League of Denial

by Mark Fainaru-Wada

  During the call with Omalu and Bailes, Tyler agreed to donate his father’s brain to their group.

  Omalu initiated the paperwork that would allow him to harvest Seau’s brain. He faxed a consent form to Tyler, who initially indicated that he was prepared to sign. At 8:38 that night, Tyler wrote in an e-mail to Omalu: “my guy is on his way here right now so I can sign it and fax it back to you.” An hour later he wrote again, asking Omalu to contact David Chao, the San Diego Chargers’ doctor, to “cross our Ts and dot our Is before proceeding.”

  Junior Seau and Chao were close. Tyler said Chao had continued as his dad’s personal physician after Seau left the Chargers. Tyler was growing wary about his decision, and he felt Chao was the logical person to help him sort out what to do. But Chao had his own issues. The day after Seau shot himself, the orthopedic surgeon appeared before the Medical Board of California to respond to allegations that he committed acts of “dishonesty or corruption” by failing to report a 2006 drunk driving conviction on an application to evaluate workers’ compensation cases. Later that year, the board moved to revoke Chao’s medical license over three separate malpractice claims. (DeMaurice Smith, executive director of the NFL Players Association, would take the unusual step of calling for Chao to be replaced as the Chargers’ doctor. A panel of independent physicians created under the league’s collective bargaining agreement ultimately exonerated Chao. Soon after, Chao resigned his position with the Chargers, citing health and family reasons.)

  Now, at Tyler’s request, Chao became the point person for what would happen to Seau’s brain. The night of Seau’s death, Chao called Omalu and berated him, according to Omalu. “That was one of the most arrogant phone calls I’ve ever been involved with in my life,” said Omalu. “This guy was yelling, was extremely arrogant, pretty much questioning who I was.” After the contentious call, Omalu e-mailed his credentials and samples of his research to Chao. He was convinced he still had “verbal consent” from Tyler to take Seau’s brain. He booked a flight from San Francisco to San Diego to do just that.

  By then, at least a half dozen prominent researchers were making a play for Seau’s brain. The deputy medical examiner, Craig Nelson, returned from Seau’s home to find a sheaf of messages stacked up at the office. “It felt sometimes to me like buzzards were circling,” Nelson said. “I have a scientific mind and a medical background, but when someone has just died, things are very fresh. Imagine that your parent dies and then hours later somebody is calling you and saying, ‘Hey, would you consider donating this for research?’ It can sit a little odd, and when it’s such an unexpected death, it makes it harder.”

  Nelson’s buzzards included a Nobel laureate brain researcher, Stanley Prusiner, director of the Institute for Neurodegenerative Diseases at the University of California, San Francisco. Prusiner, a 70-year-old scientist with a cloud of white hair, won the 1997 Nobel Prize in Physiology or Medicine for his discovery of prions, a class of infectious proteins behind brain disorders such as mad cow disease and Creutzfeldt-Jakob disease. Prusiner’s specific interest in CTE wasn’t clear, but he launched a tag-team effort with Omalu to bid for Seau’s brain. Within hours of Seau’s death, Prusiner placed calls to the medical examiner’s office to try to arrange a meeting with Seau’s family. He had his assistant call and e-mail Tyler Seau.

  Omalu and Prusiner egged each other on. “Please it is vital you get to the Seau family,” Omalu wrote Prusiner in an e-mail the day after Seau’s suicide. “I think they will give you/us the brain if you directly speak to them and play the nobel price [sic] card :)”

  Prusiner responded by e-mail 12 minutes later that he was planning to fly to San Diego to meet with the Seau family.

  But BU was launching its own offensive. At 5:55 A.M. (2:55 California time), the morning after Seau killed himself, popular Sports Illustrated football writer Peter King issued a supportive tweet for the BU Group to his more than 1 million followers: “Dedicated researchers in Boston studying deceased players’ brains for evidence of trauma attempting to obtain Junior Seau’s. Hope they do.” King thought the tweet was harmless, but it quickly morphed into a national news story that was picked up by NFL.com, ESPN.com, and other websites. Seau’s family was outraged by what they perceived as more tactless pressure. Nowinski and others scrambled to contain the damage. They urged King to “retract” the tweet and apologize to Seau’s family. Nowinski later claimed that King had based the tweet on his own assumption that BU would chase after Seau’s brain. But King said, in fact, he had confirmed BU’s interest. King refused to apologize or make a retraction. “I empathize with them and know how badly they wanted to see Seau’s brain,” he said. “I was sorry it put them in an awkward situation, because I believe in what they do.”

