This story appears in the Dec. 28, 2015, issue of Sports Illustrated. To subscribe, click here.
One late summer morning in 2014 in Lodi, Calif., Dr. Bennet Omalu was doing what he does most days. He was methodically dissecting a human body to determine why it had died.
For Omalu, who is 47 years old and the chief medical examiner of San Joaquin County, the act of performing an autopsy is a spiritual and delicate one. He treats each body, including the young Hispanic woman who now lay before him, as if it were still sentient. He gently washes it. He cuts through its skin only with clean instruments. He communicates with it. “I need your help,” he will think. “We are in this together. Please help me find out what happened to you.”
After Omalu opened the young woman's abdomen, she gave him the answer. Her stomach was filled with a pink, chalky liquid. Many opiate addicts, Omalu knew, guzzle Pepto-Bismol to counteract the nausea induced by their habit. The woman had likely died of an overdose of OxyContin, as Omalu explained to two unlikely visitors who were watching the procedure.
Twelve Septembers earlier, when he was working in the Allegheny County Coroner's Office in Pittsburgh, a very different body lay on Omalu's table. When he was a boy in Nigeria, Omalu had idolized the United States, and while he continued to do so after immigrating in 1994, he had yet to become interested in America's game, football. Though he lived in Pittsburgh, he had never heard of Mike Webster, the beloved Hall of Fame center for the Steelers, and hadn't heard the local whispers about Webster's subsequent descent into headache-wracked insanity. Webster's illness led him to live in his pickup truck, to pull out his teeth and superglue them back in and to repeatedly shock himself with a taser.
Unlike the woman in Lodi, however, Webster did not provide Omalu with an obvious answer. He appeared to be a physically healthy 50-year-old man whose brain showed no visible abnormalities.
Omalu kept digging. He eventually found, under a microscope, that Webster's brain was riddled with dark tangles of tau protein, which he believed had choked it from the inside out. He identified the condition as chronic traumatic encephalopathy—CTE—and he attributed it to the 70,000 hits to the head he estimated Webster had endured during his football career.
At first, Omalu thought the NFL would welcome his findings—especially after CTE kept turning up in the brains of other former players he examined who had suffered from mental illness and had committed suicide: Terry Long, Justin Strzelczyk, Andre Waters. Instead the league, and the football-loving public, attempted to discredit and intimidate him, branding him a quack. “I was bruised and battered,” Omalu says. “I was marginalized. I was ridiculed.” Doctors on the NFL's Mild Traumatic Brain Injury Committee blasted Omalu's conclusions as “completely wrong” and demanded the retraction of the paper he had published.
Though he was driven out of Pittsburgh, in recent years Omalu has found vindication. He perhaps never felt it so deeply as he did on that morning in Lodi in September 2014. One of the two visitors to his autopsy chamber was Peter Landesman, the screenwriter and director. The other was Will Smith, who at 47 remains one of the world's biggest movie stars. They were there to research a film that would tell the story of Omalu's struggle, and shine a light on the NFL's head trauma crisis with an impact that only Hollywood can provide.
If, as a character in the film remarks, “The NFL owns a day of the week, the same day the church used to own,” then Hollywood owns the rest of the weekend. The movie is called Concussion. It will be released by Sony Pictures on Christmas Day. Says Smith, whose 22 previous movies have grossed a combined $2.8 billion, “This is definitely the most incendiary project that I've ever worked on.”
Says Smith, “Bennet said a really cool line: ‘The truth doesn't have a side.’ I love football. I love the NFL. My belief is that the information will only make it better for all of us.”
While one review of Concussion bills it as “the NFL's greatest nightmare,” Smith's view differs. “It's not an anti-NFL movie,” he says one afternoon in early November, as he sips an espresso after a photo shoot in Los Angeles.
Smith is a lifelong football fan. His older son, Trey, played the sport in high school. “I'm a football dad,” Smith says. “The most fun I've ever had in my life is watching that kid play.” As he considered taking the role of Omalu, though, Smith thought back to a different element of his son's football career. “Back then I was worried about spinal injuries,” he says. “The concept of permanent neurological repercussions was never a discussion. I had no idea. More than anything, I was compelled to tell the story as a parent.”
Smith was moved by Omalu's personal journey, that of an immigrant who finds himself taking on one of his adopted nation's most powerful institutions, and he disappears into the role. “The contortions of his face, the contractions of his facial muscles, the way he tilts his head, his gesticulations—watching it, I thought somebody came, took my soul away from me and ran with it,” says Omalu.
Smith connected with Omalu for another reason. Says Smith, “Bennet said a really cool line: ‘The truth doesn't have a side.’ I love football. I love the NFL. My belief is that the information will only make it better for all of us.”
