4
The NFL’s Head Doctors
based on their total number of workplace fatalities, the most dangerous “regular” jobs in America are logging and commercial fishing. But football players (and before them, boxers) are arguably the best-known victims of work-related disease of any kind. No other profession—not one—outranks professional football in causing life-altering injuries.
For professional football players, one severe work-related condition is chronic traumatic encephalopathy, or CTE. The following members of the NFL Hall of Fame have been diagnosed with the disease posthumously: Frank Gifford, Kenny Stabler, Mike Webster. Recent CTE victims from the pro ranks whose cases have garnered significant attention include Junior Seau, Dave Duerson, Terry Long, and Aaron Hernandez. Battered by thousands of jarring hits, these players’ brains no longer function normally; they undergo a type of progressive degeneration that actually kills brain cells. These men are damaged beyond repair: no cast, no surgery, no medicine, no rehab can change their fates.
The mental anguish and suffering from CTE is enormous and sometimes unbearable, leading inexorably to a host of side effects and consequences, including depression, memory loss, impulsivity, violent outbursts (a particular problem given the size and strength of some football players), drug abuse, homelessness, and premature death, sometimes by suicide.
In the case of Aaron Hernandez, the star tight end for the New England Patriots between 2010 and 2012, his death in 2017 came after a long line of violent off-the-field incidents. Released by the Patriots in June 2013 after his arrest on suspicion of murder, Hernandez was convicted of first-degree murder in one case, then accused but acquitted in two others. Five days after the acquittal, in April 2017, Hernandez hanged himself in his jail cell outside Boston. Examining his brain, researchers subsequently found CTE of a severity never before seen in anyone younger than their mid-forties. Hernandez was 27 at the time of his death.
Hernandez’s brain was one of 111 former NFL players’ brains studied by the CTE Center at Boston University, under the direction of neuropathologist and neurologist Anne McKee. Standard imaging of the living brain cannot conclusively identify CTE; it can be diagnosed only by an autopsy, during which the pathologist slices the brain into thin sections and examines the tissue at the cellular level. Here, the damage is startling. Some areas may have deteriorated and atrophied, losing mass. There is often a buildup of a protein called tau, which in the normal brain works to stabilize brain cells’ cellular structure. With CTE, that same protein accumulates in excess and can alter the functioning of brain cells—or kill them altogether. Junior Seau and Dave Duerson, all-pro defensive standouts who committed suicide, were convinced that a damaged brain was the cause of their behavior and despair. Desperate to preserve their evidence for researchers, both players chose to shoot themselves in the chest.
The results of the Boston University brain study were overwhelming and distressing: 110 of the 111 NFL players’ brains were found to have CTE. Granted, this was a sample of convenience, and not at all representative of all players. Neither was there any comparison population, but given how exceedingly rare CTE is as a disease, none was needed. So while the true risk of CTE if you’ve played in the NFL may not be the 99 percent found here—and I certainly hope it’s not—the study suggests rather convincingly that at least hundreds, and perhaps thousands, of former NFL players have this brain disease.1 In some cases it is mild, in others severe, and in some totally debilitating. (Nor does the disease disable only the pros. That same study found CTE among some men who had played only in high school, not college or the NFL.2)
Faced with initial evidence of widespread, progressive, catastrophic brain damage among its former players, the NFL might have taken steps to find out what’s happening, or at least how to address it. This is not what happened. Recognizing the challenge posed by CTE to the NFL’s incredibly lucrative business, the league instead challenged the science behind football-related CTE every step of the way. Adopting the playbook designed and implemented by Big Tobacco over half a century ago, the league denied and defended. That this insidious strategy was exposed over a half century ago didn’t discourage the NFL from trying it again. America’s most popular sports league hired conflicted scientists who could be counted on to produce studies that minimized the risk of brain damage among football players while also attacking studies done by independent scientists that assert what is now widely accepted as truth: the brains of many, many football players have been irreparably damaged by the hits they took (and take) on the field.
If Big Tobacco couldn’t get away with its obfuscations fifty years ago, back in the relative dark ages of media, how did the NFL believe it could do so recently, when everyone has exponentially more tools for finding and disseminating the facts of any case? It is the common, knee-jerk response of most wealthy industries when they find themselves on the wrong side of science. In the short term it buys some time and saves some profits; in the long run, it’s doomed to fail. Unfortunately for the NFL, its business enjoys a far higher profile than any of the others I discuss in these pages. Foundry workers are not on TV every Saturday (college) and Sunday (NFL) for five months out of every year. Many of the league’s fans are parents of school kids who play football. The old news adage about trauma and reporting goes, if it bleeds, it leads. The brain doesn’t openly bleed, but the concussion story was nevertheless destined to lead the news.
