Patrick Hruby: Head Games

Jan 16, 2013
EDITOR’S NOTE: A long piece well worth the read from Patrick Hruby detailing the long history of denials and worse on the part of the NCAA when it comes to concussions. Many of the retired players may still remember (or not!) how concussions were largely ignored when you played in college and how that culture followed you into the NFL. The parallels to the League’s history of denial is not surprising, right down to their current battles with insurers over litigation coverage. (Patrick did a lot of research for this piece. There are a lot of links within this article that are also well worth clicking and reading.)
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Re-posted with permission from Patrick Hruby:
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January 16, 2013

Head Games

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Ramogi Huma wasn’t asking for much. Just for a chance to speak. An opportunity to share a few commonsense ideas about how to make college football slightly safer and more humane for its on-field participants, the young men putting their brains and futures at risk, in part, so that credit card companies and fast food taco peddlers can more easily reach potential customers.
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Reduced contact during practices. Limiting the number of regular-season games. Independent sideline concussion experts. More medical and epidemiological research. Support for brain-damaged former players. Simply warning players about degenerative brain conditions associated with contact sports. These were the major components of the plan — drawn up by the National College Players Association, an advocacy group made up of more than 17,000 current and former college athletes — and in his role as the organization’s president, Huma hoped to hold a press conference on the eve of the BCS championship at the game’s official media hotel, the better to tout the notion that maybe, just maybe, the sport should mandate all of the above. And perhaps set aside a chunk of its upcoming annual $300 million reported playoff payday for player health and safety.
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So what happened?
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“We had it all squared away with the hotel,” says Huma, a former linebacker for UCLA. “At the last minute, they checked with the BCS, who told them that they didn’t want to have anyone else putting on an event there.”
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Huma drove to the hotel anyway. He distributed a press release by hand.
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“When I got to the hotel, those press rooms weren’t booked for the time we had asked for,” he says. “They weren’t even being used. To think that player safety is such a low priority — or, even worse, to think that the people that have the power to better protect players are actively avoiding the issue or running away — that’s disturbing.”
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Of course, Huma wasn’t totally surprised. The National Collegiate Athletic Association has ignored him. So have all of the big-time, bigger-money Football Bowl Subdivision conferences, with the lone exception of the Pac-12, which met with Huma last September. “I thought that went well,” he says. “They were really open to our concerns. All the other conferences, they really don’t seem concerned to the point of any action. There’s a lot of silence.”
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While football at every level is struggling with the issue of brain trauma — it’s hardly hyperbole to call it an existential crisis – the college game’s response has been to do … well, not a whole lot. No systemic effort to reduce injury risk. No comprehensive concussion diagnosis and treatment protocol. No serious blueprint from the NCAA, which typically takes a Supreme Soviet-shaming approach to governing amateurism, crafting and enforcing endless, nit-picky rules that cover everything from text messages to high school recruits to permissible bagel toppings, all in the name of protecting athletes.
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You might think potential brain trauma would fall under the ever-expanding umbrella of the NCAA’s warm, solicitous concern. After all, colleges and universities have a longstanding moral duty to act en loco parentis. Football can be hazardous to cognitive health; experts say that the still-developing brains of college-age men are particularly vulnerable to injury. If the NCAA’s television commercials and justification for its tax-exempt status are to be believed, campus sports are supposed to help develop young minds, not damage them. Indeed, given that making football acceptably safe was the NCAA’s original raison d’etre — the organization was founded in 1906, after Teddy Roosevelt summoned campus administrators to the White House to address a rash of gruesome football injuries and deaths — you might think that sheer institutional muscle memory would prompt college sports’ governing body to adopt a more aggressive, less laissez-faire approach.
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Guess again.
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Take potential trauma exposure. Less hitting equals less chance of injury: It’s an elementary formula, physics and biology 101. An obvious place to make changes, right? In 2011, the Ivy League limited full-contact football practices to two days a week. But no major conference has followed suit. Nor has the NCAA mandated that they do so — never mind that medical science indicates that cumulative sub-concussive brain trauma (accumulated little hits over time) may be as dangerous as obvious, full-blown concussions; that brain trauma safety advocates such as Chris Nowinski of the Sports Legacy Institute have called for reducing the number of hits absorbed by football players at all levels, particularly for younger athletes; that both the NFL (one full-contact practice per week) and Pop Warner have slashed allowable practice contact accordingly; that a 2010 National Institutes of Health study found that college football players sustain more hits to the head in practices than in games; and that NFL Players Association president Domonique Foxworth recently told HBO’s “Real Sports” that unpaid college players now take more hits than their professional counterparts.
