Football concussions, a story

[Crafty_Dog]

NY Times
 By ALAN SCHWARZ
Published: February 2, 2007
Ted Johnson helped the New England Patriots win three of the past five Super Bowls before retiring in 2005. Now, he says, he forgets people’s names, misses appointments and, because of an addiction to amphetamines, can become so terrified of the outside world that he locks himself alone inside his Boston apartment in bed with the blinds drawn for days at a time.

Ted Johnson says that his behavior has become so erratic that “I can’t even let myself have a job right now. I don’t trust myself.”
“There’s something wrong with me,” said Mr. Johnson, 34, who spent 10 years in the National Football League as the Patriots’ middle linebacker. “There’s something wrong with my brain. And I know when it started.”

Mr. Johnson’s decline began, he said, in August 2002, with a concussion he sustained in a preseason game against the New York Giants. He sustained another four days later during a practice, after Patriots Coach Bill Belichick went against the recommendation of the team’s trainer, Johnson said, and submitted him to regular on-field contact.

Mr. Belichick and the Patriots’ head trainer at the time, Jim Whalen — each of whom remain in those positions — declined to comment on Mr. Johnson’s medical experience with the team or his allegations regarding their actions.

Following his two concussions in August 2002, Mr. Johnson sat out the next two preseason games on the recommendation of a neurologist. After returning to play, Mr. Johnson sustained more concussions of varying severity over the next three seasons, each of them exacerbating the next, according to Mr. Johnson’s current neurologist, Dr. Robert Cantu.

Dr. Cantu said that he was convinced Mr. Johnson’s cognitive impairment and depression “are related to his previous head injuries, as they are all rather classic postconcussion symptoms.” He added, “They are most likely permanent.”

Asked for a prognosis of Mr. Johnson’s future, Dr. Cantu, the chief of neurosurgery and director of sports medicine at Emerson Hospital in Concord, Mass., said: “Ted already shows the mild cognitive impairment that is characteristic of early Alzheimer’s disease. The majority of those symptoms relentlessly progress over time. It could be that at the time he’s in his 50s, he could have severe Alzheimer’s symptoms.”

Mr. Johnson is among a growing number of former players and their relatives who are questioning whether their serious health issues are related to injuries they sustained and the treatment they received as players. Mr. Johnson said he decided to go public with his story after reading in The New York Times two weeks ago about Andre Waters, the former Philadelphia Eagles player who committed suicide last November and was later determined to have had significant brain damage caused by football-related concussions.

Mr. Johnson said he was not suicidal, but that the depression and cognitive problems he had developed since 2002 had worsened to the point that he now takes Adderall, a prescription amphetamine, at two to three times the dosage authorized by his doctors, who have been unaware of this abuse.

When he runs out of these pills, Mr. Johnson said, he shuts himself inside his downtown apartment for days and communicates with no one until a new prescription becomes available. He said he was coming forward with his story so that his friends and family might better understand his situation, and also so that the National Football League might improve its handling of concussions.

While the league’s guidelines regarding head injuries have been strengthened over the past decade, the N.F.L.’s record of allowing half of players who sustain concussions to return to the same game remains a subject of medical debate.

“I am afraid of somebody else being the next Andre Waters,” said Mr. Johnson, who spent two weeks in February at a psychiatric hospital outside Boston with, he said, no appreciable results. “People are going to question me: ‘Are you a whistleblower, what are you doing this for?’ You can call it whatever you want about what happened to me. I didn’t know the long-term ramifications. You can say that my coach didn’t know the long-term, or else he wouldn’t have done it. It is going to be hard for me to believe that my trainer didn’t know the long-term ramifications, but I am doing this to protect the players from themselves.”

The N.F.L. spokesman Greg Aiello said that the league had no knowledge of Johnson’s specific situation. Regarding the subject of player concussions in general, he said, “We are very concerned about the issue of concussions, and we are going to continue to look hard at it and do everything possible to protect the health of our players.”

