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A head-on collision with the National Football League
In Context
Film A head-on collision with the National Football League
www.thelancet.com/neurology Vol 15 June 2016
accused him of “fallacious reasoning”, and demanded retraction of his paper. Landesman was unreserved in exposing the NFL’s denial of Omalu’s work and its elaborate plots to silence him and divert attention from the increasing numbers of post-mortem CTE diagnoses in NFL players. But Omalu did not back down in face of such pressure; his passion and persistence are expertly portrayed throughout the film, particularly in his brave and decisive move to tackle the NFL head on by releasing his findings in the mainstream press. As heroic as Omalu is, the film is also realistic about his struggles and frustrations. The hostility affected more than just himself and his career, and it was vaguely implied that the safety of his family was also threatened. In a painfully honest scene, Will Smith, as Omalu, confessed to his wife, “I am the wrong person to have discovered this”. But it is exactly because of Omalu’s good intentions and perseverance that the link between CTE and football came into the spotlight. The translation of scientific research from dense academic papers into popular culture has immense power—not only to disseminate knowledge but also to stimulate discussions and effect change in society. The rich medical details and the gripping storytelling on the big screen will no doubt encourage football players, their parents, and the public to reflect on the nature of the sport so loved by a nation. Omalu’s family name, in his native language, means “if you know, you must come forth and speak”—Omalu did exactly that, and Concussion is successful in amplifying that voice.
Concussion Directed by Peter Landesman, 2015 123 minutes First release date December 25, 2015; UK release date February 12, 2016 See Correspondence page 662 For more on chronic traumatic encephalopathy in a football player see Neurosurg 2005; 57: 128–34
Esther Lau
Science Picture Co/Science Photo Library
“I can tell something is wrong, but I can’t do this alone. I need your help to tell the world what happened to you”, said forensic pathologist Bennet Omalu to the dishevelled corpse of a homeless man, in a cold autopsy room in Pittsburgh (PA, USA). Some found Omalu’s habit of talking to dead bodies odd, but to Omalu, what was odd was the fact that the cadaver belonged to Mike Webster, former player with the Pittsburgh Steelers who made it to Pro Football’s Hall of Fame. Webster had been pulling out his teeth and super-gluing them back, and had repeatedly attempted to zap himself with a Taser gun. Examination of his medical records showed that he had been suffering for years from severe headaches, double vision, voices in his head, and mood disorders, despite having no signs of abnormality in previous CT brain scans and no obvious contusions at autopsy. What drove “Iron Mike”, legendary player of the city’s much loved football team, to become self-mutilating and die unexpectedly at age 50 years? Peter Landesman’s film Concussion tells the inspiring true story of Omalu (played by Will Smith) and his journey to uncover the cause behind the cognitive decline and mental disorders seen in some American football players, such as Webster. Omalu was portrayed as a meticulous doctor who was passionate about his field—the science of death. Being a committed Catholic, he viewed his job as a calling, and his mission was to defend and speak for the dead. Although many would have dismissed Webster’s cause of death simply as a cardiac arrest, Omalu was unable to let go of what he saw in the autopsy room and insisted that Webster’s brain be preserved and analysed. Under a microscope in his living room, Omalu was surprised to see large clumps of tau proteins, in the samples taken from Webster’s brain, that resembled the β-amyloid plaques in Alzheimer’s disease. By Omalu’s estimations, Webster had sustained more than 70 000 blows to his head during his lifetime. However, unlike many animals that have shock absorbers built into their bodies, the human brain is suspended in fluid and completely disconnected from the human skull. A human being will get concussed at a force of 60 G, while head-to-head contact on a football field can easily result in forces of up to 100 G being applied to the brain. He hypothesised that the numerous subconcussive blows triggered a cascade of neurological events, unleashing killer proteins that invaded and stifled Webster’s brain, “like pouring wet concrete down kitchen pipes”. Together with colleagues at the University of Pittsburgh, he eventually reported his findings of chronic traumatic encephalopathy (CTE). However, the real drama was yet to begin. The National Football League (NFL) dismissed Omalu as a “nobody”,
