Mike Webster was proud of himself. He was called Iron Mike because of his tenacity and perseverance, which saw him play 220 games for the Steelers in 15 seasons. To his wife, he was a dependable husband and father of their four children; to his teammates, he was a hard worker who was the first one on and the last one off the football field, then studied game footage with a photographic memory. He never complained about the pain, it was part of his profession. He bore them silently and upright. After retirement, he could have started a new life with the millions of dollars he earned playing American football, but he just kept sinking. He did not know why. No one knew. It is true that he had suffered at least 25 000 concussions in his career and had never really recovered from any of them, but that could not be the reason for his problems. Could it?
He retired a legend and a millionaire at the age of 38, but he was beginning to change. He had forgotten about the stars he so often saw in front of his eyes when he crashed his helmet fiercely into his opponent’s helmet. They were part of his everyday life during his career. The broken bones too. Once he came to a match with crutches. He played the game and afterwards had surgery on his knee, where the cartilage had broken.
No injury has ever stopped him, and now he finds himself more and more often not in the city he used to know so well. He used to pay all the bills, but now he didn’t even open the envelopes, let alone pay the bills. He didn’t even file tax returns. Just a year and a half after he retired, their house was repossessed. All the millions were gone. He didn’t know where.
He urinated in the kitchen oven. He disappeared without explanation and returned a few days later. This was followed by periods of complete numbness. Two years after his retirement, his wife could no longer cope. Convinced that he was depressed, she forced him to seek help. No one knew what was wrong with him. They separated.
Completely penniless, he moved out to try to make a living. He couldn’t hold down a job. In fact, he didn’t even go to the talks. He forgot about them. At the same time, he dreamed of new business ventures that would bring him millions. None of the ideas were realistic.
There were weeks when he slept at the train station and lived on crisps and cereals whenever he remembered he had to eat. Sometimes for days in a row he didn’t even think about it. He slept under bridges and in his semi-truck. The front glass had been missing for some time, the hole was covered by a waste cardboard box.
Sometimes he would lie curled up like a baby for two or three days in a row, contemplating suicide. In the last years of his life, he called friends and family members almost every day. He did not know where he was. And he didn’t know where home was, wherever that was.
His body was racked by convulsions and he suffered from insomnia. He bought a police Taser and shook it 10 to 20 times. It was the only way to calm his body. Sometimes he would persist until he lost consciousness, just to get some sleep.
He took Ritalin to control his mood swings. When his doctor left the area, he was forced to forge prescriptions. He was arrested by the police. He had to publicly repent for the “shame and sorrow” he had caused.
Along with Ritalin, he was taking Paxil to relieve anxiety, Prozac for depression, Klonopin to relieve seizures, Vicodin or something similar for pain, and Eldepryl, which is prescribed for Parkinson’s patients. Sometimes he has also been completely absent because of a cocktail of drugs he has ingested.
He couldn’t go to his son’s birthday party, even though it was only a 20-minute drive away. He was semi-conscious in his hotel room due to pain and medication. Next to him was a bucket full of his own vomit.
He tried to fix his missing teeth to his jaw with ordinary glue. He could not hear well. His spine was destroyed. He could hardly move his right arm, his shoulder hurt so much. A chronic injury to his right heel left him with a limp. The cartilage in both knees was gone. His joints were painful and stuck. His fingers were crooked.
He lived like a clown, but kept his dignity. He refused to ask for help, but one of his former fans offered it to him and spent the last years of his life taking care of him as best he could.
He called his youngest daughter every night. She didn’t know how bad it was for him. His two sons. They took turns living with him and trying to look after him. There was no furniture in the rented flat. He and his son slept on the floor until they were thrown out because he could not pay the rent.
He could still read. He devoured books about the Second World War as he used to, but he couldn’t remember the simple things. He kept a diary. He taped a pencil to the palm of his hand and wrote hundreds of completely confused letters. For example, he thanked his lawyer for his help when he was trying to get the NLF or the National Football League to grant him a disability pension, encouraged him that he had to keep fighting, and then started writing about wars, bloodshed and his delusions.
Reading his diary in moments of sobriety, he burst into tears. He did not understand what was happening to him, and it made him despair. Somehow, he came up with a gun. In agony, he approached strangers and begged them to shoot him.
In the mid-1990s, he saw a number of doctors, but none of them knew what was wrong with him. One asked him if he had been in a car accident, because he was showing all the signs of brain damage. “I’ve had about 350,000,” Mike replied. That’s how many times he has hit his opponent’s head, but he has certainly suffered at least 25,000 extremely hard blows to the head during his career. He didn’t know that he had also suffered a concussion every time.
