In 2007, professional wrestler Andrew "Test" Martin was interviewed for a soon-to-be-released documentary titled "The Circus: Live Fast, Die Young."
"I just turned 32 years old and went to eight funerals this year," Martin said at the time in his mild Canadian accent, sweat bathing his handsome features. "Do I want to join that club? Hell, no, I don't want to join that club.
"So either you clean up, straighten up -- or lay down beside them."
Seventeen months later, on March 14, 2009, Martin was found dead in his Tampa, Fla., condominium at age 33. The Hillsborough County medical examiner later ruled that the 6-foot-6, 280-pound specimen died of an accidental overdose of oxycodone, the addictive ingredient found in the painkiller OxyContin.
Martin's story was yet another tragic case of a wrestler who suffered ongoing emotional and substance-abuse problems and met an untimely end. The most striking example of that genre was 40-year-old Chris Benoit, who according to authorities in Georgia strangled his wife and 7-year-old son before killing himself in June 2007.
The deaths of Benoit and Martin, who wrestled for World Wrestling Entertainment from 1998 to 2004 and 2006 to '07, were widely ascribed to the culture of professional wrestling, steroids use and personal problems, but the doctor who examined both of their brains said they are bound by a more fundamental trait.
Dr. Bennet Omalu, co-director of the Brain Injury Research Institute, told ESPN.com on Monday that Martin suffered from brain damage -- a syndrome he has defined as chronic traumatic encephalopathy -- stemming from repeated blows to the head. Martin is the second former wrestler to be linked to CTE; Benoit was the first.
Omalu said he conducted an analysis of Martin's brain tissues back in April and discovered excessive amounts of tau proteins similar to those he found in Benoit -- and now a rising total of 20 dead athletes. This same chemical imbalance is found in a number of former boxers and known as dementia pugilistica or punch-drunk syndrome. The brains of Benoit and Martin, Omalu said, resembled those of Alzheimer's patients more than twice their age.
"After repeated blows to the head, at some point the brain loses the ability to heal itself," Omalu said from his home office in California's Napa Valley. "The tau impairs normal brain function and kills brain cells. The delicate balance of the neurotransmitters, which control moods and drives and maintains satiety, can be destroyed."
Omalu first discovered CTE in the brain of former Pittsburgh Steelers center Mike Webster in 2002. The Hall of Famer died of a heart attack but had long suffered from depression, memory loss and erratic behavior. Omalu believed that these symptoms could be traced to the estimated 25,000 collisions Webster incurred playing for 17 seasons in the NFL.
Terry Long, a Steelers guard, died in 2005 at age 45 after drinking antifreeze. He was Omalu's second confirmed case of CTE in an NFL player. Philadelphia Eagles safety Andre Waters, who died of a self-inflicted gunshot to the head, was the third in 2006.
Dr. Julian Bailes, Omalu's co-director at the Brain Institute and the chairman of the department of neurosurgery at West Virginia University School of Medicine, announced the Benoit findings at a news conference in September 2007 in New York. Bailes believes the Martin case is similarly significant.
"People wondered if Mike Webster was an isolated event," Bailes said from his office in Morgantown, W.Va. "And then came Terry Long and Andre Waters. When we announced our findings about Chris, some in the media said it was 'roid rage. We said at the time the real finding was that repeated head trauma was the cause.
"With Andrew Martin as the second case, the WWE and the sport in general have to ask themselves, 'Is this a trend?' The science tells us that jumping off 10-foot ladders and slamming people with tables and chairs is simply bad for the brain."
In response, the WWE issued this statement:
"While this is a new emerging science, the WWE is unaware of the veracity of any of these tests, be it for Chris Benoit or Andrew Martin. Dr. Omalu claims that Mr. Benoit had a brain that resembled an 85-year-old with Alzheimer's, which would lead one to ponder how Mr. Benoit would have found his way to an airport, let alone been able to remember all the moves and information that is required to perform in the ring.
"WWE has been asking to see the research and tests results in the case of Mr. Benoit for years and has not been supplied with them."
According to Bailes, the Brain Institute has never received a request from the WWE to see the Benoit records. He invited the WWE to review the data at any time.
A WWE spokesman also pointed to the company's Talent Wellness Program that is summarized on the corporate Web site. It includes mandatory testing of brain function by all talent, specifically the ImPACT concussion management used by the NFL and other leagues that is overseen by WWE medical director Dr. Joseph Maroon, who has been the Steelers' neurosurgeon for more than 25 years.
A failure to cope
Dawn Marie performed as a manager and a wrestler for more than a decade. Last year she founded Wrestlers Rescue, a nonprofit foundation that looks after retired wrestlers.
She said Benoit was a close friend and that she knew Martin.
"I grew up with these people," Dawn Marie said. "It's devastating to think that their career choices -- and their passion, which is the same as my own -- destroyed them from the inside out, literally.
"In this business, we are constantly hitting our heads. I didn't wrestle a fraction of what they did, and I feel the pain every day. I can't imagine what they felt."
Martin learned the craft of wrestling from fellow Canadian Bret "The Hitman" Hart. He began in professional wrestling in 1997 as "Martin Kane" and "T.J. Thunder" in the independent promotions of Canada. But Martin hit the big time a year later when he debuted for the then-World Wrestling Federation playing the role of bodyguard for the band Motley Crue. Two months later, in support of WWF champion The Rock, Martin went after rival Triple H.
