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Interview: 'League Of Denial' Authors Mark Fainaru-Wada And Steve Fainaru Talk Concussion Crisis In NFL

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This Christmas Day, Will Smith will take the already rapidly-increasing awareness of the NFL's controversial handling of its players head trauma, specifically its crisis of concussions and chronic traumatic encephalopathy (CTE), to another level.

Based on a true story, Smith portrays Dr. Bennet Omalu, a forensic neuropathologist, who discovered CTE while conducting an autopsy on ex-Pittsburgh Steelers center Mike Webster, who died at the age of 50 in 2002. A trailer for the upcoming film has Omalu waging war against the NFL and being told that he's "against a corporation that owns a day of the week."

But before Smith's portrayal, Omalu was a central figure in the investigative-reported book League of Denial and subsequent PBS Frontline documentary of the same name. Tech Times caught up with Mark Fainaru-Wada and Steve Fainaru, ESPN reporters and co-authors of the October 2013 book to discuss the original goal of penning League of Denial. 

Although, the siblings didn't have any involvement with the movie, it's safe to say that the making of the film was probably sparked by the thorough reporting presented in League of Denial.A federal judge approving a settlement agreement this past April—expected to cost the NFL $1 billion over 65 years to resolve concussion lawsuits from thousands of retired players—says the league's concussion/CTE crisis isn't going anywhere anytime soon.

Here, the Fainaru brothers discuss how rampant CTE is amongst NFL players, the league's current concussion protocol and how they hope the film captures the full complexity of Omalu's character.

How long did the reporting for League of Denial take and what was the original goal for the book?

Steve: I think it took us about 18 months of reporting from start to finish. That included the book, stories we were doing for ESPN, whose information was ultimately included in the book, and the Frontline documentary. Of course, there's reporting that Frontline did separately from the book. I think it took about 18 months.

I think our goal from the very beginning was to just tell the story. It was Mark's idea for the book after doing a story on [former NFL linebacker] Fred McNeil for ESPN and he came back with certain questions. 'Do we think we have a book?' 'How has the NFL has handled the issue and the growing epidemic that football can cause brain damage?'

Just the elements of it were pretty obvious.You have this huge corporation that earns like $10 billion a year and promotes a product that's at the heart of the culture and loved by millions of people, but is also implicated in a growing health crisis. Journalistically, it's really an attractive story, but I think also there's a public service element to it that there wasn't a lot of great information out there about how we had gotten to this point.

What was it about former NFL player Fred McNeil's story that helped triggered the book?

Mark: I got assigned by Outside the Lines to do a piece on Fred McNeil, who played about a dozen years with the [Minnesota] Vikings. Fred had a very successful career in the NFL, but had really seen football as a stepping stone to a career as a lawyer. By the time that we became interested in Fred it was because he had developed early dementia and he was no longer practicing law. He lost his partnership because of early dementia.

By the time we caught up with him, he basically could not take care of his daily existence. He had good longterm memory—could still talk about his Super Bowl experiences—but his short-term memory was largely shot. He was being cared for on a daily basis by his wife that he was separated from, and his two grown sons.

He was maybe the first player to be suing over this issue of suggesting that brain damage had caused his dementia. He had a worker's case against the Vikings. In the course of that reporting, I met Julian Bailes, the former Steelers' neurosurgeon, and a guy who became very active in this brain issue. Bailes actually had the idea for the book. He had read previous work I done on steroids in sports.

PBS Frontline recently reported that 87 deceased NFL players tested positive for chronic traumatic encephalopathy (CTE). What do you guys make of that report in respect to your reporting for the book? Were you surprised by them?

Mark: Those numbers have been consistent and evolving over time. I don't know that we were necessarily surprised by them. I think the last numbers were 76 out of 79 [in a September 2014 report]. They keep getting brains at Boston University, they keep analyzing them and they keep finding CTE. On the face of it, the number is troubling and alarming.

But I also think the people at Boston University are quick to point out that it's a skewed data set and it's not a true reflection of what the prevalence is going to be for playing the game. There hasn't been a true longitudinal study done that's going to tell you how many players are going to end up with this disease. It's a reflection of people whose families decided that their loved ones were having issues and wanted their brain studied or players who presumably were having issues and decided prior to their death that they wanted their brains for study.

