Once more, with feeling...it's not just concussions

Well, for whatever amount of time I can retain my sanity and not be overwhelmed by despair, the blog is back. Conveniently, it returns on the day the NFL is staging its conference championship games.

If you want, blame my wife for sharing this article with me.

A study published in the peer-reviewed journal Brain drives home the point that has long been burbling under the surface of the ongoing attempt to sort out the link between brain injury and sport (mostly football, but some others too). This blog has made efforts to drive home this point before.

What is helpful here is a particularly strong effort at distinguishing between three terms that are sometimes thrown about rather loosely in the discussion and drawing a much clearer distinction than is usually the case. Evidently the article's author, Cindy Boren, felt it necessary (and got editorial consent) to draw out that discussion in detail, rather than hoping folks would click on the link in the online post (or go find the journal Brain and read it).

Many studies in the past have suggested that chronic traumatic encephalopathy, hereafter CTE, was not necessarily as connected to concussions as the common wisdom tended to assume, but those studies had not been set up to control for those factors and separate concussive hits from subconcussive hits (which are just what the name suggests, hits not hard or forceful or direct enough to provoke a concussion). This study deliberately set out to control for exactly those conditions.

Note the subject of the study: teenagers, specifically teenagers with head injuries. It shouldn't be a shock by now that early stages of CTE can show up in young athletes, not just grizzled veterans, so the choice of subject isn't out of reason at all.

The key is, not surprisingly, the repetitive nature of such hits. If you play one game of football and get banged up a few times, you could end up with a concussion. You are incredibly unlikely, barring other head injuries off the field, to end up with CTE. Conversely, you can play football through two or three years of middle school, four years of high school, and never get diagnosed with a concussion, and still end up showing signs of CTE. It's not necessarily the most common thing to happen, but it does happen.

The confusion of concussions, traumatic brain injury (TBI), and CTE has tended to hinder the public discussion about all of these subjects. Dr. Lee Goldstein, one of the study's authors, spells out those differences effectively enough that it's best just to let him do it, as quoted in the article:

When it comes to head injuries and CTE, Goldstein spoke of three categories that are being jumbled: concussions, TBI and CTE. Concussion, he says, is a syndrome defined “by consensus really every couple of years, based on the signs and symptoms of neurological syndrome, what happens after you get hit in the head. It’s nothing more than that, a syndrome. You take one [symptom] from column A, one from column B.”

A TBI is different. “it is an injury, an event,” he said. “It’s not a syndrome. It’s an event and it involves damage to tissue. If you don’t have a concussion, you can absolutely have brain injury and the converse is true.”

CTE is “a bona fide neurodegenerative disease. It will progress independently of whether you have future hits and a lot of people think that the injury is the disease and it’s not. There is an injury and then it goes on to spread in the brain, like other neurodegenerative diseases.”

And that being the case, eliminating the concussions (whether by "magic helmet" or some other technological marvel) doesn't necessarily eradicate CTE.

Presumably you can see where the problem lies: it's pretty hard to play football without getting hit, probably getting hit a lot. It's kinda baked into the nature of the game. It's what gets celebrated. It's basic. Other sports also have their issues with violent contact, but few of them (maybe rugby?) are quite so intrinsically based on large and fast men hitting one another as hard as possible as football is. (Soccer fans would probably celebrate enforcing rules enough to cut down on contact if only because it would cut down on the awful injury fakery that plagues that sport.)

But yeah, it's not going to be easy to do much about repetitive hits in a sport that is all about repetitive hits.

So, as the medical evidence continues to escalate, expect more distraction. Quite frankly the NFL and maybe even the NCAA will point to concussions more and more and hope you fall for it. High school athletic associations will frankly just hope you don't notice. After all, there's really not a lot of options otherwise.

Whether such distraction will work is up to you.

One other note: the authors of this study and this article do well to point out that football players are not the only sufferers of CTE affected by this information. Outside of athletics the most commonly afflicted are soldiers, particularly in those combat zones where improvided explosive devices come with the territory. Even beyond those, though, sufferers of repetitive hits include the incarcerated, the homeless, and victims of domestic abuse.

