HJNO Jul/Aug 2023

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2023 9 Wish I didn’t know now what I didn’t know then. — Bob Seger, “Against the Wind” We are entering football season — an amazing time of the year filled with electrifying energy when young men’s performances on the gridiron provide bragging rights for schools, universities, and entire communities. It is America’s game. Young and old alike rally around players who desperately want to sail through the ranks of each level and eventually rise to the sport’s pinnacle, the NFL. It’s a dream very few, very lucky, and talented young men actually achieve; but millions try. Unfortunately for many former players, chasing this American dream created a nightmare scenario of neuro- degeneration decades later because of the lingering effects of the hits they endured on the practice and play- ing fields. Football has always been a dangerous sport ... but what former players are experiencing, chronic traumatic encephalopathy or CTE, is “dark and void of mercy,” according to one football widow we spoke to recently. Many parents and current players are not aware of the long-term brain damage many of their heroes have experienced long after they hung up their cleats. This damage was hidden by some leagues and ignored by others as many of the former players experiencing it were maligned by the very groups that sanctioned the games ... so the games could continue. Because of this coverup, many of the older players and their loved ones spent years trying to understand what was happening to the minds of these once stable men. Now that enough of them have emerged, it’s clear — football causes CTE like smoking causes lung cancer. And just like nobody can tell you how many puffs of a cigarette trigger cancer, no one can tell us yet how many hits to the head are too many. Nor do we know when CTE actually starts. Is it youth league, junior high, high school, col- lege? Currently, CTE cannot be diagnosed in the living, and it takes a long time to manifest. But we do have growing evidence in the brains of dead former football players along with their life histories, which, in most cases, were going along fine ... until they weren’t. And we also have the living former players struggling with the undiagnosed disease to serve as a warning for anyone sanctioning the game or wanting to sign a waiver for a kid who wants to play. We reached out to Chris Nowinski, PhD, co-founder and CEO of the Concussion Legacy Foundation, a non- profit organization leading the crusade against concussions and CTE and dedicated to improving the lives of those impacted. Nowinski has probably called more former players’ families asking them to donate their loved ones’ brains than anyone. He has been pivotal in bringing awareness of contact sport concussions to America and advancing the science of CTE through research and brain donations. For Nowinski, CTE is personal. As a former college football player, he knows the damage it has done to former players. He also wants to find a so- lution to the effects of traumatic brain injury, because he knows he is at high risk for CTE from playing a game he had no idea could cause neurodegeneration later in life. He now knows CTE is preventable, and he has been evangelical in his efforts to convey this research to those sanctioning the games, coaches, unknowing parents, and of course to the players who, because of their age, might not take the long-term neurodegenerative risks as seriously as an older person ... because at that age, you feel indestructible.