Friday, September 21, 2012

Head Games

Head Games, a documentary about concussions in sports. Head Games depicts a young football team in a David vs. Goliath struggle, but its real purpose is to portray a group of neurologists and advocates as underdogs fighting the business interets of football.

Still from Head Games ? 2012 Head Games the Film LLC.

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Head Games, the new documentary from director Steve James (Hoop Dreams), begins on the sidelines of a football game at Near North Elementary in Chicago. It's a school for kids with special needs, mostly black and from poor families. The pint-sized players' coach barks out the story of David and Goliath: "Your helmets are your rocks," he says, urging them to use their rocks to slay some giants. Ninety minutes later, we're at the last game of the season; Near North is down with seconds left to play. A score appears at the bottom of the screen: "David 28 / Goliath 35." Will the boys pull this one out?

I bring up these scenes not because of what they say about the movie's theme?the apparent crisis of concussions in contact sports?but because of what they say about its method. The children?s struggle stands in for the team of underdogs at the center of the film, a scrappy crew of neurologists and advocates who are battling football?s businessmen and bureaucrats. But this nifty narrative deflects attention from some deeper facts. First, that the panic over on-field head trauma has given rise to major business interests, some of which tie in to the movie's backers. And second, that the science of head trauma remains cloaked in anecdote, beset by suppositions, and hopelessly benighted when it comes to how to treat the problem.

James starts his tale with Chris Nowinski, an ex-defensive lineman for Harvard's football team who spent some time as a pro wrestler and now helps run the Center for the Study of Traumatic Encephalopathy at Boston University. He's a natural showman, smart and charismatic, and we get to watch him re-enact a few of his greatest research moments. There he is in the library, poring over scientific papers and scrawling scary numbers in his notebook. He jots one down and then stares off into the distance. So much outrage in his eyes!

Another unlikely hero: the journalist who brought the dangers of concussions to a national audience. Acting on Nowinski's tip, the New York Times' Alan Schwarz linked the 2006 suicide of former Eagles defensive back Andre Waters to the buildup of tau proteins in his brain, a sign of repeated head trauma. The film paints Schwarz as a dogged, righteous nerd?we see the calculus books on his shelf?and savvy enough to call bullshit on the NFL's bogus science. "In a way, I was becoming the math teacher that I had always planned on being," he says of his early showdown with NFL commissioner Roger Goodell. He laid out for Goodell what it meant that the brains of four ex-NFL players had shown the signs of a rare, neurodegenerative disease. "All I wanted to do was get him to understand the probabilities at work here, that it wasn't just me being a pain in the ass. It was the fact that when you're four out of four, for a million-to-1 shot, something's up," he explains.

That's when another nerd might pause to ask a question: a million-to-1, really? A major obstacle for research on traumatic encephalopathy comes from the fact that no one knows its prevalence. The neurologists at BU have found signs of the disease in most of the brains they've studied, but it's still not clear how many other football players have it, nor what the rate is in the population at large. All that makes it very difficult to figure out how CTE affects mental health, or what else it means for sufferers. When Schwarz calls the disease a "million-to-1 shot," he's fudging.

No big deal, perhaps, but for the fact that concussion research is such a fudge factory from end to end. Does CTE lead to suicide, as the film repeatedly suggests? I don't think there's any reason to say it does. (Andre Waters, for example, suffered from many other risk factors: chronic pain, a protracted family dispute, and?most glaringly?chronic and untreated depression.) Does having one concussion make the next one more likely or more dangerous, as the film repeatedly suggests? Maybe, but the evidence isn't as strong as you might think; most comes from rodent work, and what we know from people suggests the added risk extends for about a week. Should people with concussions rest until their symptoms disappear, as the film repeatedly suggests? That's been the standard advice since the 1940s, but there's very little evidence to show it's more than superstition. The only real work to support the notion came out in June, with equivocal results. (Researchers found that a week of rest taken right after getting hit did as much good as a week taken several months later.)

Source: http://feeds.slate.com/click.phdo?i=451707cffe1ed22cde98563c45e096ab

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