After The Impact: Where Soldiers and Former Football Players Seek Help For Injuries That Never Heal

Austin Kemp's NFL dream began the first day of his senior year of high school. That day 60 different college coaches called his house, asking, and in some cases begging him, to play for their football teams. A year later, the dream ended with one hit.

On the fifth play of his first college scrimmage during his freshman year two-a-days at the University of Tennessee, Kemp slammed into the fullback as a lineman tumbled onto his legs. The fullback pushed against his torso as one does to a tackling dummy, but Kemp's legs remained trapped underneath, folding him backwards until his head touched his backside.

At first, Kemp didn't feel the pain, because, for a full minute, he didn't feel anything. Only when feeling returned to his legs did he notice the gash on his hand that required 14 stitches, and the throbbing pain in his back. The hand would heal, but the back would not.

As is often the case with unwanted developments, Kemp refused to acknowledge the injury. In football culture, a injury is really just an opportunity to persevere through adversity, to fight through the pain, rise to the challenge, and battle back. It is not an invitation to give up. So he didn't.

Born and raised in Fort Lauderdale, Kemp initially preferred the beach to the football field, spending his childhood surfing, boogie boarding, and playing beach volleyball. He barely touched a football until his family moved to Brentwood, Tennessee, a Nashville suburb. At Brentwood Academy, the private Christian high school he attended, all students were required to play a sport, and with no beach available, Kemp signed up for the football team.

Kemp, then 14, was 20 minutes late to his first football practice because he didn't know how to put on his pads. But he was the best player on the team from the first moment he finally stepped onto the field. In high school, he played tight end, defensive lineman, linebacker, and quarterback; he was the kind of naturally gifted, physical athlete NFL scouts salivate about.

Kemp, at 6'4" and 218 pounds his senior year, was named USA Today All-American honorable mention on offense and defense and was Parade Magazine's All-America High School top-ranked player at "athlete", a category "for All-Americans who excel at a number of positions." Other All-Americans that year included LaVarr Arrington, Travis Minor, and Andre Carter.

During his recruitment, Kemp enlisted his dad, a commodities broker, to answer the constantly ringing phones for him. Although different schools recruited him to play different positions, Kemp ultimately received verbal or written offers from no fewer than 14 different schools, including Nebraska, Penn State, Auburn, Alabama, Michigan, and Miami. He chose to attend Tennessee to play linebacker in 1997, joining a unit with future NFL stalwarts Raynoch Thompson and Al Wilson, because he preferred to do the hitting himself.

Kemp missed only two practices after the hit that folded him backwards. Later on, he would be diagnosed with a spinal cord compression and degenerative discs in his back, but he still played for two more years.

During that time, Kemp's natural athletic skills eroded with the discs in his spine. When a doctor advised him to stop playing before his junior year, Kemp begged the doctor to force him to quit because he wouldn't be able to quit on his own. But the doctor couldn't make him do anything, so Kemp tried to rehab again. He collapsed twice in his first few workouts. After so much struggle, rehabbing for a whole year and unable to make it through a week of practice, he finally realized his football career was finished. He played his last game in 1998 before leaving the team. But football wasn't done with him yet.

Kemp's first bout of depression came immediately after giving up football. Always a fine student, his GPA dropped from 3.6 to point-six. He barely left his room. Without football, which got him national press, a high school state championship, a college scholarship, and a BCS National Championship, he was lost.

After school, Kemp followed his father and entered the financial industry as a mortgage banker and worked tireless hours. For him, finance was just another game. The business world allowed him to, at the very least, function.

Still, Kemp's job merely covered the void of losing football. On Valentine's Day in 2005, he lost his son, Jack, born with his umbilical cord wrapped around his neck. His marriage, already difficult and complicated, suffered further. Kemp sought help, confided in a professional counselor, and for years tried to work through the trauma.

Even today, Kemp finds it all very difficult to explain, often struggling to find the right words to articulate a grief that is unspeakable. Losing his son was—and still is—painful and hard. But it was also different than what he faced leaving football. Jack was there, and then he wasn't, due to a tragedy completely outside of his control. So perverse is the universe that in some ways, losing a child can be easier than losing football.