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Since 2010, the NCAA has required schools to have concussion management plans that: (a) inform athletes about the signs and symptoms of concussions; (b) remove athletes who show signs of a concussion from play; (c) prohibit students with concussions from returning to play the same day they were initially injured. The organization also has donated $400,000 to research head impacts in sports and recently appointed a neurologist as its first chief medical officer. Beyond that?
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To borrow from Tony Kornheiser: That’s it. That’s the list.
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Better than nothing? Sure. But frankly, not by much. The first two concussion plan points are obvious and far past due. The third is a bare medical minimum. The $400,000 donation is less than half of what Outback Bowl CEO Jim McVay earned in 2008 alone. Small wonder, then, that Nowinski says college football is “asleep at the wheel.” Or that a UCLA Entertainment Law Review article is titled “The NCAA Needs Smelling Salts When It Comes to Concussion Regulation in Major College Athletics.” Published last year, the 43-page piece argues that the organization has failed to adequately educate and protect college athletes.
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From a moral and practical standpoint, it’s hard to disagree. Unlike the aforementioned bagel topping rules, the NCAA’s concussion policy is a set of vague guidelines, the implementation of which is left in the hands of schools. There is no NCAA brain trauma clearinghouse, no compliance office, no monitoring staff, no get-tough punishment of programs that fail to protect athletes from potentially life-altering cognitive harm, as opposed to the unspeakable horror of talking to sports agents. What’s the NCAA’s plan for helping young men avoid the fate of Adrian Arrington, who in a lawsuit filed against the organization claims he suffered numerous concussions while playing football for Eastern Illinois and now suffers from memory loss, depression, seizures and near-daily migraines as a result of his injuries? Or to keep players like Arrington from joining the nine confirmed cases of the degenerative brain disorder chronic traumatic encephalopathy (CTE) that Boston University researchers have found in players whose football careers concluded with college? Telling its member institutions, Hey, guys, you really need to have a plan.
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“You have to question the integrity of a group that chases 17- and 18-year-olds around the nation to make sure they don’t get a free T-shirt on a recruiting trip, but when it comes to severe, long-term health consequences of football, they pretty much defer to the schools,” Huma says. “The NCAA moves heaven and Earth to pretend amateurism is real to maximize profits. The conference commissioners wanted a playoff for college football. They held meeting after meeting after meeting — and they got it. It’s pretty clear that if either made player safety a high priority, they could implement reform. That’s the reason we approached them. They have the power.”
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If the NCAA (and, to a lesser extent, the BCS conferences) have the power to unilaterally enact health and safety measures, then why are they largely sitting on their hands? The answer lies in legal liability. Or, more accurately, the calculated ducking thereof. “The NCAA is purposely taking a hands-off approach and delegating any legal responsibility to its individual member institutions,” says attorney Paul Anderson, publisher of NFLconcussionlitigation.com. “I think they believe that if they were to even start enforcing their one-line policy that says schools must have a concussion management plan in place — like the NCAA does with contact between players and agents — they would be seen as pretty much the guardian of player health and safety and would then owe a duty to all student athletes.”
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In other words: If the NCAA doesn’t acknowledge college football’s brain trauma problem in anything but the most general terms, and doesn’t try to do anything about the problem beyond making a few general suggestions, then neither a judge nor jury will be able to hold the organization responsible when the sport produces life-altering injuries and subsequent lawsuits. “I use the analogy of walking down an aisle in a grocery store, and somebody falls over and has a seizure,” Anderson says. “As an individual, you don’t have a legal duty to help them. Morally, you probably do. But the moment you voluntarily assume a duty by picking them up or standing by them, then legally, you now have put yourself in a position where you must act reasonably. Otherwise you can be held accountable.”
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By declining to create and enforce a stronger brain trauma policy — by walking past the seizure victim — the NCAA avoids legal duty, and likely has strengthened its defense against a current class-action lawsuit alleging that the organization has been negligent regarding awareness and treatment of brain injuries to athletes. (Some school districts and youth football leagues have rejected enacting safety measures for similar reasons).