  He issued a vague follow-up at 11:13 A.M.: “To clarify researchers seeking Seau’s brain: Info not from them. They seek to examine all ex-players who played contact sports. Every one.”

  When Gina heard about the requests that were pouring in for her ex-husband’s brain, she was horrified. “It was the most foreign thing I’d ever heard of, quite honestly,” she said. “And the fact that I had to have a conversation with the coroner and ask, ‘If we decide to donate it, how do you take it out? And what do you do with it?’ And here we are about to have a funeral service. This is an open casket. It was crazy. It was really bizarre.”

  Not long after the Twitter contretemps, Omalu touched down in San Diego. He was carrying a special “brain briefcase.” Nelson, the deputy medical examiner, believed Omalu had permission from Seau’s family to take the brain and thus had invited him to participate in the autopsy. Omalu’s plan was to remove Seau’s brain and fly it back to San Francisco, where he would divvy it up with Prusiner. Omalu headed straight from the airport to the medical examiner’s office, a hulking three-story building on the north side of town. Nelson told Omalu he couldn’t take any tissue without written consent from Seau’s family. That hadn’t materialized, and so Nelson asked Joe Davis, the office chaplain, to call Tyler Seau and have him fax it over. Omalu spent much of the morning chatting with Davis, recounting his battles with the NFL and talking about his faith. Omalu then joined Nelson in the autopsy suite, a cool, windowless room with fluorescent lighting and a dozen workstations equipped with gleaming stainless steel tables, oscillating saws, and plastic cutting boards. The office lent Omalu scrubs and a clear plastic visor.

  Soot and the imprint of the gun’s muzzle were still visible on Seau’s chest. He had no alcohol or drugs in his system except for zolpidem, the insomnia medication whose trade name is Ambien, and naproxen, an anti-inflammatory. Nelson made a Y-shaped incision and removed most of Seau’s vital organs. Omalu removed the brain and the spinal cord. He sliced Seau’s brain with a long knife and placed half in a small tub filled with formalin. The rest he froze under protocols prescribed by Prusiner.

  As the autopsy was wrapping up, Davis, the chaplain, received a call back from Tyler. He wasn’t calling to sign over his dad’s brain. He was in a rage, screaming about Omalu.

  “I talked to the NFL,” Tyler told Davis. The league, he said, had informed him that Omalu’s “research was bad and his ethics are bad.”

  “He is not to be in the same fucking room as my dad!” he told the chaplain. “He’s not to fucking touch my dad! He’s not to have anything to do with my dad!”

  Davis tried to calm him down.

  “Nothing’s going to happen without your permission; just rest your heart in that,” he said. “But let me ask you, why the U-turn? I mean, you talked to him last night, and the only reason he’s here is because you told him to go ahead and buy a plane ticket and come here. So just help me understand why the U-turn.”

  Tyler repeated that he had talked to “the NFL,” without specifying whom, and repeated that he was told Omalu was unethical and his research was flawed. At one point, Tyler mentioned having received advice from Chao. Davis reassured Tyler that nothing would happen without his permission. “But you got to
understand,” Davis added, “the NFL may very well not want him to do the research because he’s the guy that’s proving the post-concussion syndrome. You need to think about that.” Tyler merely reiterated that he wanted Omalu out.

  Davis hung up and went to the autopsy room. He entered with a troubled look on his face.

  “Houston, we have a problem,” he announced.

  It was too late, of course, to keep Omalu away from Seau’s brain; he already had dissected it. Nelson felt he was on solid legal ground: He had every right as deputy medical examiner to bring consultants into the autopsy room. But he wanted to protect Seau’s family, not insult them. At that moment, Omalu said, he was “persona non grata.” He felt like it was a replay of the persecution of his science and his reputation over the previous six years. “It reminded me of the way Casson, Pellman, and Viano dismissed me, actually calling me a fraud as well,” he said. “It’s the same pattern. To summarize it: a systematic effort to marginalize me, delegitimize me, and dismiss me. To pretty much make me null and void, an outsider not to be trusted.”

