Vince Lombardi coached the first Super Bowl-winning football team, the Green Bay Packers. And he famously said, "Football is not a contact sport; it's a collision sport. Dancing is a contact sport." A half-century on, as Super Bowl 50 is about to be played, the human toll of those jarring collisions is attracting the scrutiny of players, doctors, fans, and the NFL itself. But perhaps no one has looked more closely, more urgently, than Dr. Bennet Omalu.
He is the Nigerian-born forensic pathologist who's now chief medical examiner in San Joaquin County, and a professor at UC Davis. His story's told in the book and the film "Concussion." He'd been in the United States only about eight years when he performed an autopsy that would shake his life as much as football shook the life, and the brain, of that man on the autopsy table. Omalu's diagnosis? A degenerative brain disease he came to called CTE, chronic traumatic encephalopathy – in lay language, it's what happens to you when you play a sport where your head gets banged over and over and over again.
The Super Bowl is this coming Sunday. Are you going to be watching?
No, no, I don't watch football. The last time I tried watching was the last Super Bowl. The problem I have is you know the graphic nature of my imagination; when I watch and see them meeting head onto head, helmet onto helmet, what flashes through my mind is what's going on in their brains. It's like torture to me. I develop goosebumps; after about five or ten minutes into the game, I switched off my TV and started doing something else.
Your work more than ten years ago has really shaken up people who watch football, people who play football: the discovery, as your scientific paper calls it, of "Chronic traumatic encephalopathy in a National Football League Player" -- one player, Mike Webster, a member of the Pittsburgh Steelers team.
I did the autopsy on September 28, 2002, to be exact but it took me about six months to identify the disease through my research and come up with the name and all the other things. So I submitted the paper to be published and it took almost three years to publish the paper because there was this systematic attempt to stop me from publishing the paper.
I believe the spirit of Mike Webster saw it through, because when I performed his autopsy I spoke to his spirit: the patient helped me get to the bottom of his experiences and to the truth. And then after that, I have more cases: Terry Long, Andre Waters, Justin Strzelczyk – Chris Benoit was a wrestler – and several other football players. In those days, some of the NFL doctors and even some of the non-NFL doctors were insinuating that I was a voodoo doctor, not practicing science. So the truth has prevailed, I think. The families of the players and the players themselves have been vindicated.
When you published the first time, the NFL demanded a retraction. Did you understand at the time how big football was as an industry, as a sport, as a form of recreation here in the United States?
No, no, remember I was born in Nigeria, grew up in Nigeria, came here October 24, 1994; I was 26 years old. I had no clue of what the NFL was. I did not know so much about football. All I saw growing up was once in a while, I would see football being played on satellite TV, and I wondered as a child why they had to wear so much protective gear including helmets. If this was a recreational game, why should we then be protecting ourselves?
So I had no clue, but maybe there have been criticized by others [cq] but what people talk about as a weakness in my opinion was actually a strength. Because I had no clue of what the NFL was, I had no fear in me, and because I did not know what football was, I had no bias, so my mind was pristine, was virginal, I was objective , as objective as I could be.
There was a little bit of work before yours about, for example, boxers, and the dementia that might be induced by boxing. In 1969, in the House of Lords, there were physicians who issued a position paper about brain damage, an occupational hazard of contact sports. Yours was specifically focused on football.
Yes, the concept that blunt-force trauma of the head causes brain damage is a generally accepted principle of medicine. That is why I was so appalled by the NFL doctors who were denying my work. Over the centuries, we have observed that when you suffer seizures or severe devastating injuries of the brain like in motor vehicle accidents, like accidental falls in an industrial environment, you could suffer post-traumatic encephalopathy and permanent brain damage; you could develop post traumatic epilepsy. During the 16th, 17th, 18th, 19th centuries, we began to realize that boxers over time would manifest symptoms of permanent brain damage. A forensic pathologist like myself in 1924 termed it "punch drunk." Then, about 1932, punch drunk was changed to dementia pugilistica.
So in 2002, when I was examining Mike Webster's brain, it was either dementia pugilistica or Alzheimer's disease. But when I examined his brain, his brain wasn't what I expected to see in a boxer. It looked normal. And of course he was not a boxer. And then when I examined his brain, it was not Alzheimer's disease, and I even went back to the literature to search: had this been published before?
And it was not and I was actually amazed. I did not want to believe it, that this is the most popular sport in America and yet nobody, nobody. So when I developed a concept that exposure to repetitive blunt force trauma over time causes brain damage, just like in boxers, I began to wonder if this also applies to other sports, other high-impact contact sports. So when Chris Benoit died – he commited suicide in 2007 -- I examined his brain and I identified it in wrestlers too.
What I did when I identified Mike Webster's thing, I showed it to other doctors. We all agreed that this was something new, but we had to give it a name. This was not dementia pugilistica. Maybe we could have called it dementia footballitica! And I chose chronic traumatic encephalopathy; in less than ten years, internationally everybody at every level knows what CTE is.
Dr. Omalu, you say you are not anti-football, but you have been attacked for just that, calling you anti-football and even anti-American.
I'm not, I'm not. I'm a Christian and I would always refer people to a verse in the Bible, the letter of St. Paul to the Ephesians, chapter 14. I don't remember, at the end of that chapter – let me see, I have my Bible here.
Thank you. You would send everybody running for their Bibles.I'm glad you have yours.
Yes, Ephesians chapter 4 verse 22, it says that we should put away the old self and our former ways of life and continue to renew the spirit of our minds , accept the new self, In righteousness and in the holiness of truth.
That's a great verse for a scientist.