This history of obfuscation and duplicity by the NFL begins in the early 1990s, when the initial signs of a coming epidemic of brain damage first came to light. For decades, as the defensive players had gotten bigger, stronger, and faster, and their hits on the offense harder and harder, more and more players were slower and slower getting up after collisions, or they had to be helped off, occasionally with the support of teammates or on carts. The evidence was anecdotal, but reporters focused on the jump in the rate of concussions occurring every Sunday, on the increase in the number of well-known players, especially quarterbacks, who couldn’t continue to play. Their symptoms didn’t disappear with time. They got worse.
At a public forum in New York City in 1994, journalist David Halberstam questioned Paul Tagliabue, then the NFL’s commissioner, about the mounting toll of concussions among the league’s players. Halberstam was not just any journalist: He had been awarded a Pulitzer Prize in 1964 for his coverage in the New York Times of America’s involvement in Vietnam. His subsequent book, The Best and the Brightest, was one of the most important ever published on the subject of the war. So he and his question could not be easily dismissed by Tagliabue or anyone else. But of course the commissioner did try. Sports Illustrated described the encounter: “Calling the matter a ‘pack journalism issue,’ [Tagliabue] waved away concern, saying that the NFL has ‘one concussion every three or four games.’ After a few more calculations, Tagliabue pronounced a figure of 2.5 concussions for every ‘22,000 players engaged.’ His response raised echoes for Halberstam… ‘I feel I’m back in Vietnam hearing McNamara give statistics,’ he said.”3
Ironically, Junior Seau is mentioned in the very next paragraph of the Sports Illustrated article. The previous Sunday, the hard-hitting linebacker had knocked New York Jets’ quarterback Boomer Esiason “senseless.” Tagliabue tried to be dismissive, but this tactic was never going to work, not in the face of such high-profile questions and reporting. This concussion story was becoming a massive PR problem, with the league facing pressure from players, the press, and, perhaps most consequentially, from the fans and from parents wondering if they should stop their kids from playing football. If sizable numbers of parents did take this route, and if more boys followed their sisters to the soccer fields, the long-term fan base of the league would be endangered. Clearly, the NFL had to do something.
Soon after his public skewering, Tagliabue announced the formation of the Mild Traumatic Brain Injuries (MTBI) Committee, charging it “to scientifically investigate concussion and means to reduce injury risks in football.” To staff this committee, he could have turned to independent physicians or renowned brain researchers. He did not do that. Instead, the commissioner turned to people he knew and could trust, some with profound conflicts of interest: representatives from the NFL Team Physicians Society, the NFL Athletic Trainers Society (now called the Professional Football Athletic Trainers Society), and NFL equipment managers. These committee members had financial ties to the league and to specific teams, and certainly had some incentive to not acknowledge that football was damaging the brains of their players. Almost all would be inclined toward other conclusions.
The MTBI’s published papers included the reassuring statement that “none of the Committee members has a financial or business relationship posing a conflict of interest to the research conducted on MTBI in professional football.”4 (Author’s note: Yes, they did.) The chair of the committee, Elliot Pellman, was a rheumatologist with no particular expertise in neurology or brain trauma. He was, however, Tagliabue’s personal physician, and he and others on the committee were clinical consultants to various teams. In that capacity, they were personally responsible for determining whether concussed players were too damaged to return. Consciously or not, they were not likely to welcome the idea that sending players who had been knocked woozy right back onto the field might contribute to their risk of long-term brain damage. Independent they were not.
Then there’s the name of the committee—Mild Traumatic Brain Injuries—which itself implies that the MTBI Committee was preordained not to find severe effects from the collisions inherent in the game. Before any data were collected, the injuries were labeled “mild.” No one was surprised that this is exactly what the MBTI found. Eventually. For the first eight years—that’s right, years—the committee found out nothing. Between 1994 and 2002, it published nothing. But when questioned, the league could point to the committee as proof that it was working on the problem. Then, in the following three years, between 2003 and 2006, the MBTI committee published 13 papers, all in the same journal: Neurosurgery.
