While the National Football League remains the most successful sports entity in America, its foundations are being shaken by a looming health crisis. For more than two decades, evidence has been mounting that concussions associated with playing football can lead to chronic traumatic encephalopathy (CTE), a mental illness whose symptoms range from memory loss and mood changes to severe depression and suicidal tendencies.
This piece first ran in Printers Row Journal, delivered to Printers Row members with the Sunday Chicago Tribune and by digital edition via email. Click here to learn about joining Printers Row.
About 50 NFL players whose brains have been studied postmortem have been diagnosed with the disease, including gridiron stars Mike Webster and Junior Seau, who fatally shot himself in 2012. But the NFL continues to deny a definitive connection between football and CTE, despite paying $765 million this year to settle a lawsuit filed by about 6,000 retired players and their families.
In "League of Denial: The NFL, Concussions, and the Battle for Truth," Mark Fainaru-Wada, co-author of the best-selling "Game of Shadows: Barry Bonds, BALCO, and the Steroids Scandal that Rocked Professional Sports," and his brother Steve Fainaru, a former Pulitzer Prize winner for the Washington Post, tell the story of the NFL's extended campaign to suppress efforts to prove the connection between the sport and mental illness. Printers Row Journal caught up with the brothers, both of whom now work for ESPN's investigative news unit, for a conference call from their home base in the San Francisco area. Here's an edited transcript of our chat.
Q: I'll start with a small, easy question: Should football be banned?
Fainaru: (Laughs.) We think definitively no. We're both huge fans of the game. I played in high school, and we're both big San Francisco 49ers fans. I have season tickets.
We never set out to be the guys who led the charge to kill football. But at the same time, these are real issues that are facing not only the NFL but anybody involved in the game, which includes kids and their parents, as well as fans who are trying to figure out how they should look at a game that can cause so much destruction to people's lives. In the book, we just wanted to lay out how we got to this point.
Q: The book's title, though, seems to send a pretty clear message about your point of view. Perhaps I'm misinterpreting it.
Fainaru-Wada: You're misinterpreting the title of the book if you think it's about killing football. The book documents pretty extensively two decades worth of denial by the league to basically bury the concussion issue as anything serious for the sport. But to go from that to suggest the sport should be banned, that's a leap that I don't think the title implies or that we meant.
Q: Of course, there are different kinds of denial. Do you think the NFL really believes the statement it made — that football isn't causing this brain disease — or are they disingenuously denying the connection even though they know it's real?
Fainaru: Mark and I have scrupulously avoided trying to infer from the NFL's actions the answer to that question. I do think there were people in the NFL who sincerely were not convinced that the mountain of evidence that had been accumulated by some of the most reputable scientists in the country was enough for them to link football and brain damage. But then, for a period of nearly 20 years, they set out to stifle any research that ran contrary to their own conclusions. They tried to bury it, they tried to get papers retracted, they used their power with the media to attack independent scientists who were producing the research.
The cumulative effect was this incredible institutional denial that was waged at the highest levels of the NFL. Whether they did that because they were disingenuous and trying to cover up the science, or whether they simply didn't believe it, I don't think we go there.
Q: In the book you address the fact that you both work for ESPN, which is one of the leading broadcasters of the NFL. What sense does it make for you guys to be looking into this, when your employer is making a lot of money from televising football games?
Fainaru-Wada: Well, we work in a unit at ESPN that's driven by doing investigative reporting. I think it would be hard to find any investigative unit in the country—and not just in sports journalism—bigger than ESPN's. Throughout the process of reporting the book, we were also feeding stories from that research to ESPN, which was running them on TV and on its website. If we thought there was going to be any interference, that would be a problem, and we probably wouldn't be working there. But the opposite has been true. We couldn't have done the book, frankly, without the support of ESPN, which gave us the time to work on it.
Q: The NFL is one of the biggest things going in American sports and American popular culture, so you guys are scaling Mount Everest, in a way. Is the NFL unassailable?
Fainaru: I don't feel that way. I think it's been proven over and over in journalism that institutions that seemed to be completely impervious to this kind of thing are in fact as susceptible and potentially vulnerable to scrutiny as anybody else. That ranges from the president of the United States and government agencies to the biggest corporations.
