Everyone knew that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know—and what the league sought to shield from them—is that no amount of padding could protect the human brain from the force generated by modern football; that the very essence of the game could be exposing these players to brain damage.
League of Denial chronicles the tragic fates of NFL players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives; and former Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents and private emails, this is the story of what the NFL knew and when it knew it—questions at the heart of crisis that threatens football, from the highest levels all the way down to Pop Warner.
Mark Fainaru-Wada and Steve Fainaru are the recipients of the 2014 PEN/ESPN Award for Literary Sports Writing for a nonfiction book on the subject of sports published in 2013.
Behold the mighty woodpecker.
On average, it weighs about 2 ounces and can generate up to 1,000 g forces while pecking at tree limbs 12,000 times a day. Yet the wood-pecker’s brain remains pristine and unscathed, a fact that has intrigued researchers for decades. Nature essentially has turned the woodpecker into a shock absorber from beak to foot. The bird’s uneven bill deflects much of the impact of its incessant head banging. A third interior eyelid prevents its eyeballs from popping out. The woodpecker’s tongue is one of the most unusual features in nature. It extends from the back of the bird’s mouth and through its right nostril, finally wrapping itself snugly around the entire crown of the head. Chinese researchers who subjected the great spotted woodpecker and the Eurasian hoopoe to super-slow-motion replay and CT scans concluded that the tongue serves as a kind of safety belt for the brain.
In the late 2000s, Julian Bailes displayed a woodpecker skull in a jar on top of his desk in Morgantown, West Virginia. Bailes was a top neurosurgeon and a former team doctor for the Pittsburgh Steelers. He incurred the wrath of the NFL when he joined a small group of researchers who concluded that football was causing brain damage in an alarming number of former players. During a closed-door meeting in 2007 that was attended by the NFL commissioner, Roger Goodell, and 200 team doctors, trainers, and players, a neurologist affiliated with the league had mocked Bailes, rolling his eyes as Bailes showed slides of diseased brain tissue collected from dead players. “I’m a man of science!” the NFL’s neurologist had bellowed, implying that Bailes was not. It was an ugly scene, one of many that took place during those strange years when the National Football League went to war against science.
Every once in a while, someone would ask Bailes about the curious object on his desk. Bailes loved football—he had been an all-state linebacker in Louisiana—and even though the NFL was attacking him, he surrounded himself with artifacts of the sport: a shelf filled with old helmets of the Steelers, Cardinals, Chiefs, and Rams; deflated footballs; a panoramic photo of Pittsburgh’s Three Rivers Stadium, where he once had worked; and a signed photo of the legendary Steelers linebacker Jack Lambert, snarling and toothless. “My whole life was football,” Bailes would say. He would pick up the tiny bird brain from his desk and explain that if only NFL players were built like woodpeckers, none of this would have happened.
September 28, 2002, is one of the most significant dates in the history of American sports. You won’t find it in the record books.
That morning, on a stainless steel autopsy table inside the Allegheny County coroner’s office in Pittsburgh, Pennsylvania, lay the body of Mike Webster, the legendary center of the Pittsburgh Steelers. He had been stripped to his blue jeans, and his stomach had been injected with embalming fluid. Even in death, Webster looked formidable, with a muscular thickness from head to foot, a body that seemed designed to absorb and mete out punishment. But on closer inspection, it was a body that showed horrific signs of wear. Late in Webster’s life, his personal physician had noticed that the skin on his forehead had become “fixed to his scalp,” a shelf of scar tissue built up over 17 years of pro football. Odd bulges protruded from his back, varicose veins spidered down his legs, and deep cracks ran along the bottoms of his feet. His fingers were thick and crooked like splayed branches. Webster’s ex-wife, peering into his casket, had noticed that his fingers remained curled so that “it looked like he was still holding a football.” Webster was 50 years old when he died, but a lot of people thought he looked 70.
Five years earlier, when Webster was inducted into the Hall of Fame, his old quarterback, Terry Bradshaw, introduced him as “the best center that’s ever played the game, the best to ever put his hands down on a football.” Bradshaw, bald except for a fringe of blond hair, looking like a TV evangelist in his gold Hall of Fame sport coat, gazed up to the gray skies and cried: “One more time, let me put my hands under Mike Webster’s butt!” Webster, looking sheepish and befuddled, bent over in his khakis and hiked the ball to Bradshaw as the crowd roared. That was in 1997. Webster was already a very sick man. How sick, only a few people knew. Steelers fans had heard some of the stories: that Webster was broke and jobless and living in his truck, that his body was falling apart, that he was seeing a psychiatrist. The reality was far worse: Webster, a kind, thoughtful man during his playing days—many imagined he would go on to a successful career in coaching or perhaps broadcasting, like Bradshaw—had been transformed into a completely different person.
