by Bennet Omalu
One of the myths I found perpetuated as I started researching Mike Webster’s case was that such blows to the head, even those that resulted in a concussion, were thought to be minor injuries. Concussions themselves are officially referred to as mild traumatic brain injury. Think about that for a moment. How can anything be both mild and traumatic? Concussions were considered so trivial in football that throughout most of its history, unless a player was knocked out cold, both the player and the team ignored it. Some physicians have proposed that there are three grades of concussion. Symptoms of a grade one concussion include seeing stars after a blow to the head. A retired NFL tight end interviewed for this book said he saw stars in practice or in games at least once a week. Not surprisingly, he is now dealing with memory loss, even though he is only in his mid-thirties. Other players report seeing stars multiple times in a single game, sometimes more than once on a single play.
The question I then had to answer was whether or not these repeated blows to the head were responsible for the damage I found within Mike Webster’s brain. My research into brain disease took me all the way back to the time of Hippocrates four hundred years before the birth of Christ. It is a well-established fact that exposure to all types of blunt force trauma to the head damages the brain and leaves permanent sequelae, or pathological condition resulting from the injury. That is exactly what this appeared to be—a lasting pathological condition that resulted from repeated blows to the head. I explored other possible causes for what I had observed, including drug use, steroids, and genetic factors. None could explain the tau fibrils running through the brain, choking out brain cells. Blunt force trauma was the only plausible explanation based upon the research I conducted. The damage in Mike’s brain was not a side effect of any of the medications he had taken. It was not the result of any kind of alcohol or drug use, including anabolic steroids. Blunt force trauma, both concussive and subconcussive, was the culprit.
This, then, was where I found myself. I believed I had discovered a new brain disease that was caused by repeated blunt force trauma to the head—trauma related to that experienced while playing the game of football. This disease was, I believe, responsible for Mike Webster’s erratic behavior, as well as the depression, memory loss, mood swings, poor decision making, and the other odd characteristics that marked his life after football. Right away, I knew this was going to be a game changer for American football. Naively, I thought the world of football would welcome my findings with open arms.
• • • •
One day while driving home from work, stuck in traffic, I wondered what I should do next. I had become so engrossed in my research that I became somewhat overwhelmed by what I was doing and experiencing. Two types of fear came over me: the fear that I was wrong or delusional, and the fear of the impact my discovery was going to have. I had to show my research to another pathologist to confirm what I had seen or to have him show me why I was wrong. Bringing in another pathologist is the standard of practice set by the College of American Pathologists. It dictates that when a pathologist sees an unusual case, he or she should show it to a second pathologist to confirm his or her findings. I knew exactly to whom I needed to go.
When I reached my home, I called one of my neuropathology professors, Dr. Ronald Hamilton, at the University of Pittsburgh. During my fellowship in neuropathology, Dr. Hamilton had trained me in the art and science of diagnosing neurodegenerative diseases of the brain and dementias. He had a great impact on my life, not only as a pathologist, but also as a human being and the way in which I perceive those with lifestyles different from my own. For this I am eternally grateful to him.
There is a scene in the movie Concussion that re-creates the moment Dr. Hamilton first observed the slides of Mike Webster’s brain. The movie’s depiction is very accurate. Dr. Hamilton knew immediately the possible repercussions of this discovery. “We need to show this to Dr. DeKosky,” he said. Dr. Steven DeKosky was the head of the department of neurology at the University of Pittsburgh and one of the country’s leading experts on Alzheimer’s disease. When Dr. Hamilton mentioned Dr. DeKosky’s name, my first thought was, I don’t think he will want to see me. The two of us had only interacted slightly during my neuropathology fellowship. Basically, the few times I had run into him in the hospital, he had completely ignored me. After all, I was just a fellow, and he was the head of the department.
I thought I would be given perhaps five minutes maximum of Dr. DeKosky’s time. Instead, the two of us spent at least two hours discussing this case, football, and life in general. Before I left that meeting, it was clear that I needed to publish my findings. Dr. DeKosky asked if he could be a coauthor—a suggestion I gladly welcomed.
When I left Dr. DeKosky’s office, I was more excited than I had ever been. Not only had I discovered a seminal case with possible wide-ranging repercussions, but one of the leading scientists in the country had agreed to coauthor my research with me, as did Drs. Hamilton and Wecht. In that moment, I really thought this paper had the potential to do a great deal of good for very many people. Not only did I believe I had restored Mike Webster’s humanity, but I also thought this research could help the many others I suspected were suffering silently with the same disease. This research, this paper I was to pen, was for them, not for me. This was not about building a name for Bennet Omalu, but about raising awareness of the danger of America’s game and, as a result, protecting future players from the fate that befell Mike Webster.
How could I have been so naive?
Chapter Fourteen
Nearly Over before It Begins
My efforts to go public with what I had discovered in Mike Webster’s brain nearly did not happen. The biggest culprit was not the National Football League, nor was it the antiquated system in which medical research is conducted in the United States today. Neither of those made my work any easier, but they did not stop me in my tracks and threaten to end all of my work before it really even started. No, that distinction falls to a primitive, inhuman, and inhumane system with which the vast majority of Americans will never interact. My life’s work was nearly stopped completely by the United States immigration system and its set of arcane rules.