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In 2009, Philadelphia’s La Salle University paid $7.5 million to settle a lawsuit brought by the family of Preston Plevretes, a football player who suffered a severe brain injury in a 2005 game following a mismanaged previous concussion. The school admitted no wrongdoing, but no longer has a football program. The NCAA was untouched. By contrast, the National Football League almost certainly weakened its defense against an ongoing class-action concussion suit filed by more than 4,000 former players by creating a Mild Traumatic Brain Committee in 1994. (The NFL committee reportedly hiding and attempting to discredit scientific links between concussions and long-term brain damage doesn’t help, either.) Still, Anderson says, “with all that legal mumbo jumbo aside, the NCAA has failed to protect players. Morally, they have that duty. They have the ability to put things in place. They don’t want to end up facing tons and tons of threats in court. It’s unfortunate. It’s terrible. The players have no voice and no power to leverage. They’re left to fend for themselves.”
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Last season, Southern California receiver Robert Woods absorbed a jarring helmet-to-helmet hit from a Utah defender. He got up, staggered toward the wrong sideline and fell to the ground, face-first. He reportedly took and passed a sideline concussion test not by undergoing a careful exam from a trained neurologist, but by correctly answering three questions: Who is the current president? What is today’s date? What is 100 minus seven, minus seven, minus seven? Woods missed one play before returning to the game; afterward, a teammate said, “There’s no way you’re gonna have Robert sit on the bench, no matter what it is,” while coach Lane Kiffin praised him for being a “tough kid.”
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Tough like Arizona quarterback Matt Scott, who last October absorbed two hits to the head during a single play against USC, vomited on the field and remained in the game to throw the winning touchdown pass. Tough like Connecticut quarterback Chandler Whitmer, who last November suffered a concussion against Louisville and then took two more hits to the head — one of which he described as “a bullet” — against Cincinnati the next week before being sidelined. Schools are not forthcoming with medical information, but had any of the three players been concussed and allowed back on the field, they would have been put at risk for second-impact syndrome, in which a second concussion causes the brain to swell rapidly and catastrophically. The result? Severe disability or death.
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Yet none of the schools involved were fined or disciplined by the NCAA. None were even subject to an investigation. Had Woods, Scott and Whitmer been photographed in a Lamborghini parked outside a tattoo parlor passing around a bong, they likely would have sent the NCAA’s compliance department to DEFCON level 1. Instead, Huma says, all three players were left to fend for themselves.
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“That’s why our plan calls for the NCAA to have independent concussion experts on the sidelines,” he says. “Right now, team doctors make decisions, and they are put into place by athletic programs. Normally, a doctor very clearly sees his or her patient as their number one priority. But if you’re officially a team doctor, you have a conflict of interest at times. What’s best for the athletic program is not necessarily best for an individual player’s health. With Robert Woods, if it was the fourth quarter and USC had been up by three or four touchdowns, would he still have been sent out there? The team doctors and coaches are heavily incentivized to win games at all costs.”
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Huma’s organization began developing its brain trauma health and safety plan last spring. Former college and pro linebacker Junior Seau had just committed suicide, and during a weekly NCPA conference call, participants were in shock. (The NIH reported last week that an independent examination of Seau’s brain revealed abnormalities consistent with CTE). They saw the NFL cracking down on helmet hits and discussing eliminating kickoffs, trying to do something; they saw youth football following suit. But the NCAA? Zilch. “It’s the players whose health is on the line when they suit up every day and every practice,” Huma says. “They should have some say.”
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The 2010 NIH study found that football players at Brown, Dartmouth and Virginia Tech averaged about 2,500 total hits to the head over the course of a season during practice; 300 of those were forceful enough to cause concussions. Those numbers, the NCPA argues, can be reduced. Outside of anecdotal evidence, no one knows how prevalent brain damage is among former college players, nor how many of them need help. That can be studied. When current players suffer brain injuries, the NCAA and its member schools are under no obligation to cover subsequent medical expenses. That can be changed. Schools currently are not even required to tell athletes about the dangers of CTE and other long-term health risks that are associated with contact sports. That education — necessary and overdue — could start tomorrow.
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Huma says the current and former college athletes he works with understand that football is a violent, dangerous sport. They don’t expect the NCAA to eliminate risk. They do expect the organization to try. “Everyone knows football is a brutal game,” Huma says. “But we were never aware of the full toll until the last few years. There needs to be more of an informed consent in that aspect. One of the things we currently have is a culture among players who play even if they suspect they have a concussion. Our own players’ council said that the best shot of changing that is to educate athletes about the severe potential consequences of those actions.”
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Three years ago, University of Pennsylvania football captain Owen Thomas hanged himself in his off-campus apartment. He had no history of depression or mood disorders. He was 21. Five months later, pathologists found that he was in the early stages of CTE, making him at the time the youngest football player to be found with clear evidence of the disease. Morgan Thomas, Owen’s brother, supports the NCPA plan. “Owen would want his death to shed light on the issues with brain trauma,” he says. “He would want to help fellow college athletes.”