At a news conference yesterday in Miami, where the Super Bowl will be held Sunday, Gene Upshaw, the executive director of the National Football League Players Association, spoke in general terms about concussions in the N.F.L. “If a coach or anyone else is saying, ‘You don’t have a concussion, you get back in there,’ you don’t have to go, and you shouldn’t go,” Upshaw said, not speaking about the Johnson case specifically. “You know how you feel. That’s what we tried to do throughout the years, is take the coach out of the decision-making. It’s the medical people that have to decide.”

Mr. Johnson, who has a 2-year-old daughter and a 1-year-old son, is currently in divorce proceedings with his wife, Jackie, a situation that he admitted was compounding his depression.
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He was arrested in July on domestic assault-and-battery charges, which were later dropped because his wife declined to testify. Mr. Johnson said that his concussive symptoms and drug addiction not only precipitated his marriage’s decline but began several years before it, specifically that preseason of 2002.


According to Patriots medical records that Mr. Johnson shared with The Times, the only notable concussion in his career to that point happened when he played at the University of Colorado in 1993. Against the Giants on Aug. 10, 2002, those records indicate, he sustained a “head injury” — the word concussion was not used — and despite the clearing of symptoms after several minutes on the sideline, he did not return to the game.

Mr. Johnson said that four days later, when full-contact practice resumed, Mr. Whalen issued him a red jersey, the standard signal to all other players that he was not supposed to be hit in any way. About an hour into the practice, Mr. Johnson said, before a set of high-impact running drills, an assistant trainer came out on the field with a standard blue jersey. When he asked for an explanation, Mr. Johnson said, the assistant told him that he was following Mr. Whalen’s instructions.

Mr. Johnson, whose relationship with Mr. Belichick had already been strained by a contract dispute, said he interpreted the scene as Mr. Belichick’s testing his desire to play, and that he might be cut and lose his $1.1 million salary — N.F.L. contracts are not guaranteed — if he did not follow orders.

“I’m sitting there going, ‘God, do I put this thing on?’ ” Mr. Johnson said. “I put the blue on. I was scared for my job.”

Regarding the intimidation he felt at that moment, Mr. Johnson added, “This kind of thing happens all the time in football. That day it was Bill Belichick and Ted Johnson. But it happens all the time.”

Several Patriots teammates said they did not recall this incident but invariably testified to the believability of Mr. Johnson, the team captain in 1998 and 2003. Said one former teammate, who insisted on anonymity because he still plays with the Patriots under Mr. Belichick, “If Ted tells you something’s going on, something’s going on.”

Mr. Johnson said that the first play called after he put the blue jersey on, known as “ace-ice,” called for one act from him, the middle linebacker: to sprint four yards headlong into the onrushing blocking back. After that collision, Mr. Johnson said, a warm sensation overtook his body, he saw stars, and he felt disoriented as the other players appeared to be moving in slow motion. He never lost consciousness, though, and after several seconds regained his composure and continued to practice “in a bit of a fog” while trying to avoid contact. He said he did not mention anything to anyone until after practice, when he angrily approached Mr. Whalen, the head trainer.

“I said, ‘Just so you know, I got another concussion,’ ” Johnson said. “You could see the blood, like, leave his face. And he was like, ‘All right, all right, well, we’re going to get you in to see a neurologist.’ ”

Dr. Lee H. Schwamm, the neurologist at Massachusetts General Hospital who examined Mr. Johnson, concluded in a memo on Aug. 19, 2002, that Mr. Johnson had sustained a second concussion in that practice. Dr. Schwamm also wrote that, after speaking with Mr. Whalen, that Mr. Whalen “was on the sidelines when he sustained the concussion during the game and assessed him frequently at the sideline,” and that “he has kept Mr. Johnson out of contact since that time.”

Mr. Johnson said that the next day he spoke with Mr. Belichick about the incident but that they only glossed over it.

“He was vaguely acknowledging that he was aware of what happened,” Mr. Johnson said, “and he wanted to just kind of let me know that he knew.”

Mr. Johnson missed the next two preseason games, played in the final one, and then, believing he was still going to be left off the active roster for the opening game against Pittsburgh, angrily left camp for two days before returning and meeting with Mr. Belichick and confronting him privately about the blue-jersey incident.

