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Titanium Dragon


TD writes and reviews pony fanfiction, and has a serious RariJack addiction. Send help and/or ponies.

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Sep
29th
2016

Non-Fiction Book Reviews #1 – League of Denial · 3:05am Sep 29th, 2016

I’ve been meaning to do some more reading. And so, naturally, instead of reading pony stories, for some reason I read a random book I picked out at the public library.

I’m going to climb back on the horse this weekend, though.

Right after I review this book and finish my own story that I’ve been poking at for the last few weeks.


League of Denial
by Mark Fainaru-Wada and Steve Fainaru

Non-Fiction, Football, Medicine
Approximately 124,000 words

“PROFESSIONAL FOOTBALL PLAYERS DO NOT SUSTAIN FREQUENT REPETITIVE BLOWS TO THE BRAIN ON A REGULAR BASIS.”

So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: A chronic brain disease that was driving an alarming number of players -- including some of the all-time greats -- to madness.

League of Denial reveals how the NFL, over a period of nearly two decades, sought to cover up and deny mounting evidence of the connection between football and brain damage.

Comprehensively, and for the first time, award-winning ESPN investigative reporters Mark Fainaru-Wada and Steve Fainaru tell the story of a public health crisis that emerged from the playing fields of our 21st century pastime. Everyone knew that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know – and what the league sought to shield from them – is that no amount of padding could protect the human brain from the force generated by modern football; that the very essence of the game could be exposing these players to brain damage.

In a fast-paced narrative that moves between the NFL trenches, America’s research labs and the boardrooms where the NFL went to war against science, League of Denial examines how the league used its power and resources to attack independent scientists and elevate its own flawed research -- a campaign with echoes of Big Tobacco’s fight to deny the connection between smoking and lung cancer. It chronicles the tragic fates of players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives; and former Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents and private emails, this is the story of what the NFL knew and when it knew it – questions at the heart of crisis that threatens football, from the highest levels all the way down to Pop Warner.

Why I read it: It caught my eye at the local public library.

Review
Written in 2013, League of Denial is several stories twined into one – the story of how families of former NFL players cope with a severely damaged individual struggling to cope with society, the story of the league wanting to avoid liability for chronic brain trauma, and the story of doctors who discovered that chronic traumatic encephalopathy (CTE), a form of brain degeneration which can cause severe disability which has long been known to exist in boxers, was found in football players as well.

The story really follows two main storylines. The first storyline is the story of Mike Webster, a former center for the Pittsburgh Steelers (and the Kansas City Chiefs) who was a broken man by the end of his career. Suffering from severe mental problems, he struggled to cope with life, run his own business, hold down a job, or even behave normally. A great deal of the start of the book is devoted to the struggles of him and the people around him in dealing with his problems.

The second plotline follows doctors who work for and with the NFL noticing that concussions, previously seen as a relatively minor injury, sometimes resulted in players suffering from problems for weeks or even months after sustaining a concussion. Concerned that this might be affecting players, some doctors work on developing better concussion screening exams and determining how long a player should sit out after a concussion – can they come back in the same game? A week later? How long does it take for them to recover – and what are the risks if they come back too soon and get reinjured?

Curiousity over this leads to an increasing number of investigations, including by a number of very well-respected scientists as they try to determine what is and is not safe for football players.

These two storylines come together after Mike Webster dies and his brain is examined (almost on a whim) by Dr. Bennet Omalu, a temperamental, eccentric Nigerian doctor with a flair for the dramatic. Omalu, after detecting CTE in Webster’s brain, ends up in contact with the doctors who are looking into concussions, and so begins the NFL’s real problems – as well as the problems of many of the doctors involved, as they fight against the NFL and work with players to preserve their brains after truly awful circumstances.

The book contains a bunch of stories about players with concussions and players’ concerns about concussions driving early retirements, as well as very disabled players having severe problems and, in several cases, committing suicide. These stories are often quite awful, and many of them resemble each other, as people who were previously supposedly these wonderful people fell apart and were unable to function. Even Junior Seau, a former player who denied that concussions were a big deal, eventually kills himself after it becomes clear that he, too, is affected.