Yes, abused spouses and children can end up with CTE. Let that sink in.

In case you've forgotten...

The NFL as good guy?

You know things are strange when this blog, retired nine months ago for the sake of my mental health, is resurrected, for one night only, to ... I can barely type it ... praise the NFL?

How in the world did Roger Goodell turn into a good guy?

How did a protest initially scattered among a few NFL players (the primary figure among whom is not in the league at this point) become a movement that has induced even a player in staid, ultra-conservative Major League Baseball to take a knee?

How did bitter on-court NBA rivals end up allies?

How did it come to pass that an NFL owner end up joining his players on the field?

How did players in a game mostly noted for picking off about a third of them with extreme brain damage finally get woke about their status in a league that relies upon them but usually would prefer they shut up, and in a country in which that feeling goes double?

How did one of the less salutary traditions of sport/politics intersection finally get broken?

How did another of sport's less salutary traditions get interrupted for possibly the first time since World War II?

How did a league in which nine of its owners gave money to that guy end up calling him divisive?

How did the great divisions of a country end up playing out on playing fields?

How does this ever work out?

Only Nixon could go to China

It is one of those stories where, well, you just have to wonder.

About a week ago, the University Interscholastic League, which is the governing body for high school sports in the state of Texas, announced a major effort to track brain injuries among athletes who compete in high school sports in that state. Twenty-four sports will be covered. While I assume some  boys' youth soccer does exist in Texas (girls' soccer is named in the article, you'll note), as a number of professional players have come from the state, the sport most likely to be up for closest scrutiny (by those observing and reporting on the study, if not in the study itself) is football, perhaps the most sacred of idols in that state (or perhaps only second to oil).

Note: while I am intensely curious about how the University Interscholastic League governs high school sports in Texas, I'll leave that discussion aside for now.

The study is inherently significant, as noted in the article, if for no other reason than the sheer number of youth who participate in sports in the Texas system. More than 800,000 athletes participate in sports in Texas public high schools (one assumes there are plenty of private schools with sports as well; whether they are covered in the study or not is not noted). That's the beginnings of a very large database tracking brain injury in young athletes.

The League is partnering with the O'Donnell Brain Institute at the University of Texas Southwestern Medical Center for the study. Its purported aim is to provide a more scientific means to judge whether rules changes, new equipment, or other measures are in fact having any impact in preventing or mitigating brain injury in young athletes, and whether new measures are warranted or needed.

This isn't the first case of a state organization trying to track youth sports on a large scale -- Michigan is noted as having been tracking such injury for some time now. In the 2015-16 academic year football produced the most reports of brain injury, with girls' basketball coming in second, trailing by a mere 1,453 reports.

One would like to be encouraged, wouldn't one?

It all seems very serious. The University Interscholastic League's spokesman acknowledges the lack of scientific usefulness in the current system, which only requires schools to report on a rotating basis. Whatever you may think of UT, its medical program is generally well-regarded. It all sounds like it should be a good thing.

But it's Texas.

It's freakin' Texas.

The book Friday Night Lights (or the movie or the TV series) wasn't set in Pennsylvania or Ohio or Michigan, or even California or Georgia or Florida. All of those states have strong, successful traditions in high school football, as do others. But this is Texas. "Worshipful" is not too strong a word for how that state views football, not by a long shot. The saying that gives this blog its name might as well have been invented there.

Can a state with such a reverence for, such an identity with a sport like football really pull off such a study, no matter where the results may lead?

Do they really want to?

Can the UIL really keep reporting numbers of they get large and out of hand, and nothing seems to help?

Can Texas high schools really be trusted to be scrupulous about reporting all such incidents of brain injury? Can coaches, assistant coaches, trainers, doctors really stick to the rules when the pressure is on and the star quarterback might have to be held out of the big game?

It all has the potential (as it might in any state to some degree) to become a big whitewash.