One after another, these papers presented conclusions that minimized or denied the existence of any long-term effects of head trauma from playing football. They gave the league and the team owners the results they wanted: pro football simply wasn’t that dangerous. The decisions made by the teams’ physicians were the right ones. The rare concussion was treated appropriately. The game did not need to be reformed. The two MBTI co-chairs, Pellman and David Viano, a biomechanical engineer, authored a paper that summarized the MTBI committee’s research and recommendations. Here are a handful of the assertions in this summary, all of which turned out to be misleading or erroneous:
In teaching my students how to review epidemiologic studies, I often tell them, “what the results giveth, the methods taketh away.” Some of the methodologic flaws in these studies, including ones that would guarantee that fewer neurological effects would be found than actually exist, were obvious. Others were more subtle. But there were lots. Selection bias, where the participants in the study are not representative of the universe of people who should have been included, is just one of these flaws. One study, for example, included only players who were identified as having an MTBI and who then voluntarily participated in neurological testing. In all, only 22 percent of concussed players who were eligible to participate actually did. And these players represented only 16 percent of the concussions. In this relatively small group of players (143), the neuropsychological function of those who stayed off the field for more than a week after the injury was compared with those who returned to the field more quickly. No one was tested for their brain function more than ten days after the concussive event.
Not surprisingly, many of the flaws in these MTBI papers were spotted easily by the peer reviewers (experts who volunteer to review studies like these before they get published), and Neurosurgery published these cautionary reviews in tandem with each paper. This was unusual. With most journals, editors who receive reviews that identify fundamental methodologic flaws generally just reject the paper, or at the least send it back to the authors and request major revisions. Why did Neurosurgery publish the MTBI papers, flaws and all? I note only that the editor of that journal at that time was Michael L. J. Apuzzo, who also was a medical consultant to the New York Giants, and later to the NFL commissioner’s office as well. Some researchers eventually nicknamed Neurosurgery the “Journal of No NFL Concussions,” although it did subsequently publish the controversial first report of CTE found in the brain of a deceased football player.6
The limitations in these “no harm, no foul” papers, tacitly admitted by the journal that published them, did not stop the NFL’s medical experts from suggesting that the football players that make it all the way to the pros have brains that are resistant to brain damage:
[T]here may be a natural selection of athletes that make it to the NFL because players more prone to concussion may have been weeded out during high school and college play. Brain responses shown here may represent those of players who are most resistant to the damaging effects of neural deformation during head impact.7
This is a remarkable statement. The NFL was claiming that the new standards and concussion protocols that had already been implemented in many colleges and high schools were less necessary in the pros, because natural selection made professional brains more resistant to brain injury. This would represent a new wrinkle on the “survival of the fittest” doctrine.
Did anyone actually believe this? Whether he believed it or not, Tom Brady at least carried water for the statement. In late 2018, the Patriots’ quarterback remarked in an interview, “Your body gets used to the hits. The brain understands the position that you are putting your body into, and my brain is wired for contact. I would say in some ways it has become callous to some of the hits.”8 The Pellman and Viano summary agreed: “[M]any NFL players can be safely allowed to return to play on the day of the injury after sustaining a mild TBI [traumatic brain injury]. These players had to be asymptomatic, with normal results on clinical and neurological examinations, and be cleared by a knowledgeable team physician. There were no adverse effects, and the results once again are in sharp contrast to the recommendations in published guidelines and the standard of practice of most college and high school football team physicians.”5
While the NFL was purveying its own seriously compromised, dishonest “research,” it simultaneously challenged other reports whose conclusions it didn’t like. A 2009 study from the Institute for Social Research at the University of Michigan reported that former NFL players aged 30 to 49 were nineteen times more likely to develop neurological disorders than nonplayers the same age.9 The NFL paid for the study, but when it was released, its spokesperson dismissed its results, claiming “there are thousands of retired players who do not have memory problems.”10
Given the NFL’s deep pockets—and access to a journal that seemed willing to publish just about anything submitted by a certain group—the MTBI researchers might have been able to maintain the charade for a long time. But then, inevitably, football players with CTE started to die.
