Tuesday, December 22, 2015

How One Doctor Changed Football Forever

[ed. The article that inspired the movie Concussion to be released later this week.]

On a foggy, steel gray Saturday in September 2002, Bennet Omalu arrived at the Allegheny County coroner’s office and got his assignment for the day: Perform an autopsy on the body of Mike Webster, a professional football player. Omalu did not, unlike most 34-year-old men living in a place like Pittsburgh, have an appreciation for American football. He was born in the jungles of Biafra during a Nigerian air raid, and certain aspects of American life puzzled him. From what he could tell, football was rather a pointless game, a lot of big fat guys bashing into each other. In fact, had he not been watching the news that morning, he may not have suspected anything unusual at all about the body on the slab.

The coverage that week had been bracing and disturbing and exciting. Dead at 50. Mike Webster! Nine-time Pro Bowler. Hall of Famer. "Iron Mike," legendary Steelers center for fifteen seasons. His life after football had been mysterious and tragic, and on the news they were going on and on about it. What had happened to him? How does a guy go from four Super Bowl rings to...pissing in his own oven and squirting Super Glue on his rotting teeth? Mike Webster bought himself a Taser gun, used that on himself to treat his back pain, would zap himself into unconsciousness just to get some sleep. Mike Webster lost all his money, or maybe gave it away. He forgot. A lot of lawsuits. Mike Webster forgot how to eat, too. Soon Mike Webster was homeless, living in a truck, one of its windows replaced with a garbage bag and tape.

Omalu loved the brain. Of all the organs in the body, it was easily his favorite. He thought of it sort of like Miss America. Such a diva! So high-maintenance: It requires more energy to operate than any other organ. The brain! That was his love and that was his joy, and that’s why his specialty was neuropathology. (...)

Omalu stared at Mike Webster’s brain. He kept thinking, How did this big athletic man end up so crazy in the head? He was thinking about football and brain trauma. The leap in logic was hardly extreme. He was thinking, Dementia pugilistica? "Punch-drunk syndrome," they called it in boxers. The clinical picture was somewhat like Mike Webster’s: severe dementia—delusion, paranoia, explosive behavior, loss of memory—caused by repeated blows to the head. Omalu figured if chronic bashing of the head could destroy a boxer’s brain, couldn’t it also destroy a football player’s brain? Could that be what made Mike Webster crazy?

Of course, football players wear helmets, good protection for the skull. But the brain? Floating around inside that skull and, upon impact, sloshing into its walls. Omalu thought: I’ve seen so many cases of people like motorcyclists wearing helmets. On the surface is nothing, but you open the skull and the brain is mush.

So Omalu carried Mike Webster’s brain to the cutting board and turned it upside down and on its side and then over again. It appeared utterly normal. Regular folds of gray matter. No mush. No obvious contusions, like in dementia pugilistica. No shrinkage like you would see in Alzheimer’s disease. He reviewed the CT and MRI scans. Normal. That might have been the end of it. He already had a cause of death. But Omalu couldn’t let it go. He wanted to know more about the brain. There had to be an answer. People don’t go crazy for no reason. (...)

It was late, maybe midnight, when Bob Fitzsimmons, a lawyer working in a renovated firehouse in Wheeling, West Virginia, got a call from the Pittsburgh coroner’s office. It was not unusual for him to be at the office that late; he was having a bad week. He struggled to understand the man’s accent on the phone, jutted his head forward. "Excuse me? You need what?"

The brain. Permission from the Webster family to process Mike Webster’s brain for microscopic examination.

Oh brother was Fitzsimmons’s initial thought. As if the Webster case wasn’t already complicated enough.

Fitzsimmons had first met Webster back in 1997, when he showed up at his office asking for help untangling his messed-up life. Webster was a hulk of a man with oak-tree arms and hands the size of ham hocks. Fitzsimmons shook his hand and got lost in it, mangled fingers going every which way, hitting his palm in creepy places that made him flinch. It seemed like every one of those fingers had been broken many times over. Mike Webster sat down and told Fitzsimmons what he could remember about his life. He had been to perhaps dozens of lawyers and dozens of doctors. He really couldn’t remember whom he’d seen or when. He couldn’t remember if he was married or not. He had a vague memory of divorce court. And Ritalin. Lots of Ritalin.