Webster had accumulated an arsenal of weapons that included a Sig Sauer P226 semiautomatic pistol, an AR-15 semiautomatic assault rifle, and a .357 Magnum revolver. He talked frequently about killing NFL officials, including Steelers executives and members of the league’s disability board, whom he blamed for his financial troubles. Webster had become addicted to Ritalin, a stimulant normally prescribed to children with attention-deficit disorder, finding that it was the only thing that got him through the day.
Webster, more than anyone, knew how sick he was, and he believed his illness was connected to the game to which he had given his life. Webster once went six seasons without missing a single offensive play; later, when asked by a doctor if he had ever been involved in a car crash, he replied: “Oh, probably about 25,000 times or so.” He read constantly, even during the worst of his illness, and he would pore over literature on head trauma and brain disease, putting exclamation points in the margins and circling terms that he thought applied to him, such as “ice pick headache” and “disinhibition” and “dysfluency.” He wrapped duct tape around his crooked fingers so that he could grasp a pen to write thousands of letters—some ranting and paranoid, some desperate, some incomprehensible—on any scrap of paper he could find. One read:
What Do I do, I am over fucking overwhelmed … what to Do … Have NO way Be able to Help my Kids Everyone other Family Dependents and Keep Them Healthy Safe … Maybe me worthless piece of crap but can NOT Let That Get to me have to Keep Trying Keep Work at all this but How Do I Do any-thing Now?
As Webster lay dead inside the coroner’s office that September morning, a silver Mercedes-Benz turned into the back parking lot. A small, dapper forensic pathologist named Bennet Omalu climbed out. It was a mild fall day in Pittsburgh, not yet cold, the start of another foot-ball season. Outside the building, TV trucks and reporters had gathered with the news that “Iron Mike” Webster, the indestructible force of four Super Bowl champions, the center of gravity of the Steeler dynasty—“our strength,” Bradshaw had called him—was inside on a slab.
Omalu was on call to perform autopsies that Saturday because he was the most junior pathologist in the office. He had been out clubbing the night before.
“What’s going on?” he asked his colleagues.
“It’s Mike Webster. His body is in there,” one of them whispered. “Who is Mike Webster?” asked Omalu.
Over the last year or so, people sometimes have asked us: Is ESPN really going to let you write this book?
It is an interesting question. We are employees of the company once known as the Entertainment and Sports Programming Network but now commonly identified by its initials—a media empire that operates seven 24-hour sports channels, a website that attracts more than 37 million unique visitors every month, a radio network of more than 400 stations, and numerous other sports-related enterprises. The centerpiece of ESPN’s empire is its lucrative relationship with the National Football League. The network pays the NFL—and, by extension, its 32 franchises— $1.9 billion per year to broadcast Monday Night Football. That’s $112 million per game, nearly the average budget for the Harry Potter films.
ESPN’s bet on the NFL is based on its own market research, which distinguishes the average sports fan from what the network likes to call “avids”—people who follow their sports regularly and crave information about them the way they crave food. According to ESPN’s internal data, by 2012 there were 85 million NFL avids—more than a quarter of the nation. The network has been able to pinpoint almost the exact moment when pro football permanently surpassed baseball as America’s pastime: the fall of 1994, when, not coincidentally, a seven-month strike wiped out the World Series. In some major cities today, having a pro football team is a higher priority than providing basic services. The city of Oak-land and Alameda County, for example, shell out over $30 million each year to support the Raiders; by 2012, Oakland, with one of the worst crime rates in the nation, had cut 200 police officers to save money.
The national obsession with football, which blew right through the recession, has turned the NFL into the richest and most powerful sports league in the nation and a ubiquitous presence in our lives. ESPN’s research has discovered that for the first time, more people prefer watching games on television to attending them. The NFL is broadcast over five networks—including its own—and brings in annual rights fees of $5 billion. In the fall of 2012, 23 of the 25 top-rated shows on TV were NFL games. Once, when the league moved a game from Sunday to Tuesday because of a blizzard, a spokesman predicted that the ratings would be unaffected because the NFL is the “ultimate reality show” and impervious even to acts of God.
