Turns Out Brains Are Important. Who Knew?

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Speaker 1 Welcome back to the dream. Last week, I almost let our guest, Meredith Lynch, go off on a tangent about how football, the NFL in particular, has been infiltrated by private equity.

Speaker 1 I'll just add that it recently entered the NFL. What?

Speaker 1 Yes. How do you gut the NFL?

Speaker 1 Like,

Speaker 1 how do you ransack the NFL? NFL?

Speaker 1 It's called CTEs, Jane Marie.

Speaker 1 Unbeknownst to Meredith, we had already conducted the interview you're about to hear with a former player and current neuroscientist who's trying to make CTE not a thing.

Speaker 47 My name is Chris Nowinski. I'm a behavioral neuroscientist who got interested in studying the brain after I damaged mine from too many years of playing football and professional wrestling.

Speaker 1 Why, you might ask yourself, does Jane care about football? Well, first, I like to watch it. I like football players' names and their butts.
They have the funniest of both.

Speaker 1 I also like how thrilling it is. You know, when players make a touchdown and they're doing a dance, I feel like I'm doing a dance the whole time I'm watching a football game.

Speaker 48 You're also screaming at the screen. and yelling about the rules.

Speaker 1 Like an old man.

Speaker 1 Well, because I'm right. The rules don't make any sense.

Speaker 1 And I am born of a champion football player. My father played for Bo Schem Beckler at the University of Michigan until I was born, when he decided being a dentist was a better path than getting CTE.

Speaker 1 It wasn't a thing yet, but he had an inkling. He actually said that it was about his knees.

Speaker 1 He had exercises with Bo at the University of Michigan where my dad had to stand still

Speaker 1 and the entire team had to run at him and, quote unquote, try to break his knees. What?

Speaker 1 Like, that was an exercise he had to do.

Speaker 48 These are the kinds of things that were still around when I played football.

Speaker 47 Yikes.

Speaker 48 Yeah.

Speaker 1 And you were a baby.

Speaker 47 I was too small.

Speaker 48 to play the offensive line, but considered not athletic enough to play anything else.

Speaker 48 And because I was always on like

Speaker 48 JVB or whatever, we basically were the scout team for the for the actual football team, which meant I used to go up every day against this guy that was a grown ass man.

Speaker 1 About your age?

Speaker 48 No, no, he was a senior.

Speaker 1 Well, I mean, in high schools, not used that a grown-ass man, but like

Speaker 1 different from you.

Speaker 48 Grown-ass man for a high schooler. He would growl at me every single play and practice.

Speaker 1 That's kind of sexy, though.

Speaker 48 Sure. If If you're not.

Speaker 1 If you're not about to get run over, yeah.

Speaker 48 It would have been super sexy if it was sexy.

Speaker 48 But it wasn't sexy because you're wearing the itchiest, scratchiest, grossest clothes, and you have this man across from you who wants to destroy you.

Speaker 1 Yeah. Yeah.

Speaker 1 I like it.

Speaker 48 I don't know. Like one of the best players on the team.

Speaker 1 This all still sounds sexy to me.

Speaker 48 My head didn't like it. I can tell you that much.
Okay.

Speaker 1 Dan,

Speaker 1 we can't tell if you have CTE CTE yet, because as we'll learn from Chris,

Speaker 1 you can only diagnose it after death.

Speaker 48 That's true. And I think that there are worse concussions that I've had since I stopped playing football.

Speaker 1 Oh my gosh, you've made some really dumb decisions about what to do with your noggin.

Speaker 1 Dan's dad is even more embedded in football. The dude moved to Italy to coach American-style football and is basically every coach you see on a kid's movie about sports.

Speaker 1 But there's an icky side of football that really grinds my gears.

Speaker 1 And as we always say in every episode of The Dream, why is this a thing?

Speaker 1 How is this a thing? What's happening? Chris might have an idea.

Speaker 48 Should I create a little Grind My Gears drop?

Speaker 1 Yes. What show was it again? Family Guy, Peter Griffin.

