Health Column: Response to Gladwell

In the 1960s and 1970s, boxing captivated audiences across the United States. Boxing enthusiasts and casual observers across the country paid to see prize fighters Sonny Liston, Joe Frazier, Muhammad Ali and George Foreman battle in the ring from the comfort of armchairs in their local movie theaters. Ancient in its origins, boxing was a sport that embodied the American spirit. With toughness, grit and determination, any athlete, regardless of their race, background or class could find glory in the ring, and fulfill the American dream.

In the 1980s the popularity of boxing declined significantly as public broadcasts became increasingly limited, and rule changes by the World Boxing Association and World Boxing Council often resulted in multiple champions. As the popularity of boxing waned, public opinion of the sport began to devolve. Once a stage for Horatio Alger’s rags to riches Americans, many began to think of boxing as gratuitously violent and barbaric. Today boxing has faded into obscurity, and while a small group of fans remain, prize fights are no longer the spectacle they once were.

Stepping into the ring, fighters always knew that there was going to be a price to pay for victory. But only recently have scientists begun to understand just how steep that price is. As a generation of boxers begins to age in an era of modern medicine, scientists are beginning to realize the devastating effects that boxing has on long term mental health. Some scientists now believe that rates of chronic traumatic encephalopathy (C.T.E.), or dementia, in former boxers may be above 20 percent, nearly twenty times higher than in average Americans. Still more scientists believe that to be a conservative estimate.

Years after boxing has faded from American consciousness, many would like to dismiss this research as unsurprising and inconsequential. Despite American callousness, many doctors find this research to be distressing. If boxing has such a devastating effect on long term mental health, what impact could it have on the generation of young Americans battling on the football field? Football is as glamorous and popular as boxing once was, and doctors now fear that it is just as dangerous.

In the October 19 edition of The New Yorker, journalistsociologist Malcolm Gladwell published an article in which he theorized that the NFL may not be treating its athletes any better than Michael Vick treated his dogs. While the comparison seemed outrageous at first, Gladwell formed a compelling argument suggesting that the NFL actively ignores the health of its players for the sake of entertainment.

In his essay, Gladwell cited evidence put forward by neuropathologist, Dr. Ann McKee of the Bedford Veterans Hospital in Massachusetts. In her research, Dr. McKee works with Alzheimer’s patients, and occasionally she has the opportunity to analyze an autopsied brain of a deceased Alzheimer’s patient. Typically, McKee finds two different kinds of decayed or damaged tissue on these brains, beta amyloid and tau. While the origins of Alzheimer’s is still very mysterious, it is thought that beta amyloid is responsible for the onset of dementia, while tau is responsible for later stages of the disease.

As McKee has been able to analyze more and more brains, she has begun to realize that some patients who have been diagnosed with Alzheimer’s may not actually be afflicted by the disease at all. Instead, autopsies of brains of athletes formerly affiliated with contact sports have shown alarmingly abnormal amounts of tau, without a trace of beta amyloid.

Further research has allowed scientists to observe the brains of not only elderly former athletes, but also the brains of suddenly deceased young athletes, and these observations have yielded troubling results. Doctors have now been able to identify notable brain damage in even high school and college athletes.

Gladwell’s argument that the NFL is analogous to dog fighting is a provocative argument, but it may miss the more important underlying issue. If it is possible that football could significantly raise the chances of early onset dementia in former athletes, what can be done? The NFL is more popular in 2009 than it has ever been, and the glory of the gridiron lures boys of all ages to buckle their chin-straps and take to the field every weekend.

Big hits have always been a part of football. When an athlete suffers a big hit and loses his senses, it seems temporal, and players often get a cheap laugh at the expense of a disoriented player who simply “got his bell rung.”

Simply put, the effects of these blows to the head on long-term mental health are difficult to comprehend because athletes seem to rebound from them so quickly. Scientists are now learning that these hits may not be so innocuous.

Although evidence of these dangers continues to mount, it is helpless in the face of football’s ever-increasing popularity. The prominence of football in American society takes center stage, and athletes and coaches who devote their lives to a game cannot be stopped by veiled warnings of a grim demise. The scientific community has identified a potentially serious medical risk, but it is powerless to slow the growth of America’s greatest game. With a passion for football so ingrained in American culture, it is going to take drastic medical discoveries to convince an American public that would like to deny how harmful its favorite sport can be. After all, isn’t that what helmets are for?