One of my dear doctor friends and (avid football fan) once described preventive medicine as the act of being a “cheerleader for people’s health.” If you’ve ever tried to lead a cheer, though, you know you have to have a clear message and the crowd on your side, or you’ll be shouting into the void.
Early in my time at Everett health center, a young man came to my clinic for a physical exam for college. He was 19, bright, and on the football team. His ankle had been broken twice, his ACL busted. Most disturbingly, he had had several concussions. I thought about what it meant that he would have to live another 70 years with those injuries, and the many more he would accumulate.
”Are you sure you want to keep playing football, given all you’ve been through?”
”Doctor, if I don’t play, I can’t pay for college.”
I signed the form.
To get an education, this young man was putting himself at risk of chronic pain and traumatic brain injury because it was the only path he saw open to him. I prayed he would be benched.
For those who are successful in college, a career in the NFL means the very real possibility of brain damage. One neuropathologist published an article in 2017 that put this in stark relief: of 111 brains of NFL players she examined, 110 had chronic traumatic encephalopathy.
https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html
There are some of us who can separate the things we see in clinic more easily from the rest of our lives. It’s never been easy for me, so I will not be watching the Super Bowl.
My friend who had encouraged me to be a cheerleader for medicine is still a huge college football fan, even though she insists her own son will never play the game. Increasingly, football is a game of young men trying to rise out of poverty, watched by people who would never let their own kids play.
This is a longstanding tradition in American life: using the poor, powerless, and racial minorities to do jobs considered too dangerous for the more well off children. It’s easier when we don’t have to see it, but we have been watching concussions in real time for years. We even have a video of all the concussions reported last year:
https://theintercept.com/2018/02/01/concussion-protocol/
This kind of movie will become more difficult to make in the future as the league adopts tents for the “privacy of the players.” It will undoubtedly have the effect of sanitizing what we know is an unacceptable level of violence for a recreational game. At least for a time.
The makers of the concussion video stressed that they are not calling for the end of football, but I am. So say it with me: it’s time for America to play a different game.