Speaker 47 You know, that really grinds my gears.

Speaker 1 Tell me, first of all, like how you got into playing football.

Speaker 47 Yeah, I grew up outside Chicago, and I remember first getting excited about football in seventh grade because some friends were playing it. It looked cool.

Speaker 47 And my mother forbid me from playing until high school. And why is that?

Speaker 47 My mom was worried about injuries.

Speaker 47 It wasn't necessarily brain injuries back then because we didn't talk about brain injuries in football, but she knew it was more dangerous than other sports for the rest rest of my body

Speaker 47 but i i convinced her that i could do it in high school so i i signed up for you know football summer camp and then uh joined the freshman team and learned quickly that it was uh a fun sport and i had the right body type for it and so i was a two-way starter and captained to the team within you know a week within a week

Speaker 47 Yeah, well, I mean, you have to pick the starters right away. So I was the biggest, you know, one of the biggest guys in the team and I could run.
And I memorized the playbook in a day on defense.

Speaker 47 And so the coach thought, hey, well, you're middle linebacker and you call the plays.

Speaker 1 So tell me how your football career went.

Speaker 47 My football career was modest. As a recruit, I was a sort of low-level Division I, but also the Ivy League was interested and the academies.
And I ended up choosing to play at Harvard University.

Speaker 47 where I had a decent career. I ended up as a senior as a second team all-IV defensive tackle.

Speaker 1 So you're playing football for Harvard. And first of all, Harvard, you said the Ivy Leagues were looking at you.
So you were like the star football player and the smartest kid in your class?

Speaker 47 I think I didn't end up number one in my class.

Speaker 47 I was top 10. Okay.
I slept my way through calculus BC and did not get an A.

Speaker 47 So, yeah, so I mean, I was a highly recruited athlete.

Speaker 47 I did care about school and I did try hard. and I did have the scores to get into Harvard independently.

Speaker 47 I was also recruited as a basketball player to play places, but I chose football

Speaker 47 because I thought it looked, it was cooler.

Speaker 1 So then you graduate college with what? And what's the next plan? What year was this when you graduated college?

Speaker 47 So this is so we're so 1999. I'm actually, you know, one of four guys on my team that are getting looks from NFL scouts.

Speaker 47 And so we're all training together, all thinking one of us was definitely definitely going to be drafted. The other three had a chance or to get free agent signings.

Speaker 47 I ended up not getting drafted, not getting signed, which was a blessing. And I had the consulting job lined up in the life sciences industry from a summer internship.

Speaker 47 But the owner of that firm suggested to me over one conversation, like, hey, if you don't get drafted, this job's always going to be here, but I think you'd make a great pro wrestler.

Speaker 47 And

Speaker 47 it was spurred by the fact that we were both fans and we both watched it, but I didn't know that he had had this sort of weird history where he knew a lot of the people in senior levels of pro wrestling.

Speaker 47 And so when I didn't get drafted, he immediately made some phone calls.

Speaker 47 And suddenly I get a call from JJ Dillon, who used to manage the Four Horsemen and Ric Flair and those guys who ran talent for WCW.

Speaker 47 And they said, hey, we want to fly you down to Atlanta and give you a tryout with Mr. Wonderful Paul Orndorf.
And I was like, okay.

Speaker 47 So literally two weeks before I graduate, I'm flying to Atlanta and getting beaten up by Mr. Wonderful for a day, who at the end of it says, Yeah, you could probably do this.

Speaker 47 You know, you should think about it as a career.

Speaker 1 Did you think of it as a real sport at the time? No, no.

Speaker 47 So I had dabbled in theater.

Speaker 1 There we go.

Speaker 1 Yeah.

Speaker 47 So I was in West Side Story in high school as diesel and

Speaker 47 had fun doing it and then did a little bit of drama and sketch comedy in college. So I did enjoy performance.

Speaker 47 I really enjoyed the physicality of like how difficult it was to actually do what those people did in a ring. So I sort of wasn't ready to give up on athletic pursuits.

