HJBR May/Jun 2023

There is an emerging public health crisis bubbling up amid the ranks of former football players in America. Does it happen to all of them? No, thank God. But it is happening enough that we should all be concerned for any man or boy who played or is playing the game, and you, as healthcare professionals, should know what you might be dealing with and why. Chronic traumatic encephalopathy (CTE) is a progressive and fatal brain disease associated with repeated traumatic brain injuries (TBIs), including concussions and repeated blows to the head. It is also associated with the development of dementia. Frightening? Only if you or someone you care for was one of the guys who donned a football helmet and attended practices. And, if you were coached to “lead with your head,” then you are probably of the age where latent head hits might manifest into clinical symptoms of brain damage, including behavioral changes. Does there seem to be a dose response to how long they played and when they started playing? Yes. Does it matter how many concussions they have had? Most recent research says it does not. It isn’t about concussions. It is the “repetitive head injuries, RHIs,” or “sub concussive” hits, intrinsic to the game of football that are now believed to be causing neurodegeneration. When does CTE begin? We do not know. How do you stop the progression? We haven’t figured that out, either. How do you prevent CTE from happening? Well, the answer is one that is so obvious — do not play the game. This is causing an existential crisis for those involved, because they cannot figure out how to play the game without the head hits, and doing so would change our culture and cost a lot of people and organizations a lot of money. This could be one of the most fascinating topics I have ever looked into: a brain disease emerging from America’s beloved game, played by primarily healthy males in their youth, encouraged by parents, sanctioned by schools and universities, but ultimately driven by billionaires controlling the professional league and media venues who profit handsomely from it all. There are plausible deniability, red herrings of concussion protocols and rule changes for current players, but more importantly, and perhaps damning for the institutions entrusted with educating these young men, a lack of concern for their former players — hiding instead under the veil of amateur athletics and protection of state government. Because, if you don’t count the damage, it must not exist. We are going to take you on a journey this year to the underbelly of the very dangerous game of football. A game the players thought they were playing in real time but is catching them from behind. Why? Our interest was piqued when the co-founder of this Journal, my husband of 32 years and a former college football player, died at 54, his brain filled, the neuropathologists say, with neurological diseases. WARNING: The NCAA’s website refers to those of us who have donated our husband’s brains for CTE research as “troubled widows.” It quotes one of their paid neurological psychologists as saying that he, a high school football player, and hundreds of thousands of others played contact sports at various levels and have done so without having their lives marred by the type of symptoms that have led troubled widows to Anne McKee and Boston University’s CTE Center to donate our husband’s brains — the brains of those he describes as failing to “age gracefully.” For those who come out of the game we all loved unscathed, I am so happy for you. For the rest of you, this series is for you. Here we go, Dianne Marie Normand Hartley Chief Editor editor@healthcarejournalbr.com P.S. And for those of us who like to speak of the dominance of SEC football, so far the SEC is the #1 conference for confirmed CTE cases, according to BU, which has the largest brain bank of former players in America. And they are not counting at least one other SEC player, Smith, because his CTE pathology was confirmed at the University of Washington. EDITOR’S DESK 8 MAY / JUN 2023  I  HEALTHCARE JOURNAL OF BATON ROUGE   Degenerative brain diseases in former tackle football players should have us all questioning why we have and are still allowing boys and young men to play a brain damaging game when we could easily switch to games that don't destroy neurons.