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Rep. Linda Sanchez (D-CA) wants to help, too. During Congressional hearings held in 2009, she grilled NFL commissioner Roger Goodell about the league’s neglectful, duplicitous handling of active and current players suffering from brain trauma. Pro football was shamed into action, sacking its previous concussion committee, donating money to medical research and establishing a uniform concussion management plan. “For years and years, the NFL denied that multiple hits to your head could cause any kind of serious, long-term brain damage or injury,” Sanchez says. “As a result of the hearings we did, that has changed. So clearly when we shine a light on an issue, generate publicity and awareness, that can be a catalyst.”
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(If you’re wondering why Congress hasn’t held the NCAA’s feet to the fire: Rep. Sanchez has asked Rep. Lamar Smith (R-TX), the Judiciary Committee chair, to hold additional head injury hearings. Smith has not responded. Last year, the NFL’s political action committees gave Smith $25,000 in contributions, part of nearly $877,000 that the league’s Gridiron PAC handed out on Capitol Hill. Sanchez did not receive a cent.)
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“The NCAA is probably standing in the shadows thinking that nobody is paying attention to them,” Sanchez says. “If I ran the zoo — which I do not — it would definitely be a topic worthy of [Congressional] exploration.  I get that there are some practicality issues involved [with the NCAA doing more to address brain trauma in football]. But when you say, ‘We’ll leave it to each conference to develop a protocol,’ that means nothing is going to happen. People don’t generally act unless you provide an incentive to act or a disincentive not to act. It’s pretty clear the NCAA is not hands-on with this.”
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Is the NCAA failing to act out of legal self-interest? Almost certainly. Out of unchecked inertia? Perhaps. After all, the organization owes its existence to Roosevelt’s prodding. That said, perhaps the NCAA is simply being realistic. If it does adopt the NCPA plan, or something like it, then the organization takes on the duty Anderson described: the duty to act reasonably. And when it comes to brain trauma in football, does anyone know what a reasonable level of caution actually entails?
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The NCAA’s insurers don’t want to defend or indemnify the organization against the current class-action lawsuit. Concussions are notoriously difficult to diagnose and treat; return-to-play guidelines range from one week to “50 years”; the brain itself largely remains a black box of medical ignorance. Independent sideline neurologists are a wonderful idea, but there are dozens of big-time college football games every week and dozens more at the sub-Division I level, where young men’s brains are no less fragile. How many truly qualified evaluators are even available? “Most neurologists don’t deal in acute concussions,” says Matt Cheney, a football historian and author of “Spiral of Denial: Muscle Doping in America Football.” “I have one huge source in concussion science who tells me that there are probably only 5-10 people worldwide who can stand on a football sideline and diagnose concussions within a margin of only 10 percent error.”
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Cheney played college football. He took more hits to the head than he can remember. In his 30s, he started getting headaches, vision problems, vertigo. He is now 52. He wonders if the worst is yet to come, wonders if even the best-intentioned safety reforms will make any difference. Cheney cites an article, “The Football Situation,” written by a Yale professor in response to public outcry over the game’s brutality. The author extolls college football as a character-building exercise nonpareil. He describes critics as know-nothings, health and safety concerns as overblown. Grudgingly acknowledging a need for reform, he suggests stricter rules, better coaching and input from doctors and experts, all managed by caring, responsible administrators.
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The article in question was written in 1884. Sound familiar?
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“I think we’re still playing the same old circle chair game that football loves to play,” Cheney says. “The NCAA does this better than anyone, and in terms of morality and the stated ideologies of higher education in this country, I think they’re the biggest fraud of them all. Football is an ass-kicking blood sport. I got a lot of satisfaction knocking the [expletive] out of people on the field. Anyone who says this game can be safe is lying. The only thing you can do is tell the truth and warn people. Warn them. You’re not going to change this game, you know?”
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Patrick HrubyPatrick Hruby is a contributing writer for Sports on Earth. A culture writer for The Washington Times, his work has appeared in The Washingtonian, ESPN The Magazine and on ESPN.com, The Atlantic online, The PostGame, ESPNw, Business Insider and The Guardian online.
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One Response so far | Have Your Say!

  1. Dave Pear
    January 19th, 2013 at 8:50 am #

    Dave at Home

    A recent piece from the San Francisco Chronicle:
    NFL concussion suits could hit hard
    Bob Egelko

    As National Football League teams prepare for the next round of the playoffs, the NFL is bracing for a legal showdown with potentially much higher stakes: lawsuits by more than 4,000 former players and families claiming the league concealed information about the dangers of repeated head injuries.

    Read more click HERE.

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