Speaker 47 And I was really bored sitting in a cubicle, you know, renting my brain to the life sciences industry. And so I said, all right, I'll give it a shot because I had this nice golden parachute.

Speaker 1 Can I ask you to talk about not getting drafted? I feel like the dream of going to the NFL is very much a part of the American fabric fabric of

Speaker 1 kids growing up in football and then getting this big payday. Do you remember how you felt around that time?

Speaker 47 I was fine with it. So I never considered myself an NFL prospect.

Speaker 47 And I didn't enjoy football as much because at that point in my career, it had gotten very painful. Oh, like I was getting shots in my shoulder.

Speaker 47 I played my entire senior year with a really badly sprained ankle and coming off of a wrist fracture where I couldn't bend it backwards.

Speaker 47 And so I was fine not continuing, but I knew I couldn't turn down, like no one turns down the opportunity to go to the NFL.

Speaker 47 You are attracted to the dream. Like it's really hard to turn down.
You know, telling people you're in the NFL makes you a god in certain populations, but it had never been my lifelong dream.

Speaker 47 I never thought I was good enough.

Speaker 1 So that's not what you were aiming for? No.

Speaker 1 What were you aiming for?

Speaker 47 I had no idea. That's why I went into pro wrestling.

Speaker 1 Tell me how that happened.

Speaker 47 Yeah. So, I mean, like, you know, you're when you're in college, you know, people have their jobs they go into, and I just never had a real plan.
I just didn't have something I was passionate about.

Speaker 47 So I had this really nice consulting job, and I went and did it. The reason I didn't sign with WCW right away is I needed shoulder surgery with a six-month recovery.

Speaker 47 So they said, call us at the end of six months. So I did the job and lost 50 pounds and, you know, found out I had abdominal muscles after being a fat line my whole life.
And

Speaker 47 when I was ready to go, WCW was going out of business.

Speaker 47 And so suddenly this door was closed. Like they, within a year of that, they were bought by WWF.

Speaker 47 So

Speaker 47 I found out that Killer Kowalski ran a pro wrestling school 20 miles away north of Boston. And so I started going to Killer Kowalski's nights and weekends while working.

Speaker 1 Forgive me. I know that name sounds a little bit familiar to me, but who is Killer Kowalski?

Speaker 47 The killer, a killer, a killer was just a legendary wrestler from the

Speaker 47 50s, 60s, 70s, 80s.

Speaker 47 He was famous for tearing a guy's ear off with his knee.

Speaker 47 It turns out it's an accident, but you didn't tell anyone that. It was just legend.

Speaker 47 But he was, you know, just a guy with a thick Polish accent who was just the nicest vegetarian you've ever met

Speaker 47 named Killer.

Speaker 47 So, yes, I went to Killer Kowalski School.

Speaker 47 While I was trying to then pay my dues and work my way up through the Independence, WWF announced that they were partnering with MTV to do a reality show, sort of real world meet survivor, 13 people live in a house, fight for a contract.

Speaker 47 And so I decided if the door was open, I might as well send it a tape.

Speaker 1 13 wrestlers in a house looking for a WWF contract on TV.

Speaker 47 When the last one standing gets a three-year contract with WWE. And this was back when reality shows were real.
So you couldn't talk to anybody. You know, you handed over your phone.

Speaker 47 You never knew what the next day was going to bring. It was kind of crazy.

Speaker 47 But, you know, I was runner-up and being Chris Harvard was very interesting.

Speaker 1 I saw that your wrestling name had Harvard in it. And I was like, is he going to be one of those guys that went to Harvard and then everything is Harvard?

Speaker 1 You know, like you try to find a way to say that you went to Harvard.

Speaker 47 Yeah, no,

Speaker 47 we love that and we play with that all the time. You know, you want to, yeah, you want to, you want to know if a guy went to Harvard, you know, he'll tell you.

Speaker 47 And when I started calling me Chris Harvard, I should have realized like, all right, as a wrestling character, Chris Harvard's never going to be the underdog.