Jack is gone, but football is still with Kemp every day. When he wakes up to searing pain in his lower back, when his head hurts and he fantasizes about drilling a hole through his temple to relieve the pressure, it's because of football. Every few months, his back hurts so much that he literally can't move, and it's because of football. Every time it gets chilly outside, his head aches a little extra bit, because of football. His hand still has a long scar on it, because of football. It's not that Kemp purposely daydreams about what could have been; the question bombards him constantly as he tries to merely exist, and all he can do is wonder what would have happened if he went to Michigan or hit the fullback slightly differently that day in practice. He will continue to wonder, and no matter how many times he asks the question, the only response is a resounding and infuriating silence.

In order to stop asking the questions, the counselor recommended Kemp pen a goodbye letter to football. He doesn't really remember what it said, because, as a symbolic gesture, he immediately burned it. The letter had the opposite of its intended effect. Kemp describes this letter, and its charred remains, as the beginning of his downfall.

Kemp missed the game, but what he missed most was the camaraderie. Once he stopped being Future NFL Star Austin Kemp, he felt like he ceased to exist. "When I was done, I got nothing," Kemp recalls. "No thanks, no sorry to hear it from coaches, I was literally out the door and my jersey number was on another kid the next day."

Since 2009, Kemp had been to two treatment centers and seen several psychiatrists, but nothing helped. For a month this past fall, Kemp drank vodka all day, sat in a dark room, and sulked alone.

When I asked him, two months later, what he thought about as he sat in the dark, he didn't lament the 10 years working a job he didn't care about. He didn't mention the divorce, his recent diagnosis of heart failure, or even Jack. Now 37, sporting a well-groomed goatee and jet black hair behind a new pair of frameless glasses, Kemp didn't say anything at first, but took another moment in what has become close to two decades of regret. "Even 15, 18 years later, I'm still saying, what could have been if I had gone to the NFL? How would my life be different?"

In October, Kemp's drunken fog only lifted after a fit of rage caused him to punch his way through three doors. Afterwards, he called his dad, sobbing into the phone, tears and drool dripping from his face.

Through a series of connections, his dad ended up contacting Eric Hipple, the former Detroit Lions quarterback working with the Eisenhower Center in Ann Arbor, Michigan, a facility that treats individuals who have suffered traumatic brain injuries and the difficulties that arise from it, many of which Kemp—who says he was diagnosed with eight concussions during his football career but likely had closer to 20—experienced.

Hipple thought Kemp would be a fit for one of the Eisenhower Center's more intimate programs called After The Impact, specifically tailored to former NFL players and military veterans, two populations often exposed to head injuries. Through Hipple's work with the University of Michigan Depression Center, where he spoke with active and former military veterans around the globe, he saw that military veterans and former NFL players experience many of the same difficulties adjusting to regular life. It was doing this work in the late 2000s when the thought of putting them together first crossed his mind.

The 'Ranch' at After The Impact, as it is officially known, sits on a 30-acre plot some 30 miles outside of the Eisenhower Center's main campus in Ann Arbor. Google Maps says the ranch is adjacent to an airport, but it's more of a landing strip, the kind of thing you wouldn't notice unless you were looking to land your cropduster. The Eisenhower Center purchased the front half of the plot at a public auction five years ago—which includes a loft house used for another intimate setting program—and completed the acquisition in 2012. The ranch took in its first patients the following year, and has since been funded by the NFL Players Association and the Independence Fund, a nonprofit for wounded veterans. Each side pays the $400 per night fee for their respective patients (NFLPA for football players, IF for vets).

Despite never having played in the NFL or serving in the armed forces, Hipple was willing to make an exception for Kemp, whose struggles otherwise mirrored those who visit After The Impact.

On November 10, Kemp sat in a car that exited I-94 and pulled onto a two-lane road. The car sped past rustic farmhouses, open fields, and rolling hills to the horizon. After a few miles, it turned onto a gravel driveway, leading a thousand feet into the rural farmland, eventually pulling up to a large ranch-style house.

When Kemp arrived, Emily Stratton, After The Impact's behavior analyst, gave him a tour: the sprawling kitchen, the four bedrooms and two bathrooms on the ground level (with two more bedrooms and a bathroom upstairs), the finished basement with a large fish tank, a gorgeous wooden bar installed by the previous owners which the therapists now use for role playing ordering non-alcoholic drinks, the pond in the backyard where people can fish, the TV room, and, of course, the three rescue dogs roaming the grounds.

Stratton showed Kemp the schedule board: wake up around 6 AM to go to a fitness center for exercise, back to the ranch for group therapy from 9 to 11 AM, then individual therapy in the afternoon. In between, they're given reading and assignments and free time.

