By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 03/20/2011
I AM IN DETROIT visiting family, and I’ve got sports on the brain.
Last night, we watched a local news report about former Red Wing hockey star Bob Probert who died last July at age 45 with a bad heart and battered brain. His celebrity on the ice rink had derived as much from his skill with his fists as with his stick.
Earlier this month, Probert’s brain was examined and found to exhibit “chronic traumatic encephalopathy” or “CTE” – a degenerative brain disease originally noted in boxers and, more recently, football players. Caused by repetitive or severe head trauma, CTE can manifest as dementia, memory loss, depression, aggression, and suicidal behavior. According to his wife, Probert had displayed problems with short-term memory and a quick temper.
During a commercial break, one of my sisters commented upon the increasing violence she’d witnessed during her own sons’ school sports activities. “But the parents are often worse than their kids,” she said. A month ago, when her son had fallen hard on a basketball court underfoot of several players, a jubilant man in the audience jumped up cheering, vigorously punching the air with his clenched fists. Known for his disturbing elation whenever players were felled to the ground, injured, or knocked unconscious, he was finally banned from future games after enough troubled parents had complained.
When the newscast resumed, we also heard about a planned protest to denounce the Boston Bruins player whose clash on the ice last week left Max Pacioretty of the Montreal Canadiens with a concussion and fractured neck. The protest organizers were calling for tougher disciplinary measures against players who engaged in gratuitous violence, and the abolition of blows to the head in hockey.
Later that evening while retiring for the night, I was reminded of the scene from “Jerry Maguire” in which Cuba Gooding lay battered, immobile, and unconscious on the football field during a fiercely competitive game. A hushed silence hung over the stadium while everyone waited to see whether Gooding would move or speak again. When he finally did, the crowd erupted in ecstasy – a show of celebration indistinguishable from that for the touchdowns.
Most of us probably anticipated this outcome in the movie because we had repeatedly witnessed the same events in real-life football. It had become normal – and acceptable – to expect serious head injuries during the games. It was even exciting, sometimes, to feel drawn into communal experiences in which we waited united in heightened suspense to discover whether an unconscious player would rise up again – like a Phoenix, like a victorious uber-athlete who had defeated death itself.
The problem is that we have only recently begun to pay adequate attention to real-life athletes off the field or rink, away from the klieg lights, months or years after their injuries. And what we’ve sadly noted is that their head injuries – frequently dismissed as “mere concussions” or “dings” – can cause lasting and devastating effects on their memory, intelligence, behavior, and mood.
The data are just beginning to accumulate. A landmark 2009 study by University of Michigan researchers found that NFL retirees aged 30 to 49 years had a 1 in 53 chance of receiving a diagnosis of Alzheimer’s, dementia, or other memory disorders against a baseline age-adjusted risk of 1 in a 1000. We’re also beginning to look for – and document – a higher incidence of serious depression among athletes with histories of head injuries.
CTE has also been documented in college ball players. Owen Thomas – a 21-year-old junior at the University of Pennsylvania – killed himself last April and was found to have the same kind of CTE now documented in more than twenty deceased NFL players.
These new studies and observations partially expose our country’s silent epidemic of concussions in sports. But daunting statistics suggesting that four million sports-related concussions occur annually in the US do not even take into account the millions more “sub-concussive” head blows that never get documented or reported.
Even less data are available concerning young athletes for whom the potential scope of similar problems may be high. For example, more than 3 million children currently play football, and an additional million adolescents play on high school teams.
A study published last year in Pediatrics was the first to assess the causal role of sports in childhood concussions. It found a sports-related cause in nearly half of the 500,000-plus concussions among children 8-to-19 years old who were evaluated in emergency departments. Commentators speculated that such concussions in younger people might produce more severe long-term developmental and cognitive problems.
Obviously, young aspiring athletes don’t watch professional sports in order to study what not to do. Instead, they observe how games are actually played, and they emulate the successful athletes they hope to become. That is why the professional leagues and their players have to take the lead in making sports safer for generations of athletes to follow.
The NFL and NHL have been under particular pressure to make changes in the rules of play aimed at decreasing head injuries. Many currently enacted changes and proposed guidelines are welcome relief – but few go far enough, they tend to be reactive rather than proactive and preventive, and some guidelines even remain voluntary.
The problem of athletes losing their minds to sports prompts a powerful no-brainer solution: that all purposeful head hitting be eliminated without exception – be it with fists, hockey sticks, ram-rodding helmets, or the Wiley Coyote’s frying pan. (is this really controversial?) And players lacking the skills to compete within their sports without resorting to props and strategies for disabling other players ought to be dismissed as athletically incompetent and eliminated from legitimate competition.
It is magnificent to watch the human form execute feats of muscular prowess and strength. To see it move, with the self-confidence of body synched to mind – down a field, across a court, along the ice, against a sea of competitors in pursuit of victory. A trained athlete who has accomplished as much should be respected for his or her talents. And those talents should be protected from a culture of violence that has pervaded contact sports and decommissioned many athletes.
As a physician who has worked in a dementia clinic witnessing the suffering of its patients and families, it is disturbing to see how little has been done to eradicate sports-related CTE as a preventable cause of dementia. And as a sports fan, it’s been stunning to witness how the spectacle of human injury has become normalized, even celebrated, in athletic competition.
© Copyright 2011, Kate Scannell
=========================
Kate Scannell is a Bay Area physician and syndicated columnist. She’s the author of “Death of the Good Doctor” and “Flood Stage.”