Autopsies are more difficult to challenge than epidemiological studies. The damage in the CTE-diseased brains of NFL players is revealed and then reported for all to understand. The earliest prominent case of CTE in an NFL player was Mike Webster, the legendary center for Terry Bradshaw and the Pittsburgh Steelers in the 1970s. “Iron Mike” played 15 seasons with the Steelers, helping lead the team to four Super Bowl victories in the late 1970s and in 1980, before finishing up his career with two seasons with the Kansas City Chiefs. He was one of the greatest centers to play the game and was named to the NFL’s 75th Anniversary All-Time Team. In 2002, Webster died young, at age 50, from a heart attack, and his brain was autopsied by neuropathologist Bennet Omalu. Omalu’s involvement was not planned; as the most junior pathologist in the Allegheny County coroner’s office, he was working the Saturday that Webster’s battered body arrived. He was assigned the autopsy that turned him into a national figure. Three years later, in 2005, Omalu used that autopsy as the basis for a study co-authored with colleagues at the University of Pittsburgh and published in Neurosurgery. This was the first published case of CTE in a professional football player.11
In retrospect, the finding that Webster’s brain was damaged should not have been a surprise. As the center, Webster was the core of his team’s offense. On play after play after play for seventeen seasons, he took hit after hit after hit. He was Iron Mike in spirit and dedication, but his skull and brain were made of softer, more fragile stuff. Even before his retirement in 1990, Webster had started exhibiting troubling and often dangerous behavior. In a profile published in 1997, the Pittsburgh Post-Gazette reported that this former football great was “homeless, unemployed, deep in debt, beset with medical ailments, lacking health insurance, in the midst of divorce, in the care of a psychiatrist and on medication, and involved in a complex lawsuit over real estate investments.” The story added, “After waging war on the gridiron and routinely flattening the enemy, Iron Mike was finally dented, dinged and damaged by forces that he simply could not wrestle to the ground.”12
Note that Omalu’s study was not an accusation against the NFL; it did not assert the causal relationship between football and CTE. It simply raised an alarm and called for more research. Omalu naively believed his nonjudgmental work would be welcomed by the owners. Instead, they responded the same way they responded to any cautionary note whatsoever on the subject of severe brain disease among football players: deny and defend. Specifically, three MTBI committee members—Ira Casson, who would become the leading medical spokesperson for the NFL once Pellman became sufficiently radioactive, along with Pellman and Viano, wrote a lengthy letter to Neurosurgery challenging Omalu’s diagnosis. Casson is a neurologist, but neither he nor the other two were pathologists, nor were they experts in examining brain tissue. Rather than stating that these striking abnormalities in Webster’s brain were of concern and should trigger additional research among football players, they insisted there was insufficient evidence to link the abnormalities to football, or even to label them CTE. These three men, all of whom were in the NFL payroll, called on Omalu and his colleagues to retract their report.13
The Omalu team did not comply. Instead, the following year, the pathologist and his colleagues published a second paper, also in Neurosurgery, this time studying the brain of Terry Long, offensive lineman for the Steelers from 1984 to 1991, playing alongside Webster for five of those years. Long’s career was only half as long as Webster’s but more than enough to cause irreparable damage. As a lineman, he had also taken hit after hit on play after play. In 1991, he attempted suicide following a failed steroids test. In 2005, he took his life by drinking antifreeze.14 In November 2006, the same month that Omalu published his findings on Long’s brain, Andrew Watson, who had played with the Philadelphia Eagles, committed suicide; Omalu would find CTE in his brain as well. And then there was a fourth suicide, and a fifth—eventually more than a dozen among former pro football players. In each case, the brains Omalu studied looked like those seen in professional boxers, who when they are autopsied are often decades older than these former football players were at the time of their deaths. Under the microscope, the tissue shocked the pathologists. It became clear that the cause of this damage wasn’t just the concussions. It must have been the basic pounding, play after play, especially dangerous for the interior linemen who experience the most impact.
In the face of mounting evidence and publicity, the MBTI committee kept churning out studies exonerating head impacts. In one, researchers tapped rats on their tiny heads to simulate the hits in a professional football game played by men weighing several hundred pounds.15 It’s almost laughable, except that it’s not laughable at all.
With Big Tobacco, the industry’s research charade had bought four decades of unimpeded profits before Congressman Henry Waxman (D-CA) finally dragged the CEOs of the tobacco companies to testify in 1994. Under oath, these executives asserted they did not believe that cigarette smoking caused cancer. With the NFL, the increasingly infamous MBTI committee had also bought the league some time—about a decade—but this CTE story was not going to die. An ever-growing body of research suggested a literally fatal flaw at the heart of America’s most popular sport, and the league’s reaction to this research brought into question the integrity of one of our most powerful and prominent institutions. In 2009, a congressional committee chaired by John Conyers (D-MI) summoned the new NFL commissioner, Roger Goodell, who had replaced Paul Tagliabue in 2006. When Goodell refused to acknowledge a link between football and brain damage among players, Representative Linda Sánchez (D-CA) made the obvious comparison with tobacco industry’s denial of the link between cigarettes and lung cancer. A national uproar ensued.