Before Stratton sent Kemp to unpack, she laid out the ground rules. They can use their phones and laptops, call home as often as they want. The ranch is a family, and while everyone needs their alone time, they're also expected to take part in group activities. It's part of the healing process. Tired from his journey, Kemp went to his room and unpacked.

Kemp wasn't sure how he'd be welcomed at the ranch. He was the only non-NFL player or military veteran there, and, despite the phone conversation with Hipple, he worried he wouldn't have the same life experiences to share, that he would be different. Hipple says this is what newcomers always worry about—that they will be different.

Patrick Kittel works as a veterans program coordinator for After The Impact, but a year ago, he was a patient at the ranch. Back then, he had similar doubts about fitting in. A 27 year old veteran from Louisiana who served in the Marines for four years, he didn't get why the NFL players were at the ranch, too. "These guys weren't in combat, these guys didn't do what I did, they don't know what I did, it's not going to work, it's not going to make sense," Kittel recalls thinking. To him, as with many military veterans, the world was divided into two groups: those who knew, and those who didn't. NFL players were squarely in the latter group. "Nobody understands you, nobody understands why you're having these problems you're having."

It took Kittel, who battled severe PTSD and alcohol abuse after returning stateside, some time to notice the similarities between military and football life. First, there are the obvious demographic similarities: both groups tend to be 20 to 40 years old, physically active men with a strong sense of masculinity.

Then, there are the more significant cultural similarities. Partly due to NFL coaches' long-standing obsession with military tradition, both football players and soldiers are similarly trained to obey authority without question. Failure to do so jeopardizes success. The only decision-making skills developed during their careers are only relevant in hyper-specific scenarios relating to the game or battlefield. Every aspect of every day, from the second they wake up to when they go to sleep, is controlled by others. They do not own their bodies: what to eat, which doctor to see and when, what treatment to undergo, even the very determination of whether they're hurt or whether they're not is largely outside of their control. "You lose your support system, you lose your doctors, you lose your relationships with the people that you're close to, you lose your identity," Hipple summarized.

"Our combat is different," Kittel explains, "but the way Eric [Hipple] prepared for his battle and the way I did for mine, mind body and soul, putting 100 percent into everything you do, and then…" Kittel paused to gather his thoughts: "…when they're done with you, they're done with you. They get cut, they're dropped out on the streets just like me and my boys are. There's no real support system, there's no net, there's nothing to help you make that transition."

Every player has a vision of how their career ends, but it never involves getting unceremoniously cut and lingering for years in the football periphery trying to sneak back onto a roster. Yet, this is what happens to almost everyone. A former NFL player staying at the ranch who asked to remain anonymous told me that the transition was the hardest part for him, too, and plunged him into a downward spiral ending in painkiller abuse and severe depression. "It was like a movie ends and the movie should keep going," the former player told me. "It's not a good ending. You want it to end better than the way it ended. But the movie's over."

But no one would let him forget about that ending. To the outside world, he was A Football Player. "The perception is that you're not a normal person. You're supposed to play football forever."

His description of post-NFL life resembles a very specific version of hell, where the whole world talks about the one thing they are trying to forget. Hey, I saw you play! You were great! What happened, man? How do you reply when you can't answer the question yourself?

Exacerbating the transition problem, health professionals are beginning to understand that not only do former NFL players and military veterans have all of these societal challenges to contend with, but many must do so while cognitively impaired due to the repetitive head trauma they suffered. This can have many long-term ramifications, particularly on mental health, decision-making, and impulsivity—areas of the brain most often damaged due to repetitive head trauma. Football-related head trauma statistics are notoriously problematic, but even the NFL agrees brain trauma affects at least one in three former players, and studies increasingly show amateur and high school football players are at increased risk of neurodegenerative diseases as well.

The military head trauma issue has been studied much more thoroughly. According to the 2013 Center for Disease Control report to Congress, 33,149 U.S. Military personnel were diagnosed with a traumatic brain injury in 2011 alone. In that same report, the VA estimates some 771,874 veterans sought treatment for symptoms that may be related to TBI.