When he was inducted into the NFL Hall of Fame in 1997, he was already a complete social pariah. He no longer remembered that either, whether he was married or not. Or how he lost his money. Maybe he gave it away, maybe he invested it in bad business. He didn’t know. In fact, he knew very little about his life at that time.
The lawyer got the NFL to grant him a disability pension of $115,000 a year, the lowest possible pension. Most of the money went for maintenance, but what was left was collected by the taxman. Often he had no money for medicine.
At the age of 50, he suffered a heart attack at home. His son didn’t know what had happened to him. He wanted to take him to the hospital, but they wouldn’t let him. He had no health insurance. When the son finally called an ambulance, it was too late. Mike Webster died in hospital.
There is no such thing as a new disease
His body ended up on the desk of Bennet Omalu, a young pathologist who came to America from Nigeria in search of a better life. He knew nothing about American football, and even less about its players. He had never heard of Mike Webster, but he sought out his lawyer anyway.
He was obsessed with brains. Can he dissect Mike Webster’s? Webster had seen no end of doctors, but no one had found anything, and besides, the cause of death was known. Nevertheless, he secured a licence.
Even an ordinary pathologist would consider a brain autopsy unnecessary. They were perfectly normal to look at: there were no visible lesions, they were not swollen or atrophied, as boxers’ brains usually are. Webster’s medical records also did not show that he had ever had any problems with them, only that he had suffered from secondary depression, which was probably the result of a previous concussion.
Omalu took the job simply because he was curious. He had Webster’s brain sliced into microscopically thin layers, mounted on glass plates and stained to show irregularities. The first layers were as ordinary as the brain looked at first sight.
He had new layers cut. Now he was paying the costs of the procedure himself, even though they amounted to thousands of dollars. He could not justify them to his employer, but his own money bought him the freedom to work at his own pace and in his own time.
He was examining the brain layer by layer through a microscope when he suddenly noticed unusual dark spots, similar to those pathologists had already detected in boxers. They were caused by a build-up of the protein tau, which is a kind of lubricant in healthy brains, but in unhealthy brains can congeal into a kind of sludge that clogs the brain and kills off healthy cells. In Webster’s study, the protein was found to be concentrated in areas responsible for mood, emotion and learning.
Omalu showed the brain to Ronald Hamilton, his former professor and a renowned neurologist. Webster’s brain at first glance resembled that of an Alzheimer’s patient, except that he had much more of the tau protein, and Hamilton had long been researching the proteins in the brains of Alzheimer’s patients. But he had never seen anything like it.
The two men also consulted neurologist Steve DeKosky, who had previously wondered what was happening to the brains of American football players when he observed from afar how their behaviour slowly began to change after retirement. He confirmed that Omalu had found a new disease. He called it chronic traumatic encephalopathy, or CTE.
The NLF or National Football League management has strongly denied its existence. The football business is worth billions of dollars, and it has refused to be responsible for any permanent brain damage to its players, and the spectators are demanding a game as rough as the one that is destroying the brains of its players. The NLF found its own experts and tried to discredit all the findings. Omalu was left out of the controversy because he was too marginal to be worthy of mention.
But the genie was already out of the bottle and there was no stopping the debate. It is true that American football players wear helmets, but they still bump their heads violently into each other. Helmets do not cushion the impact and would not do so even if they were heavily padded.
The brain is floating in the cerebrospinal fluid and has some room to move, but when the head comes to a sudden stop in a collision with a teammate’s head, the brain moves forward and hits the skull. On top of that, many injuries are rotational because the head turns suddenly on impact. The brain rotates and the tissues are torn.
The rules of the game need to be changed, the experts involved have demanded, but the spectators disagree, and the revenue of the players, the teams and the league depend on their attention, so everything remains the same, only tragedies caused by untreated concussions are new.
Three days, three deaths
“The Chris Benoit I knew was more concerned about everyone else’s well-being than his own,” Chris Nowinski recalled of his former wrestling colleague. When they met, Nowinski went by the name Harvard Chris because he was the only Harvard student among the wrestlers. He retired from the sport because of brain injuries. Since he flew into the ring to the fierce cheers of the spectators and smashed the table with his own head, he has looked nothing alike.
His eyesight went blurry, he suffered from severe migraines, and he found it difficult to keep his balance. At the age of 24, he sometimes felt like a helpless old man. He saw eight doctors, but it was only the ninth who explained that every time he hit his head on a hard surface, he suffered a concussion. And he had many, not least when he lost consciousness as a result of the impact. Each concussion was a brain injury and after each one he would have to rest to allow his brain to recover.