I think for a lot of people it's a startling number and it really raises a lot of questions—in particularly about parents who are trying to make decisions about whether to let their kids play. But it's a number that also has to be looked at with some level of perspective. I think that's hard for some people to do because the number is so dramatic. I think even the folks at Boston University will say that even though it's a skewed data set...Ann McKee, the primary researcher [at Boston University], said that she's concerned that virtually every player is going to have this.

Just like there are former players who have been diagnosed with CTE, there's plenty of retired NFL players that don't even have signs of CTE. How would you explain that?

Steve: I don't personally think it's surprising that there are a lot of players walking around who aren't showing symptoms for the simple reason that lots of people engage in a lot of risky activities who are never affected—namely smoking. We all know that smoking is dangerous to your health. Some people have been smoking their entire lives and never have problems.

This issue hasn't been studied enough to know what the prevalence is and what percentage of players who played professional football or football generally come down with this disease. I think that's the question that's in the heart of the debate right now. Some people say the issue is overstated and some people say it actually might be understated. The reality is we just don't know. It's just not far along enough for us to now.

For me, anecdotally, what really surprised me when we were doing the book was how widespread this is and we talked to a lot of people—a lot of family members and lot of players. This is a major problem that former players are coming down with. It affects the person and everyone who loves him. It's one thing to talk about it in the abstract, but when you see the devastation occur, it really does have a major impact on your perspective.

This past March, you guys broke the story about Chris Borland, a 24-year-old San Francisco 49ers linebacker, who abruptly announced he was retiring. He specifically cited concussions, head trauma and research as parts of the reason why. What do you think about his story a few months removed? Do you think this is a sign of what's to come from other young players?

Mark: I think we were both incredibly surprised by Chris's decision—to hear from him and have him talk about why he made the decision. To have a guy who's 24-years-old, with no apparent signs of any type of brain injury or problems, deciding to walk away from a lot of money for one thing and a sport that he absolutely loves was startling.

When we did this feature, we spent a lot of time over the course of the last five months with Chris—Steve more than I did. I think the startling thing with him is the further he got away from the sport, the more pointed and clear he was about how problematic he thought it was as a whole and that it was dehumanizing and the very nature of playing a game that might lead to brain damage was troubling and potentially not right for him.

About whether there will be a Borland effect and if you'll see more players retire early, we've certainly seen some players retire prematurely. I think the question around Borland's decision that's much more likely to be impactful is what kind of role it plays in younger players and their parents, deciding to let the kids play or not. That kind of message from somebody who was so successful, reached the height of the sport and was seemingly totally healthy...to walk away, that's a powerful message.

You mentioned parents and as reports continue to surface, we imagine that many parents will prohibit their kids from playing football. But the dangers of the sport are known. Through your reporting, has anything come up where you think football in America will really take a hit in terms of enrollment through the ranks from Pee Wee all the way up to the NFL?

Steve: I think we have seen the sport is seeing participation rates drop as a result of this issue, which of course is logical. Parents are seeing the information out there and of course, they're becoming concerned. Some of them are deciding that the obvious rewards of playing football are outweighed by the risk of playing the sport. I think that will continue as the science evolves.

I guess it's possible as we learn over time that the risk was not as great as perhaps some people thought it was. But for now, that question isn't answered and we're left with the information out there and as Mark said, it's troubling and alarming.

Mark and I did a story a couple of years ago that participation rates in Pop Warner dropped nearly 10 percent, which was the highest in the organization's history. We continue to hear that rates are going down. But of course, the sport is as popular as it ever was. There was a poll in the past year—I think Bloomberg did it—where half of the people said they'd be reluctant to have their sons to play football. That's a pretty significant number.

At the same time, the viewership [of the NFL] continues to be incredibly high and it supports the sport's incredible financial power. Mark and I aren't different from anyone else—we're both football fans. We were both affected by what Borland had to say in spending so much time with him. It was really interesting to hear somebody so thoughtful and intelligent take apart the sport the way he did.