Although the problem is often portrayed as a direct causation in the media—for example: a former player committed suicide because he had head trauma—it is typically a combination of many factors that cause a former NFL player or military veteran to struggle when they return to normal society, much like it was for Kemp and Kittel. The loss of identity, substance abuse, and any damage due to head injuries combine to make re-inventing oneself much more difficult than it already is. Hipple added: "It sets up this syndrome that a person is kind of out of touch with what's happening and doesn't understand why it is happening and so they resort to other problem-solving measures which a lot of times aren't healthy."

Helping these people is a tremendously complex multifactorial problem few medical professionals are equipped to solve. According to After The Impact's surveys administered upon patient admission, all of the following symptoms are exhibited by at least 20 percent of their patients: substance abuse, physical aggression, depression, suicidal thoughts or tendencies, criminal/legal problems, post-traumatic stress disorder, and traumatic brain injury.

Very few doctors or treatment centers are equipped to take all of these factors under consideration simultaneously. If the individual becomes an addict, they seek treatment for that without addressing the underlying issues. If they become depressed, they see a psychiatrist, who is rarely qualified to detect head trauma, and instead will prescribe a battery of antidepressants, once again failing to treat any underlying issue, and often exacerbating some of the other mood disorders common with brain trauma. A neurologist might detect the head trauma, but with no known cure and limited treatment options currently available, there's not much they can do for that alone.

This, Hipple believes, is where After The Impact separates itself from other treatment centers. With on-site nurses, therapists, behavior analysts, speech therapists, 25 hours of therapy a week, and vocational training, After The Impact addresses all of the problems as best they can, putting patients in a supportive yet open environment, splitting the difference between the hyper-controlled environment in which they thrived and the freedom to which they must now adjust. The goal is to have patients leave the facility after the 30 days, equipped to manage their symptoms, and live the closest to a normal life their body allows.

For the first few days, Kemp tried to listen as much as possible during the daily group sessions which, aside from the educational component, teach mindfulness, emotional regulation, anger management, interpersonal relationships, and crisis intervention.

These may sound like basic societal coping skills, but that's exactly what makes transitioning back to regular society so difficult for military and NFL veterans. These are basic coping skills, but also ones not emphasized—or even utilized—in the military or NFL. In those environments, soldiers and players are not encouraged to resolve conflicts through patient discussion and empathy. They're trained to impose their will on others, obey strict hierarchies, physically dominate, and are rewarded for doing so. (Consider the brazenness with which training camp fights in the NFL are brushed off as routine. Texans linebacker Brian Cushing told the Washington Post, "You definitely don't want to have a soft football team. I definitely don't think we have that. It's a very competitive sport. You've got to come out every day and prove yourself." Likewise, a player involved in a training camp brawl last year told the MMQB's Emily Kaplan, "It's like a free pass. You can throw punches at guys who talk smack without getting punished like you would during the season.")

Remnants of football cliches still scatter the former players' thinking. Kemp described one of his biggest problems as "I would always speak without thinking, read and react." Same with how Kittel described post-military life, having to re-learn conflict resolution in the workplace that didn't involve obscenity-laced shouting matches and storming off in a fit.

Some of these habits get corrected through therapy, but having to live together expedites the process. There is hardly a quiet moment in the house, save for the two hours of group therapy. Someone is always watching TV—the Discovery Channel and ESPN are favorites—playing with the dogs, cooking, or scuttling about.

Most of the intense therapy takes place in group sessions, when the players and veterans voice their fears and "face their demons," as is the term used at the ranch. About what a human body looks like after being blown up by an IED. About being unable to get out of bed because you're too injured, or too depressed, or both. About getting drugged up like a racehorse so you can play with broken bones, or treating your body like a garbage disposal for your employer only to have them fire you. About feeling worthless, separated from the rest of the world. Thinking about suicide. Preparing for suicide. Coming thisclose. Wondering why you didn't do it, being glad you didn't, but knowing you'll think about it again, soon. The quietest time in the ranch is after one of these sessions, when everyone silently retreats to their respective rooms, because there is nothing left to be said.

Patients rarely fight, but shouting matches erupt every once in a while, as might be expected. One of the most confrontational incidents began as a result of two service dogs fighting. Christine Myran, vice president of programs at After The Impact, told me disagreements tend to be over small annoyances, but "I can't say that fists haven't swung."

Nevertheless, they do make regular outings to get off the ranch and have some fun, which double as chances to practice real-life scenarios in environments where they must refrain from drinking in alcohol-laden situations. Kemp's group went to Lions and Pistons games, ate buffalo wings, and bowled. Kemp finished dead last with a 108. He blamed his back.

