CTE and concussions continue to cloud Roger Goodell’s reign as NFL commissioner

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Roger Goodell has made significant changes to the game for league safety but many believe he is still coming up short.

Hall of Fame Giants linebacker Harry Carson is talking in the quiet of a conference room at the famed Waldorf-Astoria Hotel on a recent Monday, hours before the 31st annual Buoniconti “Great Sports Legends” gala begins. It is a night where hundreds of thousands of dollars are raised for the Miami Project to Cure Paralysis and its development arm, the Buoniconti Fund, which is named in honor of quadriplegic Marc Buoniconti, the son of another Hall of Fame linebacker and former Dolphins great, Nick Buoniconti.

The event spotlights spinal cord and traumatic brain injuries and the research being done to find a cure for paralysis, a cause that Carson has supported from the organization’s start. But Carson is digging deep into his own football past on this night, tracing back more than three decades to a game when he and two Giants teammates converged on Dallas Cowboys star running back Tony Dorsett.

“We were playing Dallas and I was in on a hit with Brad Van Pelt and Brian Kelley on Tony Dorsett. And I took the brunt of the hit. I went down and I was paralyzed. They put me on a board, took me off the field, took me to a hospital, and I’m laying in the ambulance and thinking I’ll never walk again,” says Carson, 62. “I was blessed in that by the time I got to the hospital, I was able to regain the use of my arms and legs. So I know what it feels like to be paralyzed.”

Carson is still upright. He appears to have few physical limitations and speaks eloquently about any issue presented to him. But the former Super Bowl champion, who last played professional football in 1988, calls himself a “realist” and says he knows that all the jarring hits and violent tackles he and his football contemporaries were involved in during their playing careers could exact a more painful toll later in life. The fallout from playing a violent contact sport is something that Carson says he already sees manifesting itself in former teammates and opponents, particularly their neurological and cognitive ailments. It is why Carson has been and continues to be a vocal critic of the NFL’s and commissioner Roger Goodell’s stance and treatment of the lightning-rod issue that has dominated the sport for the last decade: concussions and the possible longer-term health threat to athletes who have experienced repeated hits to the head, the crippling brain disease known as chronic traumatic encephalopathy (CTE). Medical experts believe the degenerative condition can cause symptoms such as depression, mood swings, memory loss and chronic headaches. As of now, CTE can only be confirmed post-mortem.

“The scary thing for me is, I’ve seen men who played before me who are now dealing with neurological issues. I’m not going to say I know what’s waiting down the pike, but I’m a realist. Guys I played with and against, I know where they’re headed,” says Carson.

Goodell has served as NFL commissioner for 10 years, and during that span he has helped steer hundreds of millions of dollars toward scientific research of concussions and traumatic brain injuries and he has championed radical changes to the game in an effort to protect current and future players’ health and ensure their safety. But like the domestic violence and sexual assault issue draping professional football, there are many critics who feel the commissioner and the NFL have come up woefully short in certain areas of the complicated and many-layered concussion issue, while continuing to market the violent sport to every age group.

“The crux of my opinion is that the commissioner is running a business, and there’s a lot of double-talk that comes out of his mouth,” says Michael Kaplen, a George Washington University Law School professor, the past president of the Brain Injury Association of New York and an attorney who specializes in brain injury lawsuits. “You can’t prevent concussions. Football is a concussion-delivery system. There’s no way you are going to make football safe. The question then becomes, what are Goodell and the league really trying to do? The money that they’re spending, the things they’re saying, it is to protect their shield. What they are attempting to do, through clever marketing, is say that they can make the game safe on all levels.

“They can’t.”

Former Giant Harry Carson (r.) is highly critical of Roger Goodell’s treatment of handling concussions.

One need look no further than Broncos safety Darian Stewart’s frightening helmet-to-helmet hit on Panthers quarterback and reigning league MVP Cam Newton in the waning seconds of the 2016 NFL season opener to see that dangerous hits still occur despite rules put in place to protect players. In video replays, Stewart leaves one of his feet, leads with his left shoulder and plows his helmet into the right side of Newton’s head, sending the QB flying.

Stewart received a fine reported to be just over $18,000, and was not suspended.

Newton remained in the game against Denver, as Carolina was driving for a winning score. The Panthers lost that season opener, 21-20. This past Monday, however, Newton was sidelined after failing the league’s concussion protocol, the result of a hit he received a week earlier in Atlanta, and did not play against Tampa Bay. Carolina backup QB Derek Anderson started, but the Panthers fell to 1-4 after the 17-14 loss to the Buccaneers.

