After the aftermath

How the NFL can help prevent tragic deaths like Junior Seau's in the future

Updated: May 17, 2012, 7:38 AM ET
By Peter Keating | ESPN The Magazine

Dejected PatsMark J. Rebilas/US PresswireOne of Seau's most successful seasons was in 2007, when he helped the Patriots to a Super Bowl appearance.

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FOR ALL THE publicity that Junior Seau's death is justifiably receiving, he wasn't the only former NFL player to commit suicide in the past few weeks. On April 19, Ray Easterling, a former defensive back for the Falcons and a leader of Atlanta's Grits Blitz defense in the '70s, killed himself with a handgun. "He felt like his brain was falling off," said his widow, Mary Ann Easterling, in an interview with Fox Sports. "He was losing control. He couldn't remember things from five minutes ago. It was frightening, especially for somebody who had all the plays memorized when he stepped onto the field."

The deaths of Easterling and Seau are an awful reminder of how dramatically the dawdling politics of pro football have slowed progress toward helping damaged retirees -- and of just how little we understand what's going on inside the brains of former players.

We don't know how many former NFL players are suffering from chronic traumatic encephalopathy, degenerative brain damage caused by repeated blows to the head. CTE can lead to depression, memory loss and dementia, and it can cause victims to lose control of their impulses. When forensic neuropathologist Bennet Omalu diagnosed the first cases of CTE in former NFL players, finding the syndrome in ex-Steelers Mike Webster and Terry Long, the NFL's experts disparaged his work. In 2005, Elliot Pellman, then-chairman of the league's concussions committee, called Omalu's conclusions "speculative and unscientific," and three members of the committee publicly urged Omalu to retract his findings. (Since then, researchers have found CTE's telltale tangles in the brains of more than 50 dead athletes, including boxers, NHL players, wrestlers -- and more NFL players.)

We don't know how many NFL retirees have brain injuries of any kind. Though the NFL has programs in place to assist former players with medical issues, neither the league nor the players association monitors the health of retired players -- a fact that shocked Congress in 2008. Four years later, that fact is unchanged.

"Guys seem okay, and then they can fall off a precipice. What we're finding is that their injuries extend to the emotional circuitry of the brain."

-- Julian Bailes, NorthShore Neurological Institute in Evanston, Ill.

We don't know precisely how many hits to the head, or what kind of play, leads to lasting damage, in part because for years Pellman and his colleagues downplayed the effects of brain trauma in the NFL, publishing paper after paper that found no worsening injuries, no cumulative effects and no permanent damage from concussions. Pellman stepped down as head of the committee in 2007, following a Mag investigation of his research methods. In 2011, a member of the NFL's Head, Neck and Spine Committee -- Mitchel Berger, president of the American Association of Neurological Surgeons -- told The New York Times "there was no science" in any of the NFL's research into long-term effects. The league's first legitimate study is just now getting under way.

The NFL has been in a bind for a few years now. What do you do when you can't cling to your old research on concussions because it's not credible, but you also can't admit it was faulty because that would expose you to massive damages in the lawsuits filed by 1,200 former players? If you're Paul Tagliabue, you retire and stop talking to the media. If you're NFL commissioner Roger Goodell, you look to the future and make as many sensible reforms as you can going forward.

Make no mistake, the NFL has taken important strides to protect active players' brains. In August, the reconstituted Head, Neck and Spine Committee sent a memo to all team doctors and trainers that stated: "Any player suspected of having a concussion is a 'NO GO' and does not return to play in the same game or practice and cannot return to play at all until he is cleared by both his team physicians and an independent neurologist." Those words would have been unimaginable before Goodell took over. Still, they came too late to help struggling, suicidal former players.

The cases of Easterling and Seau warrant special attention because both men understood the potential causes of their problems far better than past players could have but took their own lives anyway. Families and friends were at a loss to explain the self-destructive behavior of former Steelers lineman Justin Strzelczyk, who experienced hallucinations, led police on a high-speed chase and drove his car into a tanker truck in 2004; of former WWE wrestler Chris Benoit, who murdered his wife and son, laid a Bible next to their bodies and hanged himself in 2007; of Bengals receiver Chris Henry, who jumped onto the back of a moving pickup truck and either fell or flung himself off in 2009. In each case, it emerged later that the suddenly suicidal athlete had CTE.

[+] EnlargeJunior Seau
AP Photo/Paul JasienskiSeau played in 268 games in 20 NFL seasons but never officially had a concussion.

Not every player with a concussion will develop CTE. Not every player diagnosed with CTE will be violent or suicidal. But the recent headlines about the potential for brain damage from head hits ought to carry clear messages to retired athletes experiencing cognitive and emotional problems: It's not your fault. You're not alone. Help is on the way.

Brain injury specialists treating struggling retired athletes try to separate the psychological from the neurological, to get the victim to "think about thinking" by explaining that their problems have a physical cause. So far those notions aren't getting through deeply enough. Easterling knew about the long-term perils of concussions. He was a lead plaintiff in one of the player lawsuits against the league. (Or, rather, he used to know; Easterling was diagnosed with dementia in 2011.) We don't know for certain why Seau killed himself the way he did, but the circumstances eerily recall the suicide of former player Dave Duerson, who shot himself in the chest specifically so he could leave his brain to science.

It's hard even for the healthiest athletes to transition from careers filled with competition, excitement, riches and supplication of all kinds to retirement at an age when most adults still have two or three decades of work ahead of them. For some players, it's clear that neurological damage severely intensifies the sense of isolation they feel. Think about the panic and physical decline that strikes some elders who enter nursing homes and suddenly have to deal with the loss of a familiar environment and their minds at the same time and you'll have some idea of what many athletes with CTE experience. "Guys seem okay, and then they can fall off a precipice," says Julian Bailes, chairman of neurosurgery and co-director of the NorthShore Neurological Institute in Evanston, Ill. "What we're finding is that their injuries extend to the emotional circuitry of the brain. Again and again, CTE victims seem to become different people."

Seau went 20 years in the NFL without any of his teams ever listing him as having a concussion, yet in 2008 he told his friend and neighbor Taylor Twellman (now an ESPN soccer analyst): "I've had a headache for years. I can't tell you how many concussions I've had."

At least we know this much: Someone in the league or his union needed to reach out to him before he reached the cliff Bailes talks about. Concussion intervention has to be more proactive. Because after a man takes enough hits, even if he knows he's beloved and respected, even if he knows there's something wrong inside his head, even when he knows enough to leave his brain behind, it's not always enough to protect him from the final signal his damaged brain can send: Life can't go on.

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Peter Keating is a senior writer at ESPN The Magazine, where he covers investigative and statistical subjects. He started writing "The Biz," a column looking at sports business from the fan's point of view, in 1999. He also coordinates the Magazine's annual "Ultimate Standings" project, which ranks all pro franchises according to how much they give back to fans. His work on concussions in football has earned awards from the Deadline Club, the New York Press Club and the Center for the Study of Sport in Society.