Brain trauma and the NFL

Over time, it’s become obvious that some people still believe that NFL players should always have known their sport involves a high risk of lifelong problems arising from multiple concussions - and they have to know it by now.

After all, they knew about head injuries and boxing back in the 1920s, right? It’s true - such a study was done, and it did show the dangers for boxers. There were more studies in the 1950s and 60s, as well.

There’s just one problem here: the NFL has been telling the players that this was a nonissue for them ever since the league began. And that, my friends, is where the ugly truths begin.

New info keeps on surfacing regarding the history of the NFL's conduct regarding concussions and brain trauma. In recent months, several reporters and sources put together timelines of the brain injury situation vis-a-vis the NFL. An older article also came up, and they fit together into one long tale.

The first order of business is to define the role of one Elliot Pellman, MD, in this unfolding situation. By the way - the aspects that I’m going to cover, as I’ve stated, have gone on since the early years of the league. There’s far too much information to include every bit of the lies, obfuscation, and chicanery since then, though, so this article will start with the 1990s. Pellman was named head of the nascent Mild Traumatic Brain Injury committee in 1994. In many ways, that started the modern unveiling of this tragedy.

Much of the information here came from an Atlantic Magazine piece on the subject. It's incredibly damning to read it in chronological order, and I’d recommend that you do so if you care at all about this subject.

Pellman takes another huge hit in the work of Sports on Earth's Patrick Hruby. This is just a quick sample - again, I’d recommend reading the entire article:

The Jets team doctor (Pellman) was a rheumatologist, specializing in joint and muscle injuries. He was not a neurologist.

The truth is that Pellman was a rheumatologist who falsified his credentials. He claimed to have a medical degree from the State University of New York at Stony Brook, but according to the New York Times, he actually attended medical school in Guadalajara, Mexico, and had no specialized training in neurology or brain trauma. The researchers whose work he constantly claimed to be inapplicable to football began to refer to him as Mr. Pellman, feeling that he didn't deserve to be called 'Dr.’ I find myself unable to disagree.

His Mexican medical degree - which Peter Keating (see next paragraph) states was apparently required because his grades weren’t good enough to get into a US medical school - is an explanation of the circumstance in short. Simply put, the league (at that time led by Commissioner Paul Tagliabue) put in a shill with zero credentials to head their pet committee, and to make sure that their level of disinformation remained constant. And, that worked for a long time.

Here’s an article from Keating, writing for ESPN The Mag in 2006. It’s a hell of a good read. It hasn’t lost any of its punch in the seven years that have passed - rather, this is a case where past was indeed prologue. Keating’s piece takes narrative form and tells the story of Pellman and the badly named ‘Mild Brain Trauma Committee’ - so named because, after all, no one would suspect that you could have a serious brain trauma while playing football.  Right?

According to Keating’s piece, another doctor told him that, "I would hear [Pellman] say things in speeches like, 'I don't know much about concussions, I learn from my players,' and, 'We as a field don't know much about concussions,' and it used to bother (the doctor)...he (Pellman) was acting like it was new ground."

Here's a pair brief excerpt from Keating’s timeline:

1997 - The American Academy of Neurology establishes guidelines for concussed athletes returning to play. The guidelines recommend holding athletes who suffer a Grade 3 concussion (loss of consciousness) be taken "withheld from play until asymptomatic for 1 week at rest and with exertion."

My response is that modern guidelines are far more stringent because even in the 1990s, we in the medical profession knew that this was a very minimal recommendation. That the NFL still wouldn’t accept the guidelines is a fair indicator of the shell game they’ve played for well over half a century.

It’s important to recognize that Pellman has not changed his mind on the subject of brain traumas. Specifically, he is quoted as saying this:

In a 2006 article, Pellman and co-author David Viano summed up 12 years of the committee's work by writing that concussions in professional football are not serious injuries.

That’s utterly false, and it’s coming from the league’s representative. Still think that the players should know better?

Back to Keating's timeline:

2000 - The NFL rejects the 1997 guidelines. ''We don't know whether being knocked out briefly is any more dangerous than having amnesia and not being knocked out,'' says neurologist Mark R. Lovell. ''We see people all the time that get knocked out briefly and have no symptoms,'' he added. ''Others get elbowed, go back to the bench and say, 'Where am I?' ''

This is as damning as it gets. It’s pure word-salad stupidity without any vestige of redeeming medical accuracy,  wrapped up in the paper-thin fact that it comes from a physician - one who is willing to alter the recommendations by the American Academy of Neurology to fit the NFL’s narrative. The standards of the AAN have been stiffened since then. Lovell’s haven’t.

Just who is Dr. Mark Lovell?

Lovell is a neurologist and a consultant for both the NFL and the NHL. Since Lovell was the head of the University of Pittsburgh Medical Center's Sports Medicine Concussion Program, it’s theoretically good to have someone with at least some credentials on board. Lovell quickly showed, however, that he was squarely on the NFL’s bandwagon, to an embarrassing degree.  Pellman apparently chose Lovell because Lovell had conducted early neuropsychological tests for the Steelers, starting in the mid-1990s.

