Concussion: A Player's Life Sacrificed

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Science and Technology Game Changers

Bob Fitzsimmons, lawyer for now deceased football great “Iron Mike” Webster, shared his insight with me on the subject of Chronic Traumatic Encephalopathy (CTE) in sports, particularly the NFL.

The realization of head gear protection being important is not new. In 1888, college football rules only allowed tackling below the waist. Men grew their hair long thinking it would protect their heads. In 1893, U.S. Naval Academy Midshipman Joseph Reeves had a protective device made for his head in order to play in the Army-Navy game after a doctor told him that he must give up football or risk death from another kick in the head. Helmets became a mandatory piece of equipment at the college level in 1939 and at the NFL level in 1943.

Concussion: A Player’s Life Sacrificed

When Fitzsimmons originally took Webster’s case, he thought it was an obvious one of someone who had been disabled, and the causation was due to trauma for the 17 years that Webster, #52, played center for the Pittsburgh Steelers. He never anticipated that the NFL would throw up obstacles for everything they attempted to do in the case.

“I didn’t expect it to be what it was,” said Fitzsimmons. “I thought it would be a much more straightforward case. It ended up in massive litigation that lasted for a period of nine years.”

If you are familiar with the lawsuit, you know that Fitzsimmons won.

I asked him if sports medicine has progressed as far as he hoped following the CTE discovery. “The progress for cures, methods to diagnose medical conditions and diseases is never fast enough,” said Fitzsimmons. “It just never is.”

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People’s lives are tragically impacted by these diseases. We have to jump through hoops in order to get the research done properly. He believes it is wonderful and has been an eye-opening experience for the world that something that was in existence for so many years, brain injuries as a result of football and other sports, is finally coming to light. He is also really pleased with the response that has occurred academically.

“There are amazing things people are thinking about to try to eliminate the actual cause of the disease,” said Fitzsimmons, “and that is the contact with the brain when the brain hits up against the skull.”

He is very involved in research aimed at preventing the disease’s causes as well as a company that believes they have the diagnostic tools.

“We own a patent that we purchased from UCLA that can actually take scans of the brain in living individuals to help diagnose CTE,” said Fitzsimmons. “The science is fascinating — we are starting on one of our last phases of study.”

They just did the brain of football great Fred McNeill who played for the Minnesota Vikings. They scanned McNeill’s brain when he was still alive at UCLA in 2011/2012 and published a paper on it in 2013, along with the findings on four other NFL players. McNeill was the first person that they had been able to scan during his lifetime that passed away and they were also able to do his brain autopsy.

Fitzsimmons is a director of the Brain Injury Research Institute, along with Dr. Julian Bailes, Dr. Jen Hammers and Dr. Bennet Omalu, who the movie ‘Concussion’ was based on. The doctors do the brain autopsies and he looks at the slides, writes papers and helps the doctors to formulate opinions on the research being done.

“I have often wondered why people never embraced the issue of contact sports causing damage to the brain and didn’t look at it more seriously prior to Mike Webster’s case,” said Fitzsimmons. “I read many articles from the 1890s through 1940s. There was actually quite a movement back in the day when football first started in America. People were concerned about the significant head injuries and concussions, but the sport continued to grow. The masses didn’t appreciate the impact that the blows in football were having on young men’s brains back in those days. They came up with the helmet, but the helmet just basically protects the skull from fractures, it doesn’t really protect the most valuable organ in our body, the brain. At least arguably, the brain is the most valuable.”

Fitzsimmons believes Mike Webster’s case caught the public’s attention because it was the first case that anyone ever won and alleged permanent disability as the result of brain injury from football activities. When the paper Dr. Omalu wrote on his findings related to Webster’s brain autopsy hit the press, the NFL got very upset.

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“Two significant events then occurred,” said Fitzsimmons. “One, a bunch of our team went to DC and testified before Congress and one of the Congresspersons went after Roger Goodell, Commissioner of the NFL, and called him on the carpet and said this is a real problem. You are not doing anything. We are going to revoke your antitrust exemption and we are going to look into your taxes with the NFL unless you tell me that you recognize this is a problem. Goodell was then forced to recognize the brain conditions as a result of football related activities. Next, Dr. Joe Maroon, a famous neurosurgeon out of Pittsburgh, and Davies, a pathologist from New York, came down to Morgantown, WV, to meet with Dr. Omalu, Dr. Bailes and myself, reviewed slides and took those findings and went back to the NFL — that’s when changes began to be made.”