Speaker 47 uh you're going to be the bad guy then i learned the show started editing me as the bad guy oh and it gave me this nice boost into that future career because people actually thought i was a horrible person

Speaker 1 what do you mean the boost into the career like because wrestlers it's better if you're bad

Speaker 47 so wrestlers fans have to care about you and either have to really really like you or really hate you if you're in between they don't care about you right right so the world is divided into baby faces and heels good guys and bad guys

Speaker 47 When you're a wrestling character, like The Undertaker, people knew he wasn't dead.

Speaker 1 Right.

Speaker 47 But with Chris Harvard, people didn't know if I was really that arrogant Ivy League jerk or I was an okay person. Like, literally, even in the locker room.

Speaker 1 I love the idea of this character, though.

Speaker 47 Yeah, I mean, it was a great creative freedom

Speaker 47 to just say and do whatever you want and just, you know, get a microphone and insult people.

Speaker 49 You know, a friend of mine just made me realize that for the first time in history, Iowa State is being graced by an actual Harvard graduate.

Speaker 49 That's true. First time in history.
It's quite a little institution of higher learning you guys have going for you here. You know, we had a little chat at Harvard for people like you.

Speaker 1 That's all right. That's okay.
You'll all work for us someday.

Speaker 1 I love that one.

Speaker 1 So you move on from that. You're runner-up, but it sounds like you got a contract anyway.

Speaker 47 Yeah, so I go do the Indies for six months traveling the world and then they gave me a tryout at WrestleMania.

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Speaker 1 And we're back with Chris Nowinski.

Speaker 1 So now you're achieving another American dream, being on TV. Yeah.
Were you excited about that part of it?

Speaker 47 But yeah, when I made debut on Monday Night Raw in June 2003,

Speaker 47 it was very cool.

Speaker 47 It was cool to be just in a building wrestling in front of 20,000 people, you know, walking the street and people recognize you and tell you they hate you. It was great.

Speaker 1 How long did you do that?

Speaker 47 So start to finish, first time in the ring to the end was just under three years.

Speaker 47 And I was just on TV for just over a year.

Speaker 1 Why did you quit?

Speaker 47 Because I got kicked in the head in a match.

Speaker 47 It was really my fault, but his foot hit my head and I got a really bad concussion that I didn't realize was a concussion.

Speaker 47 And I kept wrestling for weeks with a damaged brain that kept getting more damaged to the point that it never quite recovered.

Speaker 47 And I couldn't actually perform the job because I couldn't remember matches. And I, I couldn't give my heart rate up without feeling sick.
So I retired from post-concussion syndrome.

Speaker 1 What did you feel like when you first got kicked in the head? You said you didn't know you had a concussion. Was it not painful enough?

Speaker 47 No, I just, I just didn't know. I mean, like at that point, like there was no such thing as concussion education for athletes.

Speaker 47 And so a concussion was defined by a doctor telling you you had a concussion. I was never knocked out.
I never had enough symptoms that I'd ever gone being seen by a doctor for a suspected concussion.

Speaker 1 Okay.

Speaker 47 When I got kicked, I blacked out. Like I couldn't remember the rest of the match.

Speaker 47 You know, so one of the important things about keeping a wrestling match safe is you know how it's supposed to end and you know when you're supposed to improvise and you know when you're supposed to hit marks.

Speaker 47 And I couldn't remember the script. And so I remember telling the other wrestlers, like, what's next, what's next, what's next?

Speaker 47 And they just would tell me. And so it was fine for the show's purposes, but I didn't realize that losing your ability to remember where you are and what you're doing was a concussion.
Right.

Speaker 47 And then I had a really just massive headache that wouldn't go away. Yeah.

Speaker 1 I've had a head injury, just full disclosure, and I've talked it on our show before, but I had a, um, what they call a diving accident. I fell out of an open staircase onto my head on a cement floor.

Speaker 1 So same Z's.

Speaker 1 Yeah,

Speaker 1 part of the club. How are you feeling today? I'm good.
My, my big cluster migraines have gone away as I get older, but I still have ocular migraines.

Speaker 1 But other than that, I'm okay, I think, for now, until we find out that I have CTE later.

