League of Denial

by Mark Fainaru-Wada

  Duerson was named to the board of trustees at Notre Dame and also served on the board of the Boys & Girls Clubs of America. He earned an MBA through Harvard’s executive training program. He had a beautiful wife and four kids.

  “We always knew that the next level we were going higher,” Alicia said of Duerson’s life after football. “David never, ever thought the next level would be going lower.”

  When Duerson decided he wanted to be bought out of his ownership stake in Fair Oaks Farms, it was to start his own company, Duerson Foods. That made sense; Duerson always thought he could do things better than everyone else and had had great success with Fair Oaks. But Harold Rice, one of his closest friends, thought it was odd that he was complaining so much about his Fair Oaks partner, Shelly Lavin. Duerson sounded irrational. “He thinks I’m some nigger he can control,” Duerson would say of Lavin. “I’m not his boy.” But Rice chalked it up to Duerson’s bluster and need to demonstrate that he was in charge.

  The new business buried Duerson financially. He had leveraged all his assets to create what he hoped would be a meat-distribution empire. Rice said Duerson spent $24 million to launch the company, when he probably should have spent $5 million. “He had emptied all the accounts for Duerson Foods, put everything in that one deal,” Alicia said.

  The people closest to him began to see him as reckless and occasionally disconnected from reality. They noticed that Duerson seemed less able to control his emotions, more prone to fits of rage. He lost his temper with employees or exploded in anger at business meetings. During one meeting with Marriott to discuss servicing the hotel chain’s restaurants, Duerson became confrontational. “You guys are looking at me like I don’t know what I’m talking about,” he said. Alicia, who was working with her husband, watched as the room fell silent. “You got to understand, Dave was 6-2, maybe 230, 240 at that time,” she said. “In a room with little bitty white men, you know what I mean? Sometimes when he got mad, he would have that glare in his eyes. I can’t explain it. It’s like you’re dealing with somebody that’s not rational.”

  In February 2005, Duerson traveled to South Bend for a Notre Dame board of trustees meeting. Alicia went with him. They had a nice dinner together and then returned to the hotel, the Morris Inn, where they went to the bar for a drink. Alicia was tired, and so she headed upstairs while Dave stayed to hang out with friends. Shortly afterward, Dave shook her awake. Alicia was certain he wasn’t drunk, but he wasn’t himself. Duerson had grown paranoid that she was having an affair, and now he wanted to confront her.

  “He wanted to discuss something that was in his head that wasn’t real,” she said. “I was trying to walk him through it to show him how it was not real, but his mind was just so screwed up. And he didn’t believe me, and one thing led to another.”

  Duerson had that glare in his eyes. Alicia became scared and tried to get away. A witness described seeing the door fly open and then Alicia being pushed out, her body slamming into the wall. Then, just as quickly, Duerson was calm, aghast at what he had done. Alicia was taken to the hospital for cuts to the head and dizziness. Duerson was charged with misdemeanor battery. The incident cost him his spot as a Notre Dame trustee. Later, he described the incident as a “one-time event” in which he lost control for “three seconds” and his “biggest regret.”

  By 2006, Duerson’s life was in free fall. He was forced to shutter Duerson Foods, the big house went into foreclosure, and he divorced Alicia. He moved down to Florida, into the ritzy condo he and Alicia had purchased as a winter getaway when their life was going so well. Gradually, he began to withdraw from family, friends, and former teammates, creating a new life in Florida built around a facade: He was fine, had plenty of money, and was on the verge of resurrecting his career.

  Tregg, a private banking analyst, knew his dad was going through a rough time, and he would call him in Florida and ask, “How’s it going, anything I can do?”

  “No, things are going fine,” Duerson would say. “I’m looking at this business. I might buy this business with this guy.”

  In reality, Duerson was deep in debt. Alicia claimed he owed her $70,000 in child support, one bank was after him for $9 million, and he was behind on his condo fees. Five months before his death, he filed for bankruptcy.

