50 pages • 1 hour read
Mark Fainaru-Wada, Steve FainaruLeague of Denial
Nonfiction | Book | Adult | Published in 2013A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Part 3, Chapter 13-EpilogueChapter Summaries & Analyses
Part 3: “Reckoning”
Chapter 13 Summary: “The Art of Disease”
The authors examine the booming new business and competitive aspect of sports-related brain research. At this point in the NFL’s concussion crisis, the brains of four dead former players had been examined, and all four had CTE. In June of 2007, the brain of another dead athlete with a history of concussions was found to have CTE. The athlete was Chris Benoit, a professional wrestler who hanged himself after killing his wife and seven-year-old son. This story, too, would become national news, but it also led to a fissure in the group of dissenters that essentially split the group into two different sets of researchers and activists who would now be competing for access to brains. In a dispute seemingly over a revelation regarding access to Benoit’s brain, the relationship between Omalu and Nowinski dissolved, with Omalu, Bailes and Fitzsimmons splitting off to form the Brain Injury Research Institute based at West Virginia University. Nowinski and Cantu merged their Sports Legacy Institute with the Boston University School of Medicine to form the Center for the Study of Traumatic Encephalopathy, but they now needed another neuropathologist to replace Omalu.
Their new neuropathologist in Boston was Ann McKee, a die-hard Packers fan from Wisconsin and an expert in tau protein. Within a few months, Nowinski provided McKee with her first brain, that of John Grimsley, who played linebacker from 1984 to 1993, mostly with the Houston Oilers. Grimsley died at 45 years old when he accidentally shot himself in the chest, but his post-retirement life was characterized by mood swings, anger, and memory problems—much the same as those before him. When McKee studied the brain, she was amazed at what she saw. Grimsley would be case number five of CTE in a former NFL player.
A few months later, in May of 2008, another former player would be dead at 45 and found to have CTE: Tom McHale, an offensive lineman from 1987 to 1995 who died of a drug overdose, would be case number six. Rather than racing for access to McHale’s brain, the two groups agreed to split it and compare findings, but even doing that turned into a macabre competition. On top of the McHale news, the Boston group also revealed that it had found early evidence of CTE in an 18-year-old high school football player who had died. McKee was a natural fit in her new position. Speaking to the media, she explained that she “had never seen this disease in the general population, only in the athletes” (265).
Chapter 14 Summary: “Big Football”
When McKee was invited to the NFL’s offices in New York to share her work with the MTBI committee in 2009, she was not sure how the disbelievers would receive her, but she understood the importance. The committee, particularly Casson, was combative and dismissive, continually looking for reasons other than football for this new disease, but the scientists there on behalf of the League seemed to be awakened. The authors point out the unique situation that the NFL was now in considering the preponderance of evidence, arguing that the League had already taken a public position on the matter countless times, but “to acknowledge otherwise was to admit that the NFL’s men were wrong, incompetent, or both” (271).
Of the two dozen or so people at the meeting with McKee, the only other woman present turned out to be an NFL lawyer, perhaps signaling that the League knew what would be coming in the future. Jason Luckasevic was a young personal injury attorney in Pittsburgh and a close friend to Omalu. When Luckasevic first started considering a lawsuit against the NFL the previous year, it was merely in defense of his dear friend, whom the League was trying to destroy. Now, however, there were new implications as more dead players were found to have CTE and the League was on record, over and over, ignoring the warnings of some of the most respected brain researchers in the country. Despite the fact that the NFL was a beloved multi-billion-dollar industry with, as the authors put it, “a legal winning percentage that rivaled that of Lombardi’s Packers” (272), a class-action suit seemed to be in the works.
On October 28, 2009, the House Judiciary Committee held a hearing on football and brain damage. The hearing was explosive not only because Goodell would testify, but also because the comparison between Big Football and Big Tobacco would come into clear focus. The comparison was made by Representative Linda Sanchez, a democrat from California, who pointed out that the League’s blanket denials and minimizing efforts were basically exactly what the tobacco companies had done previously. According to the authors, “within three weeks, Casson and Viano were out as cochairs of the MTBI committee” (283). Other changes came as well, most importantly new rules saying that teams had to consult an independent neurologist when a player sustained any type of brain injury and that players with concussion symptoms were “no go” for practice or games. The headline across the top of the New York Times sports section on December 21, 2009, read “N.F.L. Acknowledges Long-Term Concussion Effects” (285).
