CTE, The Obscure Brain Disease That Could End The NFL, Gets The Hollywood Treatment

CREDIT: Chris Pizello/Invision, AP

Will Smith, star of "Concussion," poses at the world premiere gala screening of the film during the 2015 AFI Fest at the TCL Chinese Theatre on Tuesday, Nov. 10, 2015, in Los Angeles.

The NFL has never been more popular. Every Sunday — and Thursday and Monday — millions of people across the globe gather around their televisions and computers at home and in bars to watch an inherently violent sport. But the past few weekends, during commercial breaks, there has been a rather jarring sight on game day — the trailer for the film Concussion.

Concussion tells the story of Dr. Bennet Omalu (Will Smith) discovering the brain disease chronic traumatic encephalopathy (CTE) in former NFL players and fighting to get the league to recognize his findings. While the movie is far from perfect, it is certainly filled with powerful moments.

There’s the scene, depicted in the trailer as well, when Omalu passionately pleads with an NFL doctor to “tell the truth” about the danger of concussions; there’s the harrowing portrayal of the downfall of Hall of Famer Mike Webster (David Morse), who went from being a Pittsburgh Steelers icon to living in a broken-down truck by the train tracks, tazing himself and supergluing his own teeth; and there’s the gut-wrenching moment we see 36-year-old former Steelers offensive lineman Justin Strzelczyk (Matthew Willig) abuse his wife in front of his children before taking off in his truck and speeding recklessly down the highway.

But the most powerful moment — the only moment that caused those in the audience at my screening to gasp — occurred right after that, when the movie switched from carefully framed and beautifully lit shots to grainy, raw, real-life dash-cam footage from 2004 of Strzelczyk’s truck crashing into oncoming traffic on an interstate and being engulfed in flames.

It serves as a stark reminder that while the film is imperfect, oversimplified and, at times, over-acted, it is in no way over-dramatized. This is literally a life or death issue.

Pittsburgh Steelers center Mike Webster is shown in this 1988 season photo. Webster, the indestructible Steeler with the rolled-up shirt sleeves and a look that warned don't tread on me, never met another man he couldn't beat on the football field.

Pittsburgh Steelers center Mike Webster is shown in this 1988 season photo. Webster, the indestructible Steeler with the rolled-up shirt sleeves and a look that warned don’t tread on me, never met another man he couldn’t beat on the football field.

CREDIT: Gene J. Puskar, AP

Dr. Ronald L. Hamilton, an associate professor of pathology at the University of Pittsburgh, still remembers the day in late 2002 when his former student called him up and asked to meet.

“I’ve got a really interesting case,” Omalu told his mentor. “I’d love to show it to you.”

At the time, Omalu, a forensic pathologist from Nigeria, was working at a coroner’s office in Pennsylvania. While Webster’s 2002 death was initially attributed to a heart attack, Omalu refused to believe that was the true cause; he was struck by the deteriorated state of Webster’s physique and the dramatic way his life had fallen apart. Omalu knew that brain damage had to be present in this case, so even after the initial brain scans came back negative, Omalu kept searching for answers. Using his own money, he ordered test after test, and eventually discovered brain damage similar to that found in boxers.

Omalu presented the slides of Webster’s brain to Hamilton without providing any background information, and Hamilton came to the same conclusion — this looked similar to dementia pugilistica, a trauma associated with boxers since the 1920s. Hamilton, who is played by Stephen Moyer in the film, wasn’t shocked when Omalu told him that the brain actually belonged to a former NFL player. He was, however, shocked when Omalu told him the discovery had never been published before.

“That’s when my heart started racing, my jaw dropped to the ground,” Hamilton told me in a recent phone interview. “I said, ‘Oh my God, Bennet, you don’t know how big this is.’ I knew he didn’t know American culture.”

Hamilton knew that Omalu had to be very careful about presenting what he considered a “slam-dunk case,” because he knew that the publishing the findings would create controversy. But he was still surprised by the extent of the NFL’s pushback — particularly the initial letter from NFL doctors asking for the study to be retracted and calling the findings “completely fallacious.”

And though the NFL has gotten more serious about the issue recently, establishing a concussion protocol that includes spotters in the stands and examinations by independent doctors, Hamilton knows that there is a long way to go, particularly when it comes to educating the public on the issue.

Before he watched Concussion, Hamilton said that he hoped it would “bring a truth” to the audience. “Unvarnished,” he said. “Not distorted.”

The truth, as told by Hamilton and Omalu, is that repetitive sub-concussive hits sustained in football cause trauma which leads to CTE, a progressive and debilitating brain disease that can result in dementia, severe depression, violent mood swings, and delusions.

CTE is the reason once proud and charismatic Webster spent his final days alone and in pain, hopped up on a cocktail of pain medications and sleeping in a truck with broken windows covered by garbage bags. CTE is the reason the once fun-loving and thoughtful Strzelczyk sped up Interstate 79 in New York one afternoon, stopped at a gas station to offer crucifixes and cash to strangers, and then raced through oncoming traffic, dodging cars until he hit a tanker going 90 miles per hour.

Hamilton got his wish. While the protagonist of the film is Omalu, an immigrant with numerous degrees and endearing quirks who just wants to be embraced by America, and the antagonist is the NFL, the heart of the film is the unsettling but blatant fact that the most popular sport in America is leading directly to the downfall and death of some of the idols it creates.

