League of Denial

by Mark Fainaru-Wada

  Jake Seau had played both football and lacrosse his freshman and sophomore years at The Bishop’s School in La Jolla. He was 6-feet-2 and nearly 200 pounds. In football, he played running back and strong safety. In lacrosse, he was a midfielder. By his sophomore year, he had received recruiting letters for both sports. Jake had a growing sense that football was his father’s game but probably not his. He didn’t have the same passion for it as his dad. Seau never put any pressure on Jake, just told him to keep his options open. Each year, as Jake’s love for lacrosse grew, he debated whether to play football. Each year, at the last minute, he would give in and suit up.

  But no more. Jake had made a verbal commitment to play lacrosse at Duke, a powerhouse in the sport. Football made him think of his father, and so he no longer watched many games. “I still love football,” he said. “I grew up with it; I’ve always been around it. I love the game.” But in the most personal and profound way, he was faced with the same uncomfortable questions that the rest of the country was now confronting. With so many alternatives, how can we let our children, our loved ones, ourselves, play a game that may destroy the essence of who we are? How can we enjoy it as entertainment? When his junior year came around, Jake thought about his father and himself. He thought about his family. And this time he didn’t suit up.

  “To realize this is the sport that he loved and possibly could have killed him, I just can’t play it any longer,” Jake Seau said.

  EPILOGUE

  SCARS OF THE GLADIATORS

  In 1971, a Boston respiratory specialist named Gary Huber was approached by the tobacco industry with a proposal. The companies wanted to give him money to research the connection between smoking and lung disease. It had been almost 20 years since Ernst Wynder had induced cancer in mice by painting them with tar drawn from cigarettes. Huber, who worked at Boston City Hospital’s Harvard Medical Unit, had seen one smoker after another come in with emphysema, bronchitis, and lung cancer, but there was little he could do for them. Big Tobacco said it wanted to help.

  “We mistrusted them and initially we said no,” Huber told PBS’s Frontline 24 years later, but the industry was persistent. The executives told Huber he’d have total autonomy. Finally he agreed. “This was an industry who made a product that caused disease, and if we were going to do anything about it, I thought we had to work with that industry,” said Huber, whose story is recounted in Dan Zegart’s Civil Warriors and Robert Proctor’s Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition, among other places.

  Harvard accepted $2.8 million from Big Tobacco, at the time the largest health-related grant the industry had given to a university. Over the next eight years, the grant grew to $7 million. The Harvard Project, started in 1972, produced 27 books and 54 peer-reviewed scientific papers.

  The tobacco industry had selected Gary Huber for a reason: He believed the link between cigarettes and disease was unproven. His research had shown that most animals have an “adaptive tolerance” to toxic oxygen and only a few get sick. He had noted that although many people smoked, relatively few seemed to die. Which traits, he wondered, put some people at greater risk?

  Big Tobacco’s chief lawyer, David Hardy, wined and dined Huber, flying him to Washington to meet with senators, foreign dignitaries, and cabinet members. Hardy offered soothing reassurances about Huber’s independence even as he subtly tried to edit his work. Over time, Huber became a “sycophant” of the industry he was studying, Zegart wrote in Civil Warriors, believing the support from Big Tobacco would continue no matter where his research led.

  Then, in 1977, Huber found that rats exposed to cigarette smoke for six months developed emphysema. When he prepared to announce his findings at a conference in Las Vegas, the tobacco industry sent a lawyer to try to “lessen Huber’s inclination to interpret the results as evidence of direct cause and effect.” The effort failed. Shortly afterward, Huber discovered that supposedly safer low-tar cigarettes were potentially more dangerous because their smokers puffed more frequently and held the smoke in their lungs twice as long.

  When the Harvard Project’s grant expired in 1980, Huber begged for more money. Big Tobacco cut him off.

  “You just got too close to things you weren’t supposed to get into, Gary,” a tobacco executive told him.

