Brainwashed (Amplify, 2018)
Merril Hoge
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There were 18 football-related fatalities in 1905 and by the end of the year colleges were considering banning the sport. Debate about football’s future included the President, Theodore Roosevelt, whose son played for Harvard. Eventually, sweeping rule changes were implemented to improve safety and the NCAA was formed to oversee the sport.

Football’s rules have changed frequently ever since, sometimes for safety and sometimes just to make it more entertaining. Football has flourished. Each year still brings many injuries, including around four direct fatalities – those that result from on-field injuries, rather than from an ‘indirect’ cause, such as heatstroke. Though, given that the number of players has increased unimaginably since 1905, the death rate is very low – around 0.31 deaths per 100,000 players.

Today’s safety concerns focus on the long-term effects of repeated blows to the head, particularly the link between concussion and a type of dementia called CTE, chronic traumatic encephalopathy. Evidence of the risks has led the NFL to, belatedly, change its rules in an attempt to reduce head injuries and has caused some States to consider banning contact football for children. This has upset Merril Hoge.

Hoge played running back in the NFL for eight seasons – seven with the Pittsburgh Steelers and one with the Chicago Bears. He’s no stranger to concussions – he suffered at least 12 in his playing days.

In 1994 he suffered a concussion while playing for the Bears and was cleared to play five days later, without proper checks to ensure that he had recovered. Sustaining a second concussion while still suffering the effects of a previous one can be fatal. Hoge suffered a second concussion weeks later, had to be resuscitated because he had stopped breathing and spent 48 hours in intensive care.

But he was lucky. He recovered and retired from football after being told that further concussions could lead to permanent brain damage. He successfully sued the Bears’ team doctor and embarked on a media career.

In Brainwashed, Hoge argues that the evidence for a link between football and CTE is overstated, incomplete or mistaken and that it is being exaggerated by people who plan to use it to destroy football.

I tried very hard to approach this with an open mind, even though I was unconvinced by Hoge’s position from the outset. However, the book is less an analysis of the science and more of a skirmish in the ongoing ‘culture war’ that is fuelling so much discord in the public sphere. Hoge, and his co-author, Dr Peter Cummings, are guilty of the same cherry-picking of findings and exaggeration of evidence of which they accuse others.

For example, they cite a 2017 study from the University of Iowa that found that the concussion rate in flag football for young players was about the same as in tackle football, thus suggesting that banning tackle football would not reduce concussions. However, they do not mention any of the study’s limitations, such as the fact that there are far fewer flag football players, making it hard to draw meaningful comparisons.

All studies have limitations but the authors ignore the flaws in studies that support their case, while emphasising problems in studies with which they disagree.

A lot is unknown about CTE and its causes. That’s why scientists are studying it. And there’s certainly a case to be made that everyone should calm down until we know more. Hoge could have written that book. Instead he’s opted for a polemic build on the flimsiest of foundations. Unfortunately, many of those who read it will not have read enough about the subject and will believe it.

Many of them will simply want to believe it. It fits a certain narrative about a ‘snowflake’ culture in which people are soft and a nanny state protects them from the smallest hurt. I can imagine them reading it and yearning for the days when football players were the toughest of men. Men like Mike Webster, who won four Super Bowls with the Steelers in the 1970s and died aged 50, his brain wrecked by CTE.

Football’s history has been one of change. Recent rule changes to improve safety have led to a thrilling, high-scoring game in which defenses are forced to get cleverer to compete. If further changes are coming, then history suggests that football can survive them.

Photo: Paul L Dineen

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