Debating the Frontline Documentary on the NFL and Concussions

The stadium scene.
Oct. 11 2013 12:38 PM

Did League of Denial Get It Right?

Debating the Frontline documentary on the NFL and concussions.

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Fatsis: I hope Steve Young lives a long and healthy life—love him on the teevee!—but Steve Young doesn’t know how Steve Young will turn out. It’s been obvious that big guys who crash into one another will suffer short- and long-term injuries to bones and joints and muscles since those Harvard boys were dying on the field when Teddy Roosevelt was president. (Players were getting concussed then, too.) The increasingly crippling nature of the NFL began to come under scrutiny in the 1970s and ’80s, when the league started compensating (and fighting against giving compensation to) debilitated retired players. But the sport’s ability to harm its participants’ minds was not yet known, or necessarily even suspected, until more recently. (A 2001 Sports Illustrated story about the broken bodies of retired NFL players, with Johnny Unitas’ gnarled hands on the cover, devoted a total of four paragraphs to “postconcussion syndrome.”) I think it’s natural to make a different moral calculus about the brain. Logically reasonable or not, it’s just more repugnant to think that the guy I’m watching throw a pass or make a tackle could have dementia in 10 or 20 years than it is to think he might need a hip replacement. The players agree. Arthritis at 50? Acceptable risk. Alzheimer’s at 50? Maybe not.

Engber: If those were equal odds, then sure. But what if you were confronted with a 75 percent chance of having arthritis at 50, versus a 2 percent chance of developing early onset dementia? The details matter. What’s clear is that the players should know the risks, from head injuries and joint injuries and steroids, and from the psychological rigors of retiring from a first career while still relatively young.

But the documentary sees everything in terms of the brain. We hear about the rejection of Mike Webster's application for disability payments, with 100 pages of medical evidence, as if the NFL gave him an especially hard time because he was suffering from a disorder of the mind. The league gives lots of former players a hard time on their disability claims, no matter what their problems are.

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Fatsis: Sure, but, again, for narrative and historical reasons, tracing Webster’s story makes sense. His brain was found to have something never before seen in a football player. If Webster is a good example of how disability board handled all claims, that’s an indictment of the NFL period, isn’t it?

Engber: Definitely. But it's presented as if this was evidence of the NFL's cover-up of the concussions crisis. No, it's evidence of the NFL’s long-term, blanket policy of fighting disability claims. I don't know why we would expect the league to do otherwise, especially when there's so little pressure on this issue from the media. Instead, the media obsesses over brain injuries, to the exclusion of all else. (Why? Because journalists use their brains to make a living, so I guess brain injuries seem more important.) Anyway, it's on both the league and the union to get more coverage to people who need it, whatever their condition.

Fatsis: Wait a minute. Webster’s case is presented as evidence of the NFL’s cover-up of the concussion crisis because it arguably was! In 1999, the league’s retirement board ultimately awarded him benefits, finding that Webster’s medical reports “indicate that his disability is the result of head injuries suffered as a football player with the Pittsburgh Steelers and the Kansas City Chiefs.” Was the commissioner at the time, Paul Tagliabue, aware of the retirement board decision? Were the NFL doctors who had asserted and continued for years to assert that there was no connection between playing the game and head injuries (even as players such as Al Toon, Merril Hoge, Troy Aikman, Steve Young, and others were being forced to retired because of them)? We don’t know. But I think it’s fair to say they should have been. You say the media “obsesses” over brain trauma as if it’s a bad thing. NFL brains have received so much media attention in the last few years because the issue was new, the science was evolving, and the images and stories were heartbreaking. But, here, I wrote this New York Times op-ed in 2009 about other NFL health care problems.

Engber: Fainaru and Fainaru-Wada imply that the NFL knew players were dropping like flies from concussion-related brain damage and hired a bunch of charlatans to mislead the public. Maybe it was more like the evidence on this stuff was in the early stages, so the NFL hired a bunch of skeptics who told league executives and the public what they wanted to hear. Tagliabue should have been less defensive and more interested in exploring the possibility that there was a major problem. But is that the same as a cover-up?

Fatsis: Not necessarily, but it’s just as bad. It’s bad science, bad medicine, and bad management. The point isn’t that the league should have known precisely that repetitive blows to the head might lead to early Alzheimer’s. It’s that it should have known that returning a player to a game when that player can’t stand on his own two feet was potentially doing harm, that it should have been more aggressive about doing and embracing actual science, and that it should have protected players better.

Engber: It's not just as bad, in my opinion. The league was slow to respond, but was it criminally slow? They should have supported and encouraged more research, instead of making blanket denials for the first few years. The money for deeper research came too late in the process. The NFL waited until the commissioner had been hauled in front of Congress, and also until a point when McKee and others had more specimens. When more data had accrued, Roger Goodell changed the rules, handed out millions of dollars for deeper research, etc.

The Fainarus do a great job of showing how compromised the initial MTBI Committee was, but it's not clear what could have happened instead. Between Omalu’s paper and Goodell’s semicapitulation to the dissenters, we had just three or four years of what we might call “denial.” I guess the NFL should have adopted Dr. Robert Cantu's return-to-play guidelines right away? They should have banned helmet-to-helmet hits earlier? How much earlier?

Fatsis: I don’t know exactly. And I don’t care. This is about what happened, not what should have happened. The NFL failed to respond quickly and reasonably to an emerging medical crisis, it failed to support and encourage research that might help understand the crisis, it attempted to discredit research that would be viewed as troubling, and it adopted a scorched-earth campaign of denial. That’s all kind of Big Tobacco-y, if not in scope then at least in tactics. And, in understanding the scientific and political and human dimension of what’s happened in football, it’s enough for me.

In any case, I just don’t see how laying out that narrative amounts to journalistic moral certitude. Any reasonable viewer or reader of League of Denial would conclude that no one knew at the time what precisely was killing Mike Webster and other ex-players. Otherwise they might have received better care, and their final years might have played out less tragically. Thousands of autopsies, decades-long longitudinal studies, and other research would help identify precisely why some brains wind up destroyed after years of tackle football. But as the Fainarus and Alan Schwarz of the New York Times and other reporters revealed, the NFL seemed less interested in investigating a potential medical crisis than in covering its ass, for legal, public relations, and business reasons.

If the NFL’s behavior wasn’t so bad—and if the science was so unclear—maybe the league should have rolled the dice in court rather than agreeing to spend $765 million to settle a massive lawsuit. Or maybe it shouldn’t have fought the claims so aggressively and set up a bigger settlement fund and agreed to protect current and future players who succumb to debilitating brain disease, not because a link is proven but because it would be the right thing to do. But, hey, the NFL didn’t admit any culpability. Goodell is quick to remind us of that.

Engber: You say that the argument this documentary puts forward is “enough” for you. Enough for you to do what? Stop watching football?

Fatsis: I like football. I’ve experienced it up close. I won’t stop watching, but I watch now with no small measure of concern and sometimes disgust. I can’t be sure what’s happening inside the heads of the players but, just like Ann McKee, I wonder.

Daniel Engber (@danengber) is a columnist for Slate. Send him an email at danengber@yahoo.com.

Stefan Fatsis is the author of Word Freak and A Few Seconds of Panic, a regular guest on NPR's All Things Considered, and a panelist on Slate's sports podcast Hang Up and Listen. Email him at sfatsis9@gmail.com. Follow him on Twitter.