  But Huber continued to work with the industry. Exiled from Harvard with the elimination of his funding, he moved to the University of Kentucky to work at the Tobacco and Health Research Institute despite warnings that Big Tobacco was setting him up. A tobacco lawyer sat on the institute’s board. Its signature study involved smoking monkeys that were not allowed to inhale fully, making them unusually healthy smoking monkeys. In Lexington, Huber found himself accused of the manipulation of scientific results, administrative incompetence, and even sexual harassment. Within a year, he’d been fired. He moved on to the University of Texas, where he changed his specialty to nutrition.

  When attorneys suing Big Tobacco caught up with Huber in 1997, they showed him internal industry documents to persuade him to testify against his former friends. One memo said programs such as the Harvard Project had been targeted not for their “scientific goals, but rather for … public relations, political relations, position for litigation.” Huber was stunned to learn that R.J. Reynolds had done the work he was most proud of—producing emphysema in rabbits—10 years before he had. He broke down in tears, realizing he had wasted 15 years of his life.

  “I don’t want people to think that I was bought,” said Kevin Guskiewicz.

  He was sitting in an alehouse in Chapel Hill, North Carolina, sipping his favorite porter, making the case that he was still independent after having joined the NFL’s reconstituted concussion committee.

  Guskiewicz was an original Dissenter, a respected scientist who had made his name establishing the connection between football and long-term mental illness. He wrote in 2005: “Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.” Two years later, in another paper that would define his career, he theorized that repeat concussions associated with football led to “biochemical changes” and “neuronal loss”—that is, brain damage.

  But now Guskiewicz seemed to be singing a different tune. It was nearly impossible to distinguish his views from those of the NFL. It wasn’t just Guskiewicz’s attacks on Omalu and McKee or the way he had used the NFL’s power to divert Junior Seau’s brain to the league’s researcher of choice, the NIH.

  Guskiewicz no longer seemed to agree even with himself.

  “The vast majority of the neuroscience community does not believe that research has established a causal relationship linking repetitive head trauma in football and CTE; I include myself in that,” he said after McKee released a study confirming 28 new cases of brain damage in dead football players. This occurred in December 2012. The BU Group now had 50 confirmed cases of former football players with CTE, 33 of whom had played in the NFL. By then, McKee was convinced that “most NFL players are going to get this. It’s just a matter of degree.”

  Guskiewicz said that blaming football for the devastating disease that had spread through the brains of former players such as Mike Webster, John Mackey, Ollie Matson, Dave Duerson, and Junior Seau, among so many others, was like a track team blaming Nike for a rash of ankle injuries simply because the athletes wore that brand of shoe. The same criticism, of course, could have been leveled at Guskiewicz’s own game-changing work. In fact, it was—by the NFL.

  Guskiewicz had joined the concussion committee in 2010 because he had become convinced that Goodell represented change and was committed to player safety. He thought he could use the NFL’s power and resources for the greater good. The league put him in charge of equipment and rules—he literally could change the rules of pro football!—and Guskiewicz immediately went to work. It had long been known that the kickoff was the most dangerous play in football, essentially a 22-c
ar pileup. Guskiewicz persuaded the owners to move up kickoffs to the 35-yard line, ensuring more touchbacks and fewer collisions. Sure enough, concussions on kickoffs dropped 43 percent, according to the league.

  Guskiewicz wasn’t paid to serve the NFL. His day job was still at the University of North Carolina, where, after he received the MacArthur genius grant, his meteoric rise continued. Long after his start as an ankle-taping apprentice for the Pittsburgh Steelers, Guskiewicz, still exuding a self-effacing boyishness, now chaired the university’s department of exercise and sports science. He ran the Center for the Study of Retired Athletes, which he cofounded with Bailes, and the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, named after a North Carolina high school player who died from a collision on the field.