But entertainment wrestling never lets up. There are no seasons, no holidays like other sports. Former wrestler Bret Hart explained that during his 23-year career he was on the road as many as 300 days a year. He fought in the ring every night, sometimes more than once. Alongside his regular fights, he also had to appear in promotional fights and train. His lifestyle completely alienated him from his family. “Almost everyone who ran away came back because they simply couldn’t live in the outside world,” he concluded.
Nowinski didn’t, although he also had to say goodbye to his dream of a business career. When he learned the consequences of repeated concussions, he made a cross over wrestling. He began to research the disease that was killing him and his colleagues, and to raise public awareness of the danger they faced.
It was too late for Chris Benoit. He was old school. It was a badge of honour for him to step into the ring, regardless of his injury, and to take as many punches as he could, such as the chair shot to the back of the head, standing upright. He did not pay attention to the changes, his wife and son felt them all too well.
At the age of 40, he was depressed and showing signs of dementia. He was paranoid. He found 30 different ways to get from home to the gym because he had a premonition that he was being stalked. He wrote in his diary that his memory was often failing him. His mood swung dangerously, he became more and more aggressive. His wife had already filed a restraining order for threats and breaking furniture, but withdrew it.
Four years later, he called a friend and, after a confused conversation, said goodbye with I love you. He had never said that before. He explained to his friend and others that his wife and son had poisoned themselves, and to someone that his wife had ended up in hospital. Then strange phone messages started arriving on my friend’s phone. He informed their joint employers. They tried to call Benoit, but in vain.
On Monday, they asked the sheriff to check what was going on in his family home. They got the shocking news: three-time US wrestling champion Chris Benoit had killed his wife Nancy and their 7-year-old son Daniel, and ended up suing himself. An investigation revealed that the trio did not die on the same day.
On Friday night, he tied his wife’s hands and feet and suffocated her. He put a Bible next to her. The next morning, he strangled his son in his bed. He also put a Bible next to him. The following day, on Sunday, he took his own life by hanging himself with a cable he had taken off his weight-lifting machine.
Wrestlers are the most likely to die premature deaths, followed closely by American football players, but a double murder-suicide is unthinkable for them too. When pathologists carried out an autopsy, they found in the skull of 40-year-old Benoit the kind of brain you would expect to find in an 85-year-old Alzheimer’s patient.
The tau protein, which causes neurodegeneration, cognitive problems and dementia, was abnormally high, but in Benoit’s case, the responsibility for the tragedy could not be blamed solely on chronic traumatic encephalitis.
Shortly before his death, he suffered several losses of loved ones, which affected his already poor mental well-being. When the police entered the house, they found a number of empty bottles of alcohol. The autopsy showed no alcohol in the body, but revealed a testosterone level 10 times higher. Scientists say that testosterone does not cause aggression, especially in men whose natural testosterone levels would be too low. In Benoit’s case, it could have been, because he probably also took steroids, although they were not found during the autopsy. However, the tranquilliser xanax and the opiate hydocodone were found in his system, which he used to relieve the physical pain he was suffering.
After the tragedy, his personal doctor was sentenced to 10 years in prison for prescribing him too high doses of testosterone, but the rules of wrestling were not changed. Too much money is being made in it, too.
From compassionate boy to killer
Jovan Belcher is brought to his knees by American football. The boy who worked his way out of poverty to a contract worth USD 2 million was once considered a very kind, warm and compassionate boy who couldn’t walk past girls selling cookies without giving them money. At the age of 25, he shot his girlfriend, the mother of their three-month-old daughter Zoeye, nine times with a .40-calibre rifle and then tried himself.
At the time of the tragedy, he was theoretically living his dream, having been plagued by injuries since the start of his sporting career. He was never completely healthy, but he never complained. His salary was too good and his family too poor. He played hard, direct, fierce and with his head always ready to attack.
It is not clear when exactly he started to change from a nice boy into a man capable of murder. He started drinking as soon as he broke into the professional league, some because his colleagues frequented nightclubs and he had a reputation to uphold, some because alcohol was used to numb the physical pain and the constant headaches.
He tried hard, but he was never the best or the most popular with employers. He lived in constant fear of being replaced, but that is the pressure that other professional American football players live under.
When he met young Cassandra Perkins, it seemed that he would now find a haven of calm, at least at home, but they had one wild party and another wild argument. She was too young to understand him and he was too young to know how to live with the stresses that weighed on him.