Or it has the potential to be, to use an overused sports cliché, a game changer.

A genuine and disciplined study can potentially point to what works, whether it be practice limitations, more scrupulous rule enforcement, rule changes or anything else. It could also, in the extreme, point to the conclusion that nothing really works, that football is just going to do this to some percentage of the people who play it when so much size and speed are in play.

On the other hand, a large study such as this could also become little more than a stall tactic, a cover for cries of "we don't have enough data" ad nauseam.

It may be that if a breakthrough of whatever kind is going to happen, it's only right that it comes out of Texas, the epitome of a state where the game really is "way more important than that." Rather like the historical event referenced in the title of this entry, maybe it has to be a state that so zealously embraces the game that has to the one that pushes forth the true nature of the game, or unveils whatever steps are necessary to keep it from enacting a macabre form of Russian roulette on the brains of those young athletes who play it.

It could be big, or it could be just a big sham.

Conflicts of interest

Indiana University has a history of powerhouse basketball teams. Football, not so much.

For their basketball team, anything less than contention for the Final Four is disappointment. For the football team, a 6-6 record and a bowl of any kind is a noteworthy accomplishment.

On the other hand, a Final Four run at the University of Alabama would be impressive, if not particularly noticed or appreciated there. A 6-6 record for the football team, on the other hand, would likely provoke an armed uprising in the state. Different standards at different schools.

Nonetheless, even at a school like Indiana, the pressure for football success can cause things to go off the rails.

A week ago in this blog, two seemingly unrelated stories -- one of a Harvard University study recommending changes to the hiring and oversight of team doctors, another of Indiana's backup quarterback deciding to leave football -- sat nestled next to each other as items two and three. It turns out that the two items, while not necessarily being related, were in fact going to intersect obliquely over the course of the week.

On Thursday, IU announced that football coach Kevin Wilson was no longer going to be football coach. Initial reports spoke of IU firing Wilson (and that's still how my browser bookmarks read), but eventually the departure was reported instead as a resignation. The team's defensive coordinator was immediately promoted to the position of head coach.

This was sudden. There had been no rumors or hints about Wilson's job security; indeed IU is on its way to a bowl game for the second year in a row, which is roughly tantamount to a national championship for the basketball team. If anything it seemed that all was well.

The press conference announcing the firing resignation did nothing to dispel the strangeness. The departed coach was not present, which is not completely surprising. The newly appointed coach talked, as he was supposed to do, of being honored to take the job and of continuing the team's relative success. As for the athletic director who either fired Wilson or accepted his resignation, Fred Glass gave a master class in not answering the questions asked of him. Even the ESPN writer who penned the above story found his answers revealingly unrevealing, in true lawyerly style, as below:

Glass mentioned the term "philosophical differences" so many times I began to envision him and Wilson in robes, arguing over the soul's immortality.

Glass repeatedly denied any wrongdoing, which seemed very strange. For his part, Wilson had accepted a fairly meager buyout despite being owed an average of $2.5 million over the next five seasons. That's not normal coach behavior. Something strange seemed afoot.

A couple of days later, more information started to come out. Despite Glass's protestations, there were some, shall we say, darker episodes sprinkled across Wilson's tenure at IU, episodes which (due to Wilson's departure and the evident confidentiality agreement bridling the tongues of both coach and AD) will probably never be fully interrogated and understood. (A more local view of the whole affair is here.)

At least two investigations into Wilson's treatment of players, particularly injured players, were initiated by Glass, one in April 2015 and another in the past four to six weeks. A number of former players also spoke out in the past week about Wilson's treatment of injured players during his time at IU.

Here's where we must begin to ask questions about coaching responsibility.

There isn't any likelihood of these allegations ever being settled one way or the other. With Wilson gone (and likely not to talk) and Glass having already demonstrate he won't say anything, IU will be unlikely to pursue the issue any further. Still, if even a few of the allegations reported in the last-linked article are true, there was a disturbing tendency towards belittling injured players or dismissing the severity of those injuries in the IU program.