Chapter 15 Summary: “Please See That My Brain Is Given to the NFL’s Brain Bank”
The authors begin Chapter 15 stating that “it had been 16 years since Tagliabue had created the NFL’s research arm in response to a concussion crisis the ex-commissioner never quite believed in” (286). The MTBI committee was now scrapped completely and replaced with the NFL Head, Neck and Spine Committee, headed by neurosurgeons Richard Ellenbogen and Hunt Batjer. As the authors explain, “the dissenters had won” (286). The League also took the bold steps of designating Boston University as the NFL’s preferred brain bank and pledging to encourage players to donate their brains. While the Boston University group was soaking up the spotlight and attention, Omalu seemed to have been ostracized completely. The man whose historic discovery started it all was now working as a medical examiner in California, and those now doing the cutting-edge concussion research seemed to want nothing to do with his unfiltered style.
In early 2011, another case of a former NFL player with CTE would be a shocking development. It was Dave Duerson, the staunch defender of the NFL and the NFLPA who had nearly fought other former players in the Halls of Congress, and the man who only months earlier on his radio show had lamented the NFL’s crackdown on head-to-head hits. Duerson graduated with an economics degree from Notre Dame, served as a player representative with the Bears, earned an MBA from Harvard’s executive training program, started a successful food service business after football, and was one of the NFLPA’s three voting members on the disability board. He saw firsthand the players who were now seeking benefits for their cognitive issues; all the while, he was suffering the same fate. At his condo in Florida, Duerson shot himself in the chest to be sure that his brain could be studied and left a five-page suicide note with the request, “Please, see that my brain is given to the NFL’s brain bank” at the bottom (295).
Although the NFL had pledged that Boston University would be its brain bank, its new concussion committee was trying to steer Duerson’s brain to the National Institutes of Health (NIH) for examination instead. The NFL’s new doctors were not as convinced of the link to brain damage as they had appeared in the previous year. The new committee had complaints that the Boston University group had fed into the hysteria about the risks of football and that there had not been enough research to make the link conclusively. It also claimed that the BU group was inherently biased because its fame and funding was dependent on establishing that link. Including Duerson, McKee had now studied the brains of 25 dead former NFL players, and she found CTE in 24 of those.
Chapter 16 Summary: “Concussion, Inc.”
Jason Luckasevic, the close friend and protector of Omalu, was not the only attorney ready to pounce on the NFL’s concussion crisis. Ron Feenberg, a Los Angeles lawyer, began lining up hundreds of former players to file worker’s compensation claims against their teams in California. Larry Coben, a Philadelphia attorney whose clients included former Bears quarterback Jim McMahon, was the first to file suit in federal court. Luckasevic, however, “was out for bigger game” (307). His suit was against the entire NFL for creating “a fraudulent research arm to whitewash a problem that directly threatened its bottom line” (309). Soon, the number of retired players who were suing the NFL climbed to more than 3,000—almost one quarter of all living former players.
While a tidal wave of litigation was coming at the NFL, products designed to supposedly limit or stop concussions were flooding the market, and governmental regulation followed in many cases. The authors state that “concussions had become a booming industry, attractive not only to the world’s most prominent researchers but also to any number of entrepreneurs” (311). For the most part, the products and their creators were opportunist in nature, and most were not close to having the efficacy that they claimed. The one wildly successful entrepreneurial aspect that grew from the concussion crisis was Maroon and Lovell’s ImPACT system, which was now being used by major sports leagues and organizations around the world.
Challenging the science did not previously work, so the NFL now set out to remake its image and convince the public that its product, as well as football at lower levels, was safe. The League did this on two fronts: by scaling back the notion of sanctioned violence that had always been part of the League’s marketing and allure, and by reaching out to mothers directly via internet blogging and sponsorship. The first of these aspects was more of a commercial venture, as it required removing highlight segments focusing on big hits and replacing them with ones focused more on the finesse of the game. The latter was public relations oriented, as it required bringing in a new constituency of engaged mothers.