Soon he began appearing with the name "Test," slang for testosterone. In one scripted scenario, he was a member of the Corporation, a group of wrestlers known for wielding 2-by-4s in the ring. Martin went on to win the WWF's European, Intercontinental and Tag Team championships. In 2004, after a neck injury, he underwent spinal fusion surgery and was later released by the WWE.
Martin returned to the WWE in 2006 but was suspended for 30 days in 2007 for violating the company's Talent Wellness Program when he tested positive for testosterone. He eventually was released from his contract. Martin was arrested in Florida for driving under the influence in the fall of 2007 and again in the spring of 2008. According to a time line provided to the St. Petersburg Times by the WWE, Martin spent time in a West Palm Beach, Fla., rehabilitation facility in August 2008 at the company's expense, even though he was not under contract. His father, Robert Martin, told the Times his son had been addicted to painkillers for years. Between October and December of that year, Martin kept in touch with WWE executives and attended support group meetings. He last wrestled in Japan in January.
"When I talked with his parents, they confirmed manic depressive behavior," Omalu said. "They said he just couldn't cope. They didn't think it was their son. They didn't understand what had happened.
"Andrew Martin manifested symptoms of CTE. That's what happened."
Dawn Marie, sitting in her Woodbridge, N.J., home, sounds like she is crying.
With the help of a reporter, she is calculating the "bumps" -- the euphemism wrestlers use to describe each choreographed fall -- to the head she took in five years of active professional wrestling. A main-act performer can do 250 to 275 shows a year, including training and perfecting dangerous maneuvers, plus an intense match of between four and 10 minutes. If there are, say, 20 bumps a day -- "and that's very, very conservative," Dawn Marie noted -- that works out to some 5,000 blows per year and more than 20,000 for her brief career in the ring.
"Oh, my God," she said, voice quavering. "I wonder what's going on in my brain right now. I'm so shaken up."
Doing the math, she speculated that Benoit and Martin could have endured more than 50,000 blows to the neck and head during their careers.
"I'm just floored," said Dawn Marie, a single mother. "You're telling me that people in my life are brain-damaged because of what we do for a living. That's really sad to me. It's just our ignorance. A child doesn't know that fire can hurt them until they put their finger in the flame."
When Omalu cited CTE as a factor in Webster's demise in a 2005 edition of the Neurosurgery journal, the NFL essentially dismissed him. Three doctors, all in the employment of the league, called for a retraction.
In 2006, a federal appeals court upheld a ruling by a lower court that the NFL wrongfully denied Webster disability benefits and ordered the payment of between $1.5 million and $2 million to his estate.
Gradually, the league has come to recognize the dangers of concussions and repeated head trauma. In 2007, incoming NFL commissioner Roger Goodell presided over the league's first summit on concussions. Last week he sent a memo to all 32 teams outlining a stricter concussion protocol. Players who suffer a concussion and display certain signs and symptoms should not return to a game, he wrote; previously, the standard was losing consciousness. Additionally, teams were required to consult with independent neurologists, rather than relying solely on their own doctors in assessing concussion cases.
Bailes, who was the Steelers' team physician for 10 years, was also Webster's doctor after he retired. He testified in October before the House Judiciary Committee about the issue of head trauma, a hearing that raised the profile of concussions and their fallout.
"As far as the NFL goes, I think we've moved past the point of them not believing us," Bailes said. "The findings and corroboration that CTE is real, I think, has led to the realization that we must change the way the sport is played.
"We aren't trying to ban the sport; we're trying to make it better. Wrestling ought to take note of that. The story of Andrew Martin should be a wake-up call for people involved in another very popular sport that repeated impacts on the brain are not a good thing."
A comprehensive story by Jeanne Marie Laskas in the October issue of Gentlemen's Quarterly shed further light on the work of Bailes and Omalu.
Omalu said he is encouraged by the decisions of Roethlisberger and Warner to stand on the sideline, but he warns that concussions are not the only problem. The cumulative effect of lesser but still-substantial blows, he stressed, also can cause long-term damage.
Wrestling lost another performer when Eddie Fatu, aka Umaga, died Friday in Houston at age 36. He reportedly suffered a series of heart attacks.
"We were having fun and laughing with him in October," Dawn Marie said. "It's really so sad to bury so many friends. Dying young … it's almost become acceptable, which is disgusting to me.
"Did Eddie suffer from depression? Yes. Did he have the tau in his brain? I hope they test his brain tissue to find the answer. There's an epidemic here, and we have to find out why."
Omalu, a deeply religious man, rises each day at 3 a.m. He is passionate about the forensic pathology he practices on behalf of the Brain Injury Research Institute, but five hours later he heads to his day job as the chief medical examiner of San Joaquin County in California.
He was asked what he was thinking when he discovered CTE in the brain tissue of Martin.
"What flashed through my mind?" he asked in his substantial Nigerian accent, voice rising in pitch near the end of an hourlong conversation. "I thought of Vince [McMahon], the CEO of WWE on CNN, denying the existence of CTE -- just like the NFL did.
" … When I discovered Andrew Martin was positive, I was overwhelmed as well. I'm trying to make a difference in the lives of these people.
"Denying that these athletes are at risk is wrong."
Greg Garber is a senior writer for ESPN.com.