People do love their football, but I can't tell you how many people have said after reading the book, "I'm never going to watch football in the same way again." I didn't expect that, but I can understand it, because you're basically forced to reconcile the fact that you're getting entertainment from a sport that now has been shown, with a pretty high degree of certainty, that it can destroy the very identity of a pretty large number of the players you're watching. Where all this is going, I think, is going to be led by the science. Right now, the number of players affected by this is small enough —
Q: That we know about —
Fainaru: — that we know about, exactly — that we're able to keep it at bay in our consciousness, that we sort of suspend it. We suspend it as we watch, and enjoy it. But at the same time, if we're 10 or 20 years down the road and we're talking about hundreds of players who are affected by this disease — or even more than that, as some people suspect — it's going to cause a seismic shift in the way people view the game.
Q: Someone says in the book that if 10 percent of the mothers in America begin to worry about this, football is doomed. Could there be this grassroots, ground-up effect on football's future?
Fainaru-Wada: I think we have to wait and see, but Steve and I did a story on ESPN about a month ago about the fact that Pop Warner (the youth football and cheerleading organization) is seeing a 10 percent decline over the past couple of years, and the medical director believes it's tied to concerns around the concussion issue.
Q: There have also been reports that some football players are showing signs of brain damage as early as high school. If it's determined that there's an ironclad connection between contact injuries related to football and CTE, is there anything to be done about it short of banning football altogether, in terms of changing the rules or improving safety equipment?
Fainaru: My personal view is, basically, no. I think that the game America loves right now is a violent and brutal game. The NFL is dealing with the fact that they have a major health crisis on their hands while at the same time preserving what's basically a product that people love, and that's a really hard line to walk. I think they can and have made changes that cut down on the amount of head trauma that players sustain, but the sport is what it is.
Right now we have a lot of evidence that this is a problem with a certain number of players, but we don't know much about the prevalence issue. If the science proves that the prevalence is very high, I don't think there's anything they can do to preserve NFL football without dramatically changing the game.
Q: How so?
Fainaru: People are floating all kinds of ideas. Eliminating the kickoff entirely. Having linemen start in an upright position to eliminate head trauma at the line of scrimmage. Having players play without helmets, because people now use them as weapons. But if you did those things, it would be a completely different game.
Q: To what extent do you see movement within the NFL on this issue? Are they less in denial today than, say, 10 years ago?
Fainaru: I think the answer is yes. Every week, we see a penalty called because of concerns about helmet-to-helmet hits. We see more enforcement around keeping players out who have concussions, preventing them from going back out on the field. There are more rules around having independent doctors on the sidelines, making sure that the players are examined thoroughly.
But they're still not publicly acknowledging this link between football and long-term mental illness, even though they paid out three-quarters of a billion dollars as part of the settlement of the concussion litigation. So there's a disconnect there.
Fainaru-Wada: When the commissioner himself was asked about the link not long ago, he said the same thing the NFL said in 2009, which was, "We're going to let the medical people figure that out." But as far as the medical people are concerned, they've already figured it out.
Q: You said earlier that you're NFL fans. Steve, you have season tickets. Knowing what you know from having written the book, how does it feel sitting in the stadium watching these games, especially when you see collisions on the field, players being taken off on stretchers and so forth? What goes through your mind in those moments?
Fainaru: (after a long pause): You know, I think it's a very complicated question. There are moments when I ask myself what is it exactly that I'm cheering for. There is this gladiatorial aspect of the NFL, of which the fans are definitely a part. And knowing what Mark and I know now, there are hundreds of players out there now who are hurting because of head injuries they sustained while playing professional football. At the same time, I just think it's an incredibly exciting American spectacle. And it isn't totally about the violence. These guys are just unbelievable athletes, in many ways the best athletes on the planet, and you just watch them every Sunday doing unbelievable things.
So on the one hand, I love the sport, I love watching it for a lot of reasons. I like the communal part of it. I like sharing it with my family and friends. And yet it's like we all now know too much.
And I think anybody who pauses for a second is going to be wondering, "How much am I enabling this by participating?" A lot of it is the scale of the thing. If there are a large number of players coming down with CTE, I think the whole country's going to have to take stock.
Kevin Nance is a Chicago-based freelance writer and photographer. Twitter: @KevinNance1.
"League of Denial"
By Mark Fainaru-Wada and Steve Fainaru, Crown Archetype, 399 pages, $27Copyright © 2014, The Baltimore Sun