, November 1, 2010. Details on Virginia Tech’s pioneering use of helmet-sensor technology came from the September 17, 2010, Times article and various other stories, including “Concussion Worries Renew Focus on Football Safety,” NPR, September 25, 2010.
Certified athletic trainers: Statistic came from the National Athletic Trainers’ Association.
Neuropsychological testing: Details on how trainers use neuropsych tests came from Tracey Covassin et al., “Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Practices of Sports Medicine Professionals,” Journal of Athletic Training 44:639–44, 2009. Details on the Washington state school district that rejected use of ImPACT came from “Despite Law, Town Finds Concussion Dangers Lurk,” New York Times, September 23, 2010. Kevin Guskiewicz’s quote came from Michael Popke, “Hit Hard,” Athletic Business, December 2009.
College football controversy: Details came from “Put Me In, Doc: When Doctors Must Say No to Athletes,” American Medical News, October 25, 2010.
Mayo Clinic concussion conference: Details came from multiple news stories, including “With Focus on Youth Safety, a Sport Considers Changes,” New York Times, October 17, 2010; “Panel Urges Hockey to Ban Blows to Head at All Levels,” New York Times, October 21, 2010; and “N.H.L. Declines to Modify Head-Checking Rule,” New York Times, October 22, 2010.
Canadian youth hockey study: Concussion data in peewee leagues came from Carolyn A. Emery et al., “Risk of Injury Associated with Body Checking among Youth Ice Hockey Players,” Journal of the American Medical Association 303:2265–72, 2010.
Philadelphia Eagles concussion controversy: Coverage of Stewart Bradley’s missed concussion came from multiple news stories, including “Return of a Stumbling Eagle Raises Concerns,” New York Times, September 14, 2010; “Too Little Time to Assess Injury,” Philadelphia Inquirer, September 15, 2010; “Televised Collapse Delivers Warning on Unseen Injuries,” New York Times, September 16, 2010; and “Silence Follows Announcers’ Concern,” New York Times, September 17, 2010.
Epilogue
Dave Showalter’s story: Narrative based on interviews with Dave Showalter.
NFL crackdown: Details of the head hits that led to the tipping point and the NFL’s response to them came from multiple news stories. James Harrison’s quote came from “Defenders Criticize N.F.L. for Helmet-to-Helmet Fines,” New York Times, October 21, 2010. Description of player pushback and relevant quotes came from Peter King, “Concussions: The Hits That Are Changing Football,” Sports Illustrated, November 1, 2010, and “Urlacher Upset with NFL Flagrant Hits Policy,” Chicago Tribune, October 19, 2010. The newspaper columns cited were by William Rhoden, “To Lower Violence, Escalate the Penalty,” New York Times, October 18, 2010, and Brad Wilson, “Philadelphia Eagles’ Head Coach Andy Reid Knows Preventing Head Injuries Is Worth Causing a Period of Uncertainty in the NFL,” Easton Express-Times, November 9, 2010.
Madden NFL: Details on the video game’s redesign came from “Madden Puts Concussions in New Light in His Game,” New York Times, April 3, 2011. Background on the video game’s history came from Tim Layden, “The Big Hits,” Sports Illustrated, July 30, 2007.
Dave Duerson’s story: Details came from the BU Center for the Study of Traumatic Encephalopathy’s press conference on May 1, 2011; from several New York Times news stories; and from Paul Solotaroff with Rick Telander, “The Ferocious Life and Tragic Death of a Super Bowl Star,” Men’s Journal, May 2011.
Sidney Crosby’s story: Details of his head injuries and their aftermath came from Pittsburgh Post-Gazette news stories of January 8, 2011; January 9, 2011; January 25, 2011; and April 30, 2011. Background on his concussion’s impact on the NHL came from New York Times stories of January 21, 2011, and March 14, 2011. Pat LaFontaine’s quotes came from Craig Custance, “LaFontaine: A Cautionary Tale,” Sporting News, March 14, 2011.