Within a few weeks, Goodell was motivated to dissolve the discredited MBTI committee and launch a new research initiative with a new name: NFL Head, Neck, and Spine (HNS) Committee. The old guard was out. The league’s new flagship investigation was stocked with actual neurologists and brain surgeons. Members of the new committee would not be paid by the NFL (although they would have their expenses covered and they would receive free Super Bowl tickets). Overnight, the whole line of questionable research the league had been promoting for over a decade was summarily swept under the rug. The league could no longer simply assert that research by conflicted scientists was adequate to understand the relationship of football and brain damage. Why not? The research was untenable. It was embarrassing. It was wrong. The league and its experts were getting pilloried in the press and pressure from the public and the players union was mounting. Firms that sell a product directly to consumers, as the NFL does, are more sensitive to public opinion than, say, makers of asbestos or pesticides or textile dyes.
Pressure continued to mount on the league. In 2011, former players filed a class action lawsuit, accusing the NFL of waging a “concerted effort of deception and denial” in order to “conceal the extent of the concussion and brain trauma problem.”16 Eventually 5,000 former players joined the suit, and, after much controversy, the owners agreed to pay out a settlement of approximately $1 billion. This sounds like a lot of money, but for the league it represents only a tiny percentage of its revenue in a single year. And for the players, the amount appears to not come close to adequately compensating the plaintiffs who joined the suit and the many more who will become disabled by CTE in coming years. The NFL estimates that perhaps 6,000, or 30 percent of all former players, could develop Alzheimer’s disease or moderate dementia and be eligible for compensation.17 Pressure also came from the NFL Players Association, led by their newly elected president DeMaurice Smith, who demanded the league agree to implement a comprehensive concussion protocol, including the enlistment of sideline experts, improved diagnosis and treatment, and a mechanism to jointly enforce the agreement.
The NFL needed to change its image. Goodell announced that the league was donating $30 million to the National Institutes of Health, the umbrella organization (consisting of 27 institutes and centers) that stewards much of the U.S. government’s biomedical research. The money would launch a new Sports and Health Research Program, to involve the nation’s premier medical research organization in investigating, among other topics, CTE in football players. The NFL’s press release announcing the gift reads, “National Football League Grants $30 million in Unrestricted Funding to the Foundation for the National Institutes of Health for Medical Research.”18 Note the adjective “unrestricted.” The agreement between the NFL and the NIH said clearly that the NIH would be the arbiter of who receives the funding. The NFL was obliged to provide the promised $30 million, paid over several years, even if the agreement covering management and direction of the program was terminated.
Following its normal protocols, the NIH issued a request for scientists to submit proposals for a longitudinal study of CTE among football players. The proposals were evaluated through a peer-review process, the results of which would inform the NIH’s decision of where the funding would be awarded. The academic researchers who were part of the NFL’s HNS Committee were among many that applied. But the winners of the competition were the researchers associated with Boston University, led by Robert Stern, the director of clinical research at the university’s CTE Center and an expert in neurodegenerative diseases. Stern was not a stranger to the NFL. His group had done extensive research on brain disease among football players and had become the leading institution for examining the brains of deceased players. In the class action lawsuit players had brought against the NFL, Stern had filed an affidavit opposing the settlement, asserting that the proposed settlement would result in players with brain damage not receiving adequate compensation.
The NFL now balked. Various officials, including Pellman, who served as the league’s medical director, complained to the NIH on three grounds: Stern had a conflict of interest, having filed that affidavit; the group was unqualified (their expertise was in neuropathology, not in conducting the longitudinal study they were chosen to undertake); and their project plan did not meet objectives of the overall initiative. The league requested that the funding go to the applicant group that included three investigators from its own Head, Neck, and Spine committee, one of whom was participating in the negotiations with NIH around the grant.19
Clearly the NFL had a different understanding of the meaning of “unrestricted” funding. The league was challenging a longstanding NIH policy that donors are explicitly prohibited from involvement in the grant-selection process, and the NIH proceeded without heeding the concerns the NFL had raised about Stern and his group. The government agency held that the Boston team was well qualified and that the proposed study met the project’s objectives. To the NFL’s allegations of Stern’s conflict of interest, NIH policy was also clear: authoring a scientific paper (or an affidavit) is not the same as having an employment relationship. Stern did not have an employment relationship with NFL players or the league itself, and accordingly he had no conflict of interest.