A desire to disseminate the truth usually ranks far down the list of Hollywood's motivations. Almost all of the major studios have lucrative NFL connections. “It was threading a needle,” says Landesman, who played center at Brown and is a former investigative journalist. “FOX couldn't make this movie. NBC couldn't. Disney couldn't make it. Viacom couldn't. So there was just one studio to go to.”
As Landesman tells it, in the summer of 2014 Sony almost immediately bought his just-finished script, which was based on a 2009 GQ article by Jeanne Marie Laskas. Smith was attached within days, and the movie was green lit in a matter of weeks. By October, principal photography had begun in Pittsburgh.
Not everything about the buildup to Concussion's release has been so smooth. In early September The New York Times published a story headlined “SONY ALTERED 'CONCUSSION' FILM TO PREVENT NFL PROTESTS, EMAILS SHOW,” which quoted communications revealed by the hack of the studio's emails. The article claimed that Sony had “found itself softening some points it might have made against the multi-billion-dollar sports enterprise.” One email from Dwight Caines, Sony's president of domestic marketing, read, “We'll develop messaging with the help of N.F.L. consultant to ensure that we are telling a dramatic story and not kicking the hornet's nest.”
Both the filmmakers and the NFL deny that they cooperated on the film, and that they exchanged more than a few early, cursory emails about it. While Landesman concedes that he cut from an early version of the script a scene that depicted commissioner Roger Goodell—who is played by Luke Wilson, and who has very little screen time—he did so because he couldn't verify the event had actually occurred, though he believes it did. (In the cut scene, Goodell receives a midnight call at his home from NFL doctors, informing him of the death by suicide of former Chicago Bear Dave Duerson.)
“This movie, like all movies based on nonfiction stories—if we're smart and if we care—goes through a strong vetting process to be sure we tell the best, most truthful, most impactful version of the story,” Landesman says.
Besides, to those who have followed the NFL's head trauma crisis—via Laskas's article, the Times's extensive coverage, the Frontline documentary League of Denial and many other media outlets, including Sports Illustrated—Concussion covers little new ground. What it does is tell the story of Omalu's fight, of the plight of former players like Webster, Strzelczyk and Waters and of the NFL's cynical denial of it, in an unsparing and often horrifying way. Viewers might object to certain elements of Concussion: a love story between Omalu and his wife, Prema (played by Gugu Mbatha-Raw) that seems shoehorned in; the way certain scenes seem to have been exaggerated for dramatic effect. But anyone who has seen the movie—which the author of the September Times article hadn't—would have trouble believing it had been softened.
Concussion is new as far as the scale and reach—a Will Smith movie, released on Christmas—with which it tells the story, and explains the science that underpins it. Says Omalu, ”The truth is the truth. The truth has always been the truth. But now the truth is emerging on the mountaintop, in great light.”
In the NFL's headquarters on Park Avenue in New York City, past glass doors emblazoned with the words RESPECT—INTEGRITY—RESPONSIBILITY TO TEAM—RESILIENCY, there were no circled wagons to be seen on a Tuesday morning in early December. Just 2 1/2 weeks before Concussion's release, the league's defense against it had been most notable for its mildness. It made no objection when trailers for the film were shown during its games, starting on Thanksgiving. “I don't know if we could have or couldn't have, but we certainly didn't do anything to stop them from advertising,” says Jeff Miller, the NFL's senior vice president of health and safety policy.
In his office, with Richard Ellenbogen—the head of neurosurgery at the University of Washington and the cochairman of the league's Head, Neck and Spine Medical Committee—on speakerphone, Miller outlines the NFL's reaction to a film which, to his knowledge, no one in the office had yet seen. “We've been interested in talking about issues of health and safety for the purposes of improving our game at other levels, [and] investing in scientific research around those things, for quite some time,” Miller says. “If this movie offers an opportunity to publicly talk about player health and safety and what the league's doing to pursue the goals that we've set, then we welcome the conversation.”
What follows is an impressive, and dizzying, discussion of all of the measures that the NFL has taken to make its game less damaging to its players: of multimillion dollar research grants, and rule changes, and concussion protocols, and independent neurologists, and youth safety programs, all of which demonstrate that the league is now taking its head trauma problem seriously.
The topic of Case Keenum—the St. Louis Rams' quarterback who on Nov. 22 was allowed to stay in a game after he was clearly concussed, struggling to get up and wobbling on his feet—is broached. Ellenbogen, who stresses that he is not paid by the league, admits that the event was an error. But he argues that the fact that it was such a notable one demonstrates how far the league has come from the days when ESPN ran its “Jacked Up” segment, which highlighted that week's most brutal hits and is shown, to cringing effect, in Concussion. “I've read one or two reports from this season where we could have done things better,” says Ellenbogen, of the reports that unaffiliated neuroconsultants now file for each team after each game. “Out of 500? Boy. If any surgeon or any doctor had a complication rate that low, they'd be celebrated.”