Troy Aikman: Quotes came from Troy Aikman, “The NFL Should Proceed with Caution on Head Injuries,” Sporting News, December 21, 2009.
Harry Carson’s story: Details came from John Solomon, “Retirement Plan #2,” Sports Illustrated, June 1, 1998; William Nack, “The Wrecking Yard,” Sports Illustrated, May 7, 2001; Bob Drury, “This Is Your Brain on Multiple Concussions,” Men’s Health, July/August 2006; Greg Garber, “Concussions Still Carson’s Concern,” ESPN.com, February 2, 2010; and Victoria Schlesinger, “Heads Up,” Discover Presents The Brain, Spring 2010.
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Index
Page numbers in italics refer to illustrations.
Abb, Chari, 85–94
Abb, Chris, 89, 90–94
ABC, 40
ABC News, 112–13, 116
absence seizures, 62
accidents, xii, 15
see also car accidents
Adams, J. Hume, 157–58, 162, 164
Afghanistan, 108, 114–19
Aikman, Troy, 17–24, 29–30, 40–41, 43–44, 129, 264, 273–74
Akron, University of, 57–58
Albert Einstein College of Medicine, Gruss Magnetic Resonance Research Center at, 174–75
Ali, Muhammad, 178, 179–82, 183, 184, 196–202, 203
beatigs taken by, 196–99, 201
biography of, 200–201
brain changes in, 200–201
as Cassius Clay, 194, 195, 196, 197
Foreman’s fight with, 183, 196–97
Frazier’s fights with, 196, 197–98, 201
at Olympic Games, 201–2
Pacheco and, 197–99
parkinsonism of, 181–82, 185, 199–202, 208
Patterson’s fights with, 209
in Requiem for a Heavyweight, 195, 196
retirement of, 199
Robinson as idol of, 194
All the King’s Horses and All the King’s Men video, 104
Alzheimer’s disease, 247
amyloid beta plaques in, 175–77, 213, 214–15, 217, 230
celebrity victims of, 194
dementia pugilistica’s resemblance to, 177, 185, 192, 205, 211, 231, 232
football-in
duced CTE vs., 215, 230, 231, 232
genetic factors in, 205–6
head trauma linked to, 194, 205
hippocampus as origin site of, 215
memory problems of, 230, 232, 233
mild cognitive impairment and, 241, 246
tau tangles in, 177, 192, 214, 230
TBI linked to, 175–77, 223, 228
amantadine, 138
American Academy of Neurology, 204, 208
American College of Sports Medicine, 263
American Medical Association (AMA), 204, 207
American Neurological Association, 208
amnesia, 4, 6, 117, 188–89, 254, 277
amygdala, 169–70
amyloid beta plaques, 175–77, 213, 214–15, 217, 230, 233
amyloid precursor protein (APP), 175
Anthropological Society of Paris, 148, 151
apoE 4 genetic mutation, 205–6
Arizona National Guard, 68–75, 80
athletic trainers, 8–9, 10, 11, 15, 25, 26, 32, 48, 57, 121, 129, 245, 249, 260–62, 265
Australia, 164, 207
autopsies, 13, 14, 146, 147, 149, 151, 157, 162, 164, 175, 186, 191, 213–19, 220, 225–28, 229–34, 246, 250, 258
axons, see diffuse axonal injury
Bailes, Julian, 228, 234, 246–48
Bailey, Ace, 52
balance problems, 60, 100, 134, 136–37, 262, 277
vertigo in, 4, 19, 187, 190
Baltimore Colts, 235–44
Barnum, P. T., collection of, 146, 147
basketball, 51, 57, 256, 261
women’s, 27–31
Baun, Whitey, 36–40
Baun, Willie, 36–40, 58
Baylor University Medical Center, 18–19
Bedford VA Medical Center, 228–34
Belichick, Bill, 249
Benítez, Wilfred, 195
Benoit, Chris, 228