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Film A head-on collision with the National Football League
www.thelancet.com/neurology Vol 15 June 2016
accused him of “fallacious reasoning”, and demanded retraction of his paper. Landesman was unreserved in exposing the NFL’s denial of Omalu’s work and its elaborate plots to silence him and divert attention from the increasing numbers of post-mortem CTE diagnoses in NFL players. But Omalu did not back down in face of such pressure; his passion and persistence are expertly portrayed throughout the film, particularly in his brave and decisive move to tackle the NFL head on by releasing his findings in the mainstream press. As heroic as Omalu is, the film is also realistic about his struggles and frustrations. The hostility affected more than just himself and his career, and it was vaguely implied that the safety of his family was also threatened. In a painfully honest scene, Will Smith, as Omalu, confessed to his wife, “I am the wrong person to have discovered this”. But it is exactly because of Omalu’s good intentions and perseverance that the link between CTE and football came into the spotlight. The translation of scientific research from dense academic papers into popular culture has immense power—not only to disseminate knowledge but also to stimulate discussions and effect change in society. The rich medical details and the gripping storytelling on the big screen will no doubt encourage football players, their parents, and the public to reflect on the nature of the sport so loved by a nation. Omalu’s family name, in his native language, means “if you know, you must come forth and speak”—Omalu did exactly that, and Concussion is successful in amplifying that voice.
Concussion Directed by Peter Landesman, 2015 123 minutes First release date December 25, 2015; UK release date February 12, 2016 See Correspondence page 662 For more on chronic traumatic encephalopathy in a football player see Neurosurg 2005; 57: 128–34
Esther Lau
Science Picture Co/Science Photo Library
“I can tell something is wrong, but I can’t do this alone. I need your help to tell the world what happened to you”, said forensic pathologist Bennet Omalu to the dishevelled corpse of a homeless man, in a cold autopsy room in Pittsburgh (PA, USA). Some found Omalu’s habit of talking to dead bodies odd, but to Omalu, what was odd was the fact that the cadaver belonged to Mike Webster, former player with the Pittsburgh Steelers who made it to Pro Football’s Hall of Fame. Webster had been pulling out his teeth and super-gluing them back, and had repeatedly attempted to zap himself with a Taser gun. Examination of his medical records showed that he had been suffering for years from severe headaches, double vision, voices in his head, and mood disorders, despite having no signs of abnormality in previous CT brain scans and no obvious contusions at autopsy. What drove “Iron Mike”, legendary player of the city’s much loved football team, to become self-mutilating and die unexpectedly at age 50 years? Peter Landesman’s film Concussion tells the inspiring true story of Omalu (played by Will Smith) and his journey to uncover the cause behind the cognitive decline and mental disorders seen in some American football players, such as Webster. Omalu was portrayed as a meticulous doctor who was passionate about his field—the science of death. Being a committed Catholic, he viewed his job as a calling, and his mission was to defend and speak for the dead. Although many would have dismissed Webster’s cause of death simply as a cardiac arrest, Omalu was unable to let go of what he saw in the autopsy room and insisted that Webster’s brain be preserved and analysed. Under a microscope in his living room, Omalu was surprised to see large clumps of tau proteins, in the samples taken from Webster’s brain, that resembled the β-amyloid plaques in Alzheimer’s disease. By Omalu’s estimations, Webster had sustained more than 70 000 blows to his head during his lifetime. However, unlike many animals that have shock absorbers built into their bodies, the human brain is suspended in fluid and completely disconnected from the human skull. A human being will get concussed at a force of 60 G, while head-to-head contact on a football field can easily result in forces of up to 100 G being applied to the brain. He hypothesised that the numerous subconcussive blows triggered a cascade of neurological events, unleashing killer proteins that invaded and stifled Webster’s brain, “like pouring wet concrete down kitchen pipes”. Together with colleagues at the University of Pittsburgh, he eventually reported his findings of chronic traumatic encephalopathy (CTE). However, the real drama was yet to begin. The National Football League (NFL) dismissed Omalu as a “nobody”,
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