Speaker 1 Oh, I was a kid. I was six or seven.

Speaker 47 You're not going to get CD from that.

Speaker 1 Oh, good. Okay.
Well, don't tell me how you know that yet. Okay.
So you

Speaker 1 so you have this concussion. How did you feel your prospects were going forward when you had to quit the WWE?

Speaker 47 Well, my prospects in wrestling were good. I mean, actually, looking at a magazine, I was named 2002 Newcomer of the Year by Raw magazine.

Speaker 47 And that was a year where we were like, you know, Brock Lesnar's floating around, John Cena, you know, some real big stars. That was my class.

Speaker 1 I forgot John Cena was a real WWE guy. And Batista.
I know, I know.

Speaker 47 He's such a legend now, but no, back then he was a guy, you know, still trying to find his way like me.

Speaker 47 So, no, I mean, they assumed that I would have a career like those guys had, but it didn't work out that way. And what'd you do next?

Speaker 47 You know, they're trying to send me doctors, put Humpty Dumpty back together again. The eighth doctor I see is Dr.

Speaker 47 Robert Cantu, who is the first doctor to help me appreciate that this was a concussion and it wasn't my first concussion. And I'd had a ton of concussions over my career.

Speaker 47 And I just, by not ever recognizing them or taking time off, I turned what would have been a recoverable injury into something that he's not sure if I'm ever going to get better from.

Speaker 47 That was about three months after the concussion.

Speaker 47 And I was like, wait a second, I'm a Harvard grad and I didn't know that every time I got kicked in the head and tackled somebody and the sky would change colors or I couldn't remember where I was, that that was a brain injury.

Speaker 47 I needed to rest it like I would would any other injury.

Speaker 47 That sort of insight blew me away. And the fact that he didn't know what was going to happen to me long term either was also concerning.
And so I wasn't happy with the answers that I had.

Speaker 47 And so basically I took what he told me and I led me to going to the Harvard Medical School Library and starting to read.

Speaker 47 every study ever on concussions to try to find if there was something I could learn that would help me get better or figure out what was going to happen to me.

Speaker 47 And that idea of the fact that there was all this knowledge out there that we weren't being told as athletes and the fact that I screwed up my own brain out of my own ignorance.

Speaker 47 You know, I said, hey, Doc, like, why is no one telling athletes this? And he was like, well, I've tried to tell people, but no one listens to doctors. You have a platform.

Speaker 47 Maybe you could convince them.

Speaker 47 And so I decided to write a book. That was my big idea is I, as a pro wrestler, going to write a book about complex neuroscientific and cultural issues around this injury.

Speaker 47 I wrote this book, Head Games, Football's Concussion Crisis in in 2006. And one of the things, so I sort of told the story of, hey, we're missing all these concussions.
Athletes aren't telling doctors

Speaker 47 how they feel because we don't know any better. And all the people who are retiring due to concussions aren't getting better when you go find them.
They're still struggling.

Speaker 47 And there's this, I called it a concussion crisis. Like we're just not acknowledging this invisible injury because it's invisible and no one's talking about it.

Speaker 47 And as I did that research, I also learned after reading the studies that the NFL had gotten into the research game, but they were publishing big tobacco-like studies saying everything was fine while they were putting people who were knocked unconscious right back into the game.

Speaker 47 And that really pissed me off. And so I wrote a chapter calling them big tobacco and exposing how these studies were so stupidly designed.

Speaker 47 And I got a $4,000 advance because no one wants to read a book like this. And I had to buy $21,000 worth of liability insurance for my accusations I made against the NFL.

Speaker 47 But it was something I believed in. And I realized that people were actually dying because of this.

Speaker 47 And I basically, my penance for damaging my Harvard educated brain was to try to take a stab at changing the culture on this.

Speaker 1 Well, I've seen your story on TV about the book. I mean,

Speaker 1 I feel like it's a very well-known kind of expose.

Speaker 1 Well, it did open up this criticism, though, of the NFL. Can you tell me about that?