These group outings are sometimes the most important moments. Myran told me a story about a veteran at the ranch with severe PTSD. As part of a group activity, everyone decided to go see a movie. The man hadn't been to a theater since he returned from combat, terrified to go in public. Three very large football players, with whom he had developed a rapport over the weeks, insisted that he go with them and wouldn't take no for an answer. When they got to the theater, the three football players surrounded the veteran like personal bodyguards, escorted him through the lobby, and sat around him in the theater, protecting him. They watched the whole movie.

While in Michigan, Kemp saw several doctors, including a neurologist, endocrinologist, and even an optometrist who noticed his headaches may have been due to poor vision and prescribed him glasses. After meeting with a neurologist for three hours and undergoing a battery of tests and scans, he was diagnosed with a damaged pituitary gland, which affected his hormone levels, potentially causing various ill effects such as weight gain, loss of motivation, anxiety, and depression. "It just opened up all these answers for me."

After about two weeks, Kemp began to notice changes. "I felt like there was a hole that was starting to get filled." Between the doctor visits, learning coping skills, the therapy sessions, and exercising again, he felt the threads of his life rolling back together.

There was a moment it all clicked back into place; a breakthrough, so to speak. He doesn't remember exactly when it was, around ten days into the program perhaps. Kemp was on the phone with his wife, whom he had married six months prior. He started to get upset; about what he can't remember—a testament to its lack of importance. In the past, he might have immediately lashed out, or, perhaps worse, bottled the emotions inside until they couldn't be contained any longer, making the blowout even more severe. Instead, he paused, processed his feelings, and thought about the best way to react. He and his wife had a productive conversation. Everything was fine. It was still reading and reacting, to use his term, but slower, more calculated, even elegant in its simplicity.

"If you look at it, it's so simple," Kemp told me. "But no one has ever taught me or shown me how." He knows his work isn't done, that one successful moment isn't a lifetime of restraint. "This place, they don't fix you. They teach you certain skills, and ultimately it's up to me and every other individual here to go home and keep those skills going to where it eventually becomes natural."

The day I visited the ranch, a few of the patients were boiling cabbage over the massive center island in the kitchen and organizing sugar cookies fresh from the oven. Kemp was packing his bags, getting ready to catch a 10 PM flight to Nashville. When I walked in the front door, he reached out his gigantic hand and greeted me with a broad smile even though he didn't know who I was yet.

After The Impact compares every patient's exit tests to their admission counterparts, using standard psychological measures such as the PHQ-9 and GAD-7, along with basic questionnaires. They've found a 30-day stay at the ranch leads to decreased anxiety by 45 percent, decreased depressive symptoms by 49 percent, 32 percent lower aggression, a 17 percent increase in memory functionality and a similar increase in motor skills.

But, there is no guarantee it stays this way. Patients return to the real world, and, sometimes, find the problems they left behind come right back. Some return to the ranch, or, perhaps, seek other treatment that may work better for them. The first patient at the ranch back in 2013, a "big football player" as he was described to me, had to stay for six months.

Kemp knows this is, that the real test will be two, three, four weeks after he gets home. There is permanent damage inside his head that all the therapy in the world can't correct. But he can cope. He compares the task ahead to reprogramming himself to act in a way previously foreign to him.

Myran likes to point out that most medical ailments are "incurable," like brain injuries, but they can be treated or managed. "It's just like having a heart condition or something else. You're going to be fine. You can get past it."

Whether or not this is a medically sound statement, I see the utility in it. Every patient who walks through the door believes their best selves no longer exist. To rob them of the possibility of improvement, to tell them their lives are over because they have a brain injury, is to deny them the most elemental reason for existence: that tomorrow might be better. In a house with five other people going through the same existential quandary, they can work through it, together, once again as teammates.

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Kemp spent Thanksgiving at the ranch this year. He missed his family, but he doesn't regret the absence. The hope is he'll be home for next Thanksgiving, and the one after that. He says he wants to be around for 50 more Thanksgivings, which would make him quite the elderly man by then. His glasses will be thicker.

He smiles thinking about it, fiddling with the frames and using his index finger to push the glasses up the bridge of his nose. He had forgotten some of the little details about the world, like the sway of faraway branches in a stiff breeze or the active nose of a jogging dog. It's the kind of minutiae that passes most of us by unnoticed. He's still getting used to seeing it again.