I came to the United States at the age of twenty-six on a visiting scholar visa. There are numerous categories of visas, and this was the one I was granted to come to America for the program at the University of Washington to which I had been accepted. After my year in Washington, I renewed my visa with the same category when I entered residency training and later when I started my first fellowship in Pittsburgh. However, as strange as it may sound, my visa required me to leave the country once a year and have my visa renewed there. I could not go to an immigration office in New York or Pittsburgh. Instead I had to travel to Canada or Mexico or even go back home to Nigeria and go through the renewal process at an American embassy. Renewing my visa required me to wade into the gargantuan bureaucracy of filling out confusing forms and answering questions in an interview with an official of varying temperament. Some of the interviewers were quite pleasant. Others spoke down to me and acted like I was a convicted felon applying for parole rather than a legal immigrant and future citizen of the United States of America. I soon learned I needed to have an immigration attorney accompany me to guide me through the process and deal with unexpected surprises. All in all, remaining a legal immigrant to the United States was very expensive and time-consuming.
In the spring of 2005, in the middle of revising and completing my academic paper on the Mike Webster case, I had to drop everything and take off for a week to go to Mexico for the annual visa renewal process. Up until 2005, I normally went to Toronto or Montreal. They were closer, and Canadians speak English. However, some United States embassies in Canada instituted new rules and changes that made it very difficult for my immigration attorney to accompany me. I’d been through this process enough times to know I needed my lawyer with me. My attorney recommended we go to Nogales, Mexico, instead of to Canada. Looki
ng back, it was a wise choice.
One Monday morning, I flew from Pittsburgh to Tucson, along with about a half dozen to a dozen other people in the same boat as me. That night, we stayed in a nice resort on the outskirts of Tucson and then drove down to Nogales early the next morning. If everything went according to plan, we would return to Arizona that night. Nogales is a border town, with a town in Arizona and one in Mexico of the same name.
The drive down Interstate 19 took us through desert mountains and hills covered with majestic cactuses. The dry desert landscape could not have been more different from the deep greens of western Pennsylvania. Yet I found it to be beautiful, just one more expression of the incredible diversity of America. After perhaps an hour’s drive, we arrived in Nogales, Arizona. Above the city sat huge, beautiful, multimillion-dollar homes on hills looking down on the valley below. The undulating hills stretched on before us, but the further south we went, the looks of them drastically changed. I could not see a visible line drawn in the sand, but as we crossed the Mexican border, the huge estates were replaced with shanties and abject poverty. It was as though I had crossed over into a completely different world.
The distinction between the wealth of America and poverty of Mexico could not have been more glaring. My mind went back to the questions I used to ask when I lived in Nigeria, where a sharp distinction was drawn between different parts of the country. Looking around Nogales, I was right back there again. The images made me angry, but I did not have time to dwell on it, because I had business that had to be done.
My attorney helped me and the rest of the group through the border crossing. From there, we headed straight for the American Embassy. All of us already had visa interviews scheduled. I had filled out all of the necessary forms and had my attorney double-check them to make sure everything was in order. The interview itself would take less than a half hour. However, there was always a delay between the interview and the actual visa stamp being issued. That meant we would all go out to lunch, pick up our visas in the afternoon, and be back in Tucson in time for dinner that night.
A ridiculously long line stretched out from the embassy gate. If we had to wait in that line, we might not get back to Tucson for a day or two. Thankfully, because we had appointments, our attorney was able to speed us through the line and into the waiting area within the embassy walls. The difference between the scenery inside and outside the embassy gates was also dramatic. The moment you walked into the embassy, everything had the look and feel of the United States. If I did not know I was in Mexico, I might well have believed I was back in Pittsburgh, albeit a hotter and dryer version.
I took a seat in the waiting area and waited my turn. As was now my habit, I wore a tailored suit and tie and designer shoes. My wardrobe reflected the influence of Cyril Wecht. He pulled me aside one day and told me that if I wanted people to take me seriously, I needed to dress like a successful medical professional. Down in Nogales, I was one of the few dressed so formally. All sorts of people filled the waiting area. Above the room were photographs of then president George W. Bush and the secretary of state Colin Powell. One by one, members of my group had their numbers called and made their way to the counter for their interviews. I waited with eyes closed, trying to relax.
At long last, I heard someone call my number. I gathered all my papers and went to the counter where the interview was to take place. The word interview may conjure up an image of sitting down with an immigration official, perhaps across from a desk, but that is not the case. The visa interview is conducted at what most closely resembles a very secure bank lobby or prison visiting area. Just like in Lagos, Nigeria, a thick pane of glass separated me from a lovely, thirtysomething-year-old Hispanic woman. I spoke to her through a small speaker in the glass.