Benson, Dick, 253
Berbick, Trevor, 199
Bigelow, Henry J., 147
bomb blasts, xiii, 68–85, 108–14, 118–19
IEDs in, 69–71, 76–77, 115, 159
Boothby, Michael, 116
Boston Society for Medical Improvement, 147
Boston University, Alzheimer’s Disease Clinical and Research Program at, 228–34
Bouillaud, Jean Baptiste, 148
“Boxer, The” (Simon and Garfunkel), 208
boxing, xiii, 50, 160, 177, 178–211, 213, 224, 230–32, 233, 247
banning of, 190, 204, 207–8
brain damage as goal of, 207
deaths in, 206–7, 210
football vs., 49
force of punches in, 195
in Great Britain, 189–91
heavyweight, 178–85, 186, 188, 193–94, 195, 196–202, 203, 209–11
in 1920s, 185–89
prizefighter’s curse of, 181, 193, 199
safety reforms for, 192, 204, 206–8
state licensing of, 199, 208
see also dementia pugilistica
Bradley, Stewart, 264–65
Brady, Tom, 229
brain:
amygdala of, 169–70
animal studies of, 26, 157–59, 160, 162, 165–70
autopsies of, 13, 14, 146, 147, 149, 151, 157, 162, 164, 175, 186, 191, 213–19, 220, 225–28, 229–34, 246, 250, 258
blood flow in, 173–74
blood supply of, 171
brain stem of, 200–201
cerebellum of, 192
cortex of, see cerebral cortex
dopamine in, 199–201
immature, increased vulnerability of, xi–xii, 16, 25–26, 33–34, 127, 167–70, 273
language area of, 148–52, 150
localized functions of, 142, 143–56, 153
motor function in, 148
neurotransmitters in, 170, 200
plasticity of, 168–69
retraining of, 267–68
rewired connections of, 82–83, 93, 100, 175
septum of, 182, 184, 192, 200
substantia nigra of, 192, 200–201
swelling of, 13–14, 17, 32, 52, 56, 122
whale’s, 161
Brain, 157
Brain, Lord Walter Russell, 190
brain banks, 228–34
brain changes, 191–92, 200–201, 230–32
cerebral atrophy, 182, 184, 191, 193, 200
chemical, 26
hole in septum, 182, 184, 192, 200
brain chemistry, 26, 166–74
glucose metabolism in, 166–67, 171, 172–73
metabolic cascade in, 170–72
brain damage, 92, 142–56, 157–77, 214
as boxers’ goal, 207
case histories of, 143–56
documentation of, 142–43
microscopic, 157–60, 159, 162, 214–15, 217
minimized, 35
neurosurgical, 152–56
permanent, xi, 7, 8–9, 11, 16–17, 23, 24, 26, 31–35, 55, 63, 66, 127, 131, 159, 162, 171–72, 233, 249, 256, 267
visible, 143–48, 156
see also diffuse axonal injury; frontal lobe damage
Brain Damage in Boxing: A Study of the Prevalence of Traumatic Encephalopathy among Ex-Professional Boxers (Roberts), 190–91
brain injuries, see traumatic brain injuries (TBIs)
Brain Injury Association of America, 101, 275, 279
brain scans, 73–74, 157, 166, 172–75, 181, 247
CAT, 13, 37, 60, 61, 96, 102, 121–22, 134, 142, 182, 184, 193, 199, 200, 207, 208
DTI, 174–75
fMRI, 173–74, 259
MRI, 142, 150, 151–52, 200, 208
PET, 172–73, 174
Brenner, Teddy, 198
British Boxing Board of Control, 190
British Medical Journal, 189–90
Broca, Paul, 148–52, 150
Brolinson, Gunnar, 260
Brooks, Jill, 5–7, 61–67
Buck, Joe, 264
Buffalo Sabres, 53–55
Burke Rehabilitation Center, Brain Injury Program of, 206
California, University of:
at Berkeley, 167–68
at Davis, 151–52
California, University of, at Los Angeles (UCLA), 165–73
Brain Injury Research Center of, 166