"With all due respect, you’re losing your train of thought, sir," Fitzsimmons said to Webster. "You appear to have a serious illness, sir." Not a pleasant thing to tell anyone, and here was a hero, a famous football player Fitzsimmons once bowed to, as did all young guys worth the Terrible Towels they proudly waved in the 1970s. The Dynasty! The black and the gold! It fueled optimism here, up and down the rivers, mill towns held tight in the folds of the Allegheny Mountains. And here was Iron Mike himself.

As a personal-injury lawyer, Fitzsimmons thought what he saw in Webster was an obvious case of a man suffering a closed-head injury—the kind he’d seen plenty of times in people who had suffered through car crashes and industrial accidents. No fracture, no signs of physical damage to the skull, but sometimes severe psychiatric problems, memory loss, personality changes, aggressive behavior.

"Please help me," Mike Webster said.

It took Fitzsimmons a year and a half to hunt down all of Webster’s medical records, scattered in doctors’ offices throughout western Pennsylvania and West Virginia. He sent Webster for four separate medical evaluations, and all four doctors confirmed Fitzsimmons’s suspicion: closed-head injury as a result of multiple concussions.

Fitzsimmons filed the disability claim with the NFL. There are several levels of disability with the NFL, and Mike Webster was awarded the lowest one: partial, about $3,000 a month.

Fitzsimmons said, "Oh, please." He said if ever there was a guy who qualified for the highest, it was Mike Webster. The highest level was "total disability, football-related," reserved for those who were disabled as a result of playing the game. It would yield Webster as much as $12,000 a month. Fitzsimmons said to the NFL, "Four doctors—all with the same diagnosis!"

The NFL said no. Four doctors were not enough. They wanted Webster seen by their own doctor. So their own doctor examined Webster...and concurred with the other four: closed-head injury. Football-related.

The NFL pension board voted unanimously for partial disability anyway.

Fitzsimmons said, "You have got to be kidding me." He filed an appeal with the U.S. District Court in Baltimore, where the pension board is headquartered. The judge reversed the decision of the NFL pension board—the first time in history any such action had been taken against the NFL.

And yet still the NFL fought. They took the case to federal court. They said Mike Webster—who had endured probably 25,000 violent collisions during his career and now was living on Pringles and Little Debbie pecan rolls, who was occasionally catatonic, in a fetal position for days—they said Mike Webster didn’t qualify for full disability.*

Mike Webster and Bob Fitzsimmons grew close during those days. In fact, Mike Webster clung to Fitzsimmons like a baby to his mamma. He took to sleeping in the parking lot, waiting for Fitzsimmons to show up for work. He would stay there all day, just watching, waiting, and when Fitzsimmons would go home, Mike Webster would go back to his truck and write him letters. Hundreds and hundreds of letters. "Dear Bob, Thank you for helping me. We’ve got to keep up the fight. We have to see this thing through." And then he would start talking about wars. And blood splattering. The letters would inevitably trail off into the mutterings of a madman.

And now he was dead.

Bob Fitzsimmons did not know what in the world to say, in 2002, to the man with the thick accent who called from the Pittsburgh coroner’s office, four days after Mike Webster died of a heart attack, asking to study Webster’s brain. Fitzsimmons was, in truth, grieving his client’s death deeply; Mike Webster had been living for nothing but the case, the appeal, the last victory against a multibillion-dollar entertainment industry that seemed to have used him, allowed him to become destroyed, and then threw him away like a rotten piece of meat.

And now he was dead.

"Yes," Fitzsimmons said. And he gave Omalu the brain.

by Jeanne Marie Laskas, GQ |  Read more:
Image: Nick Veasay