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Seeing Stars (Suffer Brain Injuries)

Imagine old Daffy Duck cartoons, with pastel songbirds circling as a cuckoo clock sounds in the background. The reality is a bit more serious.

Not long ago, ESPN had a segment that ran during the Monday Night Football (MNF) halftime show. This segment was called "Jacked Up", and featured the most violent (though non-penalized) collisions from the previous Sunday's games. After a brief set-up by co-host and ex-linebacker Tom Jackson (get it?), the clip would roll and some unfortunate player would be blindsided, pile-driven, laid out, or otherwise violently disposed of in the course of a play. As his rough fate befell him, the announcers all chimed in with a gleeful chorus of how this player "got… JACKED UP!"

The show is no longer a part of the MNF coverage any more, but it was a part of the broadcasts in 2004. That's the year that an ex-offensive lineman for the Pittsburgh Steelers named Mark Strzelczyk, who had been recently battling depression and reported hearing "evil" voices, led police on a high-speed chase through central New York state that ended with his pickup truck ramming a tractor trailer and exploding.

When doctors conducted a post mortem on Strzelczyk, he was found to have extensive, pre-existing brain trauma, which explained his depression and dementia. His brain, in fact, was likened to that of an 80-year-old (Strzelczyk was 36) or a professional boxer. Instead, Strzelczyk was a pro football player. As a lineman, he never made an appearance on "Jacked Up", but the repeated head trauma he suffered as a result of taking part in 60 or more collisions per game had taken its toll, nonetheless.

At first, the NFL refused to comment on the link found by the physicians in the Strzelczyk case. Five years later, though, the league remains dogged by increasing evidence of traumatic brain injury amongst its players. A number of high profile players have suffered concussions this season. Most recently, both quarterbacks to play in last year's Super Bowl -- Pittsburgh's Ben Roethlisberger and Arizona's Kurt Warner -- went out with suspected concussions on the same day (in separate games). Prior to that, Philadelphia Eagles' running back Brian Westbrook had two concussions in 20 days.

And these injuries have not been limited to the pros. Top ranked University of Florida saw their quarterback, Tim Tebow, knocked out when his head hit the back of his own lineman's knee. California's leading rusher, Jahvid Best, was also concussed for the second week in a row when, leaping over defenders and into the end zone against Oregon State, he fell on the back of his head.

Best's latest injury has been the most dramatic of this year's football season by far. With his initial leap, he cleared a defender and the goal line, only to fly into a second defender, whose attempted tackle sent him soaring even higher. Dropping from a great height, Best twisted in mid-air and landed on the back of his head and neck. The force of the fall sent his helmet flying off and knocked him unconscious. Best then began to exhibit "decorticate posturing", an involuntary stiffening of the limbs as a result of severe brain trauma.

Universally described as a "scary moment", Best was carted off by medical professionals and immediately hospitalized. Yet spectacular injuries like his are few and far between in football (though they are increasing in regularity). And that's part of the problem. The effects of concussions are just beginning to be understood as both cumulative and subtle.

Rarely will players be rendered completely unconscious. With increased padding and helmets, it's more likely the case that they become a bit disoriented and woozy as the result of a violent blow to the head. But in a sport driven by an ethos of machismo and the denial of pain, very few players would willingly remove themselves from a game as a result of something like a mild concussion. That even a mild one looks to increase their susceptibility to future concussions doesn’t seem change the issue.

There are, in fact, a host of ready-made euphemisms that play down the seriousness of a player's brain trauma: getting one's "bell rung", needing to "clear the cobwebs", "seeing stars", being "dinged up", etc. One might imagine the old Daffy Duck cartoons, with pastel songbirds circling the injured player's head as a cuckoo clock sounds in the background. The reality, though, is more serious, especially for players after they finish their careers. An increasing amount of research is suggesting that the long-term effects of concussions can produce dramatic decreases in brain function. More than just absent-mindedness, players can be affected by severe depression and the sort of hallucinations that drove Mark Strzelczyk to his doom, or that contributed to the 2006 suicide of ex-Eagles defensive back Andre Waters.

Doctors, for their part, are calling for increased study. Some of the most revealing examinations of the causes and effects of concussions can only take place on a player's brain after their death. As a result, a campaign is underway to get players to donate their brains posthumously to help in gaining understanding of this phenomenon. In the meantime, NFL commissioner Roger Goodell has been called before Congress (in a predictably pro forma, ineffective inquiry) to explain what's being done by the league to better protect the players. Goodell's response ("reduced red tape") and his refusal to admit that football concussions contribute to long-term mental illness suggest that the players may be on their own.

Meanwhile, fans demand the kind of spectacular violence that is precisely what leads to concussions in the first place. It's no accident that segments like "Jacked Up" get primetime billing on basic cable. The spectacle of violence is a major, if not the, major selling point of football. It imbues the games with danger and drama, and intensifies the struggles of its participants for the spectators. It's not at all the case that football fans thrill to see players knocked unconscious. But neither are they disturbed enough by the possibility to switch the channel.

Taking their cues from the coaches and players, fans complete the circular, masculine ethos of the sport, demanding that overprotected quarterbacks "wear dresses" and thrilling when their team pummels a rival. As greater attention and increased study are paid to this issue, though, there may be a reckoning in football's future -- both for fans and for players. With the expected future findings from the medical profession, players may soon begin to wonder if the long-term risks to their mental health are worth their salaries. Fans, too, are likely to be confronted by the invisible, collateral damage they once so enthusiastically cheered on from the safety of their seats.

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