Medical Center of, 199–200
Camp, Walter, 49
Campbell, Clarence, 52
Canada, 51–52, 56–57, 154, 207, 263
Canadian Football League (CFL), 57
Cantu, Robert, 12–16, 167, 223–24, 228, 234, 257–59, 262, 263–64, 265
car accidents, xiii, 15, 68, 102, 105, 127–28, 129, 132, 159, 162, 227
catastrophic, 85–94
minor, 94, 95–101
Carey, Jamie, 27–31
Carson, Harry, 274–75
Casson, Ira, 182, 207, 216, 246–48, 255
CAT scans, 13, 37, 60, 61, 96, 102, 121–22, 134, 142, 182, 184, 193, 199, 200, 207, 208
CDC video, 31–32
Centenarian Study, 229, 233
Center for the Study of Traumatic Encephalopathy, 229, 232, 250, 255, 270
Centers for Disease Control and Prevention (CDC), xii, 11, 16, 255, 278, 279–80
cerebellum, 192
cerebral cortex, 167, 169
atrophied, 182, 184, 191, 193, 200
dorsolateral prefrontal, 174–75
posterior parietal, 173–74
Chassay, Mark, 29–30
cheerleading, 31, 134–41
Chicago Bears, 124, 269
child abuse, 108
children, 133, 223, 247, 255–60, 269, 275
football players as role models of, 24, 47, 120, 253, 256, 273
permanent brain damage in, 16–17, 31–35, 257
public service announcement aimed at, 255–56
undocumented TBIs in, 102–8, 258–60
vulnerable brains of, xi–xii, 16, 25–26, 33–34, 127, 167–70, 273
youth sports and, 27, 36–
40, 47, 48–49, 53, 56, 63–65, 67, 253, 255–59, 263, 265, 272
see also football, high school; second-impact syndrome
Chrebet, Wayne, 45–46
chronic traumatic encephalopathy (CTE), 189, 205, 206, 217–18, 247, 272
see also dementia pugilistica
chronic traumatic encephalopathy (CTE), football-induced, 212–44, 246–48, 257, 270–71, 273–75
in active college player, 258
Alzheimer’s disease vs., 215, 230, 231, 232
amyloid beta deposits in, 214–15, 217, 230, 233
in autopsied brains, 213–19, 220, 225, 226, 227–28, 229–34, 246, 250, 258
behavior changes in, 212–13, 215, 220, 227, 238, 239
caretakers of, 235–44
concussion history in, 215, 216, 218, 224, 228, 238, 241, 273–74
depression in, 213, 217, 218–19, 223, 224, 225, 227, 240, 258, 274
in eighteen-year-old boy, 250, 253, 258
financial hardships imposed by, 215–16, 235–37
as “gridiron dementia,” 228, 234
media coverage of, 227, 232, 243, 247–48, 250–51, 252
memory loss in, 215, 224, 232, 233, 238–39, 240–41, 270
and NFL health benefits, 215–16, 236–37, 243–44
paranoia in, 213, 217, 224, 225, 227, 239, 242–43
personality changes in, 213, 215, 217, 224, 225, 227, 230, 232, 238, 239, 242–43
progressive nature of, 228, 235, 236, 238–43
suicide and, 217, 218–19, 220, 224–25, 228, 232, 258, 270, 274
tau tangles in, 214–15, 217, 230, 233, 250
“Chronic Traumatic Encephalopathy in a National Football League Player” (Omalu), 216, 224
coaches, 2, 3, 8–9, 11, 26, 32, 36–40, 41–43, 44, 49, 57, 59, 61, 63–64, 80, 121, 122–24, 125, 126–27, 129, 130, 133, 166, 248, 249, 254, 255–56, 260, 262, 272–73
cognitive deficits, 29, 31, 54, 65, 66, 77–83, 86, 88–94, 97–101, 102, 103, 122, 123, 181, 189, 190, 249, 252, 259, 267, 274
cognitive impairment, mild, 241, 246
cognitive neuroscience, 151
cognitive therapy, 80, 82–83, 99
Collins, Michael, 129
Columbia-Presbyterian Medical Center, 196
The Concussion Crisis Page 38