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Dangerous games


The images on the large screen came one after another, each more disturbing and haunting than the other. There was Mike Webster shown naked from the waist up, lying dead on an autopsy table. There was Terry Long dead on an autopsy table with his tongue sticking out, still showing the pain of someone who had endured a prolonged death after ingesting antifreeze. Then there were simply the words of Dr. Bennet Omalu -- who didn't show pictures of Andre Waters because he shot himself -- as he described Waters' condition at his autopsy.

Dr. Omalu gave the presentation at the National Summit on Concussion last Friday in Los Angeles. Several doctors and researchers presented some alarming findings in an effort to increase awareness of concussions in sports, superficially in the NFL. As Dr. Omalu went through his slides, each image was tied together and gained a new historic significance when the disease that put these men on those tables was given a name: Neurofibrillary Football Linked Dementia.

While the name may sound like something you would find in a medical journal, if we shorten it we can see it for what it really is -- NFL Dementia.

The term was used by Chris Nowinski, who authored Head Games, a book on concussions in the NFL, and began the investigation into the Waters case. Nowinski and Dr. Omalu, the neuropathologist in all three of the above cases, realized after leaving Waters' mother's house in Belle Glade, Fla. on April 7, where they had conducted a psychological autopsy on Waters' next of kin for a medical paper, that these cases might show a distinct type of dementia.

"We saw different clinical manifestations of the disease than we would expect to see, for example, in boxers with what we call dementia pugilistica," said Nowinski. "That evidence, combined with the [brain] tissue evidence, combined with known unique biomechanical forces of football have lead us to propose that this may be a different subtype of chronic encephalopathy."

The dangers of head injuries in sports have risen in national prominence recently in large part because the NFL and the NFL Players Association continue to deny that there is any link between concussions suffered while playing football and an increased risk of dementia, a claim that was debunked repeatedly during the summit.

"This case series constitutes indisputable scientific evidence of the link between repeated concussions in football and dementia and major depression," said Dr. Omalu. "Given the prevailing scenarios in these cases of abnormal proteins in such young athletes it cannot be caused by anything else but repeated concussions."

One after another, respected experts presented information that built a crystal clear picture that concussions are among the most serious injuries in sports. Yet concussions are rarely recognized and treated properly, according to Dr. Gerry Gioia of the National Children's Medical Center in Washington.

Experts maintain that the damage caused by concussions is compounded exponentially by returning to play before the brain has recovered, and the research shows that it is unlikely that the brain ever fully recovers in time to return to the same game.

Despite this data, however, presenters showed that as many as 99 percent of athletes play through their concussions, and that at the NFL level, even when the doctors do discover a concussion, they still allow more than 50 percent of athletes back into the same game.

Waters once said, "I stopped counting my concussions at 15. I just wouldn't say anything. I'd sniff some smelling salts then go back in there."

Agent Leigh Steinberg has seen the effect concussions can have on a players and is now trying to educate everyone connected with sports on the dangers of head injuries. Sitting in his hotel suite during a break in the summit, Steinberg explained the how concussions have impacted his clients Troy Aikman and Steve Young, whose careers ended prematurely due to head injuries.

"Spending that night with Troy Aikman in the hospital [after the 1994 NFC Championship game] was a disturbing experience," said Steinberg. "He kept asking me the same questions over and over, and finally I wrote the answers out on a piece of paper. It didn't get much better the week after when he had to play in the Super Bowl. He was not doing well that week. He was sick to his stomach and not feeling good.

"Steve Young once told me he had untold numbers of mini concussions and didn't even think he had a concussion in the Arizona game [in 1999 that ended his career]. It made it clear that [diagnosing] it was so subjective in that situation. Asking the player is not sufficient."

Before Waters took his life last year he told people on numerous occasions, "I need help." Only time will tell if future players get the help Waters never received before they become another tragic case study of NFL Dementia.