This is one of the most important books about American football today, and one that all contemporary fans should make time for. It chronicles the growing research around concussions and a degenerative brain disease called chronic traumatic encephalopathy. The book charges that the NFL lied about the prevalence of concussions in football and deliberately sought to downplay evidence of the dangerous effects of concussions on players.
Much of what is in the book, which began life as an ESPN documentary, had already been published elsewhere but it is collected here in the most comprehensive and thorough assessment of the concussion issue. The NFL maintains that player safety has always been paramount but the book accuses Paul Tagliabue, NFL commissioner between 1989 and 2006, of handling the concussion issue in the same way that tobacco companies dealt with links between their products and cancer.
What is clear is that the league frequently played down concussions, with Taglibue himself describing the problem as “relatively small” and suggesting that journalists were overreacting. He has since said he regrets those comments. The league’s own investigations were often led by people who lacked the qualifications to be effective because, for example, their expertise was in a different branch of medicine. And ultimately the league acted to protect its product, rather than its players.
Whether all this was a matter of conspiracy or complacency mixed with incompetence is hard to say. The book pretty clearly argues for the former. Critics of the book say that the authors did not give due weight to the safety measures the NFL has put in place since the early 1990s and point out that much of the science around concussions and CTE is still unclear.
Back in the 70s, concussions were seen as an occupational hazard and players were expected to shake them off and get back in the game. Players report not knowing what quarter the game was in, wandering in a daze to the wrong sideline or getting up to find that the sky had changed colour.
CTE has been studied for more than a century, as doctors examined ‘punch drunk’ boxers, but two things have changed over the last couple of decades. First, doctors now understand just how dangerous concussions can be. In certain circumstances, they can be lethal. And second, there is a greater understanding of the danger of lesser blows – so-called ‘sub-concussive hits’ – and how these can cause damage over time.
The risk to football is huge. If parents worry about the risk to their children then talented athletes will take up other sports, which will eventually lower the standard of play in the NFL. It’s also possible that spectators will be put off by the thought of watching players endure life-threatening damage and the popularity of the sport will decline. It’s worth remembering that boxing was once America’s most popular sport.
The League’s slow reaction did not help. The NFL now finds itself entangled in legal disputes with former players while it struggles to adapt the rules so that the sport will become safer. “Taking the head out of the game” is a common modern cry.
This book was one of the key drivers of the change currently taking place in American football and any fan who wants to understand why these changes are happening should read it.