“It’s as clear as a bell — ‘I had to see if you could play,’ ” Mr. Johnson recalled Mr. Belichick saying. Minutes later, Mr. Johnson said, Mr. Belichick admitted he had made a mistake by making him wear the blue jersey. “It was a real kind of admittance, but it was only him and I in the room,” Mr. Johnson said.

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Mr. Johnson sat out the season opener but played the following Sunday against the New York Jets, a game in which Mr. Johnson said he could not remember line formations and was caught out of position because he could not concentrate. After sitting out the next game against Kansas City, Mr. Johnson played against San Diego and had the same problem.

He learned how to manage the disorientation and played the rest of the season but said that, “from that point on, I was getting a lot of these, what I call mini-concussions.”

Mr. Johnson added that he did not report these to his trainer or coaches for fear he would be seen as weak.

This continued through the 2003 season, Mr. Johnson said, as he noticed himself feeling increasingly more unfocused, irritable and depressed. Teammates noticed as well, said Willie McGinest, a fellow linebacker who now plays for the Cleveland Browns.

“He was always an upbeat, positive guy,” Mr. McGinest said. “After the last few concussions, you could tell he was off at times.”

Playing poorly, Mr. Johnson lost his starting job.

In the week before the 2004 Super Bowl, Mr. Johnson said, a friend who supplied amphetamines to several major league baseball pitchers gave him some Adderall pills to cure his lethargy and increase his concentration. “It was the best I had felt in the longest time,” Mr. Johnson said. “The old Ted was back.”

After playing only sparingly in that Super Bowl, Mr. Johnson began taking larger and larger doses before and throughout the 2004 season, when he regained his starting position at middle linebacker and helped the Patriots win their second consecutive Super Bowl.

The better mood did not last long, he said. The minor concussions — euphemized as “dings” in N.F.L. lingo — that he regularly sustained in practice and in games hurt more than the Adderall could help. The thought of violently tackling a player, he said, “made me physically ill.”

“For the first time in my life,” he said, “I was scared of going out there and putting my head in there.”

Mr. Johnson retired before the 2005 season and briefly worked as a football analyst for WBZ-TV in Boston. But he said his malaise and cognitive problems were only getting worse, and in his attempt to regain some sort of balance, he wound up taking large amounts of antidepressants along with increasing amounts of Adderall, creating a dangerous up-and-down cycle that he realized required professional attention. Last February, he spent two weeks at McLean Hospital, a psychiatric institution in suburban Belmont, Mass.

Mr. Johnson said he felt no better after that experience, and he quickly resumed the Adderall abuse that continues today. He has moved out of his former house during his divorce proceedings and lives in a two-bedroom apartment downtown, which after three months contains dozens of half-open moving boxes.

“Welcome to the glamorous life of a former N.F.L. player,” he said. A half-hour later, he stepped into his Range Rover and drove to his local CVS to pick up another bottle of Adderall. The 72 pills of 30 milligrams each are supposed to last nine days, but he knows he will blow through them in four or five.

One of his most maddening frustrations, Mr. Johnson said, is that no tests — from M.R.I.’s to other scans of his brain — have confirmed his condition, causing some people in his life to suspect that he is wallowing in retirement blues. “That’s ridiculous,” he said, “because I always treated football as a steppingstone for the rest of my life. I used to have incredible drive and ambition. I want to get my M.B.A. But I can’t even let myself have a job right now. I don’t trust myself.”

Dr. Cantu, his neurosurgeon, said he was convinced that Mr. Johnson’s condition was primarily caused by successive concussions sustained over short periods of time. He said that M.R.I.’s of Mr. Johnson’s brain were clear, but that “the vast majority of individuals with postconcussion syndrome, including depression, cognitive impairment, all the symptoms that Ted has, have normal M.R.I.’s.”

The most conclusive method to assess this type of brain damage, Dr. Cantu said, was to examine parts of the brain microscopically for tears and tangles, but such a test is done almost exclusively post-mortem. It was this type of examination that was conducted by a neuropathologist at the University of Pittsburgh, Dr. Bennet Omalu, on the brain of Mr. Waters after his suicide, revealing a condition that Dr. Omalu described as that of an 85-year-old with Alzheimer’s disease.

