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The central theme running throughout “Discovery,” the first section of League of Denial, is that of mental and physical toughness. The game of football is one that requires specific athletic abilities such as speed and strength, but no attribute pays off more for football players than toughness. The very essence of the sport is contact, as hitting in the form of blocking and tackling occurs on every single play. With that contact, injuries come as well, and players are taught at a young age to play through pain. That was certainly true of Hall of Famer Mike Webster, the central figure in League of Denial, who once played every single offensive snap over a six-year period—a total of 5,871 consecutive plays. In Chapter 1, the authors state that Webster “lived by one central tenet: Never come off the field” (28).
Although that toughness element—players urging themselves and being urged by coaches and teammates to play through pain—had always existed, it became especially prophetic and dangerous when applied to the mostly invisible injuries of concussions. Until concussions began receiving attention in the 1990s, they were “still regarded as the neurological equivalent of a stubbed toe” (32). Players were expected to play through concussions even more so than other injuries because, as the authors point out, “the sports medical community had viewed a concussion as an invisible injury. You couldn’t x-ray it or scope it or put a cast on it, so how serious could it be?” (35). Gary Plummer, a linebacker with the San Diego Chargers and San Francisco 49ers in the 1980s and 1990s, admits that his reaction to the news that multiple players had retired due to concussions was “they’re pussies.” Plummer also admits that “just raising the issue contradicted pretty much everything he had been taught and believed about pro football” (79).
Scientific acceptance versus scientific denialism is the overarching theme running throughout Part 2 of League of Denial. Denialism is typically referred to as the act of refusing to accept reality or facts as a form of avoidance. In this regard, the authors make the argument that the NFL was practicing denialism throughout the concussion crisis, dating back to the mid-1990s. At this point, there was very little evidence proving that concussions had the long-term effects of brain damage, although many researchers suspected it. It was, however, very clear that concussions in the NFL were doing more damage than ever before. One person sounding the alarm was superagent Leigh Steinberg, who began holding seminars on the effects of concussions. Steinberg did try to associate the NFL, but the response was silence. In Chapter 4, the authors state that Steinberg “felt the culture of denial was so embedded in the NFL that it was if he had asserted that the world was round instead of flat” (79). Steinberg himself points out that “no one wanted it to be true. No one wanted concussion to pose a threat to the NFL. No one wanted there to be long-term ramifications” (82). The only response that Steinberg ever got from the league was “show us the studies. There are no studies” (82).
That denialism morphed into scientific denialism in the 2000s, when scientists began producing empirical evidence that brain damage was being discovered in dead football players. In 2002, neuropathologist Bennet Omalu discovered brain damage in Hall of Fame center Mike Webster. At roughly the same time, the NFL’s Mild Traumatic Brain Injury Committee, which had been assembled to study the issue, began publishing academic studies that repeatedly made the case that there were no long-term effects of concussions. When Omalu’s research was published in the same journal, the MTBI committee attempted to have it retracted. Within a year, Omalu had found the same disease, which came to be known as chronic traumatic encephalopathy, in the brains of two more NFL players who both died by suicide. The NFL’s MTBI committee, meanwhile, continued publishing research concluding that there was no link between concussions and brain damage.
Changes were taking place within the NFL around the issue, namely improved disability plans and rule changes to take concussions more seriously, but its position that no link existed between football and brain damage did not change even as more and more dead players were found to have CTE. Ann McKee, a neuropathologist at Boston University who began examining dead football players in 2008, stated that she “[has] never seen this disease in the general population, only in these athletes. It’s a crisis and anyone who doesn’t recognize the severity of the problem is in tremendous denial” (265).
Propaganda as a public relations strategy as a theme in League of Denial is most prominent in Part 2, “The Dissenters,” and Part 3, “Reckoning.” Propaganda is defined as misleading or biased information that is meant to sway public opinion. Public relations might best be defined as the professional maintenance of a public image on behalf of either a company or a person. Given those definitions, the NFL clearly began disseminating propaganda when its Mild Traumatic Brain Injury Committee began publishing its research in Neurosurgery, the academic journal. Although the MTBI committee was formed in 1994, it did not publish its first paper until 2003, later publishing 15 more papers through 2009. The committee itself was flawed from the beginning because it consisted primarily of team doctors rather than actual brain researchers, but Commissioner Paul Tagliabue’s intent may have been sincere. The authors explain that “the MTBI committee was a logical response to a mushrooming public relations crisis” (125). However, the appointment of Elliot Pellman, a rheumatologist who shared Tagiabue’s skepticism toward the seriousness of the issue, as the committee’s chairman suggests it was more a public relations ploy.
The more obvious use of propaganda as a public relations tool by the NFL occurs as the concussion crisis deepens and a second and third case of CTE are found in deceased former players. In 2006, Roger Goodell took over as the NFL’s commissioner and almost immediately called for a 2007 Concussion Summit as a first step to address the issue. In what many thought was a positive sign, even many of the dissenting scientists who had raised objections to the MTBI committee’s flawed research were invited to participate. The summit, however, became controversial primarily because Ira Casson, the new chair of the MTBI committee, openly mocked the research showing cases of CTE in the brains of dead players. Despite a Concussion Summit that was to give the impression that the issue was being taken seriously, the NFL’s MTBI committee had already decided that the research did not prove a link between football and brain damage.
In late 2009, the NFL acknowledged for the first time that “it’s quite obvious from the medical research that’s been done that concussions can lead to long-term problems” (284). That candor was followed by the league donating $1 million to the Boston University Center for the Study of Traumatic Encephalopathy, the primary group that was out to prove the link between football and brain damage. The NFL also announced that it was designating Boston University as the league’s preferred brain bank and encouraging its players to donate their brains. Not long after the NFL seemed to have finally accepted the science, the League contradicted itself and was now attempting to steer brains away from Boston University and to the National Institutes of Health to be examined by its own researchers. That contradiction was reinforced when the NFL accused the Boston University group of “feeding into a growing hysteria about the risks of playing football” (301). The NFL had attempted to handle the crisis both by discrediting dissenting conclusions while promoting its own conclusions and by appearing to take action, but neither had worked. By 2012, the NFL’s new public relations strategy was to remake its image.
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