  “Why do I deserve to be treated the way I’m being treated?” Omalu asked, growing emotional. “For doing good work? Isn’t that what America is about: doing good work, enhancing the lives of others?”

  Omalu returned to San Francisco, depressed, his brain briefcase empty. “My poor wife, who’s seen me go through this over and over and over, she cried, you know?” he said. “After that I just said, ‘You know what? This is it for me. I think I’ve done my part.’ The Junior Seau case made me regret ever getting involved in CTE.”

  Prusiner, oblivious to the debacle that had taken place 400 miles to the south, sent Omalu a celebratory e-mail, attaching an article from ESPN.com, which had learned that Omalu had participated in Seau’s autopsy. “Your trip to San Diego was really important,” the Nobel laureate wrote. “Please see the wonderful attached write-up about you, the CTE identifier. I shall call Tyler and David Chao tomorrow and create a time to meet them in SD.”

  The chances of that happening were exactly nil. The world again had changed. Omalu and Bailes, Nowinski and Cantu—all of the Dissenters—had succeeded in toppling the NFL’s established order. It was an astonishing achievement. Casson and Viano and the MTBI committee were gone. Pellman seemed to be in internal exile, still with the league but unseen. But there was a new order. Those men had been replaced by other men with their own views about what was best for the NFL. Omalu was never part of that world, but now BU, too, was about to be elbowed aside by the league regardless of the framed commitment hung up on the wall back in Boston.

  As he appealed to the Seau family through Chao, Nowinski emphasized BU’s status as the official brain bank of the NFL. But at the same time Nowinski was trying to close the sale, the NFL was working to direct Seau’s brain away from BU. At the center of the league’s effort were the members of the new concussion committee. Behind the scenes, they had their own strategy to secure Seau’s brain. They hadn’t succeeded with Duerson’s brain a year earlier, but this time they were prepared. To execute their plan, they summoned the same power, resources, and reach that until recently had been used to deny the very existence of brain damage in football players.

  The point man was Kevin Guskiewicz, once one of the original Dissenters but now a powerful member of the reconstituted committee. Guskiewicz was one of the critics the NFL had recruited after disbanding the old MTBI committee. Now he found himself working against his former allies, including Bailes, his cofounder of the Center for the Study of Retired Athletes. Guskiewicz and Chao had a mutual friend, a former trainer at UNC, and Guskiewicz advised Chao to send Seau’s brain not to Omalu and Bailes or the BU Group but to the NIH, where the head of research for the NFL’s new concussion committee, Russ Lonser, worked as chief of surgical neurology. That is, Lonser worked for both the NIH and the NFL.

  Guskiewicz had never forgotten his revulsion when Omalu put up photos of Webster’s corpse three years earlier at the Palm Beach meeting of the Players Association. Guskiewicz said he told Chao that “within the circles that I hang out within the scientific community,” Omalu was known for “sensationalizing at times” and for “showing slides of the deceased person—their brain—and that sort of thing.” Chao relayed the message to Seau’s family: Omalu was bad news. But Guskiewicz wasn’t done. He told Chao about his concerns that BU had its own agenda, that McKee was fanning the hysteria about football and brain damage by overstating the prevalence of CTE.

  Guskiewicz, like his colleagues on the NFL’s new committee, thought donating the brain to the NIH was a tidy solution to a messy situation. The brain race had gotten out of hand. Guskiewicz had an uncle in Latrobe who died of pneumonia in his early forties; the ordeal was traumatic enough without the presence of strangers clamoring for his organs. “All this knocking on doors, the calls, I just can’t imagine going through it,” Guskiewicz said. “It puts a black mark on the entire neuroscience community because some of us, I think, are perhaps guilty by association. So I think that’s concerning.”

  Two months after Seau’s death, after the intervention of three members of the NFL’s concussion committee and the team doctor for the San Diego Chargers, his brain was shipped to the NIH.

  Two months after that, the NFL donated $30 million to the NIH for concussion research, the largest philanthropic gift in the league’s history.

  The NFL said there were no strings attached to the donation, a pledge identical to the one the league had made to BU three years earlier.