“The type of changes that Andre Waters reportedly had most likely Ted has as well,” Dr. Cantu said.

Experts in the field of athletic head trauma have grown increasingly confident through studies and anecdotal evidence that repeated concussions, particularly those sustained only days apart, are particularly dangerous. Dr. David Hovda, a professor of neurosurgery and director of the Brain Injury Research Center at U.C.L.A., said, “Repeated concussions — it doesn’t matter the severity — have affects that are more than additive, and that last longer.”

Sitting in his apartment this week, Mr. Johnson said that he had not considered a lawsuit against Mr. Belichick, any Patriots personnel or the N.F.L. He said that his sole motivation was to raise awareness of the dangers that football players can face regarding concussions.

Asked who was to blame for his condition — Mr. Belichick, Mr. Whalen, himself or the entire culture of the N.F.L. — Mr. Johnson thought for 30 seconds and said he could not decide.

Several hours later, he was riding in an elevator up to a consultation with Dr. Cantu. As the door opened on the seventh floor, a middle-aged man walked out and smiled warmly at Mr. Johnson. “We missed you this year,” he said.

“Thanks, man,” Mr. Johnson said with a grin and a nod. Later, Mr. Johnson said something else went through his troubled mind at that moment.

“I miss me, too,” he said.

[matinik]

Effects of head trauma scaring Turley
Michael Silver

By Michael Silver, Yahoo! Sports 5 hours, 59 minutes ago


When Kyle Turley(notes) reflects on the most significant concussion of his nine-year NFL career, he has to work hard to suppress his laughter.

While playing for the St. Louis Rams in 2003, the ultraphysical tackle took a blow to the helmet and lost consciousness on the final play of the third quarter. He spent the rest of the game – which seemed, to him, like it lasted five minutes – on the sideline in a daze. He wanted to wave to his wife, Stacy, but was unable to remember the location of the luxury box where she was regularly stationed and eventually gave up. At game’s end he retreated to the locker room with his teammates, and then things got even blurrier.

“I went into the shower, and as the story was told to me later, I was sitting at my locker, butt-naked, when our owner [Georgia Frontiere] came in to congratulate us,” Turley says. “I don’t remember doing this, but everybody said I stood up and hugged her, totally naked, right there in the middle of the room.”

Yet any unintentional humor that stemmed from the incident is trivial given the long-term damage that Turley, a former NFL All-Pro, may have sustained from that and other instances of head-related trauma. More than a year and a half removed from his playing days, Turley is now experiencing symptoms which, he and his doctors fear, could point to a chilling prognosis.

Late last month Turley, with no apparent cause or warning, collapsed while listening to music at a club near his Nashville-area home and passed out for several seconds. Shortly thereafter, while battling vertigo, he began vomiting uncontrollably as Stacy rushed him to a nearby hospital. After being admitted to an emergency triage unit, a disoriented Turley was in and out of consciousness for the next several hours.

At one point, he recalls, “I was having a full-on seizure-type-thing, probably because my potassium levels were so low. I was on a table just flipping around like a fish; I was fully conscious and knew what I wanted to say, but I couldn’t speak. Realistically, if I hadn’t gone to the hospital, my kidneys could’ve shut down and I probably could have died.

“It was definitely the scariest experience of my life.”

Nearly four weeks later, what’s even scarier to Turley is the notion that his nightmare may have only just begun. Though doctors haven’t been able to give him the conclusive cause of the episode he experienced that night – or of the migraine headaches, dizzy spells and disorientation which have followed – the presumption is that he’s feeling the effects of the head-related trauma he endured during his playing career.

One expert even fears that Turley could be on the road to contracting Chronic Traumatic Encephalopathy (CTE), the degenerative neurological condition that, researchers think, contributed greatly to the violent deaths of former NFL players Andre Waters and Justin Strzelczyk.

Now here’s perhaps the most disturbing information of all: Turley, relative to his peers, had no sense that he was a particularly likely candidate for such a daunting diagnosis.