When he signed a contract for almost 2 million dollars, it seemed that he had finally made it: he had secured his existential security and was expecting his first child. As the son of a single mother, he promised himself to give his daughter a different life.
But he and Parkins continued to argue. He drank more and more and took more and more painkillers. He took a mistress and Parkins moved out with her two-month-old daughter. Two weeks later, she returned.
Belcher also did badly on the pitch. His friends noticed that he was increasingly forgetful and unreliable. The headaches and mood swings were getting worse. He was experiencing fits of rage. He knew something was happening to him. He started to talk about memory and consciousness losses, about which he had previously remained silent. Often he would lose the thread of a conversation or would fall silent in the middle of a sentence because he did not remember what he was talking about. He could not concentrate.
No one knows what happened that fateful day, but it seems that he returned home drunk and depressed after spending the night with another woman. He then shot his girlfriend nine times: in the neck, chest, abdomen, hip, back, leg and arm. When he had finished, he bent down, kissed her on the forehead and apologised.
His mother stood by. She was in complete shock. She called the police, he drove to the stadium. He still had the gun. He walked in front of the coach and the general manager of his club, knelt down, crossed himself and allegedly said to them: “I did it. I killed her. I have to go. I can’t be here.” Police sirens echoed in the distance as he fired a bullet into his own head.
A year after his death, his mother had his body exhumed and two weeks later his brain was examined. It was discovered that he suffered from chronic traumatic encephalitis.
Concussion is not always innocent
Doctors have always known that concussion is not innocent. Hippocrates spoke of the condition commotio cerebri and described it as the loss of speech, hearing and vision that can result from movement of the brain.
The Persian physician Abu Bakr Muhammad ibn Zakariya Razi, in the 10th century, distinguished between two types of brain injury: one he described as bruising, swelling and bleeding, which kill a person instantly, the other as more subtle. The latter makes a person dizzy and can also make him faint, but he recovers from it.
He was the first person to use the phrase concussion, and in the early 16th century, the Italian physician Jacopo Berengario da Carpi was the first person to realise that concussion causes the soft brain matter to collide with the hard skull and actually scratch the brain.
But they could not confirm his findings because few people died of concussion and the brain was never routinely examined during the autopsy. Without pathological findings to confirm the condition, the word ‘concussion’ remained a description rather than a diagnosis, and there was no need for a diagnosis because it was believed that, except in the most severe cases, the effects of concussion were not permanent.
It was only in the first half of the 20th century that doctors began to realise that cerebral palsy was not always a transient condition that did not affect brain changes, and that it was very likely to lead to secondary denervation.
Forensic pathologist Harrison Martland was particularly interested in the brains of boxers at the time. He observed how strangely they behaved after a punch: they staggered around the ring as if they were drunk. People laughed at them, and he wondered what was going on in their brains.
Towards the end of 1928, he finally described the phenomenon he called “drunk on the blow”. The condition, he said, occurs most often in inferior boxers who receive numerous blows to the head and are just waiting for the knockout to put them down, and in those players who use them only for training and lie on the ground several times a day.
Medicine had not dealt with this phenomenon before, but to him it seemed very serious: in the case of intoxication due to a blow, certain brain injuries occur due to a single blow or repeated blows to the head or jaw, he explained. This causes numerous concussions and haemorrhages in the deeper parts of the brain, he continued, but he had no evidence of this.
He did not perform any autopsies on any brains of any boxers, he just predicted that there were lesions, that scar tissue would appear in their place and that this would cause the brain to atrophy. In his estimation, this must have occurred in at least half of the boxers who lasted long enough in the ring. He added that this should not be tolerated any longer, but people liked boxing the way it was and everything went on as normal.
The scientific proof of his claim was only found in 1973 by the British neuropathologist J.A.N. Corsellis, who studied the brains of 15 former boxers and all the clinical data he could gather from their family members.
In all brains, he found abnormal and specific tissue lesions with abnormal spindles in abnormal sequences. Even before he looked at the brains under the microscope, he knew that the boxers had suffered severe brain damage. He called the disease dementia pugilistica.
Young people with the brains of old people
It has changed the behaviour of boxers, and the wife of American football player Justin Strzelczyk has also started to notice changes. Once considered a lively man and a joyful banjo player, he now behaved as if he had bipolar disorder. She diagnosed him herself after his mood began to fluctuate inexplicably.
She was contemplating divorce, he was taking steroid-like substances to ward off depression and what he called “the bad guys”, the voices that haunted him. He agonised for a long time before the water broke over the edge.