  Duerson had maintained his connections with Upshaw, still hoping against all reason that he might someday lead the union. When Upshaw died suddenly in 2008, Duerson’s dream was revealed to be just that—a dream. But he was allowed to keep his appointment as one of the union’s three voting members on the disability board. The position put him in contact with the growing number of retired players who were seeking benefits for cognitive problems stemming from football. He also was familiar with the league’s ongoing attempts to deal with the problem, mostly through rule changes and fines to limit blows to the head.

  If there was a point when Duerson became conflicted by his own worsening condition and his disdain, public and private, for the claims that football caused brain damage, he didn’t show it. Nor did he hide his contempt for what he saw as the softening of the game.

  Duerson had a radio show, Double Time with Double D, that ran on VoiceAmerica. On October 21, 2010, Duerson told his listeners, “I’m pissed today.”

  He lamented the NFL’s crackdown on dangerous head-to-head tackles. He read one of his own Facebook postings: “The Big Hit has been told to turn in his pads and jockstrap.” He read several comments from readers ridiculing the league for trying to “sissify” the sport. At one point, Duerson recalled a 1984 playoff game in which his teammate Todd Bell blasted Redskins running back Joe Washington. “He helicoptered this brother, helicoptered him,” Duerson said. “It was a wonderful hit, it was clean, but based upon what the commissioner is talking about today, they would have suspended Todd on the spot.” Later he added, “I have expressed several times, there is nothing like hearing the air rush out of a man’s body.”

  At no point during the one-hour show did Duerson address the issue behind the rule changes: the possibility that football was causing neurodegenerative disease in his fellow retired players.

  Four months later, Duerson was alone in his Florida condo, carefully plotting his suicide. He laid out a Bible, set aside books for various family members, and smoked one last cigar. At 2:52 A.M.—just before he shot himself, authorities concluded—he sent a text message to Alicia. The last line read: “I really do think there’s something going on in my brain in the back left side. Get it to the NFL. Please.”

  Duerson sent a similar text to his fiancée and scribbled the same message at the end of his typed suicide note. Clearly, he wanted to leave nothing to chance.

  The task fell to Tregg, but Duerson’s son had no idea how to go about donating his father’s brain to science. Like every other football fan, Tregg knew that concussions were a hot topic, but he hadn’t heard about CTE or the initiative to create a brain bank for NFL players. Tregg had only questions, most of which he thought were bizarre: How does one donate a brain? What is the NFL’s brain bank? Does the coroner need to do something special to keep my dad’s brain? What does this do to our funeral plans?

  In his search for answers, Tregg called the Players Association, figuring his dad had worked with the union and someone there would be able to help him. He reached one of his father’s former teammates.

  “My dad committed suicide and I’m trying to donate his brain to the NFL,” Tregg said. “Can you help me?”

  “Okay, I’ll get on this and call you back,” the man said. At the same time, Alicia Duerson sought help from Connie Payton, the wife of Bears great Walter Payton, another former teammate of Duerson’s. On the Duersons’ behalf, an employee from the Paytons’ foundation contacted the NFL’s offices and explained the family’s desire to donate the brain to science.

  Despite Duerson’s last words—“Please, See That My Brain Is Given to the NFL’s Brain Bank”—no such place existed. But it was hard to imagine that any other research
institution except Boston University—the league’s “preferred” brain bank—fit that description. Both the union and the league had pledged to encourage players to donate their brains to BU after death. The NFL’s $1 million gift was intended to underwrite the BU Group’s research. Shortly after the donation, the group presented Goodell with its “Impact Award” during a gala fund-raiser at the Boston Harbor Hotel. Guests were treated to a large cake adorned with a football-shaped “brain” that appeared to be made of fondant.

  Tregg was directed to Nowinski, who explained the process and sent him the paperwork. Fighting through a haze of sadness and exhaustion, Tregg read the documents. He stopped at the language describing how even his father’s eyes would be part of the donation.