Recently, people have been questioning more whether youth sports are reacting to these findings and protecting their players well enough. Fitzsimmons believes it is a controversial question — there are oftentimes two or more schools of thought on how to address a problem.

Some people believe that youth playing football really does not have any impact, and the problems they have with concussions are not a major problem. Others believe that because their brains are still being developed, young people should not play any contact sports at all. However, it is not just the concussion caused by a blow to the head that’s detrimental. Sub concussions, the ones that are near misses, are equally harmful. That’s an important aspect of the conversation.

There are also those who believe you should not play at a young age when you cannot consent to participate in a sport that could damage you for life. This is especially true considering it’s a stage in your life when your brain is still growing, and damage to it could be more profound.

“I don’t know who’s right or who’s wrong,” Fitzsimmons said. “But if we correct the entire sport from top to bottom it’s going to make it safer.”

Fitzsimmons made it clear that he is not in any way advocating banning football or doing away with it.

“I think football is a great sport and has some wonderful attributes,” said Fitzsimmons. “It creates a spirit of camaraderie, teamwork, leadership, sacrifice and courage. It’s up to others to decide if those pluses outweigh the chance that a child could end up at some age with significant brain damage that may cause all sorts of psychological problems – loss of memory, aggression, suicide attempts and more. It’s something that we as a society need to decide – is this something we want?”

Taking it to the next level, I asked Fitzsimmons if he felt the NFL was doing enough by putting a certified athletic trainer in the press boxes and a neurosurgeon or person with brain trauma expertise on the sidelines at each game to help monitor head injuries.

“That’s just a piece of the puzzle,” said Fitzsimmons. “It requires a lot more. It is my understanding from the statistics that the amount of concussions in the NFL was the greatest this year than it has been in three or four years. So whatever they’re doing doesn’t seem to be helping. There is much more that can be done. I think that the manner of play needs to be changed. I’ve advocated for years that the linemen instead of being in a three-point stance, be in a two-point stance because when you go to three-point, you automatically put the head in to the game — we need to look at all the rules to take the head out of the game.”

There is also a lot of technology that is being tested and researched right now. For instance, there’s an outfit that has a collar that causes pressure to the arteries that allows more blood to be in the vault of the brain, and by putting more fluid in there you have less ability for the brain to move. The brain sits in the bath of fluid and when motion is abruptly stopped and the body continues forward, the G-forces allow the brain to hit up against the skull itself.

Another item they are experimenting with is a skull cap with monitors. It is similar to a hair net, and the little monitors on it transmit any forces that are exerted to the different parts of the brain to a handheld computer on the sideline that measures it. These are just a few of the great things people are doing to help on-field study.

Off-field study such as genetic testing is also being performed.

“We’ve done genetic testing on about 40 brains including hockey, football, boxing and wrestling,” Fitzsimmons noted. “We collected entire brains to study. We also collected blood and fluids in order to conduct additional studies. It’s all part of the puzzle, determining whether or not people with a certain gene are more apt to develop CTE than others. They actually identified some genes they’re looking at, one is called APOE4. They’re looking at it to see if it has statistical significance. If we found out that little Johnny or Susie has that gene, is he or she more apt to develop CTE?

Fitzsimmons is fascinated by the research being done now.

“That’s why the story doesn’t go away,” said Fitzsimmons. “The story is where everybody shakes their head and asks why didn’t we do this before Mike Webster? Why wasn’t all this research being done? Why wasn’t there caution and changes being made? People had their ideas. The what keeps the story perpetuating.”

Also, it involves people that are the icons of our society. We look up to athletes in this country. Every kid wants to be a football player, race car driver, hockey player or some famous athlete.

“Our society is based on sports in large part,” said Fitzsimmons. “That’s why you don’t want to throw the game out. You want to try to make it safer and make sure that’s going to be acceptable.”

We all know that there are risks in life. If people are willing to take reasonable risks then that’s okay, but they should also be firmly aware of the dangers involved.

“We don’t want to send a young man out who wants all the money and fame in the world, which many of our youth do, without knowing what he is getting into,” said Fitzsimmons. “You may end up with permanent brain damage and not be able to find your car keys when you are 50 years old and have to have people drive you around. That’s a major consequence to consider and realize.”

Fitzsimmons is very pleased with the steps that have been taken so far to help to make the sport of football safer, but he believes a lot more needs to be done.

“The ultimate goal is to eliminate brain injuries and hopefully, one day, develop a cure for CTE,” he stated.

Exciting new technology like the skull cap with monitors is making a difference. The future looks promising as scientific knowledge advances and produces other significant beneficial game changers.

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