The subsequent congressional inquiry into this disagreement found that while the NIH did engage in negotiations with the NFL and attempted to address some of the league’s concerns, “NIH leadership maintained the integrity of the process and thus ensured that the best applicants received the grant.” Nevertheless, the NFL, accustomed to getting what it wants and unhappy with the outcome of the NIH’s peer-review process, pulled its support from the endeavor, falling about $18 million short of their initial promise of $30 million in unrestricted funds. The league was willing to brave the bad publicity, likely in the hope that the public’s attention had shifted elsewhere.20
In 2015, Hollywood took up the players’ cause—sort of. The movie Concussion dramatized the work of Omalu in investigating the Mike Webster tragedy and the NFL’s attempts to subvert his findings. Will Smith played the starring role of Omalu. The NFL fought back on this front as well. As reported in the New York Times, “In dozens of studio emails unearthed by hackers, Sony executives, the director, Peter Landesman, and representatives of Mr. Smith discussed how to avoid antagonizing the NFL by altering the script and marketing the film more as a whistle-blower story, rather than a condemnation of football or the league… Dwight Caines, the president of domestic marketing at Sony Pictures, wrote in an email on August 6, 2014, to three top studio executives about how to position the movie. ‘We’ll develop messaging with the help of NFL consultant to ensure that we are telling a dramatic story and not kicking the hornet’s nest.’”21
The following year, the flaws in the bogus research of the MTBI committee were topped by a new revelation in the New York Times: the committee’s concussion database, meant to catalog all concussions diagnosed by league medical staffs between 1996 and 2001 and the backbone of the league’s claims around concussions during that period and beyond, was incomplete. This was discovered by reporter Alan Schwartz, who obtained a copy and compared cases in the database to the league’s publicly disclosed weekly injury reports. It was easy to break the anonymity of the cases, since the database has plenty of identifying information about each listed episode, including the date of each concussion. The Times study showed that at least 10 percent (or 100 cases) of the 1,000 head injuries diagnosed by team doctors and reported to the league were missing from the research. This included all the pertinent injuries suffered by members of the Dallas Cowboys, one of the league’s iconic (and wealthiest) teams. Other journalists published findings that challenged the league’s studies on other grounds and exposed the prevarications. That bibliography is a long one. The work of the journalists had a huge impact, promoting the important findings of Omalu and others in the academic literature—and exposing the tainted academic studies that were published in peer-reviewed journals alongside them.
“Professional football is more dangerous than almost any other job in America. Why don’t you do something about it?” For seven-plus years at OSHA, I entertained that question too many times to count. My answer was disappointing to some who thought OSHA could be the savior here: if I wanted to make this federal agency the enemy of the majority of Americans, the easiest way to do so would be to announce that we were going to mandate changes in their favorite professional sport in order to make that sport’s workers much less susceptible to injury—especially one specific injury. Besides, OSHA had far more pressing issues to address, including protecting workers who had no voice at all in their workplace but who were exposed daily to hazards that could destroy their lungs or cut off their fingers.
OSHA may not provide the solution to the perils faced by football players, but the tide is turning as public awareness increases. On this subject, at least, fans do want to know the truth—although they may not want to think about what that truth should entail in terms of changes to the game.
Football isn’t alone, of course. The scrutiny into the harms of football extended quickly to North America’s other popular and violent sport, hockey, and its billion-dollar National Hockey League (NHL). Alas, the world’s largest hockey league could do no better than its football brethren in demonstrating the usual knee-jerk reaction: announce that the problem isn’t real and attack independent scientists who claim otherwise. When former hockey players filed their own class-action suit, the hockey league demanded the Boston University CTE Center, which was not a party to the suit, hand over large quantities of records and materials, so the NHL could “probe the scientific basis for published conclusions” and “confirm the accuracy of published findings.”22
In 2016, Senator Richard Blumenthal (D-CT) asked NHL Commissioner Gary Bettman, “Do you believe there is a link between CTE and hockey?” Bettman’s response was a 24-page letter that delivered his characterization of the scientific evidence to date: “The relationship between concussions and the asserted clinical symptoms of CTE remains unknown.”23