  “You want to take his eyes?” Tregg asked Nowinski.

  “Yes, we need to take the eyes; they are actually really important to our study,” Nowinski said. BU was exploring whether an examination of the optic nerve might help with the diagnosis of CTE.

  “Okay,” Tregg recalled saying, “and then I just signed it. And then we faxed it off. And that was it.”

  But the NFL wasn’t nearly as unified behind BU as the league’s letter of support and million-dollar gift suggested. Top members of the reconstituted concussion committee were already expressing doubts about BU and, unknown to the BU researchers, were working to keep Duerson’s brain away from the group.

  The new NFL doctors said they had four primary concerns about BU, which they voiced to fellow researchers, journalists, and the families of former players: (1) There wasn’t enough research for BU to state conclusively that football-related head trauma was causing CTE. (2) BU had oversold its findings, feeding a growing hysteria about the risks of playing football. (3) BU refused to share brain tissue with other scientists, making it impossible to validate its conclusions. (4) The group’s growing fame and funding were predicated on establishing the link between football and brain damage, creating an inherent bias.

  By then, Ann McKee had emerged as BU’s rock star, eclipsing even Nowinski. Her appeal as a spokeswoman seemed boundless. The sudden attention had yanked her out of her “rabbit hole” of self-imposed scientific isolation and cast her into the spotlight, where she was sought out by everyone from 60 Minutes to HBO to explain the new football disease. Laypersons, journalists, neuroscientists, athletes—all seemed fascinated by her dazzling looks and her ability to make CTE understandable. Much was made about how McKee studied the brains of dead players during the week, then put on her cheesehead and her Packers jersey to watch Sunday’s game. “She’s a brilliant scientist who happens to be a little blond bombshell,” said Eleanor Perfetto, the widow of a former player, Ralph Wenzel, whose brain was studied by McKee. Introducing McKee at a conference in Las Vegas, a fellow researcher gushed: “In addition to having golden features, she has a gold standard. If it doesn’t meet her gold standard, it ain’t CTE.”

  McKee and her colleagues had used their platform to become increasingly assertive about the dangers of football. One of their most ominous assertions was that full-blown concussions weren’t what was triggering the disease. Rather, McKee and her group believed that CTE was essentially dementia pugilistica—boxer’s dementia—now being found in other contact sports, especially football and hockey. As in boxing, it was the accumulation of hundreds or thousands of “subconcussive” blows that caused the damage, not one big knockout punch or open-field collision. “We don’t think it’s because of direct blows,” McKee said. “This is a very internal part of the brain. I mean, it’s really deep inside.” Cantu called CTE “a dose-related phenomenon” involving “total brain trauma.”

  These assertions had obvious implications for the NFL. The league could change the rules to cut down on helmet-to-helmet hits. It could monitor the number of concussions in an effort to reduce them. It could put independent neurologists on the sidelines to look for concussions and try to end the culture of pain that pressured players to play through it. But if CTE was occurring at a deeper level, as the BU Group believed, that raised questions about the very essence of football.

  One of BU’s main critics was Mitch Berger, the chairman of the neurological surgery department at the University of California San Francisco Medical Center. Berger, a strapping former Harvard defensive end with wavy salt-and-pepper hair, had been brought onto the new NFL committee to conduct a longitudinal study on football-related head trauma—the long-term study that had been started and then abandoned by the original MTBI committee. Berger, who once had a tryout with the Bears, was so prominent and well regarded within the neurosurgery community, UCSF put his face on a billboard off Interstate 80 near the San Francisco side of the Bay Bridge.

  Berger didn’t doubt that McKee had seen CTE in some former players, but he was troubled by what he perceived as the BU Group’s agenda. The group’s survival, he felt, depended on proving that CTE was a major health problem. “I mean, their whole existence, their funding, relies on this [idea] that they’re perpetuating that it’s a fact if you play football you’re going to have some form of cognitive impairment,” he said. “So it’s very, very difficult to accept it because it is so biased. I mean, anybody would say the same thing: You can’t help but believe there’s a bias. This is what they’re there to do—to show that there is a link.” He called BU’s reluctance to share brain tissue with other scientists “suspect.”

