Tuesday, October 13, 2015

Brain and body, continued: invisible costs

The previous post on this blog opened up the issue of the differing kinds of injuries in football and the degree to which one (physical, bodily injuries long common to football) or the other (concussions and sub-concussive trauma to the brain) could be deemed worse from an ethical or experiential perspective.

There is another perspective to this question, one which can complicate the fan's ability to make sense of this issue in weighing participation in football as a fan or consumer.*

*I'm trying to address two different dimensions of the experience of following football (or any sport): the emotional allegiance one pays to team or player, and the economic contribution to that team or player via purchasing tickets or souvenirs associated with them.

Bodily injuries, like those suffered by Jamaal Charles of the Kansas City Chiefs or Nick Chubb of the Georgia Bulldogs this weekend, can usually be spotted in real time. A player gets hit. Possibly the player doesn't get up, or does so gingerly, or is perhaps holding leg or arm or whatever part has been hurt. Or possibly the player continues in the game, but is noticeably impaired in doing so -- can't plant on that foot, or arm can't make the throws anymore. It isn't always that obvious, but that injury to some body part is likely to be noticeable in some way. The severity of the injury may not be clear until later, beyond "he's not coming back," but that there is an injury is usually noticeable to any fan paying more than minimal attention.

Some kinds of injuries to the head are also immediately noticeable. A whole bunch of Michigan Wolverines fans, and a decent-sized television audience, picked up pretty quickly that Michigan quarterback Shane Morris was not right in the head after a helmet-first hit against Minnesota last fall. Both the NFL and NCAA have instituted concussion protocols in an attempt to avoid compounding one damaging hit with another, but as the video included in the Morris story demonstrates, a player who is bound and determined to re-enter the game despite "having his bell rung," i.e. the least qualified persion in the entire stadium to determine his fitness to play, can get away from distracted coaches and medical personnel who carry little authority as far as players (and sometimes coaches) are concerned. Nonetheless, at least there are now procedures in place to address blows to the head and their immediate impact, which has not been the case for most of the game's history. (For what it's worth, multiple sports now employ some version of these protocols, with soccer, interestingly enough, being the laggard in this regard.)

However, concussions are not the end of the story.

It is clear from the research that is starting to accumulate on the subject, hits that directly cause concussions are not the only hits that contribute to long-term brain debilitation such as chronic traumatic encephalopathy (CTE). Note here a study pointing to evidence of blood-brain barrier disruption (BBBD), leading to an autoimmune response potentially associated with brain damage (this link offers slightly more accessible language, and this one a somewhat more detailed description of the research), in college football players who did not suffer concussions.

In short, an awful lot of hits that are causing this accumulation of brain trauma can't be identified in real time. They look like normal hits, because they are normal hits. You are probably seeing them happen in any game you watch and have no idea. It's this kind of thing that has caused the NFL to admit in court documents that they project that one in three NFL players to suffer some kind of long-term debilitating brain trauma. Rounding down, that's seven of the twenty-two players on the field at any given time, more or less (punters and kickers are probably not among the high-risk members of the population, granted).

Adding to the insidous nature of this ethical question is that no two players seem to be affected the same way. Obviously some players have managed to have substantial college and pro football careers and not end up on a morgue for brain analysis. Why? And will we ever be able to know why?

The point is: the injuries that lead to these cases of long-term brain trauma aren't necessarily obvious or even visible to you, the fan, over the course of a game. And the game itself very much depends on exactly those hits for its appeal and its very substance.

It's impossible to avoid quoting Paul Stone, author of the article linked from traumaticbraininjury.net above, to frame one of the most disturbing elements of this situation:

The injuries are practically invisible, egos and career stability often keep players from reporting their own injuries, and chronic traumatic encephalopathy is being found in more and more players. How is the sport supposed to fight hits that are fundamental to the sport?

How, indeed?

In short, it is not possbile to walk away from a football game, on the collegiate or professional levels at minimum, knowing that you didn't see any hits or plays that contributed to some player's potential future CTE-induced suicide. You can't know.

At least at this stage of football, such realization must be part of the equation in considering your participation in football as fan or consumer.


Image: stopCTE.org

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