Paul Bright was 23 years old when he died on September 1, 2014, in a motorcycle accident.
A successful chef working for a catering company, Bright was, according to his mother, Kimberly Archie, a “typical all-American boy.” He played American football from 7 to 17, first at junior level, then at high school. Always undersized but never outmatched in terms of courage, Bright’s story is one familiar to hundreds of thousands of children and young adults across America.
But the game he loved slowly killed Paul.
Unbeknownst to everyone—because the disease is undiagnosable until death—Paul Bright had developed chronic traumatic encepalopathy (CTE), the degenerative brain condition named by Bennet Omalu, a neuropathologist who first discovered the disease in the brain of Mike Webster, a legendary former Pittsburgh Steeler.
What happens is this: Every time a person suffers a hit to the head with enough force to make the brain shake inside the skull, the axons, which carry the brain’s messages via electrical impulses, shear. If that happens enough times—and scientists are not quite sure how many it takes—then proteins, called tau, start to build up on the brain, leaving scar tissue. That is the start of CTE. Paul Bright never had a diagnosed concussion, but you don’t need to in order to develop CTE. Enough little shakes to the skull is all it takes. Then come the symptoms, which are similar to Alzheimer’s but arrive far earlier in life.
“As he got older, he had difficulty keeping focus,” his mother recalls, speaking by phone from her home in Beverly Hills, California. “I also noticed some irrational behavior, like he got a ticket on his 21st birthday—they called it a ‘wet and reckless,’ which meant he had been drinking but wasn’t over the limit. I think it was an illegal lane change.
“I had a really bad reaction to that—not that I instantly felt CTE, but I felt something was wrong. We both, his boss and I, told him not to go out on his 21st birthday, to stay off the street. He wouldn’t listen. He died driving reckless on a motorcycle. I knew how but not why. The why was CTE. Look at the previous cases—people with brain issues tend to drive badly.”
Paul Bright’s brain was examined by Dr. Ann McKee at the University of Boston, who found the tell-tale proteins that indicate progressive degenerative brain damage.
On December 25, the Hollywood feature film Concussion was released in theaters in the U.S. (It comes out in the U.K. in February.) The movie is a dramatization of Omalu’s pioneering work. The Nigerian-born doctor is played by Will Smith. Archie, now one of the United States’s most prominent campaigners in the fight against the dangers of repetitive head injuries, was invited to the premiere.
“The movie is well done—people love Will Smith. He will probably win a bunch of awards. He does a really good job. It evoked unbelievable emotions. I never went and saw my son’s dead body—when I went to the movie, I got to see exactly what they did to him [cutting open his brain to examine it]. For me it was horrific, incredibly emotional. I cried through the entire movie.”
Paul Bright barely made it to adulthood before CTE swept him away. George Visger, though, got all the way to the NFL before his problems began.
“It was my first season in 1980, my rookie year—the first play I was involved in with the [San Francisco] 49ers,” he recalls. “The first play at the end of the first quarter, I suffered a major concussion. I don't remember that game or the one the next week, and a week later when my memory started to come back the trainers and doctors laughingly told me I went through over 20 smelling salts in the game. I never missed a play or a practice, and a few months later I developed hydrocephalus and underwent three brain surgeries in eight months.”
In 1986, Visger, having sued the NFL and returned to complete his biology degree at the University of Colorado, suffered five more brain surgeries and several seizures. He now documents every detail of his daily life in a notebook, because his short-term memory has been damaged so badly.
Concussions could end up costing the NFL billions of dollars in lawsuits from thousands of players who allege that the league’s powerbrokers knew about the risks and kept them concealed from the stars of the show. Visger, though—“by the grace of God,” he says—is at the lowest level of neurocognitive impairment. His payout, if it comes, will stand at $180,000.
Football is America’s game—a “replacement for religion” as Archie puts it. And the NFL has profited to an almost mind-boggling degree, building itself into a business that posted annual revenues of $9 billion in 2013. CTE, and the prevalence of the disease among the young, however, has given it a PR nightmare. And Concussion is likely to worsen the public’s perception of the game.
“No single event is going to turn the tide on this issue,” says Chris Nowinski, co-founder of the Concussion Legacy Institute in Massachusetts and a former football player himself. “We have had Dave Duerson, Junior Seau, Frontline, various books, various documentaries. It’s an accumulation of information, but this is a very complex issue so we just have keep educating.”
Nowinski is unique in that he has suffered from multiple concussions, both as a football player at Harvard and then in the WWE, the professional wrestling company, before becoming a brain researcher.
“The correlations we see with CTE very much mimic smoking and lung cancer. It’s not one cigarette that’s the problem, it’s how many years you smoke, how many packs per day and how old were you when you started,” Nowinski says. “We need to start hitting kids in the head when they are a little older and hit them fewer times a day, and then just be very happy that most adults will not get hit in the head unless you pay them, so eventually CTE becomes rare and more confined.”
His words, had they been followed, would almost certainly have saved Paul Bright.
“This isn’t a concussion crisis,” Archie says. “This is a repetitive head trauma crisis. Football has issues because of one, the helmet and two, the number of participants. In soccer you have the repetitive hits but not the five-pound weight on your head.
“I don’t think the film is this huge alarm bell that is going to lead to moms across America pulling their kids out of sports. It’s a Hollywood movie. So its power is limited. But I do think it will bring about awareness of what CTE is.”
Visger, meanwhile, will keep living out of his notebooks, running his environmental consulting business and working “16, 18, sometimes 19 hours a day” because he gets distracted so easily.
“When people see what really goes on—we have had three mothers of former high school football players who never had concussions, all three suffered from depression and killed themselves, and all three kids tested positive for CTE—who in the hell is going to let their kids play a game like this? And keep in mind how many guys have gone downhill, been written off as drug addicts—but no one ever tested their brains.”
On December 22, ESPN reported that it was pulling out of funding a Boston University brain study. An NFL spokesman denied the story. Brian McCarthy, the vice president of NFL communications, tweeted: “NFL did not pull any funding. NIH [National Institutes of Health, the medical research arm of the U.S. Department of Health] makes its own decisions.” But the implication was further damage for the league.
Yet there has been progress. On December 23, Nowinski’s Concussion Legacy Foundation reported that Eric Winston, at just 32 still a current player with the Cincinnati Bengals, had agreed to donate his brain to CTE research when he dies.
That will not solve the brain injury crisis among America’s youth. “I knew from interviewing so many NFL players that the earlier they started, and the position they played, played a big part in how many hits they took and that they all had brain damage. Something along the CTE spectrum. I knew my son was exposed to those risks,” says Archie.
Bright died from playing a game, his mother believes. That same game altered the course of Visger’s life, says the former pro. Concussion may do some good by dramatizing an enormously complex issue. But away from the red carpet, the glitz and glamor, the search for the truth goes on for the victims of America’s Game.