'Concussion' Is Important Simply Because It Exists

It's difficult to pinpoint the precise moment public perception toward the NFL began to trend negative. But with the holiday release of Concussion, a new film focused on the league's consistently escalating medical crisis, something that has been slowly thickening in the undercurrents of the scientific and intellectual communities for over a decade has become clear: There is something very wrong with football. This has proven to be a jagged and bitter pill for many, but it appears that now is the time for the medical as well as the ethical and social implications of the game to be seriously addressed. There is a rapidly growing body of literature devoted to the "The End of Football," and the sentiment surrounding this conceptual novelty has already shifted from laughable to intriguing.

Concussion tells the story of Dr. Bennet Omalu, a Nigerian-born forensic pathologist. Since co-authoring a paper published in 2005 titled "Chronic Traumatic Encephalopathy in a National Football League Player," Dr. Omalu has been one of the key figures in the investigation into the long-term and potentially devastating neurological effects caused by playing football. Chronic Traumatic Encephalopathy, a term he coined better known as CTE, is a degenerative disease of the brain caused by repetitive trauma to the head, marked by atrophy and the accumulation of tau protein, associated with dementia, depression, and other symptoms of major mental instability, and, crucially, now found in an overwhelming majority of deceased NFL players.

In Concussion, Omalu is played by Will Smith, and the narrative naturally bends to a strong performance from its star to an ultimately detrimental effect, often relegating the most compelling tension—an inquiry into the NFL's systematic attempts to cover up and undermine the developing scientific evidence linking the inherent activity of the sport to significant health concerns—in favor of the melodrama of one man fighting a growling and shadowy organization. Spotlight, a similar movie currently in theaters, details the Boston Globe's efforts to unravel a massive sexual abuse cover-up by the Boston Archdiocese, fixates on the issue and not the individual, lending it a weight that Concussion, despite documenting serious transgressions on an even larger scale, just doesn't have. It is important mostly for simply being made, and could serve as a kind of prologue for a more definitive film a few decades away.

Earlier this month the New York Times ran an opinion piece written by Dr. Omalu under the fairly severe headline " Don't Let Kids Play Football" appealing not to parents but rather to Capitol Hill to establish a minimum legal age for football, like for voting or drinking. In the wake of his earlier research and amid the media swirl around the movie, his plea feels only partially incendiary, and if what he's positing is true—that CTE can develop through even the relatively minor contact of even grade-school football—then the dismantling of football's all-consuming grip on the fundamental level of this country's existence is inevitable. "If a child who plays football is subjected to advanced radiological and neurocognitive studies during the season and several months after the season, there can be evidence of brain damage at the cellular level of brain functioning, even if there were no documented concussions or reported symptoms," Omalu writes. "Depending on the severity of the condition, the child now has a risk of manifesting symptoms of CTE, like major depression, memory loss, suicidal thought and actions, loss of intelligence as well as dementia later in life."

At this point there is no conclusive data to substantiate or undermine this claim, and, due mainly to the pathological reality of being unable to detect or diagnose CTE in a living brain, we are nowhere close to understanding most of the nuances associated with this still very newly discovered disease. There is a case to be made that the risk and effects have been sensationalized by an overactive media, and it's not just NFL suits or angry fans making the claim: Last week Slate columnist Daniel Engber penned a lucid takedown of the film and the "pervasive national myths about head trauma," arguing that much of the mounting evidence implicating football and CTE with the major neurological degenerative manifestations is anecdotal and circumstantial. Engber cites two major studies, one conducted in 2012 by the National Institute for Occupational Safety and Health indicating that former football players both lived longer and were less likely to commit suicide than the statistical average, the other a 2008 University of Michigan-led survey, that found the rates of depression and aggression in retired NFL players were in line with population averages (although he does admit that the same study suggests that a former player is six times more likely to be diagnosed with Alzheimer's, dementia, or another memory-related disease). Engber concludes that our knowledge of an illness "still in an embryonic stage" is imperfect, and that is certainly a highly rational approach.

And yet it's hard to reconcile that with this, from Frontline:

Or with this headline and lede from the New York Times "Brain Trauma to Affect One in Three Players, NFL Agrees":

The most vocal and prominent intellectual figure leading the charge against football is New Yorker staff writer Malcolm Gladwell, who has likened football to dogfighting, compared the sport and CTE to coal mining and black-lung disease, and deemed it a "moral abomination." The ethical and existential issues he raises—how can we, knowing what we now know, justify not only allowing the game to continue, but to also remain fervently devoted to it—should give even the vaguely philosophically inclined fan pause. An economics-fueled scenario he has put forward is a "ghettoization" of the sport at the professional level, with the player demographic skewing dramatically poor, as those at the lowest rungs of the country's social and fiscal ladders will take on the health risks in exchange for the monetary reward. It's not a huge stretch to imagine a future society judging our current fixation with the NFL to be as grotesque and barbaric as we now consider the gladiatorial games of Ancient Rome.

So what would a more acceptable version of the game look like? If I embrace the shittier parts of my own brain, it's honestly probably not something I would want to watch. The aspects of football that make it so appealing are of course the ones that make it so intrinsically addictive, and curtailing them to a reasonable modicum of safety feels futile. It's been proven again and again to be awfully hard to legislate successfully against human nature, regardless of how vicious or bad. The challenge will be to learn to hold both instinctual strands—the somewhat perverse base-level pleasure that has and continues to draw so, so many people toward the sport, and the somewhat slower knee-jerk empathy that comes from seeing someone seriously and repetitiously debilitate themselves—and develop some kind of internal mechanism that balances the perspective. The work of Dr. Omalu, and the effect that Concussion has had in catapulting it to a more immediate presence on the national agenda, is just the first salvo in what will be a difficult and protracted culture war trying to make peace with just another violent contradiction in a country composed of almost nothing but.

Cody Wiewandt is a writer living in New York.

Concussion is in theaters nationwide.