02 December 2012

This is your brain on football

From a previous post in January:
Football seems to subject its players to enough physical and neurological risk that I expect I'll discourage my future patients from joining a competitive football team. Friends of mine who played Division I college football loved it and have gone on to play professionally. They continue to live and breathe football. But I noticed a tollfrequent concussions, dramatic injuries and surgeries, shocking addiction to painkillers, and a difficulty in balancing the competing demands of being a student and of being a quasi-professional athlete.

Scientists are finding that the constant hits (even "microtraumas" that don't rise to the level of concussions) that football players endure can cause chronic traumatic encephalopathy (CTE). CTE is a progressive, untreatable, dramatic, and ultimately fatal decay of the brain that can only be diagnosed post-mortem. Researchers are increasingly conducting autopsies on NFL players and college football players, and they are finding shockingly widespread evidence of CTE. Even deceased players in their 20s and 30s are turning up with CTE, which is otherwise seen only in the elderly. The science in this field is preliminary, yet it is increasingly clear that professional, college, and high school football is a tremendously risky endeavor.

I really do enjoy gridiron football, and on the brisk evening of a big college game I was one of the shirtless guys in the stands wearing body paint. Yet recently I've stopped attending games and I even feel conflicted about cheering my home team while I watch on TV. Wouldn't it make me a hypocrite to say one thing to my patients and do another? Am I taking all of this too seriously?
Moments ago, a big-deal paper out of Boston University (BU) was released by the journal Brain. The BU team discovered 15 previously-unknown cases of CTE in former NFL players. That means that of the 34 brains of deceased NFL players examined so far by the BU team, 33 have been found on autopsy to have CTE. The team also diagnosed CTE in some football players who didn't play football beyond college or high school, as well as in some NHL hockey players. The paper also looked at controls (patients who played sports besides hockey or pro football) and found few with CTE. The team also catalogued the devastating neurological symptoms suffered by the players with CTE, like depression, explosivity, and dementia. It strikes me as a thorough and well-done paper with major findings.

In my mind, the release of this paper is a watershed moment. The science on CTE is in. Football clearly destroys some of its players' brains. The questions at this point are how many of its players are affected, and how badly.

I don't feel conflicted anymore. Until the sport changes, I'm done with following football.