  But the NFL gave Guskiewicz everything he needed to fulfill his duties for the league. When he needed “big dollars,” he said, he would seek out Jeff Pash, the NFL’s number two executive, and say, “Jeff, we need to buy six new systems, and it’s going to cost $250,000 to install; can you authorize the purchase? And Jeff then does that.” The NFL insisted that its new concussion committee—like its old concussion committee—was totally independent, yet the league monitored interviews and filtered communication with the media. Guskiewicz and his colleagues reported directly to Goodell, who came to North Carolina in March 2013 to lecture on football and safety.

  People noticed Guskiewicz’s transformation. Matt Chaney, a concussion blogger highly critical of the league, satirized him as “Gus Genius” and wrote that he “epitomizes the wily football-funded researcher, morphing from game critic to advocate committee member. The NFL specializes in buying off such pliable ‘experts.’ Kevin Guskiewicz is no genius; he’s just become another football insider of unearned credit and privilege.” The blogger Irv Muchnick started calling Guskiewicz “Dr. No Jr.”

  The most bizarre aspect of Guskiewicz’s new role was that he found himself working with Elliot Pellman, his former scientific nemesis, who continued as the NFL’s medical director and even attended committee meetings. How Pellman survived baffled even Guskiewicz. “It’s a question that many of us have asked,” he said. “I mean, I really don’t know.” Another league-affiliated doctor, half joking, said he assumed Pellman “has incriminating photos hidden somewhere.” Pellman, of course, was a walking repository of information about the NFL’s concussion policies; the most obvious explanation was the lawyers wanted to keep him close. Guskiewicz said he didn’t mind as long as Pellman stayed as far away from him as possible. He said his only interaction with the NFL’s medical director was to send him his receipts to get reimbursed for his travel expenses.

  Guskiewicz said the former head of the Mild Traumatic Brain Injury Committee was adept at processing his breakfast receipts.

  “He does it really well,” Guskiewicz insisted. “I have to tell you, if only the university could reimburse me as quickly as he does; it’s usually within minutes and the check’s in the mail. But I know, it’s comical.”

  There was something poignant about Guskiewicz’s ongoing research. He was trying to make a violent game safe. His latest work involved helmet sensors that measured the magnitude and frequency of blows. One of Guskiewicz’s sons was playing high school football. On Friday nights, on a glowing field like thousands all over the country—the field where his son played—Guskiewicz watched his sensors pick up one collision after another, play after play after play.

  Guskiewicz loved football. He had loved it ever since he had ridden his bike to watch his heroes, men such as Mike Webster and Terry Bradshaw and Mean Joe Greene, from the hill overlooking the Steelers’ training camp in Latrobe. The game was part of him, part of his American story. That’s the thing about football, why it’s different from cigarettes and coal dust and not wearing your seat belt and a whole range of other things that have been proved bad for us. We love football. Americans by the millions are complicit in making the sport what it has become, for better or worse. The outcome of the NFL’s concussion crisis will affect the country. But it will be determined not by the “enemies” or “opponents” of football but by those in love with the sport: the players, the fans, the advertisers, the book writers, the moms and dads and kids. Even the scientists.

  Guskiewicz didn’t believe his views had changed. He thought the pendulum had swung too far since his studies, before we really know how many people get brain damage from playing football, or how exactly that occurs, or what the true risks are. McKee, for all the publicity surrounding her work, for the many brains she’d examined, had not established “a cause and effect relationship” between football and neurodegenerative disease, Guskiewicz said. Her insistence that she had, and the insistence of others, such as Omalu, Cantu, and even Bailes, had created an unwarranted backlash against the NFL, he thought. “Some of them are beating their fists on the table a little harder than others to say, I’m convinced this exists,” Guskiewicz said. “I mean, if it existed to the extent that some people have said, we would have an epidemic on our hands. And I don’t think that we have an epidemic.”

  The Center for the Study of Retired Athletes had evaluated more than 400 NFL players. “I hope that I look as good as three-quarters of them when I’m 55 or 60,” said Guskiewicz. “So it’s not happening to everybody. There is certainly a quarter of them that need some help, and we’ve got to figure out how we intervene. But as I’ve said, three-quarters of them look really pretty good. And I don’t think we have a bias. I think we’re seeing the typical player walk through our door.”