Here's where the idea of conflicts of interest comes in.

Wilson (or any head coach) had the responsibility not to put players at unacceptable risk. That's standard for any coach in any sport.

Wilson also, as any coach in any sport, was responsible to win games.

Those are obvious and universal responsibilities. In addition, in college football, a coach has other concerns beyond those -- seeing that the players are not wiping out in the classroom. Whether or not the coach personally gives a whit about the academic progress of the players, such progress gets measured, and the team actually can suffer consequences if, for example, a certain percentage of the team's players fail to graduate in a timely manner over the course of years. (You might recall that the University of Connecticut basketball team got banned from the NCAA tournament in 2013, at a time when that team was carrying a graduation rate of 8% among its basketball players.) Even if a head coach doesn't directly oversee the academic progress of the team's players, a poor rate comes back on the head coach.

Again, if the stories told about Wilson are true (and the "if" is not insubstantial here), even such a concern as that last one about academics can become an impediment to proper regard for a player's health. The more prevalent concern here in this blog is a kind of emotional manipulation; ridiculing or demeaning injured players as a means to induce them to come back from their injuries too soon.

It's pretty insidious, if you think about it; you get deniability ("hey, he said he could play...") and the player back in action. Eighteen- to twenty-two-year-olds, wildly competitive athletes at that, are not noted for sober judgment or careful balancing of risk. They're frankly easy to manipulate. And it looks possible that Wilson did exactly that.

Let's try to be understanding here; it's hard to keep so many things in balance. While Wilson might have had a nasty streak in his personality (according to some accounts), even a well-intentioned coach of good character can find it challenging to keep up success on the field and in the classroom and still keeping a proper eye on the health of the team's players.

If I'm ever going to start getting hate mail over this blog, it might finally happen because of this topic. Coaches are gods (at least as long as they succeed). It's not just in football; think of how long Bob Knight took to wear out his welcome at IU (in basketball, of course). But there's a media apparatus dedicated to their ongoing deification of coaches across many sports, but particularly so in football (college even more than pro). Nick Saban at the University of Alabama could probably kill and eat a cheerleader at the fifty-yard line at halftime during a game and keep his job. College football coaches always get the benefit of the doubt. Always. Unless they lose, or people get arrested, or overwhelming national attention of a bad kind comes to your program. Ask Art Briles, even as plenty of Baylor folk insist he should have been retained.

Players, on the other hand, are tools (particularly football players). Useful, and even beloved to a degree, as long as they "do their job." Academic failure only matters so far as it causes the player to be unable to play -- not remotely in terms of their education or development as human beings. Personal problems? Get that out of your system before game time, boy (racial coding very deliberate). And don't you dare have an opinion that your coach doesn't give you.

It's hard to challenge a coach who is having even a little bit of success. So if a coach who has the team succeeding even a little gets accused of pressuring injured players to play too soon, who in the administration or -- God help us -- the fanbase is going to hold that coach accountable? Aside from the affected player's parents, perhaps?

It's an unpleasant question to ask, but it had better be asked: are football coaches the best ones to be trusted with making decisions about the health of players (or having authority over those who do), particularly in an age where we have a lot more clue just how much damage football can do to bodies and/or brains?

Fred Glass (right, with new coach Tom Allen) at his lawyerly best.

Weekly Reader: Headlines and reflections

Last week's post on this blog was a public regrouping in order to put forward a small part of the Christian ethical foundation underlying this ongoing project. Today's post will be similar, except framed in a reading of some of the recent headlines directly or indirectly pertaining to the subject and seeking to tease out where these ethical concerns may intersect. It is an excercise in developing a methodology, or trying to do so anyway. So, on with it.