The players—the larger-than-life men on whom this $10 billion industry was built—participate in what the historian and former Kansas City Chiefs offensive lineman Michael Oriard has described as “contact ballet.” The violence, of course, has always been a big part of football’s appeal, but it’s cinematic and filtered, almost like a war movie. The destructive force behind the sport was seldom considered. In 2004, a football-loving physicist at the University of Nebraska named Tim Gay set out to calculate the magnitude of a Dick Butkus hit. Applying Newton’s second law of motion, he calculated that Butkus, who played at 245 pounds (about 30 pounds lighter than many linebackers today), generated 1,150 pounds of force when slamming into a running back of approximately the same size. “That’s the weight of a small adult killer whale!” Gay added helpfully. But rarely did fans dwell on the implications for the men on either side of that transaction.
And then, one Saturday morning in 2002, an obscure forensic pathologist cut open Mike Webster’s skull.
That decision—and its consequences, growing by the day—is the subject of this book. There has never been anything like it in the history of sports: a public health crisis that emerged from the playing fields of our twenty-first-century pastime. A small group of research scientists put foot-ball under a microscope—literally. What they found was not the obvious, as many people later would claim. We all knew that football was violent and dangerous, that one hit could break your neck or even kill you. No, what the researchers were saying was that the essence of football—the unavoidable head banging that occurs on every play, like a woodpecker jackhammering at a tree—can unleash a cascading series of neurological events that in the end strangles your brain, leaving you unrecognizable.
The researchers who made this discovery—you could count them on one hand—thought NFL executives would embrace their findings, if only to make their product safer. That is not what happened. Instead, the league used its economic, political, and media power to attack pioneering research and try to replace it with its own. Its resources, of course, were considerable. For years, the NFL would co-opt an influential medical journal whose editor in chief was a consultant to the New York Giants. The league used that journal, which some researchers would come to ridicule as “the Journal of No NFL Concussions,” to publish an unprecedented series of papers, several of which were rejected by peer reviewers and editors and later disavowed even by some of their own authors. The papers portrayed NFL players as superhuman and impervious to brain damage. They included such eye-popping assertions as “Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.” The NFL’s flawed research was shaped by a web of conflicting interests. Riddell, the league’s official helmet maker, used the re-search to create and successfully market a helmet it claimed significantly reduced concussions in children—a claim that triggered an investigation by the Federal Trade Commission, which concluded it was false.
The NFL’s strategy seemed not unlike that of another powerful industry, the tobacco industry, which had responded to its own existential threat by underwriting questionable science through the creation of its own scientific research council and trying to silence anyone who contradicted it. There are many differences, as we shall see, but one is that football’s health crisis featured not millions of anonymous victims but very public figures whose grotesque demises seemed almost impossible to reconcile with their personas. One eight-year NFL veteran would kill himself by drinking antifreeze. Another prominent player would crash his Ford pickup into a tanker truck while leading police on a high-speed chase. Two players, Dave Duerson and Junior Seau, would fire handguns into their chests; Seau, one of the finest linebackers to play the game, used a .357 Magnum that his family didn’t know he owned to shoot himself in a guest room of his beach house filled with the memorabilia of a 20-year career. As the crisis grew, the brains of those famous players became valuable scientific commodities. A macabre race ensued among researchers to harvest and study them—even while the bodies were still warm. Minutes after Seau’s body was carted out of his house, his oldest son, Tyler, began getting calls seeking his father’s brain.
The story is far from over. As this book was being written, nearly 6,000 retired players and their families were suing the league and Rid-dell for negligence and fraud. Their argument was that the NFL had “propagated its own industry-funded and falsified research” to conceal the link between football and brain damage. One week before the start of the 2013 season, the NFL settled the case—agreeing to pay the players $765 million, plus an expected $200 million in legal fees. The NFL did not admit wrongdoing, but the settlement hardly resolved the question at the core of the league’s concussion crisis: How dangerous is football to one’s brain? Unlike smoking, there was no scientific consensus about the risks of playing football. One neurosurgeon connected to the NFL said children were more likely to sustain a brain injury riding a bike or falling down. Another neurosurgeon, also connected to the league, called for abolishing tackle football entirely for children younger than 14.
The prevalence of chronic traumatic encephalopathy (CTE) —the name for the insidious disease found in the brains of Seau, Duerson, and the others—is also unknown. The leading expert on the subject is a blond Green Bay Packers fan named Ann McKee, who works out of a redbrick building at the Department of Veterans Affairs outside Boston in an office cluttered with football helmets, bobblehead dolls, and a Packers cheesehead resting atop a plastic heart. In a nearby building, the largest collection of NFL brains is stored in a freezer at −80 degrees Celsius.
By the fall of 2012, McKee had examined the brains of 34 former NFL players. Thirty-three had CTE. We asked her what percentage of NFL players probably had it.
The following exchange ensued:
McKee: I don’t think everybody has it, but I think it’s going to be a shockingly high percentage.