Concussion — which is based on the true story of Omalu’s research, first told by Jeanne Marie Laskas in a 2009 article in GQ— does a great job of clearly explaining the science behind CTE. Omalu describes the disease as a “killer protein” that is “choking the brain.” He also explains how brain damage occurs: the brain swishes back and forth in the skull. He describes the fact that a woodpecker’s’ tongue actually wraps around its brain while it’s pecking at something, keeping the brain from moving back and forth. Humans don’t have such a mechanism in place. It’s almost like, as Omalu says in the movie, humans aren’t meant to play football.

There are significant problems with the film’s script and pacing, however. The first half, where Omalu is discovering and researching CTE, drags on for far too long; reading books and looking through microscopes isn’t exactly compelling theatre. Most of the characters around Omalu are painfully one-dimensional — not just those opposed to his findings, but also his love-interest-turned-wife, who is reduced to wide-eyed stares and the occasional cheerleading speech. The dialogue is often cheesy, and the most interesting part of the movie — the NFL’s push-back and attempts to stifle Omalu’s findings — feels crammed in towards the end.

But despite reports from the New York Times that Sony altered the film to prevent NFL protests, the movie does not go easy on the league — and that includes former commissioner Paul Tagliabue and current commissioner Roger Goodell. Those who are unfamiliar with the story will be appalled at the league’s reaction to Omalu’s research. And, to director and screenwriter Peter Landesman’s credit, there is a dedication to facts and no attempt to shoehorn a happy ending onto a story that is still very much ongoing.

Overall, Hamilton was happy. “Concussion is an impactful and important movie,” he said after screening it on Tuesday. “No one who sees it will come away unchanged. This movie will affect the way many Americans watch the game, the way they think about the game, the way they play the game and the way their children play this uniquely American and inherently violent game.”

Dr. Bennet Omalu seen at Columbia Pictures Special screening of 'Concussion' at Regency Village Theatre on Monday, Nov. 23, 2015, in Los Angeles, CA.

Dr. Bennet Omalu seen at Columbia Pictures Special screening of ‘Concussion’ at Regency Village Theatre on Monday, Nov. 23, 2015, in Los Angeles, CA.

CREDIT: Eric Charbonneau/Invision, AP

This month, Omalu wrote a piece in the New York Times entitled, “Don’t Let Kids Play Football.”

“Our children are minors who have not reached the age of consent,” he wrote. “It is our moral duty as a society to protect the most vulnerable of us.”

The piece inspired more controversy. Dr. Julian Bailes, a prominent neurosurgeon who has partnered with Omalu on CTE research and is played by Alec Baldwin in the film, disagreed with Omalu’s suggestion, and ESPN analyst Danny Kanell referred to it as a “war on football.”

Hamilton, however, was thrilled to see the article run, and completely agreed with Omalu’s conclusion.

“It’s a game. You’re playing Russian roulette with your children’s brains. How can you do that?” he said. “It’s not a war on football, it’s a war on brain injury.”

Since Omalu first discovered CTE over a decade ago, subsequent research has only supported his initial findings. The Department of Veterans Affairs and Boston University found CTE in the brains of 87 of 91 deceased former NFL players it studied. And the pros aren’t the only ones being impacted — a recent study by the Mayo Clinic found evidence of CTE in 32 percent of the brains it studied from males who had any documented history of playing contact sports (even at an amatuer level); comparably, none of the brains examined without a documented history of playing contact sports had signs of CTE.

There has also been extensive reporting since on concussions and the NFL’s role in covering up the evolving science, most notably in the 2013 book and corresponding PBS special League of Denial. As a result, players are more aware of the risks and are being more cautious. In fact, multiple NFL players have retired in the past year due to concerns about brain injury and before the 2015 season began, an NFL rookie retired out of fear that the next hit to his head “could possibly kill me.”

Still, some aren’t thrilled with the Hollywood treatment this issue is getting. The family of Dave Duerson, a former NFL player who is portrayed as an adversary in the film, told the New York Times that they were unhappy with Duerson’s portrayal in the film. “They completely made stuff up,” his son said. And earlier this month, ESPN NFL reporter Adam Schefter told radio hosts Mike & Mike that if people want to learn more about this issue, they should just watch League of Denial. “We don’t need to see Will Smith, and other people acting this out,” he said. “It’s happening every day in front of our eyes.”

However, the filmmakers stand by the creative licensing they took in order to turn the subject into a powerful and cohesive narrative, and Hamilton is supportive of the dramatization because he knows that this film –which is already receiving awards-show attention thanks to Smith’s performance — is making a hard-to-digest subject more palatable and buzz-worthy. This is a movie that will be hard for anyone — even a league as untouchable as the NFL — to ignore.

CTE is a very difficult disease to study since it can only be diagnosed posthumously, so Hamilton hopes that as people become more aware of the truth about the correlation between football and brain damage, more research will be funded. In addition to the current work being done to isolate the tau protein that is at the center of the disease, he wants to see more long-term studies done on living people — including high-school and college football players — so that the scope of the disease can be fully understood.

Concussion is by far the most high-profile exploration of the dangers of football, but only time will tell whether that will lead to any reduction in the NFL’s popularity. Many, including USA Today columnist Christine Brennan, doubt that it will.

After all, even Hamilton still loves the game and watches football. Of course, he watches differently than most of us. Whenever someone falls, he watches to see if their head hits the ground forcefully. Every time that happens, he sees the brain damage happen in real time.

He acknowledges that rule changes are making the game safer. But does Hamilton ever envision a time where football can be enjoyed without the threat of the players suffering irreversible, long-term brain damage?

“No,” he said flatly. “Football is going to be football, and there’s always going to be a degree of head trauma.”