I look at myself like a lot of people. I'm not sure I want my son playing the sport, but I love watching the sport and I continue watching it a lot. For me, it's more of a communal activity. I like hanging out with my son and watching football, I like hanging out with my friends and watching football. I even like sometimes hanging out and watching football with my brother [laughs]. I think there gets to be a point, where you have to ask yourself, 'what are you rooting for if part of the end game is physical, longterm destruction?' But I guess, I'm not quite there yet.

Do you think the NFL's current concussion protocol is up to speed or do you think more can be done to protect its players from concussions and head trauma?

Mark: There's a couple of questions that play around that. One is what do you want the sport to be? The NFL is what it is. It's a violent sport, as we all said, and that's what we all love about it. For two decades, the NFL denied the sort of idea that you have a connection between football and brain damage. Now, at the NFL level, there's an understanding that it's a potential risk of the sport, so it's, 'What are we doing?'

At its core, the sport is often banging heads. The folks at Boston University will tell you that the highest percentage of cases of CTE are amongst lineman. It's not defensive backs, who are blowing up wide receivers on plays and the wide receivers getting concussions. It's linemen who are engaging in head banging on every single play. It's the nature of the sport.

There's a real question of whether you could legislate that out without changing the game entirely. Is the NFL addressing the big head-to-head hits more than they used to? It seems to be. Have they made rule changes that are effective in terms of reducing concussions on certain plays? Yeah, they virtually eliminated the kickoff by moving the kickoff up. They've reduced hitting in practice, which everybody would agree is a way to help mitigate against concussions.

On the question of sideline protocol, there are some doctors who would suggest that it's pretty hard to determine whether in four minutes or six minutes on the sidelines if the player has a concussion or not. Of course the players, they just want to get back on the field, so that dynamic is complicated.

In the end, it's what could be done without changing the game entirely and what should be done without changing the game entirely? They spent so many years marketing the sport around violence because that's part of what we all like and want in many ways. Now, to shift and suggest that there's a way to play the game safer, I think to some people rings a little hollow.

Through your reporting, Dr. Bennet Omalu was a prominent figure in the book and continues to be in relation to CTE and NFL players. At any point while working on the book, did you think that he was so interesting that a movie could be built around him to tell the story about CTE and the NFL?

Steve: Yeah, definitely. The guy is such a cinematic character. Mark and I always felt like he is such a compelling figure and his discovery had such major implications that there was no question in our minds that if somebody was going to make a movie out of all this, he was the one to focus on. I don't think it surprised us at all that somebody wanted to make a movie about it.

Mark: He's just riveting. You can't make up a guy like Omalu. It will be interesting to see what the movie is like; how much of the nuances [are captured]. One of the powerful things about him is he is incredibly smart and interesting, but is also, as the book points out, his own enemy in many cases. How much of that will you get in this movie?

Steve: We're both hoping that they capture Omalu in the full complexity of his character. That would be excellent. I'm not sure if they could do it. He's a real complex guy. He's a Nigerian immigrant, who had never been exposed to football and suddenly thrust into a situation that completely changed America's pastime sport.

He's an extremely religious man, who uses the word, 'f***,' in every other sentence and is also deeply spiritual. He's an incredibly educated doctor, who has also been very indiscreet at times about the realities of what he's doing in terms of showing autopsy photos in public forums and talking in real specificity about what it means to dissect a body.

Mark and I have an enormous amount of respect for him and we think it's fantastic that he's getting all the attention that he deserves. But if we have any hope for this movie, it's that they really capture the incredible depth of this guy.

It's one thing to put all that reporting out in a book and continue to report—the same way PBS Frontline is doing—but what does it mean to the issue to have an actor the caliber of Will Smith portray Omalu? One would think that alone would take awareness to a whole other level.

Mark: I would imagine so. I just think the idea that it's being made into a Hollywood big picture movie raises [the awareness]. It's a whole different medium. We'd love to think that everybody wanted to read our book, and Frontline had these fantastic numbers, but it's still Frontline, a PBS program, and the book is in its own little world.

So, you're suddenly exposing this issue and the way it has been dealt with by the NFL to an infinitely larger group of people. Then add to that, you have a star-studded cast with Will Smith. It's obvious it's going to raise consciousness and awareness of the issue and raise people's awareness of who Omalu is. There's tons of people who have no idea who this guy is unless they've read the book or watched the documentary.

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