  Berger likened the hysteria generated by BU to fears that cell phones caused brain tumors. For BU to suggest an absolute link between football and brain damage was “irresponsible,” he said.

  Berger’s criticism was a common refrain: How could McKee be certain that head trauma was causing this disease? In fact, she couldn’t be sure. It was all too new, and there weren’t enough cases. The mechanism by which head banging turned into brain disease was unknown, though it was well established in the scientific literature that head trauma could lead to long-term cognitive problems.

  Yet there wasn’t a single recorded case of CTE in someone who had not sustained some form of brain trauma. To scientists such as Omalu, Bailes, McKee, Cantu, Hamilton, and DeKosky, along with numerous others, that alone was overwhelmingly persuasive. There was simply no other common factor. It was true, as critics like Berger noted, that there was a self-selecting quality to the cases: McKee was getting the brains of people who had been profoundly impaired, and their families wanted answers. The BU Group was drawing from a sample size that was “skewed beyond belief,” Cantu acknowledged. But the sheer number and variety of cases was impossible to ignore, he felt.

  “Mitch Berger, with all due respect, is full of shit,” said Cantu, defending the BU Group when the criticism surfaced publicly.

  “No, not with respect,” Cantu added testily. He suggested that Berger and others were jealous about the publicity the BU Group and McKee had received. “This is a neuropathological diagnosis that’s black-and-white, and one confirmed by anyone who has looked at the tissue,” Cantu said. “It’s not something with bias. It’s not like if this brain doesn’t have it, we’ll duck it or stick it in a bucket.”

  Nowinski called Berger’s comments “bizarre. I mean, the facts are the facts.” He noted that the criticism had come from “somebody connected with the group that profits from the sport.”

  Berger and other members of the NFL committee wanted to steer Duerson’s brain away from the BU publicity machine. The designation of BU as the NFL’s preferred brain bank and the $1 million donation had predated the new committee by several months. The doctors thought it was irrelevant. Almost from the new committee’s inception, Ellenbogen and Batjer had advised Goodell to start funneling the NFL’s money to the National Institutes of Health. Their argument was that the NIH could play a neutral role—“like Switzerland”—and farm out the research to independent scientists who didn’t have a vested interest in proving that CTE was connected to football.

  The conflict put Duerson’s family in the cross fire of a highly unusual situation. Duerson had ask
ed to make sure that his brain was turned over to the NFL’s brain bank. The NFL had designated BU as its “preferred” brain bank, and league officials had even directed Duerson’s family to Nowinski. Yet the NFL’s doctors wanted to divert Duerson’s brain away from BU to the NIH.

  “We had Dave Duerson’s brain,” Hunt Batjer, one of the committee cochairs, would later complain. “We talked to the family, the coroner, we had two outstanding neuropathologists waiting via NIH. But Nowinski flew into Chicago and told the family he represents the NFL, and they got it.”

  It hadn’t gone exactly that way. But Batjer’s tone reflected the new NFL committee’s disdain for the BU Group. It was a fight that was far from over.

  Two and a half months after Duerson’s suicide, BU held a press conference to announce that he had CTE. Alicia, Tregg, and Duerson’s other three children attended.

  McKee said the case was indisputable evidence that the disease was connected to football. She added: “I think in Dave Duerson’s case it drove him to suicide.”

  For McKee, Duerson’s death was simply more proof that the NFL—and, by extension, the entire football-mad country—was facing a huge problem. Including Duerson, McKee had examined the brains of 25 deceased NFL players; 24 had CTE. McKee understood the lingering doubts. She herself had once had them. With each new case of CTE, she thought: “I just can’t even believe this.”