Yes. What that simply means is that we as a society, we evolve. And as we evolve, we become more intelligent. And we begin to give up less intelligent ways we did things in the past. We've done that with cigarette smoking. We've done that with alcohol consumption. We've even done that with something as basic as sex.
Knowing what we know now, if you are an adult and you decide to play football as it's played today, I would be the first to stand by you and defend your right to play football. Or even boxing. But for our children, our children, it is our moral duty as a society to protect our innocent , the most vulnerable of our society.
Can you give me an example of what kind of emails and letters you get, good and bad?
A majority are, I would say, of hundreds of thousands of emails, 99.9 percent of the emails are very good. Now, about zero point one percent are very negative. And many of them are coming from fellow doctors.
Why is that?
I don't know. I've asked a psychologist who says it's professional envy and jealousy, people who believe you don't deserve the recognition you are receiving.
Because you're Nigerian?
Some of them. Some of the emails because of my skin color and my accent. There are just some people who believe that intelligence is exclusive to only certain types of people or a certain group of people. And I know some of those people; that is the very disheartening thing. I know some of those people.
Have you seen any changes to the game played at any level, the idea that if you look like you've got a concussion you've got to sit out the game?
Your risk of suffering brain damage is not about concussions. It is about exposure to repeated blunt force trauma of the head. So you can suffer brain damage without manifesting any concussions. Like Mike Webster: he played for 17 years' there was no single documented concussion in his career.
So a child who plays a game of football for one season without any documented concussion -- several months after that season, if you subject his brain to sophisticated psychological testing and radiological testing, functional MRIs, there is evidence of brain damage.
And so I want parents to know that with or without a helmet, with or without a documented concussion, exposure of your child's brain to repeated blunt-force trauma – because that is it is, when you're wearing a helmet, and you slam into another person, that is blunt-force trauma. Your child has a risk of developing permanent brain damage.
Let me share a story with you. I have a friend who is a professor, a very intelligent guy, and he has a son. His son was an A-plus student. His son was going to medical school. His GPA was above four-point-zero. He played high school football for two years and after high school he struggled. His grades dropped from an A-plus to a C-minus. He eventually dropped out of medical school, and actually left college. His father never made the link until he saw the movie "Concussion." And he called me crying on the phone, that he did not know.
So I don't want people to retrospectively be regretful. I don't want any parent to suffer that. I'm a parent too. There is power in knowing and when you know you make enlightened decisions.
So Dr. Omalu , short of not playing football at all, are there any changes in the rules or the equipment that which would allow this game to be played without the kind of risk you talk about?
There are other non-contact sports. High-impact contact sports is not the only sports we have, especially for children.
You're also concerned about CTE and another demographic group of Americans, not just children.
Black men make up about six percent of the population in America, but black men make up about 70 percent of football players. So is this a public policy question? Black men as a minority: do they bear the greatest burden of this public health hazard? I wasn't surprised when I heard that black men have the highest unemployment rates. Could this be one of the factors that are contributing to black men not being competitive in the employment market? Because many of them are exposed to repeated blunt-force trauma. I was told that in Texas, beginning from the age of three to four years old!
Playing football! And even boxing! If you go, many of the boxing teams I've seen are located in minority areas. I've not seen a boxing team in an exclusive upper middle class area, no. And so are we further undermining the underclass by exposing them to these harmful sporting activities?
I think I've read that you believe that O.J. Simpson may be suffering from CTE.
I went through the O.J. saga, his story, and his irrationality, his impulsivity, his disinhibition, by disinhibition meaning you're beginning to lose your learned behavior, his sexual improprieties, his violent tendencies, domestic violence history -- in fact, almost bordering on irrationality, irrational behaviors. Even after he was acquitted in the murder trial, he still went on – you know, he's in jail today because of some stupidity. After 2002, I've always suspected that O.J. Simpson is a victim of this disease. He's a victim too.
Dr. Omalu, I don't know whether you heard or saw that at a campaign event, Donald Trump, the Republican candidate for president, said he's frustrated with the changes in the rules that the NFL has embraced, to take hits to the head out of the game: "WHAT USED TO BE CONSIDERED A GREAT TACKLE … YOU'D SAY, WOW, WHAT A TACKLE! BING, FLAG! FOOTBALL'S BECOME SOFT … BUT Football has become soft like our country has become soft, IT'S TRUE." What do you think of that?
I want to find out if Donald Trump's children played football. I bet you that his sons did not. What I'm seeing now, I was informed a majority of the professional players come from the south [cq] states, southern: Louisiana, Alabama, Texas, South Carolina. And if you look deeper, the majority of them come from poor backgrounds.
Many doctors I have met, many professionals, I ask, does your child play football? "Oh no, my child doesn't play football." So this behavior is beginning to manifest an epidemiological trend for a disease like sexually transmitted diseases. These are diseases that gravitate to the poor because of lack of knowledge, information, education and enlightenment.
So people like Donald Trump will brag, because it is not his children.
The film "Concussion," starring Will Smith playing you, will reach a much larger audience -- millions of people more than can possibly read your research. Where did the film get it right, and where did it overreach?
Everything in that movie happened in real life, with some degree of dramatization and creative license. It is a true and accurate depiction of my life, everything was, everything happened. I think Will Smith did a phenomenal job. I think the director did a phenomenal job in telling the story of such a complex issue in two hours. And that movie is highly, highly educational. Hollywood, it's a great agent of change in America.
Dr. Omalu, is there a sport you like to watch?
I watch soccer. I watch badminton. I watch lawn tennis. And I love swimming.
You will have Super Bowl Sunday to do all of those things since you won't be watching the football game.
I'll spend that with my family. We'll cook some Kenyan cuisine and have some quality family time.