Speaker 47 Yeah. So what sort of happened next was sort of how things changed was the book comes out in October 06.
No one cares.

Speaker 47 But I've learned that the way that you can see long-term effects from concussions was this disease, chronic traumatic encephalopathy, what we can now call CTE, that we used to call punch drunk because it was well known in boxers 100 years ago.

Speaker 47 But no one ever looked outside of boxing to see what was going on.

Speaker 47 And as somebody who was hit in the head 10,000 times at this point, I knew that your brain can't tell whether it's a football helmet or a fist that's punching you in the head.

Speaker 47 Your brain's going to feel the same thing.

Speaker 47 So

Speaker 47 two NFL players have been studied. I interviewed the doctor who did those, who was in the concussion movie.

Speaker 47 And a month later, Andre Waters, who I grew up watching, strong safety for the Philadelphia Eagles, takes his life in his mid-40s.

Speaker 47 He was known as being a hard hitter. And so I ended up assuming that someone was going to mention CT, that it was known, but no one did.

Speaker 47 So then I called the medical examiner in Hillsborough County, Florida. got a hold of him and said, hey, are you going to study this guy for CT? And he told me no.

Speaker 47 And basically over a series of conversations, I convinced convinced him that he should be studied. And he told me how you get someone studied, which was having to call their family and get permission.

Speaker 47 And so I did that.

Speaker 1 How was that call?

Speaker 47 It was, I had a, wrote out a script and I was sweating profusely because I just, you know, couldn't imagine having to make this call, especially not being a doctor at that point.

Speaker 47 But none of the doctors would do it.

Speaker 1 I did ask everyone else if they would call.

Speaker 47 And nobody was comfortable calling a mom who's in her 80s who just lost her son to suicide to ask, you may not be aware of this, but his brain is still available for study, even though you just left his funeral.

Speaker 47 So anyway, you know, I think it took something to make that call, but the reason I keep doing it is because his family was so amazing.

Speaker 47 They were actually just appreciative that somebody cared why Andre died.

Speaker 1 Yeah.

Speaker 47 And they saw his behavior changes. They knew something was wrong with him.
And so after they vetted me and said, all right, we believe in what you're trying to accomplish here. We'll let you study.

Speaker 47 When you die from unknown causes,

Speaker 47 they will keep tissue and blood for future analyses in case anything else is learned.

Speaker 47 So basically, five parts of his brain were still available in the medical examiner's office while the rest of them was buried.

Speaker 1 And so what did they find?

Speaker 47 So Andre had CTE.

Speaker 47 And he was the third of three NFL players to have CTE.

Speaker 47 Two of the three had killed themselves in their mid-40s. Mike Webster was famously known to be homeless and in terrible mental shape when he died of a heart attack at 50 or so.

Speaker 47 So the deal I made was: look, if you know, these first two cases were published in the journal Neurosurgery, which regular people don't read. And no one had known about it.

Speaker 47 And it had never been a national news article. But I knew the power of the media.

Speaker 47 And I said, if people are killing themselves because they have this disease and the NFL is covering it up, people need to know.

Speaker 47 And there's a reporter named Alan Schwartz, who at the time had written some columns on baseball statistics for the New York Times, who I'd been introduced to when I was writing the book by a mutual friend.

Speaker 47 He took a great interest in what I was writing and had gotten me a literary agent and introduced me around New York because he believed that I had something.

Speaker 47 I called him and I said, hey, I've got this. CT case.
I think it's a really important story.

Speaker 1 What do I do with it?

Speaker 47 And he said, you're right. This is something the New York Times should be interested in.
Let me make some calls. And he calls me back and he goes,

Speaker 47 The editorial staff's asked to see you in New York next week.

Speaker 1 Oh, wow.

Speaker 47 And so I hop a train from Boston to New York and I go with him to the New York Times building and sit down with the editors and say,

Speaker 47 this is the story. NFL players are getting this punch drunk disease and the NFL is covering it up and someone needs to say something.
And

Speaker 47 Jason Stallman, who was a deputy sports editor at the time, what he said to me was, We're the New York Times. How do we not know about this?