But what if the problem is not just with concussions, but with the very nature of the sport, and with the thousands of subconcussive hits that Bennet Omalu believes felled Mike Webster and others like him? To Dr. Ellenbogen, who points out that Omalu's theory remains a hypothesis, it's a value proposition. “I respect Dr. Omalu's opinion,” he says. “I have a very different view of this. As a practicing neurosurgeon that takes care of kids and adults, I think it's much safer to get kids out there, doing exercise, playing the sport of their choice—and we can ameliorate the risks.” (Of course, it might be even safer to have kids exercise in ways that might not carry with them the risk of a long-term neurodegenerative condition.)
“There's no higher priority at the league than the health and safety of our sport,” says Miller. While he mentions the NFL's 88 Plan, which has so far provided 210 retirees with up to $100,000 a year to pay for medical expenses for neurological diseases, the league's response to Concussion is clear. Its primary focus is not on the uncontrollable past, which the film depicts, but on the present and future.
"They say NFL is short for 'Not For Long.’ Well, that don't just stand for how long you're going to play. It stands for how long you're going to live."—Keith McCants
If the NFL is looking forward, Keith McCants—a linebacker who played six pro seasons with the Buccaneers, Oilers and Cardinals—can't help but look back. McCants was arrested multiple times for drug-related offenses after he left the league, due to an addiction that stemmed, he says, from drugs he was administered to keep him playing. “They shot me up with morphine, cortisone, toradol, whatever it took to keep me on the field,” he says. "Then they kicked my ass to the curb.”
At 47, McCants no longer goes outside at night, for fear that he will get lost, and in conversation he often loses track of the topic at hand. In early December, McCants attended a screening of Concussion in Atlanta. He cried throughout his six-hour drive from Tampa, emotional at the prospect of even seeing it. He cried during the movie, too, overcome at its depiction of what some players, like his old friend and Cardinals teammate Andre Waters, had endured. “I now know why Andre killed himself, I know why Junior Seau killed himself, I know why Keith McCants wanted to kill himself,” he says.
"If I knew what I know now, if I knew giving people concussions would kill people, I would never have put on a jersey," he says. "If you break a bone, that's fine. If you break a knee, that's fine. But to break a brain, that's unacceptable.
“They say NFL is short for 'Not For Long,'" he says. "Well, that don't just stand for how long you're going to play. It stands for how long you're going to live.”
“Historically, in the long run, knowledge never makes things worse, even if it may not feel good for a minute.” —Will Smith
The scientific community's grasp of football's long-term neurological effects on its participants remains only in its nascent stages. CTE's prevalence, exact causes and biological mechanisms—why not every player seems to suffer from it—are only minimally understood. “There are many people that go on to very successful careers,” says Ellenbogen. “You gotta look at the numerator and you gotta look at the denominator.”
While Concussion is a work of advocacy, it's also, inevitably, more than that. The film's social media hashtag is #ForThePlayers, but it might also be #ForTheBoxOffice, or maybe #ForTheOscar. Smith has already been nominated for a Golden Globe.
“I was just telling this particular story as truthfully, beautifully and impactfully as I could,” says Landesman. “The consequence of the storytelling is beyond my control.”
The long-term consequence of which Omalu dreams? It's not the end of football. “If you make up your mind to play, I would be the very first person to stand beside you and support that right,” he says. But he hopes that children will be one day banned from participating in contact sports, like tackle football, until they have reached the age of consent and can decide to undertake a potentially dangerous activity for themselves, as with smoking and drinking.
As of early November, nearly 40 current and former NFL players had reached out to Smith, asking to see the movie. To him, that portended an ideal result. “At a minimum, if the players are aware, they have the final say of how they interact with one another on the field,” he says. “For me, this is strictly about knowledge. Historically, in the long run, knowledge never makes things worse, even if it may not feel good for a minute. Bennet Omalu is not an angel. The NFL's not the devil. It's about the process of change and the introduction of new, inconvenient information, and that's always going to be painful.”
Adds Smith, “I think the legacy of this movie is, it illustrates and articulates what happened in a way that is visceral and cinematic, so you can't ignore it.” As of mid-December, though, the review compiler Rotten Tomatoes rated Concussion reviews at 63% positive on its Tomatometer; the website BoxOffice.com—considered by many to be the most accurate source of publicly available box office projections—was predicting that the film, competing against the new Star Wars, would pull in a domestic total of $55 million, and $12 million on its opening weekend. That opening haul would translate to around 1.45 million ticket buyers, which is about 6% of the number of viewers drawn by the average Sunday Night Football game.
Don't expect Roger Goodell to be lining up at his local multiplex on Christmas. “I'm guessing he doesn't see a lot of movies, because he's sort of working 24/7,” says Miller. “But if I find out from him that he intends to see it, I'll let you know.”