He stopped his semi-truck at a petrol station. He had $2400 and a bunch of crosses. He started handing them out to passers-by. Then he got in his car and drove off. He was driving at 145 kilometres per hour, and the police, who were following him, were too. Sixty-five kilometres further on, he crashed into a tractor trailer. His car exploded. Justin, 36 years old, was dead at the scene.
An autopsy on his brain showed that he suffered from CTE, although his mother could not recall him ever complaining of a concussion. He was another athlete who saw concussions as part of the game rather than a serious injury, yet even pathologist Omalu was surprised when he opened his head. Justin was too young to have suffered such severe damage as his brain was revealing, because until then the disease was thought to progress slowly, with symptoms appearing somewhere between the ages of 44 and 50.
But Nathan Stiles only had 17 when he was flown by helicopter from the football field to hospital. He played a great first half, but just before half-time his mother noticed an unusual gait. He sat down on the bench by the pitch and immediately became unconscious. Early the next morning, he died of a brain haemorrhage caused by a premature concussion.
Nathan was almost a model son: an excellent student and a born athlete, who excelled in golf, basketball and American football. But he was never spared: once he was hit in the head by a golf ball, another time by a basketball, and while playing American football, his head was constantly banging against his opponent’s.
About a month before his death, he complained of a headache. His coach banned him from playing. When he was no better five days later, he had a brain scan, but no changes were detected. The doctor banned him from playing for three weeks as a precautionary measure. Before he returned to the field, he had to get a doctor’s certificate of good health, because the US state of Kansas is one of 34 states where athletes are not allowed to play after an injury unless they are formally healthy.
Nathan no longer complained of headaches. He played one game, passed his school exam and then made a great start to the next game. His parents were in complete shock when they watched from the stands as he stumbled unconscious to the ground, and even more so when Chris Nowinski called them in the morning. Just a few hours earlier, they had been told that they had lost their teenage son and he now wanted his brain for a brain bank researching chronic traumatic encephalitis and finding a cure.
“I have already called hundreds of families within 48 hours of the death of their loved ones. It is never easy. Honestly, I hate every call,” Nowinski explains, but he turns the number over every time. One athlete’s death may save another’s life, he believes.
Nathan’s parents gave up their son’s brain more out of instinct than deliberation, because the cause of death – a brain haemorrhage – was known, and Nathan was too young to be showing signs of chronic brain damage. But when the pathologist cut them open, she couldn’t believe it: at 17, he already had chronic traumatic encephalitis. This made him the youngest patient with a disease that can only be diagnosed after death because, unfortunately, the brain has to be cut too radically.
Dave Duerson knew almost everything about KTE when he stepped on the threshold of death. For six years, he was a member of the committee that decided whether or not disabled veterans would get a pension. Once a staunch trade unionist, he was now the most dog-eat-dog of all the committee members. No one knew that he was also ill at the time, having suffered countless small concussions during his 11-year career as an American football player, which made him feel sick after every game and reverberated in his head. He kept quiet about it at the time, but now he knew that he was in for a life of agony and suffering.
He has drawn the curtains in his Florida apartment. He made a shrine out of his medals and the American flag. On the kitchen table, he stacked instruction sheets and a typed letter. In it, he told his ex-wife how to handle business matters when he was gone.
He described in detail why he wanted to end his life, having gone from a multi-millionaire to a poor man with no rent in five years. He went into more detail about the depression that was killing him, the intolerable headaches and the blurred vision. He revealed how he had lost his way in the city he had once known as his pocket, and how he had been driven mad by the holes in his short-term memory that had forced him to write everything down, yet he could not remember, for example, what he had eaten for dinner.
Gone are the days when he made his classmates jealous because he hardly had to learn with his photographic memory. Only fragments remain of his dream of an academic career, which almost led him to give up sport.
Now he stripped naked and lay down on the bed. Thinking of the man who would find his body, he covered himself with the sheets. Then he shot himself. He left a note on the table asking for his brain to be handed over to a brain bank in Boston. To keep them intact, he shot himself in the heart.
“My dear angel, I love you infinitely. I am sorry for my past, but I am afraid this sword over my head is real”, he wrote in a farewell letter to his new chosen one, with whom he was planning a future together. She also called the police to break into his apartment. The overworked detectives had never seen a suicide so meticulously planned and so consistently executed.
The autopsy revealed that 51-year-old Dave Duerson also had chronic traumatic encephalitis. He became one of the few retired American football players to end their lives by suicide.