ITEM: The NFL is considering dropping or severly curtailing its schedule of Thursday night games in future seasons.
REFLECTION: I see two particular concerns that are revealed by this piece of news.
The NFL is considering this move for one reason, and one reason only: poor ratings. Others connected to the game have certainly raised other concerns about the package -- bad games, over-saturation, and even player safety on occasion. However, these have been the case for a while -- really, is it not clear that playing a game on Sunday and turning around and playing another game four days later could make it difficult to get every body, or everybody, healed even to a minimal degree? Nonetheless, only the middling ratings for the games seems to have gotten the NFL's attention. So...
1. Why are we so confident that a league that has ignored safety concerns so far in inflating the NFL's Thursday presence, from Thanksgiving Day to a few late season weeks to half a season and, this year, to a full season, can truly be trusted to give enough of a damn about player safety in any other context, absent the pressure of losing not making enough money? To presume that a non-ethical actor is suddenly going to act ethically is, well, not very ethical, is it?
2. The flip side of this realization is that FANS DO HAVE POWER to cause the NFL to change its ways. Withhold your money, or even your attention, and look what can happen! This realization makes it a lot more difficult to cling to the notion that an individual's turning away from the game, for example, "won't make a difference." It apparently can effect the league when people don't watch. So fan responsiblity really does matter.
Sidebar: Some of the same concern will need to be directed at college football as well, in which some teams and leagues play some truly bizarre schedules -- Tuesday and Wednesday nights, even -- and Thursday games have been in place for some schools for as much as twenty years.

ITEM: A study from Harvard University recommends, among other things, substantial changes to the structure by which medical personnel are deployed in the league; the league responded with predictable staged outrage (predictable if you've been paying attention to the league for a while).
REFLECTION: Aside from yet another case of academia being out of touch with the real world, this story points to the mania for control that also contributes to the NFL's untrustworthy nature where player health is concerned.
The study proposes that doctors monitoring health not be employed by the league. The logic is simple; doctors who answer to the league or to an individual team are inherently in a position in which the interests of the team or league (i.e. get the star back on the field as quickly as possible) and the interests of the player (don't die, or don't hasten your own death unnecessarily) do not align, despite the NFL's vapid denials of conflict of interest. (The incredibly fatuous statements attributed to NFL spokespeople in the article suggest that the NFL is either unbelievably ignorant of what "conflict of interest" means, or desperately trying to muddy the waters on the subject.)
And as to claims that the proposed system is unworkable? Then are you serious about the health and safety of your players? It really is that simple.

ITEM: Zander Diamont, a backup quarterback for the University of Indiana Hoosiers, has decided to forego his final season of eligibility after "a lot" of concussions in his career (dating back to high school), summing up his decision with the pithy and on-point comment "I need my brain."
REFLECTION: As has been noted in previous blogs, not everybody would necessarily agree with that last comment.
Of course, as Diamont openly admits, he didn't have an NFL career ahead of him, and he is set to graduate from IU this spring. The lure of a pro career does often interfere with good judgment, it seems. (He's also the son of a soap-opera star, and perhaps that lessens the financial pressures that may cause some to press on in the game and hope against hope for that pro career.)
Also noteworthy is Diamont's acknowledgment that his particular playing style was such that he was more prone to head shots, and that his relatively small size made it hard to have any success without putting himself at greater risk. What is rare here is Diamont's apparent ability to see through it all and come to a decision to step away from the risk before it becomes harm. Hopefully.
What becomes a concern is the degree to which young men, who have been playing football since elementary school in many cases, are terribly good candidates to come to such conclusions more often than not. And this comes back to the root concern of this blog: just because young men are free to put themselves at such risk and to choose the harm, are we Christians ethically or morally free to participate in it with our dollars or our presence or our adulation? And if you've read much of this blog, you'll know where this blog stands.

ITEM: A lawsuit filed on behalf of 142 former NFL players calls on the league to acknowledge CTE as an occupational hazard that should be covered by worker's compensation.
REFLECTION: As much as I would typically be sympathetic to the plaintiffs, some shifty stuff is going on here.
The article states that the lead plaintiff was "diagnosed with CTE in 2015." Um, what? Since the article also seems to indicate that said plaintiff is also still alive, something is wrong here. If some doctor is "diagnosing" former players with CTE (and naturally, this is in South Florida, or Flori-duh), then either some amazing breakthrough has been made in complete and utter isolation and with absolutely zero publicity, or somebody's scamming somebody. Considering that, despite some progress, CTE cannot be definitively identified except posthumously...yeah, ethical dubiousness isn't acceptable on either side of this struggle.