Chapter 17 Summary: “Buzzards”
In the decade since Webster’s brain was found to have CTE in 2002, hundreds of other former NFL players were having the same sort of dementia-like cognitive problems. Scores of those players died during that time and were also found to have CTE. Many died by suicide, but easily the most shocking suicide of a former NFL player occurred on May 2, 2012, when Junior Seau, one of the greatest linebackers to ever play, shot himself. Like Duerson, Seau shot himself in the chest, but he left no note indicating that the purpose was to preserve his brain for study. A guaranteed first-ballot Hall-of-Famer and 12-time Pro Bowl selection, Seau had retired only three years earlier after 20 years with the San Diego Chargers, Miami Dolphins, and New England Patriots. As the authors explain, Seau’s brain was “the most coveted specimen to come along since the connection between football and brain damage became known” (325). The final chapter of League of Denial focuses solely on Seau and the morbid competition between researchers to secure his brain.
The shocking aspect of the Seau news was related not just to how great of a football player he was, but also to the fact that he was seemingly so well-adjusted to life after football. However, like so many other players whose minds were deteriorating from CTE, Seau’s outward appearance was all a façade. His Junior Seau Foundation was one of the most successful athletic foundations in the country; he had become a successful restauranteur and was a beloved community leader. However, he, too, was changing drastically after football. Seau was drinking heavily, developed a gambling addiction, had fits of rage, and had trouble concentrating. In 2010, he was arrested for assaulting his girlfriend, but no charges were filed. The following day, Seau drove his SUV off a cliff along the Pacific coast in what many considered to be a suicide attempt. Before Seau’s body even left his Oceanside house, Omalu and Bailes were on the phone with his son Tyler, asking for his father’s brain.
According to the authors, at least five other prominent researchers were also “making a play for Seau’s brain” (332). Naturally, Nowinski and the BU group were trying to secure it as well, and popular Sports Illustrated football writer Peter King took to Twitter to post his support of them. The Seau family viewed the situation with disdain. After the death, Tyler had contacted David Chao, the Chargers team doctor who also was Seau’s personal physician, and told him that it would be his decision where the brain went. Because Tyler had given him verbal consent, Omalu was about to begin Seau’s autopsy, but he was stopped at the last second and told that Tyler did not even want him in the room. Chao had steered Seau’s brain to the NFL’s new concussion committee, which now included Guskiewicz, one of the original dissenters. The ghoulish brain race ended with Seau’s brain at the NIH, which confirmed the presence of CTE.
Epilogue Summary: “Scars of the Gladiators”
The Epilogue further examines the comparison between big football and Big Tobacco. The authors compare the role that Gary Huber, a respected respiratory specialist, played in unwittingly aiding the tobacco industry’s fight against science to the role that some in the neuroscience community, namely Kevin Guskiewicz, have played in aiding the NFL’s pattern of denial. Huber was a researcher at Harvard in 1971 when he agreed to work with the industry to research the connection between smoking and lung disease. Over the next several years, Big Tobacco donated millions of dollars to the Harvard Project. Huber’s research did not find what the tobacco industry wanted, and, after unsuccessfully attempting to influence his conclusions, Big Tobacco stopped the grants to the Harvard Project. Huber mistrusted the industry to begin with but decided it would be better to try to affect change from within the industry. Later, he discovered that the tobacco industry had already done the research and had the answers; his 15 years of work were nothing more than a public relations ploy.
Guskiewicz, one of the original dissenters, established a link between football and brain damage in 2005. He was among those in the neuroscience community who were most critical of the MTBI committee, but in 2010 he joined the League’s new overhauled committee and softened his stance concerning the link. Similar to Huber, Guskiewicz thought that Goodell represented change and that he could affect the greatest change toward player safety by working from within the NFL. The similarities between how big football handled its concussion and brain damage link and how Big Tobacco handled its cigarettes and cancer link are inescapable. The lawsuits against these two industries are one of those inescapable similarities. All the various suits against the NFL were “consolidated into one ‘mass tort’ involving nearly 6,000 former players or their families” (347). In 2013, the league agreed to pay $765 million plus another $200 million in legal fees. As the authors point out, “it was seen by many as a victory for the NFL” (348-49).
Part 3, Chapter 13-Epilogue Analysis
Part 3 is titled “Reckoning,” referring both to the NFL’s slow acknowledgement of the seriousness of its concussion crisis and to the consequences that the League now faced because of its years of denialism. Part 3 covers the broad topics of how sports-related brain research turned into a business and a competition, the unavoidable comparison between big football and Big Tobacco, and the NFL’s public relations strategy in dealing with the issue. The secondary theme that emerged in Part 2, propaganda as a public relations tool, is built upon throughout Part 3. The primary stylistic element used in Part 3 of the book is sequencing, as the authors return to a strict timeline of events taking place between 2007 and 2012.