“I never considered myself a guy that had a lot of head injuries,” Turley says. “But the doctors I’ve seen are very concerned about my past history, and when I look back on some of what I experienced, it makes me angry. Guys are going crazy, and my wife and I just had a baby boy. I don’t want that to happen to me.”

Turley, who believes he was given inadequate medical care during his career by the three teams for which he played, plans to contact a lawyer about the possibility of suing the NFL. “We could be talking about a class-action suit,” he says.

Turley’s concern comes at a time when awareness about brain injuries finally seems to be gaining traction among NFL players, team physicians and league and NFL Players Association officials. A league-sponsored players’ health and safety summit on mild traumatic brain injury was held in Chicago in 2007, followed by another concussion-specific conference at the league’s New York City headquarters this past May.

Among the promising developments: a move toward uniform terminology and testing policies among team medical personnel; enhanced helmet technology; recent rule changes regarding helmet-to-helmet and other dangerous hits, and the elimination of the kickoff wedge; a “whistle-blower” hotline for players to report unsatisfactorily addressed head injuries; and an apparent push by newly elected NFLPA executive director DeMaurice Smith to make player-safety issues more of a priority than they were under predecessor Gene Upshaw.

“ ‘Passionate’ doesn’t begin to describe how De Smith feels about the medical issues,” says Dr. Thom Mayer, who has been the union’s medical director since 2001. “He is possessed. To him, they are non-negotiable. He has suggested that I attend the [negotiation sessions for the new collective bargaining agreement] and I intend to be there at the table.”

Still, says Arizona Cardinals receiver and special-teams ace Sean Morey(notes), a member of the NFLPA Player Safety and Welfare committee, the current landscape is far from ideal. For one thing, players aren’t educated enough about the long-term safety issues associated with concussions.

“In my experience, 50 percent of players’ concussions go unreported, and that’s something we’ve got to change,” says Morey, one of three current players (along with Seattle Seahawks middle linebacker Lofa Tatupu(notes) and Baltimore Ravens center Matt Birk(notes)) who announced earlier this week they’d agreed to donate their brains after death to a Boston University medical-school program that studies severe postconcussion ailments. “If players understood the risks more clearly – the effects of cumulative concussions or of suffering repetitive head trauma over the course of a career – I believe they’d be a lot more willing to let the trainers and doctors do their jobs.”

One major problem, as Turley, Morey and others readily admit, is that there are a lot of forces working against increased diligence on the part of players. For one thing, because NFL employment is such a tenuous proposition for many, most non-stars fear that they’ll be replaced if unduly sidelined. It’s also true that most players are highly competitive souls who pride themselves on toughness and try to plow through all but the most debilitating injuries.

“Professional players naturally want to play,” Morey says. “We want to keep our jobs, we have loyalty to our coaches and teammates, and we desperately want to win. Typically, when we get a concussion, our first reaction is to avoid the trainer at all costs. That’s just our mentality, our culture.”

For that reason, many minor concussions are routinely dismissed as “dings” by the afflicted party, with no sense of the potential for long-term consequences. “I think most of us have no idea how many concussions we’ve really had,” says New Orleans Saints linebacker Scott Fujita(notes). “In my experience, when you’re evaluated on the sidelines, as long as you can see how many fingers the doctor is holding up and you’re willing to play, you’ll play.”

In Turley’s case, it rarely came to that. Aside from the serious concussion he suffered in St. Louis, he says the other cases of head trauma he experienced in the NFL “were ‘dings’ where I’d get cross-eyed and not see straight for a whole series. … I’d see three guys for every real one, and I’d say, ‘[Expletive] it, I’m gonna hit the guy in the middle.’ That happened to me maybe two or three times every season.”

Given that Turley experienced vertigo as early on as his college days at San Diego State – a condition doctors have recently told him is treatable – he says the treatment he received from team medical personnel was cavalier and not viewed from a long-term health perspective. (Turley played for three franchises: the Rams, Saints and Kansas City Chiefs. All three teams denied requests by Y! Sports to speak to doctors and trainers who evaluated him.)