First Published in Print: 03/20/2011
I AM IN DETROIT visiting family, and I’ve got sports on the brain.
Last night, we watched a local news report about former Red Wing hockey star Bob Probert who died last July at age 45 with a bad heart and battered brain. His celebrity on the ice rink had derived as much from his skill with his fists as with his stick.
Earlier this month, Probert’s brain was examined and found to exhibit “chronic traumatic encephalopathy” or “CTE” – a degenerative brain disease originally noted in boxers and, more recently, football players. Caused by repetitive or severe head trauma, CTE can manifest as dementia, memory loss, depression, aggression, and suicidal behavior. According to his wife, Probert had displayed problems with short-term memory and a quick temper.
During a commercial break, one of my sisters commented upon the increasing violence she’d witnessed during her own sons’ school sports activities. “But the parents are often worse than their kids,” she said. A month ago, when her son had fallen hard on a basketball court underfoot of several players, a jubilant man in the audience jumped up cheering, vigorously punching the air with his clenched fists. Known for his disturbing elation whenever players were felled to the ground, injured, or knocked unconscious, he was finally banned from future games after enough troubled parents had complained.
When the newscast resumed, we also heard about a planned protest to denounce the Boston Bruins player whose clash on the ice last week left Max Pacioretty of the Montreal Canadiens with a concussion and fractured neck. The protest organizers were calling for tougher disciplinary measures against players who engaged in gratuitous violence, and the abolition of blows to the head in hockey.
Later that evening while retiring for the night, I was reminded of the scene from “Jerry Maguire” in which Cuba Gooding lay battered, immobile, and unconscious on the football field during a fiercely competitive game. A hushed silence hung over the stadium while everyone waited to see whether Gooding would move or speak again. When he finally did, the crowd erupted in ecstasy – a show of celebration indistinguishable from that for the touchdowns.
Most of us probably anticipated this outcome in the movie because we had repeatedly witnessed the same events in real-life football. It had become normal – and acceptable – to expect serious head injuries during the games. It was even exciting, sometimes, to feel drawn into communal experiences in which we waited united in heightened suspense to discover whether an unconscious player would rise up again – like a Phoenix, like a victorious uber-athlete who had defeated death itself.
The problem is that we have only recently begun to pay adequate attention to real-life athletes off the field or rink, away from the klieg lights, months or years after their injuries. And what we’ve sadly noted is that their head injuries – frequently dismissed as “mere concussions” or “dings” – can cause lasting and devastating effects on their memory, intelligence, behavior, and mood.
The data are just beginning to accumulate. A landmark 2009 study by University of Michigan researchers found that NFL retirees aged 30 to 49 years had a 1 in 53 chance of receiving a diagnosis of Alzheimer’s, dementia, or other memory disorders against a baseline age-adjusted risk of 1 in a 1000. We’re also beginning to look for – and document – a higher incidence of serious depression among athletes with histories of head injuries.
CTE has also been documented in college ball players. Owen Thomas – a 21-year-old junior at the University of Pennsylvania – killed himself last April and was found to have the same kind of CTE now documented in more than twenty deceased NFL players.
These new studies and observations partially expose our country’s silent epidemic of concussions in sports. But daunting statistics suggesting that four million sports-related concussions occur annually in the US do not even take into account the millions more “sub-concussive” head blows that never get documented or reported.
Even less data are available concerning young athletes for whom the potential scope of similar problems may be high. For example, more than 3 million children currently play football, and an additional million adolescents play on high school teams.
A study published last year in Pediatrics was the first to assess the causal role of sports in childhood concussions. It found a sports-related cause in nearly half of the 500,000-plus concussions among children 8-to-19 years old who were evaluated in emergency departments. Commentators speculated that such concussions in younger people might produce more severe long-term developmental and cognitive problems.
Obviously, young aspiring athletes don’t watch professional sports in order to study what not to do. Instead, they observe how games are actually played, and they emulate the successful athletes they hope to become. That is why the professional leagues and their players have to take the lead in making sports safer for generations of athletes to follow.
The NFL and NHL have been under particular pressure to make changes in the rules of play aimed at decreasing head injuries. Many currently enacted changes and proposed guidelines are welcome relief – but few go far enough, they tend to be reactive rather than proactive and preventive, and some guidelines even remain voluntary.
The problem of athletes losing their minds to sports prompts a powerful no-brainer solution: that all purposeful head hitting be eliminated without exception – be it with fists, hockey sticks, ram-rodding helmets, or the Wiley Coyote’s frying pan. (is this really controversial?) And players lacking the skills to compete within their sports without resorting to props and strategies for disabling other players ought to be dismissed as athletically incompetent and eliminated from legitimate competition.
It is magnificent to watch the human form execute feats of muscular prowess and strength. To see it move, with the self-confidence of body synched to mind – down a field, across a court, along the ice, against a sea of competitors in pursuit of victory. A trained athlete who has accomplished as much should be respected for his or her talents. And those talents should be protected from a culture of violence that has pervaded contact sports and decommissioned many athletes.
As a physician who has worked in a dementia clinic witnessing the suffering of its patients and families, it is disturbing to see how little has been done to eradicate sports-related CTE as a preventable cause of dementia. And as a sports fan, it’s been stunning to witness how the spectacle of human injury has become normalized, even celebrated, in athletic competition.
© Copyright 2011, Kate Scannell
=========================
Kate Scannell is a Bay Area physician and syndicated columnist. She’s the author of “Death of the Good Doctor” and “Flood Stage.”