Then there are former players like Carson who are critical of how retired NFL players with debilitating neurological ailments and brain disease have been treated by the league, especially in the shadow of the deaths of many former players including Junior Seau, Andre Waters and Dave Duerson, who all committed suicide and who were diagnosed with CTE. A seismic class-action lawsuit filed in 2011 (and consolidated in front of a federal judge in 2012) by more than 4,500 former NFL players accused the league of hiding, for years, the long-term health dangers caused by football-related head injuries in an effort to protect the league’s image. The league settled for nearly $1 billion, but none of the plaintiffs have seen any of that money because several appeals are still playing out through the legal system. Since there was no discovery process, the public may never learn who in the NFL knew what and when.

“It’s just about preserving the game. It’s not about player safety. If it was about player safety, when a player gets hurt, the league would say, ‘We’re going to guarantee your salary.’ Or the league would provide lifetime health benefits to retired players,” says Kaplen.

But maybe the most telling criticism of the commissioner and what Forbes estimated this year is the nearly $15 billion business Goodell oversees, is the failure on the NFL’s part to acknowledge a link between football-related head injuries and CTE until earlier this year, when one of the league’s top executives spoke before Congress and testified that there is a connection.

Even so, at least one prominent medical expert says Goodell and the league are channeling too much of their efforts on concussion research and treatment.

Panthers QB Cam Newton has taken quite a few frightening hits this season already.

“The focus on concussions actually takes away from the bigger and more difficult issue to deal with,” says Dr. Robert Stern, a Boston University professor of neurology and neurosurgery and the director of clinical research for the BU Alzheimer’s Disease and CTE Center. “The more the NFL or others focus on concussions, the more that they can say they’re doing something about it. The more they can count them and say, ‘Aha, we’re paying attention to it and we’re changing the rules to reduce the big helmet-to-helmet hits. And we’re changing the rules to make sure someone is removed from play when they have an obvious symptomatic concussion.’

“All of that is really important. In no way am I saying concussions shouldn’t be dealt with. That’s critical,” Stern continues. “But there’s two different issues going on — one is concussion, which is by definition a temporary problem. The other is this disease called CTE, which appears to be associated with repetitive head impact exposure, regardless of whether there are concussions. It’s that hit after hit after hit that takes place in football that is just part of the game. Yes, things can be done about concussions, and that’s great. But then we have to think about what can be done to reduce the exposure to the repetitive hits that players (absorb). The more that the world focuses on concussions, it takes away from the focus on perhaps the more important issue when it comes to long-term consequences of what happens when playing football. People need to understand that CTE is not the cumulative effect of multiple concussions.”

During an appearance before the House Committee on Energy and Commerce in March, the NFL’s senior vice president of health and safety, Jeff Miller, said that there is a link between football-related head injuries and CTE, the first time the league had publicly acknowledged such a connection. Only a short time before Miller’s congressional appearance, during Super Bowl week in San Francisco, one of the members of the NFL’s head, neck and spine committee, Dr. Mitch Berger, had said no such connection has yet been established.

But Miller says now that his testimony before Congress didn’t draw any backlash at the NFL offices on Park Ave. In fact, Miller says that his remarks “were consistent with what the league has said around this issue for a number of years.”

“There’s a poster in our (NFL) locker rooms published by the CDC (Centers for Disease Control) that says concussions can have long-term effects, even death, if not treated,” Miller continues. “A relationship between concussions and long-term effects has never been much of an issue. The big questions that come on that topic and that I addressed in the congressional testimony — and this is where what I said was quite consistent with what Dr. Berger said — ‘What’s the incidence of this? How prevalent is it? What causes these things?’”

Miller’s latter three points are notable in that they underscore an integral part of the CTE research that Dr. Stern is leading at BU, using a $16 million grant from the National Institutes of Health (NIH). The grant is part of a $30 million donation by the NFL to the NIH in 2012. Republican and Democratic House members have squabbled this year over whether the league tried to strong-arm the NIH into steering the money away from Stern, who has been critical of the league on the concussion issue. The BU professor says he will not comment on that controversy, and instead is energized by what the seven-year grant might allow him and his colleagues and some 50 investigators to uncover about CTE.

Andre Waters, a safety for the Eagles, is one of several players who has committed suicide following his football career.