In Chapter 13, “The Art of Disease,” the authors begin with an anecdote about Chris Benoit, a professional wrestler who murdered his family and then killed himself in 2007. Omalu found that Benoit’s brain was riddled with CTE. Benoit did not come from the world of football, but the finding reinforced the science because he had suffered a number of serious concussions throughout his wrestling career. Chapter 13 also reveals how the scientific endeavor of sports-related brain research turned into a competition because of a fissure that developed between the primary researchers, essentially splitting the small group of dissenters into two camps that would now compete for the brains of dead athletes. With this split, a new neuropathologist who would play a major role in the concussion crisis entered the game. Ann McKee, a researcher based in Boston, joined author and concussion activist Chris Nowinski to work with Boston University’s Center for the Study of Traumatic Encephalopathy. Nowinski, a media-savvy former professional wrestler, was the driving force behind the personality clash that split the dissenters into two camps.
The authors title Chapter 14 “Big Football,” making use of a metaphor and the stylistic element of figurative language. Their reference here is to an analogy that would prove to be a public relations nightmare for the NFL—the comparison of the NFL, or “big football,” to the tobacco industry, which became commonly referred to as “Big Tobacco” in the 1990s when it was discovered that the industry had gone to great lengths to cover up the science proving that smoking causes cancer and lung disease. The comparison to Big Tobacco had been leveled before, but when Representative Linda Sanchez did so during the House Judiciary Committee’s 2009 hearing on football and brain damage, it had a different effect. The authors point out that the comparison was damaging because it rang true, arguing that “the NFL had used its power and vast resources to try to discredit scientists it disagreed with and bury their work, cherry-picked data to make selective arguments about concussions, and elevated its own flawed research” (280).
In Chapter 15, the authors’ tone changes to a slightly more optimistic one, signaling that a corner might have been turned in terms of how the NFL was now prepared to deal with its concussion crisis. It was certainly true that the NFL was now at least recognizing the problem. The League even took the steps of scrapping its MTBI committee and designated Boston University as the League’s preferred brain bank for its players to donate their brains. Such steps might have been strictly public relations moves, but the steps were real. Another suicide by a former NFL player occurred in early 2011, but this one would be much more earth-shattering than those before it. The player was Dave Duerson, a hard-hitting Pro Bowl safety for the powerful Chicago Bears of the 1980s. This case was different for two primary reasons: Duerson had been a staunch defender of the NFL who was opposed to new rules outlawing helmet-to-helmet hits, and he left behind something of a manifesto asking his family to see that his brain was given to the NFL’s brain bank.
Chapter 16, “Concussions, Inc.,” covers the business and entrepreneurial element that sports-related brain research spawned and the public relations makeover that the League attempted to get started. The fact that brain researchers were now competing against one another for access to brains was not the only business aspect that grew from the concussion crisis. The market also became flooded with products and gadgets designed to lessen head injuries, but most of those seemed to be more for profit than for medical benefit. The change taking place within the NFL that was most visible to the public might have been the image makeover that the League was attempting. Despite having long promoted itself as “a refuge for legally-sanctioned violence” (318), the NFL now needed to soften its image. The public relations campaign primarily involved advertising and reaching out to mothers.
The final chapter of League of Denial strikes a somber tone in exposing what the authors refer to as the “brain race—the morbid competition between groups of researchers vying for the brains of dead football players. The authors appropriately title the chapter “Buzzards.” Although this competition had been taking place for the previous few years and involved the families of numerous recently deceased players, by far the most shocking example came as a result of the highest-profile death yet. On May 2, 2012, news broke that Junior Seau, one of the greatest linebackers to ever play, had committed suicide by shooting himself in the chest. Immediately, as many as six prominent researchers were trying to get Seau’s brain. Seau, like virtually all the former NFL players whose brained had been examined post mortem to that point, tested positive for CTE. The authors close the book with an Epilogue that provides a deeper examination into the big football–Big Tobacco comparison and reveals that the NFL, just before the book was published in 2013, settled a mass tort brought by nearly 6,000 former players or their families for $765 million.