ITEM: Liberty University has hired Ian McCaw as its athletic director.
REFLECTION: While there are about a million things that can be said about this subject, for this case (sticking with the football/CTE issue) we are again forced to consider the issue of trustworthiness, but this time from an explicitly Christian (or nominally so) perspective.
McCaw, of course, was previously the athletic director at Baylor University, at a time when the institution failed spectacularly at dealing with revelations of sexual assault among its athletes. Apparently Liberty's desire to become the Notre Dame of evangelicalism is not about to be sidetracked by mere concerns about the safety of women on campus.
The Washington Post's headline on the article places the stakes pretty high, but not inaccurately so, I'd say. If the term "evangelicalism" hasn't taken enough abuse as a result of the presidential campaign, items like this should help push that over the top.
Of course, one of the principal evangelical leaders involved in that campaign was none other than Jerry Falwell, Jr., the president of Liberty University. The juxtaposition of those two tidbits is juicy enough to warrant a larger concern about just what evangelicalism means anymore. Can an evangelicalism that wants to portray itself primarily through athletic success -- at any cost, apparently -- be trusted with the health of the players who are supposed to bring that athletic success? And a school that is so little concerned with what happened on McCaw's watch at Baylor is not that likely to care for the long-term health of its athletes, either.
The win-at-all-costs mentality of college football is sad enough among the largely secular universities who enjoy most of the success in it these days. Seeing schools who shout loudly about their "Christian character" be so cavalier about such costs, and prioritizing athletic success to the degree that it calls that character into question, is profoundly hard to swallow. It's hard not to wonder if grappling with football and the harm it does to some percentage of its players is going to have to go forward without much participation from the evangelical wing of Christianity, or whether that wing is capable of forming a Christian ethical response to the harms (as opposed to risks) of football.

Zander Diamont says "a lot" of concussions is enough.

Christian ethics, the human body, and football

Part of my responsibility in purusing this project is to put forth a coherent ethical response to the ongoing concern of football and the traumatic brain injury associated with it. Amidst the gathering of new stories and accounts of the experiences of former and now deceased players, the inability or unwillingness of football leagues or collegiate conferences to take the issue seriously beyond a basic CYA instinct, and possible changing attitudes among fans or players, I occasionally need to drop back and gather up some of the ethical foundation and procedure behind the project, to try to keep myself from getting too far off track.

So bear with me, please.

I have been reminded of two basic concerns underlying an ethical approach to this question; one concerning the possible audience for such concern, and another pointing to a basic reason why Christian ethics must (in my opinion, humble or otherwise) address the issue.

Note the choice of the term "Christian ethics." That is a significant limitation on whatever comes out of this pursuit. In trying to sort out what kind of Christian ethical position I'm coming from I've come to conclude that based on what I hope to be the outcome of such a project, my target audience is limited to what is theologically called the "body of Christ."

It isn't because I think the opinions and actions of those of other faiths are irrelevant or unimportant -- quite the opposite. It is simply that, in my role as a Christian (specifically Presbyterian) pastor, my most basic concern is to in some way provide spiritual guidance and direction so that the members of the body of Christ (we usually call them "Christians" though I am growing less and less fond of that word in its current state every day) are formed and matured into people who live rightly, more so than trying to direct individual actions so that individuals act rightly.* This might not sound like what you've perceived as the role of Christian ethics (or ethics in general), and there are certainly others who will disagree.

*Here one might look into Samuel Wells, Improvisation: The Drama of Christian Ethics (Grand Rapids: Brazos Press, 2004), especially his introductory chapters.