While these stories are emotionally touching, the stories of the doctors are much more continuous. We get to know the people involved and see the professional and personal tensions between various concussion researchers, as well as scientists hired by the NFL more or less to (futilely) cover their own asses. We see that Dr. Omalu is good at cutting up bodies, but we also hear about his flair for the dramatic, his overreach, and his love of showing dead bodies to audiences. We see the tensions between groups of researchers who are seeking fame and attention, as well as people who make money off of the crisis in various ways – selling products (none of which actually help to prevent concussions) and fighting back and forth over whether or not football is even safe to play at all.

These stories are pretty compelling, and the characters are pretty interesting. I’m not sure to what extent the personalities were exaggerated to make for more interesting reading, but we get some idea of several of the main players and what sort of people they are, and the eternal fight. The book is a nice morality play of good vs evil, of those HEROIC RESEARCHERS vs the MEAN OLD NFL which doesn’t want to be held financially liable, and the sycophantic NFL scientists who are fighting back against our heroes.

There’s really only one problem with the book, and that is that the science in it isn’t very good. The book talks about how there are groups of people who are obviously fighting the NFL’s fight in this. But there’s a greater degree of complexity there; we also see other motivations as well. One of the recurring themes is that several groups of people are wary of the people who are pushing hardest for the football-CTE link, because these folks are making their money off of pushing the link, refusing to share their brains (donated by grieving families) with other scientists, and we see several kind of shady people on that side trying to promote snake oil to prevent concussions (both safety equipment and dietary supplements which there is no evidence help at all).

While it does show the sort of snake oily side of things, where it fails is the heart of the scientific argument. Throughout the book we’re given glimpses of doctors on the sidelines who are impressed by the research but are simultaneously wary of the conclusions. One doctor – Dr. Davies – notes that a lot of the people involved appear to also have a history of steroid use. Other doctors note that while there appears to be a link, it is notable that not everyone does develop it, even people who get really beat up. Is steroid use a triggering factor? Is it gene-linked? Are concussions really what is doing it, or are sub-concussive injuries building up and breaking down people’s brains? Are patient histories of substance abuse or other such things important? Is the fact that an awful lot of the stories about the people who ended up severely messed up came from poor backgrounds, while the better-off people who were concussed and ended up fine, like Joe Young, coincidental because of the whole American Dream story, or does having a bad childhood predispose you towards the condition, or make its symptoms much worse? Why are symptoms showing up sooner in some people than others? Can we actually prove a causative link? (This is much harder than laypeople think it is!)

The list goes on. And while the book briefly mentions doctors talking about these things, it often portrays the doubters in a negative light, even while some of them bring up legitimate points. The hostility towards the concussion researchers is portrayed as just people being defensive of the NFL, but some of it is genuinely about people reaching for conclusions which aren’t supported by the evidence – at one point, the book notes that all but one of the 30-odd brains investigated by the Boston University group showed CTE, but other researchers noted that the brains in question were donated by people who had major problems in life – not a randomized, representative sample of brains. And yet we see the head of the Boston University group ponder openly to the press that perhaps all football players have it.

I can see why the scientific community would be concerned about that - that’s really a classic example of overreach by a researcher.

Ultimately, this book was a good read if you’re interested in the stories behind the NFL’s concussion crisis and their concerns about football causing permanent brain damage. If, however, you’re hoping for a good look at the actual science of it, this is not the book for you.

Recommendation: Worth Reading if you’re more interested in the story than the science.


The deadline on the FlutterDash group contest draws ever closer; you have until next Monday to submit your stories to the contest. We’ve gotten several entries so far, but if any of the rest of you are interested in throwing your hats into the ring, or working to get your story done, here’s another friendly reminder.

Number of stories still listed as Read It Sooner: 160

Number of stories still listed as Read It Later: 542

Number of stories listed as Read It Eventually: 2005

Comments ( 1 )

I listened to an NPR thing on this and also concussions in the sporting world in general especially in regards to olympic events and how Europeans were skeptical of American's worry.

Good stuff, by which I mean bad stuff.

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