We will know when former players or their families choose to have their brains given for examination after their deaths. Given the ever-increasing awareness of the effects of football and the thousands of hits its players sustain over the course of their participation on the youth, high school, college and pro ball (for those who get that far), that number is fairly likely to increase. Even that won't necessarily be a complete picture, since most of those who choose to donate are those who experienced symptoms of brain decline during their lifetimes.
(Side note: you could possibly do science a great favor, as a former player, by submitting your brain for study especially if you do not experience such symptoms in your lifetime. Understanding why some are afflicted by CTE and some are not would be an important advance in understanding this trauma.)
However, even that picture won't necessarily reflect the whole story.
That Mike Webster's condition became known to the public has as much to do with the fluke of what Pittsburgh medical examiner was called in to examine the body when it arrived at the morgue. There's not any guarantee that a different examiner would have chosen to perform the more extensive examination that Dr. Bennet Omalu did on that occasion. If that had not been the case, who knows if anyone would have chosen to probe further into the deaths of Justin Strzelzczyk or Terry Long.
Before that awareness in the medical community, we will never know how many former players wer afflicted by the condition in the 1950s, '60s, '70s, or '80s, or even earlier. They might have gone down as simple cases of dementia, or something other like Alzheimer's, or simply unexplained illnesses.
Or unexplained suicides.
In researching on this subject, I came across the story of Jim Duncan. Duncan played briefly in the NFL in the late 1960s and early 1970s, with its pinnacle in the 1970 Super Bowl season of the Baltimore Colts, for whom he started as a defensive back in that championship game. He also featured as a kick returner that season.
The next year he began the season with the Colts as a starter. Injuries derailed his season, though, culminating in a head injury that November. Though no concussion was diagnosed, his season ws more or less off the rails at that point.
Perhaps more interestingly, both team and family members noticed changes in Duncan after the injury; team officials spoke of changes in his personality, while his mother recalled that Duncan began to experience memory loss.
Duncan's life went downhill quickly from there. He was traded the next season to the New Orleans Saints, but was waived by them, and after a failed tryout with the Miami Dolphins (then coached by his former Colts coach Don Shula), he was out of football. A side business went south, treatment for mental illness was required, and his marriage came apart. Finally, in October 1972, according to an official police report, Duncan committed suicide by entering a courthouse, grabbing a police officer's gun, and shooting himself.
The questionable circumstances of his death carry unpleasant resonances with modern headlines about young black men and shootings at the hands of police officers. The other circumstances of his last two years, though, sound awfully familiar to those who have followed the story of CTE:
Football? Check.
Head injury (whether diagnosed as concussion or not)? Check.
Memory loss? Check.
Personality changes? Check.
Business troubles? Check.
Insinuations of drug use/abuse? Check.
Suicide (possibly)? Check.
There will never be any way, at this point, to conclude or demonstrate that Jim Duncan suffered from CTE. His relatively young age, only 26, would not be a disqualifying factor, as the likes of Michael Keck and Tyler Sash demonstrate. But Duncan died forty-four years ago. Analysis or study isn't going to be possible. And there are enough questions about the circumstances of Duncan's death that should not be dismissed that CTE cannot be assumed. But it doesn't seem as though it can be ruled out either.
But we will never know.
And it's very hard to believe he's the only such case.
(Side note: normally I'd have put in a whole bumch of links on Jim Duncan, but most of them are in Google News and Google Books which don't always link well. Google "Jim Duncan suicide" to see reports in The Afro American, Jet, and other sources that discuss aspects of Duncan's life and death.)
Jim Duncan returning a kick in the AFC Championship game of the 1970 season (played Jan. 3, 1971), at the height of his brief career.
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