Question: If you believe that there is a shockingly high number of football players who are bound to suffer from it, how can we even justify having people play professional football?
McKee: Well, I think, you know . . . how come I just don’t say, “Let’s ban football immediately”?
McKee: I think I would lose my audience.
That brings us back to the question: What’s in it for ESPN to support this book? Why would the network that stages the rough equivalent of a Harry Potter movie every week let us dig into a subject that examines the darkest underside of the network’s biggest product.
ESPN—itself worth an estimated $40 billion—subsists on sports information, any sports information, much the way the Wall Street Journal and CNBC subsist on financial information. “The value of the NFL to us is the ubiquity of the sport across all our platforms all the time,” John Skipper, now ESPN’s president, explained to the New York Times when asked about the staggering contract in 2011. “It’s just stupendous for us. It’s daily product—we don’t have a day without the NFL.”
From its modest beginnings, journalism has been part of ESPN’s DNA. We work out of a cubbyhole of the empire, an investigative reporting unit with the unusual mandate to investigate the very products that ESPN is selling. It is, in many respects, a journalistic mine-field. But for a network that traffics in sports information, one piece of sports information is in particularly high demand these days: Is football killing its players?
Do we really want to know?
“You mean that guy who was on TV?” Bennet Omalu asked his colleagues as he arrived at the coroner’s office.
Omalu had seen the reports of Webster’s death, the stories about his life unraveling over the final few years. Omalu didn’t think much about it. He had never attended a football game. He found the sport brutal and strange, “extraterrestrials running around a large field and tackling one another, sometimes in a ferocious manner.”
Omalu himself was something of an alien. At that moment, his visa had lapsed, and he was in the process of renewing it to stay in the United States. He was a small man, about 5-feet-6 and black, with a voice that went up several octaves when he was excited, which was often, and a perfectly round head, like a 16-inch softball. Omalu had been born in the middle of Nigeria’s civil war in the short-lived secessionist nation of Biafra. He came to the United States in 1994 and immediately began collecting degrees. He obtained his medical license in Indiana and Pennsylvania (later he would add California and Hawaii); an MBA; a master’s degree in public health; and board certifications in anatomic pathology, clinical pathology, forensic pathology, neuropathology, and medical management.
Omalu’s specialty was the science of death.
A deeply spiritual man, he believed, in fact, that he could talk to the dead. Before dissecting his subjects—murder victims, people who had died of unknown or suspicious causes—he carried on internal conversations with the people laid out before him, imploring the dead to help him figure out what had caused their demise.
Now he talked to Webster.
“Mike, you need to help me. I know there’s something wrong, but you need to help me tell the world what happened to you.”
Omalu used a scalpel to make a Y-shaped incision along the length of Webster’s torso. He peeled back Webster’s abdomen, which was thick and taut from the embalming fluid. He removed Webster’s rib cage with a small oscillating saw. He inspected the internal organs in situ and then removed them one by one. He weighed the organs—the liver, the pancreas, the heart—on a scale and then sliced them into pieces on a plastic cutting board before placing them in jars.
The assistant then propped up the back of Webster’s head on a rubber tee. She made incisions across the scalp and over the ears. She pushed the rough skin of Webster’s forehead over his eyes and pulled back his scalp to reveal the top of his head. To see the skull exposed is to understand the preciousness of its contents, the brain’s utter indispensability to who we are. The brain sits inside a quarter-inch-thick vault of bony plates, in a bath of cerebrospinal fluid. It is not easy to remove. The autopsy suite filled with the high-pitched whine of the circular saw as bone dust rose from Webster’s head.
For all the punishment Webster’s body had absorbed, his brain looked normal. It had no visible bruises or aneurysms within its soft gray folds. In its natural state, the brain is almost gelatinous; to examine it further would require soaking it for weeks in a tub of formaldehyde and water, a process known as fixing. The process stiffens the brain until it can be sliced like pound cake and then shaved into slivers to be viewed under a microscope.
But that wouldn’t be necessary here. The official cause of Webster’s death was “acute myocardial infarction”—a heart attack. The assistant began to gather Webster’s brain with his other organs, to be placed back inside his body.
Omalu paused. The death certificate had noted somewhat mysteriously that Webster suffered from “depression secondary to postconcussion syndrome.” Omalu thought about the reports he had seen on television that morning about Webster’s erratic behavior. He thought about a previous patient, a battered woman whose autopsy had shown signs of brain disease. “It was a decision that you just make in the spur of the moment,” he later would say.
“Fix the brain,” he ordered.
The assistant balked. Webster’s brain was normal, wasn’t it? He had died of a heart attack.
“Fix the brain,” Omalu said, this time more firmly.