  On one level, it made perfect sense. The chase for Junior Seau’s brain had turned into a macabre spectacle, adding to his family’s anguish. The NIH could apportion his brain tissue to any independent scientist, not just those whose reputations would be enhanced by the diagnosis. As Gina Seau said, “I didn’t care about what people and doctors were competing for. I just cared about a high level of scientific study, doing it properly without bias. I cared about us getting to the bottom of what was really happening without anything to prove. We just wanted the truth.”

  But of course there was another side to it. In Wheeling, West Virginia, Bob Fitzsimmons watched the battle over Seau’s brain with knowing bemusement. The former coach of Team Webster, the man who beat the NFL in court for $1.8 million, Fitzsimmons had followed the league’s tortured struggle to get a handle on the concussion crisis for two decades. He wondered how much had really changed. Mike Webster had gone mad and died. Junior Seau had gone mad and died. How many more players were out there? The league had embraced BU’s researchers and given them money. When the NFL didn’t like the message, it cast BU aside and picked another partner and shelled out more money. Despite numerous offers, Fitzsimmons had decided not to take cases against the NFL in order to focus on the science. But he couldn’t help but see a pattern.

  “I guess the National Institutes of Health is now involved. I guess they somehow got drafted by the NFL,” said Fitzsimmons, still in the firehouse-office where Mike Webster once slept in the basement. “They had an early draft, I think, and they drafted the NIH and paid them a pretty good salary, too, from what I hear.”

  On the day Seau shot himself, Gary Plummer got a call from a former teammate.

  “Please, bro, tell me that there’s more to it than just the concussions, tell me that, please,” said Steve Young.

  The Hall of Fame quarterback was in a panic. For years, Young had been telling himself that he wasn’t Mike Webster, that he wasn’t even Merril Hoge or Al Toon. He was the Vanilla Guy. He’d had his concussions, but that wasn’t what had driven him out of the game. And now people assumed that Junior Seau had shot himself because of concussions. Young wanted to know it wasn’t true, had to know it wasn’t true.

  Plummer knew both men well. Young had none of Seau’s problems: the money, the gambling, the drinking, the estrangement from his kids. To be around Steve Young for any length of time was to see how incredibly normal his life was, his conversations interrupted by calls and texts from h
is wife, wondering why he hadn’t completed an errand, or messages from friends making sure he knew it was his day to carpool the kids.

  “Steve, you don’t have relationship issues like this, you don’t have debts and people calling in markers, you’re not an alcoholic,” Plummer told Young. “I really don’t think that in a million years that’s going to be an issue for you.”

  Plummer told Young he thought concussions had been “somewhere in the neighborhood of 10 or 20 percent” of Seau’s problems.

  Young sounded relieved. “You’re right, I know you’re right,” he said. “Bro, I can’t thank you enough.”

  But of course Seau had had CTE. That was certain. The NIH had distributed unidentified tissue from three different brains to three independent neuropathologists. One of those brains belonged to Seau, another to a person who had had Alzheimer’s disease, and the third to a person with no history of traumatic brain injury or neurodegenerative disease. All three neuropathologists concluded that tissue taken from Seau’s brain showed definitive signs of CTE. So did two NIH researchers, for a total of five confirmations. The telltale neurofibrillary tangles of tau protein that Omalu first spotted in Webster were found “within multiple regions of Mr. Seau’s brain,” the NIH reported. Officials refused to speculate on the cause of Seau’s brain damage. But his family was told by Lonser he had gotten the disease from “a lot of head-to-head collisions over the course of 20 years of playing in the NFL,” said Gina. “And that it gradually, you know, developed the deterioration of his brain and his ability to think logically.” Lonser, though, did not express that in any of his public comments.

  The discovery that Seau had had brain damage provided no solace to his children; in some ways it made them feel worse. “It didn’t take any of the pain away; I feel it almost brought more,” said Tyler Seau. “Mainly, because I feel bad that I didn’t try harder. And just the pain that he was going through for how many years?” In the weeks leading up to the diagnosis, Jake Seau thought that when it finally came, “it’d answer a lot of questions. And, really, it just gave me more. You know, that’s just one question answered that we kind of already knew the answer to. But then there’s hundreds more.”