In 1995, Lovell began to run the NFL's neuropsychology program, which encouraged teams to gather data to help decide when to return players to games. It was a fine example of shoddy data accumulation. Some teams submitted data, some did not. The process of gathering it was haphazard. The information accumulated is so poor that it never would have been published if not for the connection with the NFL, as the editors of the journal Neurosurgery have attested (see Keating).

This is also from Keating’s work:

Elliot Pellman looks Wayne Chrebet in the eye in the fourth quarter of a tight game, Jets vs. Giants on Nov. 2, 2003, at the Meadowlands. A knee to the back of the head knocked Chrebet stone-cold unconscious a quarter earlier, and now the Jets' team doctor is putting the wideout through a series of mental tests. Pellman knows Chrebet has suffered a concussion, but the player is performing adequately on standard memory exercises. "This is very important for you," the portly physician tells the local hero, as was later reported in the New York Daily News. "This is very important for your career." Then he asks, "Are you okay?" When Chrebet replies, "I'm fine," Pellman sends him back in.

No one who has just suffered a concussion is capable of determining their own fitness to continue. There’s a huge breach of medical ethics in even considering returning such a player to the game. Did that stop Pellman? Not at all. Ethics aren’t his strong suit.

Pellman would tell Dr. William Barr, a neuropsychologist who studies the interaction of the brain and mind, that there was one key rule: "Don't talk to the press." So much for the transparency that Commissioner Roger Goodell asserted was present when he lied repeatedly before Congress about the league’s’ deep concern’ for the players. Barr would later be fired. According to him, it was for refusing to vet all his public statements ahead of time through Pellman.

"Their conclusions were totally at odds with my experience," said Barr. "I can't believe you could have Wayne Chrebet on your team and conclude there is no increased risk of concussions."

In 2010, the co-chair of the CMBT was Ira Casson. Casson told Congress that year, "Tau deposition is the predominant pathology in a number of other neurologic diseases that have never been linked to athletics or head trauma."

This is another outright lie. Later in the year, the NFL disbanded the committee to distance itself from Pellman, Casson, and their actions and statements. Keep in mind - this was only three years ago.

How is it that the players ‘should’ know things that their team physicians apparently don’t? How can we rationally expect them to understand and adhere to a process that the league itself has continued to claim isn’t dangerous?

Taken as a whole, these four articles (including the NYT piece exposing Pellman’s falsehoods about his degree) explain clearly why so many NFL players don’t believe that they’re in danger. The NFL itself has gone to such extraordinary lengths to hide that fact from the players, that I can’t blame a bunch of very young men, most of whom have zero medical training, and whose jobs depend on their health and aggression, when they are told by their physicians that the data does not support that conclusion.

Neither should you.

In that same vein, the league isn’t really gathering data in the clinical research sense of the term - they’ve just been preparing a defense for the inevitable lawsuit(s) which now have over 4,200 players represented. The presiding federal judge, Anita Brody, just required that the sides try two months of mediation. Good luck there.

When Goodell was called on the carpet by Congress in 2009, he lied through his teeth about the league’s firm commitment to gathering and acting on accurate data to save the health of the players. It was, he claimed, a central goal of the league. But nothing in the historical record even hints that his statements might be true.

Goodell has increased the league’s revenues tremendously, though. Michael MacCambridge attests in his encyclopedic America’s Game that Goodell was famous for his desire to ‘monetize’ everything possible when he was Tagliabue’s assistant. He’s done a good job on that end.

He could have done as well in dealing with the players’ health. Instead, he’s pushing for an 18-game schedule that would serve to shorten careers and increase injuries, which in turn would also reduce salaries for veterans, who earn higher wages as their careers progress. If you don’t think that’s come up in private, you haven’t been following the story.

I want to be very clear about something - the NFL Player’s Association has also made a nearly endless slew of mistakes and missteps in their interactions with the league, players, and the public. I don’t give them any slack on this.

With that said, nothing in the NFLPA’s sometimes bizarre actions gives any less validity to the inevitable conclusion that the league itself has been engaging in an organized and deliberate attempt to falsify or misstate the data, to repress or dismiss new information, or to deal with any of this in a professional and transparent manner.

Instead, the NFL has deliberately ignored established data, starting with the 1920s study on boxers and brain damage, continuing through the 1950s and 60s, and on through the first decade of the 21st century. When you look at that record in its totality, I’d defy anyone to make the case that the players ‘ought to know’ what their own team physicians often claim isn’t true.

If it were a single doctor, it would be malpractice.

It’s not.

Rather, it’s the majority of the NFL owners and their professional liars that should bear the consequences of lying to the players who suffer cognitive loss, memory problems, speech problems, and emotional outbursts, all of which are common outcomes from multiple-concussion patients.

The problems of chronic pain and joint degradation would take a very long article to cover, so let me just say this - the NFL has treated that information exactly as they have the information on concussions and their consequences.

They’ve lied, cheated and ducked their responsibilities in a manner that should cost them billions when the lawsuit finally is heard.

I’d suggest that you read the links I’ve provided fully, and then make up your own mind.

Learn to laugh at yourself. You will be ceaselessly amused. - Sri Gary Olsen

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