“My biggest goal professionally is to be able to develop methods of detecting and diagnosing CTE during life,” says Stern, who adds that such a medical breakthrough is, in his mind, possible in the next 5 to 10 years. The first participants in the study are already being examined. “That’s the only way we’re going to really come up with answers to critical questions. The other important side of the project is to try to further our understanding of what the risk factors are for developing CTE. We don’t know why one person gets it and another person doesn’t. The focus is on variables such as different aspects of exposure to repetitive head impacts — what amount, what type, what severity, what age — as well as the genetics. Are there specific genetic predispositions for either increasing risk or decreasing risk for the disease?”

Repetitive hits to the head are one of the many aspects of the game that Miller says the NFL has tried to address through rules changes. Miller says that in the last 15 years, which includes Goodell’s entire tenure as commissioner, there have been 40-plus rules changes related to improving the health and safety of players.

“There is enforcement of the rules regarding helmet-to-helmet contact, which has included greater rate of penalization around that, more suspensions and fines related to it in an effort to try and change the culture of using the head,” says Miller. “But also the rules changes, like getting rid of the crown of the helmet rule.”

Some of the newest efforts put into place by the league to address player safety, Miller says, include having unaffiliated doctors on both sidelines during preseason, regular-season and playoff games. The doctors are paid for by the NFL.

“We introduced the notion of unaffiliated doctors, whose sole role is to help out with concussion diagnosis and treatment of the players on the sideline,” says Miller. “It’s a mandate that (each) unaffiliated doctor participate with a member of the team medical staff responsible for concussions when a player is being evaluated.”

Another change in games is to have two trainers, instead of one, viewing the action from a stadium skybox (it has been just one trainer watching games for the past four years). If the trainers see a player who appears to be injured, or who may have suffered a concussion and no one on the field is intervening, the trainers have the authority to stop the game with a call to the field. If it’s a head injury, any player escorted off the field would then have to go through the normal concussion test protocol to determine if he can return to the field or not.

But for every rule or step put into place to try and ensure player safety, there are incidents like when Newton was clocked earlier this season. Or the game last year in which Rams QB Case Keenum’s head slammed against the turf when he was tackled by Baltimore Ravens defenseman Timmy Jernigan. Video replays show Keenum was extremely woozy after his head hit the ground, and when he was prostrate he immediately put both hands on his helmet. Keenum had to be helped to his feet by a teammate, but he remained in the game. He proceeded to throw a catchable pass on the next down that Wes Welker couldn’t handle. Keenum then fumbled the ball on the ensuing down that set up the Ravens’ game-winning field goal.

Seau, who committed suicide in 2012, was discovered to have CTE.

“If you look at the Case Keenum situation last year, that was a demonstration of some human error. We spent a lot time in the offseason with the medical representatives from the players talking about how we (can) do better,” says Miller. “That’s led to an enforcement mechanism introduced this year. Should violations of protocol exist, the (NFLPA) and NFL will investigate it, and if it’s proven there were some violations of protocol, the team can be fined. And over stages, it can eventually go towards (something) more significant than just fines.”

Some active players say the changes to the game are effective, even if there is a decades-old, macho mentality ingrained in the game where players take the field regardless of whether they feel physically compromised.

“I think (it’s) clear the concussion protocol and waiting to play and everything, it seems like there’s a lot more precautions taken into it and trying to eradicate the macho mentality that it’s not that big of a deal, when in reality it is a pretty large deal,” says Jets center Nick Mangold. “Yeah, they’re trying. It’s never really going to be fully fixed until you get all the players to be on board with it as well, because you have that mentality that people want to be out there and playing.”

Retired Jets star running back Curtis Martin, who was an honoree at the same 31st annual Buoniconti gala Harry Carson attended, says Goodell has “done a good job, especially when it comes to this area of concussions.”

Martin — who has an ownership stake in an Israeli company called ElMindA, which uses Brain Network Activation (BNA) technology to diagnose concussions — says he has gone through an “extensive amount of testing” to ensure his brain is healthy. Martin, 43, says that it is in the best interests of the NFL to do the same for its employees.

“I was very fortunate. The brain is different for everyone. Someone can have one concussion and it ruins them for life. I can’t even count how many I’ve had. My brain is as healthy as it could be,” says Martin, who did not join in the concussion lawsuit. “(The NFL and Goodell) are doing everything that they can. Like I said, it’s to their benefit to do so because if parents become more and more afraid of allowing their kids to play football, that’s going to affect the entire NFL.”