In New Orleans, Turley says, “I got out of bed one day and ran into a wall. My wife had to drive me to practice, and when I got there and told them what was up, all they did was put me in a room, put the lights out and say, ‘Lay down and go to sleep.’ I was puking all over the place, in and out of consciousness – I probably could have died. At the end of the day, they called my wife and had her pick me up, and that was it.

“I had some serious episodes like that, and never did they tell me to see this specialist or get these tests or figure out if it could be treated. Now I see that vertigo is a big problem with retired players, and it [expletive] me off.”

After his severe concussion (and unclothed encounter with the now-deceased Frontiere) in St. Louis, Turley says, “They put me in a room, and they were gonna let me go home. I was walking out of the dome with my wife, and we ran into [the Green Bay Packers’] Joe Johnson, who’d been my teammate in New Orleans. He could tell I wasn’t right and told Stacy, ‘Man, he’s [expletive] up.’ She said, ‘I know. I need some help.’ Eventually she found someone and had to force them to take me to the hospital, and they kept me overnight.

“The next week, my head still wasn’t right but they let me play in that game against Pittsburgh. I was like, ‘[Expletive] it, I’ll play.’ But I wish I hadn’t.”

Turley, who finished his career with the Chiefs in ’07, remembers sitting in a cold tub after a game at Arrowhead Stadium with teammate Richie Scanlon, a special-teams player and linebacker.

“He came in and had a broken nose that was cracked all the way across,” Turley recalls. “All of a sudden, in 50-degree water, he passes out. I went and told the trainers and doctors and they said, ‘He’s all right.’ I said, ‘No, he’s not. If you guys let this guy go home right now, I’m gonna file a report against you for negligence.’ He ended up in the hospital, and they kept him for a couple of days.”

Under the whistle-blower system now in place, Turley (or any team employee) could have called an 800 number to report Scanlon’s situation to the league and NFLPA without fear of retribution from his employer. Yet Turley believes there is a larger issue at cross-purposes with player safety.

“The problem is, the team physicians are employees of the club,” Turley says. “They have the team’s best interests at heart, and that’s having your best players on the field, regardless of whether that’s in the best interests of the player. So even if you’re in Disneyland in your head, if you can play semi-effectively they still want you out there. There’s a complete [expletive] bias.”

Turley says that the NFLPA, as it negotiates a new collective bargaining agreement with the league, should push for union-employed doctors on the sidelines.

“Perhaps that could work in an ideal world,” says Dr. Gary Solomon, a Nashville-based neuropsychologist who is a Titans team physician (and who has recently evaluated Turley, which he won’t discuss). “But that’s not where we live.”

Adds Chris Nowinski, a former Harvard football player and professional wrestler who is the co-director of Boston University’s Center for the Study of Traumatic Encephalopathy: “That system would be scrapped the second Tom Brady(notes) was yanked in the fourth quarter of a close game. But it is a problem – players tell us all the time, ‘Doctors are more worried about keeping their jobs than about our health,’ and some of the more ethical team doctors have been fired in years past. There’s no easy answer to this, but it should start with having a highly trained neurologist on the sidelines.”

Solomon, who also serves as a team physician for the National Hockey League’s Nashville Predators, says another problem is the lack of a uniform system for evaluating brain injuries.

“The methods of evaluating concussions are as varied as the number of trainers and physicians,” Solomon says.

The issue was addressed at the health and player safety conference in Chicago, attended by team doctors and trainers, league-office personnel, NFLPA officials and leading neurologists. From that point forward, the league mandated baseline testing for all players – providing a “before” snapshot of cognitive abilities which could be compared to such tests after an incident – in an effort to ensure that those who sustained concussions were not prematurely cleared to return. (The NHL had instituted such a system a full decade earlier.)

The whistle-blower hotline was also established, though its impact does not seem to have been profound. Fujita said neither he nor any of his Saints teammates had ever heard of the program, and Mayer, the NFLPA’s health director, concedes: “We’ve not seen a lot of traffic there, quite frankly. This is a work in progress.”

For all the positive developments in recent years, it’s clear that more can be done.

