It’s been 10 years since Dr. Julian Bailes placed his fateful phone call to Dr. Bennet Omalu, the pathologist who discovered a disease he named “chronic traumatic encephalopathy” in the brains of deceased football players. At the time, Omalu was under assault from physicians on the National Football League’s payroll.
“I believe you,” Bailes told Omalu.
That call was a turning point in Omalu’s effort to get the NFL — and the world — to recognize a link between repeated blows to the head and telltale changes in the brain associated with depression, early-onset dementia, aggressive behavior and suicide.
Bailes’s words carried weight. He was medical director of the Center for the Study of Retired Athletes at the University of North Carolina, and he had been a team doctor for the Pittsburgh Steelers. It was in Pittsburgh that he met center “Iron Mike” Webster, the first player Omalu diagnosed with CTE.
Omalu and Bailes went on to make a scientific case that a history of blows to the head, even those below the level of concussion, can have powerful long-term consequences. Joined by a cadre of physicians, attorneys and public health specialists, they forced a reluctant NFL to take some responsibility for the safety and brain health of its players. Their story is recounted in the new film “Concussion,” which opens on Christmas.
Bailes now chairs the Department of Neurosurgery at the North Shore University Health System in Evanston, Ill., where he continues to treat those with brain trauma, to conduct research and to advocate for safer athletic play. He spoke with The Times about his efforts to improve football through science.
You were among the first to recognize CTE in retired professional athletes. It remains a controversial diagnosis. Do you have any doubt that CTE is real?
No. And the only known cause we have is exposure to repetitive concussions or subconcussive impacts.
But there’s still a lot we don’t understand. We certainly don’t know the prevalence of it, who gets it and why, how many former players have it. We don’t know all the manifestations of it, and we don’t know if there are drugs or substances or activities that can contribute to its development.
Is the NFL doing enough to prevent concussions and their long-term consequences?
They’ve done a lot. Frankly, I’m not sure how much more they or anyone else can do.
Now we need to try to reduce the exposure — are there any further rules changes that should be made?
Maybe we need to take linemen out of the three-point stance. They start off every play leaned over and then strike out with their head on essentially every play. So they have this constant, gratuitous head contact over and over.
Also the worst injuries — the really big hits — are on plays like punt returns, where the player is running 30 to 40 yards down the field and then strikes another player. We may need to look at reducing certain plays that have a high potential for injury.
Do you have kids, and do they play?
I have two sons who played football in middle school. They don’t play anymore, but they were old enough to understand what it was about, and about its risks and the benefits.
Can better equipment make football more safe?
There are promising technologies, like a different form of helmet or different materials that could dissipate or reduce forces to the brain. There’s something called a “head health network” that puts sensors in helmets so that a concussion expert can do a virtual consultation on an iPad from the sideline or in a locker room.
Another thing I’ve been involved with for the past five years is looking at internal jugular vein compression by a collar or band around the neck. This would partially block the return of blood from the brain to the heart. Increasing the amount of blood inside the cranium and reduces the ability of the brain to slosh back and forth when the head takes an impact.
We’re looking for technologies like these to be part of the solution in the near future.
We’ve been working with Dr. Jorge Barrio and Dr. Gary Small at UCLA to develop a special PET scan to detect CTE and CTE-like changes in living people. Until we can make the diagnosis in someone who’s alive, we have no chance of helping them.
You’re very active in promoting concussion-reduction efforts among young players, including heading the medical advisory committee for Pop Warner Football. Why is this important?
The future of football entails kids being able to play safely and enjoy it. A few years ago, Pop Warner became the first level of play to eliminate head-contact drills in practice. We limit all contact drills of any type to one-third of their practice. We do everything possible to make the game safer. We now think that, per season, only 1% of Pop Warner football players get a concussion.
It starts there, but we know that at every level of play, this kind of emphasis on improving the safety of the game is important.
What do you tell parents when they ask your opinion?
I do think we can continue to enjoy this great sport, if it’s done with the kinds of reforms that have happened recently.
What do you think when you hear influential parents, including President Obama, suggest that it might be irresponsible to let kids play football?
This is just another thing I disagree with Obama about. It is safe to play football, if someone plays in a league that adheres to the rules and to a modern way of thinking about how football is taught and coached and played.
If kids understand this is a collision sport and it‘s what they want to play, I think they should enjoy the many, many benefits from this sport — just as I think they should enjoy playing soccer or hockey, which also come with risk of concussion.
What do you tell someone who’s already had concussions and is risking CTE down the line?
Besides don’t play? If you’re really worried about the potential for brain injury short- or long-term, that would be my advice.
How did it feel to see Alec Baldwin play you in “Concussion”?
It’s pretty exciting. He’s a great, accomplished actor, so it’s an honor to have someone like that portray me and what we went through.
What do you think of the movie in general?
It’s an accurate movie. It’s factual, and the timeline is correct.
I’m interested to see how the movie is received. Hopefully, something positive will come out of it, and people will gain some greater appreciation not only for what we went through, but for what it took to get the science accepted. And it has been accepted.
This interview has been edited for length and clarity.
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