Christian ethical thought has at different times emphasized very different outcomes for the body of Christ -- sometimes emphasizing loyalty to the State as a means of guaranteeing the influence of the Church (and yes, quite a few nominally Christian leaders are clearly taking this approach today); sometimes propagating a canon of law or rules, adherence to which demonstrated one's faith; sometimes emphasizing the rationality of the faith, or its suitability to the improvement of the individual vs. the larger body. By staking out the position I have, I am certianly "showing my bias" -- the importance of community and "body of Christ" over individual supremacy, a preference for formation of habits and even "instincts" to respond ethically to situations that haven't necessarily existed before, rather than prescribing a rulebook and then trying to bend current situations to that rulebook (football is, after all, a relatively recent thing in history, though there are other activities that the Christian ethical response to which will be informative), and others I'm sure I'll hear about.

For the moment, though, the big concern that arises from this is that if my primary concern is with the body of Christ, then what I say should not be considered authoritative over those who do not claim membership in said body. It ain't because I don't care. And if a book or some other product eventually does hit the market, my Jewish or Muslim or agnostic friends (or anybody else) should certainly feel free to buy a copy. <grin> But all of this really does come out of a pastoral and theological foundation, and those who do not partake of such a foundation cannot be bound by my arguments from it.

So the language of this project is likely to get more and more faith-specific -- not with intent to offend, but simply trying to do the only job I can do here.


The second reminder to myself comes in a sideways fashion from the first -- specifically from my job being directed toward the "body of Christ," i.e. the Christian (there's that word again) church. Part of the reason is that I don't believe that followers of Christ, professors of an incarnational faith, can be indifferent to those activities in human existence that regularly and routinely cause harm to the physical body.

We are, after all, followers of a victim of torture. The scourging, whipping, imposition of a crown of thorns, and other abuses visited upon Jesus wouldn't even remotely pass muster under the Geneva conventions today, and I'm pretty sure crucifixion would fall under the ban on "cruel and unusual punishment" even for the most zealous defenders of capital punishment (on second thought, maybe not all such defenders). One of the key events in the narrative of Christianity is an act of physical destruction.

Not surprisingly, Christian ethics and doctrine have not typically looked kindly on activities that visit lasting harm on the body (leaving aside for the moment those who hold to soul/body dualisms of some sort, except to say that I'm not one of them). Capital punishment (usually) comes under criticism; abortion is sanctioned; harm to the body through drugs or alcohol or other foreign substances is decried; sports such as boxing have, eventually, fallen out of favor in many Christian circles. It certainly remains possible that football will similarly fall out of favor, although with such virulent attachments to it still in place in some corners of the church that doesn't seem likely any time soon, no matter how much nobodies like me might protest. But it's becoming harder and harder to ignore the degree to which the game produces an awful lot of broken bodies, even if the damage takes five or ten or twenty years to show. That can't be acceptable in an ethic that takes seriously the idea of human beings created in the image of God.  

Here's a case where our ancestors in the faith have provided some thought that can be applied to the modern case, albeit indirectly at best. The criticisms of Tertullian, Augustine, and the like against the gladiatorial combats and contests of the ancient world don't necessarily transfer directly to modern critiques of football (the spectacle of death is not immediate in the NFL, at least for now), but the concerns both about the aforementioned imago Dei and the impact such spectacles had on those who viewed them should not be dismissed. Augustine's account of his unfortunate friend Alypius at the spectacles sounds pretty mild compared to the total besotted intoxication fans display at the modern spectacles on Saturday afternoons (or nights, or now Thursdays or Fridays), or Sundays (or Mondays, or now Thursdays). That infatuation and saturation with the spectacle becomes an unavoidable part of teasing out a Christian ethical response to the seemingly intractable destructiveness of the game on some sizeable number of its players, and has inevitably to be answered and critiqued as part of the process of ethical inquiry.

In short; the destructive quality of football (which seems more intractable and less fixable than in sports like hockey) has to be addressed, but we're going to have to untangle some seriously dubious entwinement of football and religionesque ritual and worship while doing so. And yes, the "i" word (idolatry) is probably going to have to be invoked at some point.

I...I can't even...

