Five years ago I made a video about how dangerous tackle football is, especially for little kids. I was motivated by a few doctors who came forward to say, basically, “Look, the science is clear: one concussion as a kid is too many, it screws up their cognitive ability for weeks, it can lead to lifelong problems if there are repeated injuries, and scientists have to gather together as one to say that this is a public health menace.”
After reading their report, I was convinced that even though I, personally, love to watch and play football, we should not allow children to play tackle football and we need to change the rules and the equipment for everyone to reduce the risk of brain injury.
That same year, there was a growing public concern over brain injury in football players, as people learned about chronic traumatic encephalopathy, or CTE. CTE is a disease that results from repeated injury to the brain, in which tangles of a protein called “tau” end up bunching up all over the brain. These abnormal tau tangles are found in brains as people age, but when there are a lot of them that indicates a serious problem, like Alzheimer’s. Researchers discovered these abnormal tangles near the blood vessels in the cortex of football players who died young, suggesting that it was caused by repeatedly hitting the head. It also correlated with serious behavioral issues, like criminal activity and violent rage.
The same year I made my video, Will Smith starred in the film Concussion, about one of the researchers who discovered CTE in football players. I’m not saying that my and Will Smith’s achievements are equal, I’m just pointing out that 2015 was a big year for people really beginning to take notice of what was happening. The researchers had been looking at the connection for years, but the NFL worked very hard to silence them and pretend as though there was no epidemic happening amongst their players.
Eventually the NFL admitted that the evidence was overwhelming and they started to do something about it, sort of. Like, they definitely now run ads during games bragging about the new helmet technology they’re working on, which is…something. So in my head, for the past few years I’ve had this idea that the NFL is generally an evil corporation that tried to downplay and hide a serious health concern while these researchers were good and smart and, well, scientific.
But a new series from the Washington Post has revealed that, like Dr. Ben Goldacre is fond of saying, I think you’ll find it’s a bit more complicated than that.
I never saw Will Smith’s film but apparently Concussion focused on the real-life doctor Bennet Omalu, one of several researchers who was looking into CTE and was bullied by the NFL over his findings. The Post points out that while Omalu was one of the early researchers who found the connection between CTE and football, his science was, well, not sound. His big break was examining the brain of “Iron Mike” Webster, an NFL player who died in 2002 at the age of 50 of a heart attack. Omaul published a paper claiming to find evidence of an abundance of tau bundles in his brain, suggesting CTE. The problem was that the photos he published as proof didn’t show CTE…they just showed a few tau that could have been considered normal for a man of 50.
Other researchers agree that Webster probably did have CTE, but the paper doesn’t do a good job of proving that, and Omalu has stashed away Webster’s brain and refuses to talk about it. His own partner in that research suggests that the photo mix-up was probably because Omalu didn’t really know what he was doing. “He wasn’t an expert,” said Alzheimer’s researcher Peter Davies. Eek.
It gets worse, though. Omalu has transformed himself from researcher to paid consultant who earns nearly a million dollars a year testifying in court cases and diagnosing CTE pretty much in every brain he sees. Other experts in CTE, like Ann McKee (neuropathologist for Boston University’s CTE Center) point out that Omalu has gone off the deep end by describing a variety of CTE he calls “incipient CTE,” which can be diagnosed by seeing “a combination of none to sparse” abnormal tau in the cerebral cortex. The researchers point out that literally the only way to recognize CTE is by dissecting the brain of a deceased person and noticing the large number of tau tangles near blood vessels deep in the cortex. You can’t say “oh there’s also this other CTE where none of that is there.” It’s like saying the defining characteristic of a couch is having cushions, then pointing to a boat and saying “this couch’s defining characteristic is that it has no cushions.” That’s…that’s not a couch. That’s a boat.
And while brain disease experts agree with Omalu about the danger of football, and especially the advice that young kids should not play tackle football, they disagree with his assessment that that holds true of pretty much every other contact sport out there. There isn’t much evidence to be worried about hockey, wrestling, or martial arts, but Omalu is insisting that all of these things should be off limits to kids. When asked where the science was to back up his recommendations, he leans on one study out of Sweden on people with traumatic brain injuries before the age of 25. The lead researcher in that case says that Omalu is grossly misunderstanding the study.
It’s all pretty fascinating and sad, because I love the story of scientists investigating a mystery and then coming up against a huge, admittedly evil corporation that is trying to silence them. But I’m glad I read the Washington Post piece about Omalu, who many people probably don’t know may actually be a quack, especially if they only know of him through the movie Concussion. He’s making big money with bad science, and I wanted to let you all know about it because I’ve previously talked about this issue in a way that, even though I never mentioned his name, may lend credence to him. Omalu may have been right about the connection between football and CTE back in 2015, but that doesn’t mean he’s been right about anything since.