While Eddie George, another retired NFL star running back and a former Heisman Trophy winner for Ohio State, admits that the league “maybe in the past turned a blind eye” to the dangers of football-related concussions and the health of players, the 43-year-old George echoes Martin’s sentiments.

Frank Gifford, laid out on the ground by Chuck Bednarik, was also found to have CTE after his death last year.

“I think the NFL is doing what they can in terms of making the game safer without diluting the game in which it is, because it’s a violent game. They’re going through the processes of finding out just how to protect the players and make the game safer,” says George, who was a guest at Sports Illustrated’s

“Sportsperson of the Year” event last year at Manhattan’s Chelsea Piers. “We’ve got to find better ways to educate kids on how you hit, not to use their head as a weapon.”

George’s son, Jaire, plays football at Vanderbilt University, and the elder George says he supports his son’s football pursuits “wholeheartedly.”

“If his avenue takes him through football, so be it,” George says.

One issue that recent NFL retirees and current players may fail to appreciate, however, is the complexity of the brain, says Thomas Demetrio, the co-founder of the Chicago law firm, Corboy & Demetrio. Demetrio represents the family of Dave Duerson, who fatally shot himself in the chest in 2011 at age 50. Players who say they are healthy in their post-playing days should consider the case of Duerson – who transitioned into a successful businessman following his football career. Or the death of former Chargers player Paul Oliver, who killed himself at age 29, and who was diagnosed with CTE.

“When (Duerson) retired, he was healthy. He became a very astute business person,” says Demetrio. “He had a great family life. And then there was this slow, mental deterioration. Nobody connected it because that’s the nature of CTE. It’s progressive. Paul Oliver shot himself in front of his wife and two children. You don’t do that. Nobody does that. He just had no control. This society that we know, we continue to gather around the TV to watch modern-day warriors battle because the NFL is the biggest show in town. Even if current players read or know about people like Duerson, they really believe, ‘That’s not going to happen to me.’ They don’t appreciate the complexity of the brain and what repetitive hits can do.”

Demetrio says he believes the NFL withheld information from players, trainers, doctors and owners with regard to the dangerous consequences of football-related concussions. Had people like Duerson known about such information earlier, perhaps he could have sought treatment or gotten help. “That treatment, I’m not sure what it would be, or what it will be, but it could have prevented a suicide,” says Demetrio. “Any way you look at it, rules changes to the game are great, but we continue to see violent hits. These guys are like human missiles. Your brain is not meant to withstand that.”

Dave Duerson also took his life.

The NFL player pipeline, starting with the youth football programs that parents across the country continue to support, is where the seeds are planted for what could lead to debilitating brain disease later in life, according to Dr. Stern, the BU professor. Stern says that it is mind-boggling how parents would allow their children to play an impact sport like football during a period in life when the brain is in critical stages of development.

“There’s no reason in my mind why children should be hitting their heads repeatedly while they’re going through brain development. We’re crazy in how careful we are about protecting the safety of our children,” says Stern. “We go to huge extremes. And yet we then drop our kids off at a playing field, have them put these huge helmets on and say, ‘Go at it. Hit your heads over and over again.’ Now the focus is, ‘We’re making it safer by making sure that there’s no head-to-head hits. We’re making it safer by managing concussions.’ That’s all really important. Concussion management and detection, that’s gigantic for kids. But what about all those other hits that don’t result in symptoms? We’re still saying it’s OK for kids to hit their heads over and over again.”

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Harry Carson never joined the concussion lawsuit like so many of his football peers. His reasons for declining are simple. Carson says lawyers in New York approached him about joining, but he did not want to appear as if he was only doing so because he would stand to benefit financially.

“When this whole thing started snowballing, I intentionally opted not to be a part of it because it was more important for me to continue to talk about the issue,” says Carson. The Hall of Famer also adds that he has no plans to donate his brain to science after he dies, as was the case with Seau and other late NFL players.

“The reason why, I know what they’ll find. It’s better to ask me now while my brain is still functioning, than to have my brain in some jar on the shelf.

I’ve been talking about this issue since 1993. If anything, I’m one of these specimens — ‘OK, I’m here if you want to talk.’ I can share all kinds of information from my own standpoint, because I’ve lived with it,” says Carson.

As for the profession he retired from long ago, Carson laments that it is a business, and one that has only become more and more lucrative for its commissioner and owners. Nobody wants to end the money train when business is good.

“I think that their No. 1 priority has to be to protect the shield, and make sure that the game is not impacted in any way, shape or form,” says Carson. “They are about the business of football.”