“May I please have your papers?” she said with a very kind tone. I passed them to her through a slot at the bottom of the glass. As she thumbed through them, she asked me a handful of questions. I answered each as best I could. With each answer, she checked off a box on a document I could not see. Once or twice, my attorney stepped in to help me answer the questions she asked. After a couple of minutes, she looked up from the pile of papers, smiled, and said, “Everything seems okay. Please have a seat in the waiting area, and I will be back with you in a couple of minutes.” My attorney explained that she had to do a security check before she could approve my visa. “It’s just a formality,” he said. “There shouldn’t be any problem, since you’ve already been in the country for many years now.”
I sat down with the rest of my group. Everyone else had already been approved and were anxious to get to lunch. What should have been at the most a five-minute wait turned into ten minutes, then fifteen, then twenty. Members of my group fidgeted. None of us knew one another outside of this little trip to Mexico. The feeling in the group seemed to be, Why is this guy making us wait? Finally they all went outside to wait.
Thirty minutes after my interview, the woman who had interviewed me asked me to return to her window. My attorney whispered to me on the way up, “This is unusual.”
As soon as I got to the window, the woman called me by my first name. Her tone had changed from sunny to concerned. “Bennet, there’s a problem.”
My heart sank.
“What is it?” my attorney asked.
“Bennet’s name is listed on the security alert list.”
“The what?” I asked.
“The security alert list. These are people who are wanted or who are suspected to be a risk to the United States. After 9/11 we have cracked down on any potential threats. For some reason, your name is now on that list,” she explained.
I was dumbfounded. “How is that possible?” I asked. “Someone else must be using my name. I am a doctor. I work for the Allegheny County medical examiner’s office in Pittsburgh. How could I possibly be on a security alert list?”
“I thought about that, and so I double-checked the information. I confirmed that indeed the person on the list is Bennet Omalu from Nigeria with your same birthday. It is you,” she said.
I glanced over at my attorney. The look on his face told me this was serious trouble. “So what does this mean?” I asked.
“It means you will not be allowed to return to the United States,” she said.
Those words would have been devastating enough if I were just a visitor to the United States, but my life was there. My closest friends were in the U.S., my fiancée, my life’s work, to say nothing of everything I owned in this world. Now all of it was about to be stripped away from me. “What can I do?” I asked.
“It seems your name was added to the list by the American Embassy in Nigeria where your original visa had been issued. Because they added it to the list, they have to remove it. I’ll contact them and see if I can discover what’s going on over there.” She smiled to try and reassure me, but it did not help.
My attorney requested to speak with the consul to discuss my case and receive further clarification. I went back to the waiting area. A short time later, my attorney came back and motioned for me to follow him outside. There we found the rest of our group, hungry and restless. They picked up very quickly on what was going on. My attorney pulled me aside and said, “Bennet, I have to take the rest of the group back to Tucson. Unfortunately, you will have to stay here. The lovely woman in the embassy has initiated the process of removing your name from the list, but it’s going to take some time.”
“How much time?” I asked. I was not equipped to stay in Mexico for even one night. My luggage was back in Tucson waiting for me. I didn’t even have a toothbrush with me.
“It may take several hours, or it may take a few days. There is no way to know,” he said. “Listen, before I leave with the group, I will help find you a place to stay tonight.”
I looked around at the surrounding town. From what I could see, finding a decent place to stay was going to be a big problem. We finally found a roadside motel. The building was run-down. When I got to my room, the
smell nearly knocked me over. Along the base of one wall, I saw cockroaches scurrying amongst rat feces. A single lightbulb hung down from a wire in the middle of the room. My attorney went to the room with me. “I think they will get this cleared up very quickly. You are no security risk. This is obviously a case of mistaken identity.” He looked around the room and sighed. “Hang in there, buddy. It’s just one night.”
I smiled. “I’ve seen worse.” After I got checked in, we found a small store where I purchased a toothbrush and toothpaste, along with a small bar of soap. I had $200 cash on me, along with a credit card. I did not have a cell phone with me. Back then, cell phones were not as prevalent as they are today. However, I had my attorney’s number. I could call him with a phone card if I needed him.
My attorney and the rest of the group got in our van and went north to the border. I walked down the dusty main road to purchase a telephone calling card. Thankfully, every place in town accepted U.S. dollars as payment. I went to a local shop and bought some rice and beans and a bottle of Coke, along with a large container of bottled water.
Back in my room, I picked up the phone and called Prema. I told her everything that had happened. “Don’t worry. Everything will be all right,” I told her, even though I wondered if it would be. Then I called Father Carmen and told him what had happened. I asked him to pray and asked him to tell the reverend sisters at the convent to start praying as well. Finally I called my family in Nigeria. I had one request for them: pray! From across the globe, my prayer warriors went into battle, asking God to manifest Himself and make a way where there seemed to be no way. I knew our prayers would be heard: “For where two or three are gathered together in my name, there am I in the midst of them.”1 The people whom I asked to pray were all such holy people that I believed God was more likely to hear their prayers than mine, since I was such a miserable sinner.