Book Commentary: Unintended Impact

Prebstle, Jim. Unintended Impact: One Athlete's Journey from Concussions in Amateur Football to CTE Dementia. Edina: Beaver's Pond Press, 2015. 265pp. ISBN 978-1-59298-883-9.

I have previously in this blog raised the unsettling spectre that, aside from those former NFL players, known and yet to be known, suffering the lingering effects of chronic traumatic encephalopathy (CTE), there might well be numerous players (thousands? tens of thousands?) whose career arc never approached the NFL but yet suffer from the same debilitating effects of their shorter football careers.

This book tells one such story.

Dick Prebstle grew up in the football-crazed precincts of Canton and Massilon, Ohio. Born in 1942, he progressed through what was already a familiar path for a young athlete; beginning to play tackle football at age ten, getting onto the high school team (in his case skipping the "freshman team" that was more common in the 1950s), and as a successful high-school star (and also an excellent student), being recruited to a successful collegiate program, in his case at Michigan State. Prebstle was mostly a backup quarterback at MSU, and a succession of severe injuries, including a now-shocking number of concussions, ultimately ended his career prematurely. (His younger brother, the author of this book, would last longer in football, and was a member of MSU's 1965 national championship team, but neither brother would play in the NFL.)

Dick Prebstle's post-football life seemed destined for success, despite an unsuccessful attempt at law school. He ultimately made his way into business; getting a foothold in the insurance business before  maneuvering his way to the acquisition of a construction equipment company.

Jim Prebstle's story of his big brother's rise and decline has been dropping hints along the way -- frequent migraines, unexpected illnesses suggested as stress-related at the time -- that all was not to be well, but the decline is marked sharply at this point. Without giving away too many details (you are supposed to read the book after all), Jim Prebstle reads Dick's decline in retrospect, armed (as he and Dick's other family members were not at the time) with the understanding of CTE's effect on the afflicted brain. While a CTE diagnosis, which can only be confirmed posthumously, cannot change the suffering its victim and family go through, it can be a means to understand how a seemingly healthy and successful man like Dick Prebstle could be laid low so suddenly. The most marked changes in behavior and cognitive function began to manifest themselves in Dick Prebstle in the early 1980s, according to Jim Prebstle's account.

Dick Prebstle lived until 2012, aged 69.

Think of thirty years in fearsome mental decline, kicking in before age 40.

Jim Prebstle's account is straightforwardly retrospective, reading Dick's life in light of his posthumous diagnosis. Having learned how CTE works, through their experience with the Boston University study that has announced so many such diagnoses, Jim and other relatives of Dick, including wife and children, are calling up painful and baffling memories, and beginning to re-interpret those memories through new information and understanding that was simply not out there in the 1980s. (The book's Forward is by Dr. Robert A. Stern, a member of the BU study group, and is particularly useful to read and digest.)

As Jim Prebstle's account unfolds, a plethora of related issues float, sometimes unintentionally, to the surface -- the relationship between brothers, particularly the overachieving older brother and the younger brother constantly judged by his elder's accomplishments; the "warrior codes" and implicit assumptions about manhood attached to football; the sheer lack of understanding of brain injury and the harrowingly outdated and ultimately deadly way young football players were taught to hit head-first; the sheer idolatry (my word, not Prebstle's) of football in certain parts of American culture; the "steel mill mentality" of the upper Midwest; the bitterness and rancor that result from disputes over care of dementia patients; the staggering physical deterioration of a CTE-afflicted brain; and many more.

The one significant disappointment of the book is the Epilogue, in which football idolatry still demands an Affirmation of Faith in the sport despite its destruction of some percentage of those who play it. The insistence that there has to be a way to make the sport safer still rings out, despite the lack of any evidence that this is so. Preserving football still comes first.

Nonetheless, read the book as a kind of personal counterbalance to a more broad-based account such as that in League of Denial. I suspect more such stories are going to begin to appear, as more former players or their family members try to understand what they or their loved ones have suffered, and how it could all be a result of the game they loved.