“Based on our meeting in May, you have to say the NFL is more interested than they’ve been – but I wouldn’t say they’re appropriately interested,” Nowinski says. “We need more education and open discussion about this, and the NFL and NFLPA control the access to the players, so it’s really on them. The first reason I got involved in this was I thought it wasn’t right that people didn’t have a choice in their own future. It’s like with smoking: Telling people the consequences and giving them the choice is Step One.”

Morey speaks of recent enhancements in diagnostic technology and expresses the hope that they’ll soon be implemented. He also suggests reinstating a short-term injured-reserve list, this time specifically for head-trauma victims, as an incentive for teams to be conservative with players coming off concussions.

“If a player loses consciousness,” Morey says, “he would go on the 15-day IR, and the team could be given a roster exemption so they could sign another player at his position while he’s out.”

None of these potential improvements, of course, will do retired players such as Turley much good. As someone who has been heavily involved with Gridiron Greats, a nonprofit organization that aids needy ex-NFL players, Turley is well aware of the harrowing statistics retired players face: an obscenely high divorce rate; a similarly high likelihood of economic hardship; and the potential surfacing of anxiety, anger-management and other psychological issues.

All of this can be linked, at least on some level, to the aftereffects of concussion. Turley has already been treated for depression and anxiety, and he fears that “I might literally go crazy, like Andre Waters and Justin Strzelczyk did.”

Those were two of the six former NFL players who were diagnosed with CTE after their brains were studied posthumously at Boston University. An abnormal toxic “tau” protein was found in the brain tissue, a sign of brain degeneration similar to that found in Alzheimer’s patients. Waters, a former Eagles defensive back who three years ago committed suicide at age 44, was said to have the brain makeup of an 85-year-old man who was in the early stages of Alzheimer’s disease.

While other physicians have argued that CTE is multifactorial, suggesting that afflicted patients likely have a genetic predisposition for the condition and speculating about a possible link of steroid use, Nowinski says: “From a public-health perspective, that’s absolutely irrelevant. Even if trauma is but one of the factors, it needs to be addressed.”

Though Nowinski’s co-director of the Center for the Study of Traumatic Encephalopathy, Dr. Robert Cantu, has not examined Turley (who says, “I have never taken steroids”), Nowinski is familiar with the former player’s travails and believes there is cause for worry.

“I was concerned about Kyle even before this latest episode he had,” Nowinski says. “The symptoms he’d been having – regular headaches, depression – those two things alone are concerning, having seen that in some of the CTE guys and others who’ve suffered from postconcussion syndrome, as I have.”

In the aftermath of his ER visit in August, Turley felt as though he were recovering from the type of severe concussion he experienced in St. Louis six years ago. Early on, while attempting to close a set of double doors at his home, he had trouble recognizing which one to shut first in order to lock them.

“I had to sit there and test both doors multiple times,” he says, “because I couldn’t remember – even though I had done it unconsciously every night for the last two years.”

Driving, until recently, was a struggle – on more than one occasion Turley had to pull over on the side of the road because of dizziness. In recent days, however, he has become comfortable behind the wheel, and a sense of normalcy has returned. He’s back to playing music (his band, Turley, has a few gigs booked) and enjoying his and Stacy’s five-month-old son, Dean, who, says his proud father, “is gonna be a monster. His hands are as big as my buddy’s 2-year-old daughter’s hands. He’s trying to walk before he can crawl.”

Turley’s greatest fears – that he won’t be able to share in the joy of his son’s upbringing; that Stacy will be left to care for a cerebrally impaired husband – have made him as enraged as he famously was during his playing days. (The NFL once mandated that he take anger-management classes after he ripped the helmet off a New York Jets player during a nationally televised game.)

“This is [expletive],” Turley says. “I’m [expletive] as much as anything. They’re ruining guys’ lives, potentially. I mean, I barely drink, I don’t smoke – I’m a perfectly healthy person without any reason for this to be happening, and look at me. I literally could’ve died after I collapsed, and who knows when it might happen again?

“I’ll probably have to sue the NFL, but the reality is the NFLPA is as much to blame as anyone,” Turley says. “It’s just [expletive] criminal and it’s gonna come to a head.”

If so, that’ll be one helmet-to-helmet collision – a figurative one – that could actually help improve the overall health of current players.