  By 2013, the NFL was spending tens of millions of dollars—spread among leading physicians and institutions throughout the country—to become the main sponsor of research that holds the potential of its own undoing. Nearly every prominent scientific group involved in that work—Boston University, the National Institutes of Health, the University of North Carolina—has benefited from the NFL’s riches. Does that mean that all the science is tainted or that Kevin Guskiewicz was bought? No. Does it make the research independent and credible? Time will tell.

  But once again, the NFL was in control of the science of concussions.

  It wasn’t just Guskiewicz. As the league moved into this murky next phase, it was often hard to tell where people stood and whether anything had changed.

  Merril Hoge, who retired from the NFL in 1994, the Season of the Concussion, because he couldn’t remember his daughter’s name and briefly went blind, claimed that football was no more dangerous than riding a bike, an assertion the NFL made repeatedly. Hoge was a board member of USA Football, an organization endowed by the league and identified as the “official youth football development partner of the NFL.” He espoused the league’s message of teaching proper tackling to take the head out of the game, a concept many players thought impossible and almost laughable.

  Hoge used his role as an NFL analyst on ESPN to criticize those who would question the dangers of football. When former quarterback Kurt Warner, who led the Rams to victory in Super Bowl XXXIV and won two MVP awards during a 12-year career, said he would prefer that his sons not play football, remarks similar to those made by former greats such as Bradshaw and Carson, Hoge publicly attacked Warner as “irresponsible” and “uneducated.”

  Some people seemed to be lining up on both sides of the debate. Cantu, another original Dissenter, now was serving as a senior adviser to the NFL concussion committee. At the same time, he dispensed paid advice to the lawyers suing the league during a February 2012 strategy session in Philadelphia. When the NFL found out about his appearance, league officials sent a warning letter to the lawyers to stay away from Cantu because he worked for them. After discovering Cantu’s conflicting roles, the lawyers for the players decided he was tainted as an expert witness and backed away.

  The lawsuits, including the first one filed by Jason Luckasevic and his colleagues, had been consolidated into one “mass tort” involving nearly 6,000 former players or their families. That included Bubby Brister,
whose long-ago concussion with the Steelers led to the creation of ImPACT and neuropsychological testing in the NFL. It also included the relatives of Junior Seau. Twelve days after the NIH announced that Seau’s brain was riddled with CTE, his family sued the NFL. The Seaus alleged that the league “deliberately ignored and actively concealed” the risks of chronic brain damage “from the players, including the late Junior Seau.”

  By the time the two sides appeared in court in April 2013 for a hearing on the NFL’s motion to dismiss the case, Luckasevic and the others had given way to David Frederick, a Washington superlawyer who once clerked for Supreme Court Justice Byron “Whizzer” White, the former star halfback. The NFL was represented by Paul Clement, a former U.S. solicitor general. Both men had argued numerous cases before the Supreme Court. It didn’t escape notice that the NFL’s chief outside counsel, Covington & Burling, was a veteran of the tobacco wars, one of two law firms—the other was Shook, Hardy & Bacon—that served as “guiding strategists” for Big Tobacco. Before taking over as commissioner, Tagliabue worked as the NFL’s lawyer for the powerhouse firm, but it’s not known whether he played a role in the tobacco strategy. After retiring as commissioner, he returned to Covington & Burling, where he serves as a senior counsel as part of the firm’s Strategic Risk and Crisis Management Team.

  For decades, Covington & Burling’s lawyers directed litigation, public relations, and opposition research against those who warned against the dangers of smoking. The firm served as the first legal counsel for the Tobacco Institute, which produced industry-friendly research. It helped draft a more lenient liability law, coordinated denials about the dangers of secondhand smoke, and subsidized tobacco-friendly scientific witnesses who were referred to as “whitecoats.” In 1987, after the surgeon general concluded that secondhand smoke caused cancer and respiratory disease, Covington & Burling partner John Rupp famously told a group of tobacco executives they were “in deep shit.”