Brain injuries and legal battles: the NFL's persistent problem with CTE

The Guardian

6 days ago

On Monday evening, a man brandishing an AR-15-style rifle walked into the east midtown Manhattan office tower where the NFL is headquartered and killed four people before turning the gun on himself.
Authorities say the man, 27-year-old Shane Devon Tamura of Las Vegas, traveled to New York days before the incident, and surveillance footage from the Park Avenue address showed him arriving in a suit and tie that concealed body armor.
Though the motive for the shooting remains unclear, police found a three-page note in Tamura's pocket in which he railed against the NFL and blamed football for giving him CTE, an incurable brain illness. The shooting – which seriously injured an NFL employee, according to a staff email sent by the commissioner, Roger Goodell – marks a new chapter in the league's decades-long history of denying concerns about long-term effects of head injuries in the sport. 'Study my brain, please,' reads Tamura's note. 'I'm sorry.'
Whatever the truth that eventually emerges from Tamura's medical problems, his note is sure to reopen the existential debate that nearly stalled football's surging popularity during the 2010s.
Short for chronic traumatic encephalopathy, CTE is a progressive disease associated with physical contact that causes the brain to bang against the inside of the skull. In CTE cases, a protein called tau overdevelops in the brain, choking off blood vessels and the neural pathways that abet memory and impulse control. Some direct effects of CTE include mood disorders, cognitive impairments and behavioral changes; often, it results in dementia. Crucially, CTE can only be diagnosed posthumously.
CTE was identified almost a century ago in boxers who exhibited memory loss, impaired gait and other symptoms of neurological decline. (They called CTE 'punch-drunk' syndrome back then.) And while the disease has since emerged in hockey, soccer and other full-contact team sports, it's football that holds the greatest potential for CTE. Many associate the game with its big hits, but the repeated collisions in between (often characterized as mini-car crashes) have just as much chance to lead to CTE over time, if not more so.
Helmets, despite what manufacturers and the league itself may claim, offer scant protection. The longer one plays, the greater potential there is to become afflicted with CTE – which makes the risks especially acute for competitors who start young like Tamura, who played in high school. Starting in 2018, a number of state lawmakers introduced legislation to prohibit children under the age of 12 from playing tackle football – but few of those proposals made it out of committee.
The NFL has long been aware of the head injury threats to its players, forming a committee specifically to address mild traumatic brain injury (MTBI) as early as 1994. Eight years later, fans were blindsided by the death of Mike Webster, a cornerstone of the Pittsburgh Steelers 1970s-era dynasty.
In retirement, Webster was diagnosed with amnesia, dementia and depression. He lived out of his pickup truck and electroshocked himself to sleep. Following Webster's death at age 50, he became the NFL's first CTE case after the forensic neuropathologist Bennet Omalu examined his brain tissue. Omalu and his peer neurospecialists published research linking football to CTE, highlighting Webster and Terry Long – a Steelers teammate who also suffered from depression and died by suicide at age 45. But when Omalu's findings were presented to Goodell at a league-wide concussion summit in 2007, Ira Casson, the Long Island neurologist who co-chaired the NFL's MTBI committee, flagrantly dismissed them.
The NFL's CTE casualties would only mount from there. In particular, four players had their brains posthumously donated to Boston University's CTE Center, the foremost database of its kind, and the findings ratcheted up concerns about the disease's impact in professional football to an unprecedented level. Dave Duerson, a Chicago Bears hero who found more post-retirement success in the business world, sent texts instructing family members to donate his brain to science before shooting himself in the chest in 2011. Junior Seau, a hall of fame linebacker for the San Diego Chargers and New England Patriots who was renowned as the NFL's happy warrior, killed himself in much the same fashion in 2012.
Aaron Hernandez – a preternaturally talented receiver who was tied to the murder of three people, one of them a friend – killed himself in prison in 2017 at age 27 and was later diagnosed with the worst case of CTE ever found in a young person. (He took up the game at five years old.) In 2021 Phillip Adams, a veteran of five NFL teams who shot and killed five people in his South Carolina home town before shooting himself, was found to have had CTE all over his frontal lobe – the part of the brain responsible for decision-making, impulse control and other executive functions.
OJ Simpson also nearly donated his brain to Boston University, but he eventually backed away from comments he made in 2018 expressing curiosity over whether he had CTE and was ultimately cremated. Of the 376 former NFL player brains that the center has examined since 2008, it has found CTE in 345 cases. By contrast, BU researchers found only one instance of CTE in a 2018 survey of the general public, and even that sample came from a former college football player.
BU researchers would further sound the alarm on the head injury dangers that tackle football poses to kids whose developing brains, necks and bodies are not yet ready to absorb such impacts. In 2019, a high school football player named Wyatt Bramwell, who killed himself months after graduating high school, became the youngest player to be diagnosed with advanced CTE. While many past CTE cases have been associated with violent behavior, there's no conclusive proof of any direct links.
The combination of Seau's death in 2012, the 2015 release of the Will Smith film Concussion (which focuses on Omalu's quest to hold the NFL accountable for head injuries) and more than 4,500 players filing suit against the league for concealing head injury dangers would throw the NFL – the world's biggest and most profitable sports league and an American cultural institution – into full-blown crisis mode.
To staunch the drop in viewership and combat a rising disinclination among parents to sign their kids up for football (a move many prominent former players endorsed), the NFL legislated some collisions out of the game and beefed up safety protocols while ramping up its promotion of flag football – to the point of successfully lobbying for a place for the non-contact version of the sport on the Olympic program for the 2028 LA Games. In 2013, the league agreed to a landmark $765m settlement with former players that included payouts but, crucially, no admission of liability and limited compensation for CTE claims.
It wasn't until 2016 that the league finally acknowledged the link between football-related head injuries and CTE – and, still, the legal battles continued as the league outright denies claims while punting the responsibility for medical care to individual teams. Meanwhile, retired players, who were left to manage their health problems in the background, could only call out the league for prioritizing profits and scold the game's incumbent generation of stars for not doing enough to consider their forebears in collective bargaining. The deeper the NFL digs in, the more it gives college and high school leagues permission to do the same and risk tragedies like the one that unfolded inside the very building where the league is headquartered.
Tamura never played in the NFL, but he did carve out a respectable high school career at Los Angeles county's Granda Hills Charter, distinguishing himself as a running back and kick returner. Those two positions, high-impact in both their potential for scoring and for brain injury, would have certainly increased his vulnerability to CTE – especially if Tamura took up the game before high school. He seemed to realize something about himself was off, too.
In the note he left behind, Tamura suggests he may have even taken up Long's habit of drinking antifreeze to cope with potential CTE symptoms, and resigns himself to feeling powerless to take on the NFL. Since covering the initial news of the attack at headquarters on its website on Monday, the league's official media channels have moved back to tracking the latest developments from team training camps.