Speaker 1 Right.

Speaker 47 And I said, Well,

Speaker 47 it's because it's being covered up. I don't blame you because I didn't know about it either.
And I was out there banging my head for a long time.

Speaker 47 So they went for it and they put it on the front page of the New York Times the week before the Super Bowl. And they hired Alan Schwartz full-time to start covering this issue.

Speaker 47 And he ended up writing 200 articles in the Times exposing this huge issue with concussions and CTE.

Speaker 1 Amazing.

Speaker 1 First of all, what do doctors see when they look at a brain that they suspect has CTE? What's there or not there?

Speaker 47 When someone has CTE, what you will see is a pattern of brain cell death that is specific to the disease. You have a protein in your brain cells.
It basically holds your axons

Speaker 47 open, you know, so there's tunnels inside that molecules are moving around.

Speaker 47 Basically, what we've learned is that when you stretch an axon quickly and traumatize it, that protein can start to fall apart and it sort of crumbles, and then you find clumps of it.

Speaker 47 The protein is called tau. It's well known because it's one of the hallmarks of Alzheimer's disease and about 15 other diseases.

Speaker 47 But with CTE, it's in a peculiar place. It's around blood vessels and it's at the bottom of the valleys of the surface of your brain.

Speaker 47 It's called the sulcal depths of the cortex.

Speaker 47 What we've learned essentially is that

Speaker 47 because of the shape of your brain, if you rapidly move a brain that has these hills and valleys on the surface, the strain is most felt at the bottoms of those valleys.

Speaker 47 And so basically what you're seeing is evidence of injury. And

Speaker 47 once the injury is there, for some reason, in some people, it just starts spreading spreading after you stop getting hit in the head.

Speaker 1 Are these what we would call plaques?

Speaker 47 They're not the plaques. Okay, still aren't.

Speaker 47 That's the other hallmark of Alzheimer's that people are learning how to treat or get out of the brain.

Speaker 47 But we're talking about the other one, tau protein, which is much, much harder to deal with because it's inside the cells.

Speaker 1 Fascinating. How long had science known?

Speaker 1 That that's what you look for in a head injury. How new was that science?

Speaker 47 Well, it wasn't really that well associated with head injuries. It was known that acutely you'll see some elevated tau, but it goes away.

Speaker 47 You know, tau, when we first discovered punch drunk, we didn't even know what tau was. Punch drunk in the 1950s was

Speaker 47 described as certain things you'd see in a brain, but it wasn't until the late 70s, early 80s that we even could find an antibody that stained this tau protein and made it visible.

Speaker 47 So it was sort of a new thing. There was no science on really what to look for.
There was an extrapolation from studies done decades before to say this is CTE,

Speaker 47 but

Speaker 47 when we're talking 2007 right now, it wasn't until 2015 because of our work that the National Institutes of Health actually first published this is what CT is.

Speaker 47 So at that point,

Speaker 47 we can look back and go, yeah, we were right, but it was speculative back then.

Speaker 1 Can you quantify the problem of CTE or potential CTE? Like how many concussions does your average football player or wrestler suffer in their career?

Speaker 47 Great question.

Speaker 47 So there's two things to quantify. One is the disease and one is risk for the disease.
On the disease itself, there are Dr.

Speaker 47 Ann McKee, who's really led all this work and is the neuropathologist that I send all our 1,600 brains to that we've helped recruit for. She's created a four-stage system.

Speaker 47 And so, you know, when you're in your teens or 20s and you get it, you have these tiny lesions in the frontal lobe and that's stage one. And then they spread.

Speaker 47 By the time you you get to stage four usually 30 to 50 years later it's everywhere throughout the brain

Speaker 47 in terms of your risk that's something that we need to figure out so what we have learned is that it's not the number of concussions that predicts cte

Speaker 47 and the reason it doesn't is because when you're getting hit in the head all the time

Speaker 47 you are getting microscopic brain damage or subclinical traumatic brain injury that you can't feel.

Speaker 47 And so, what correlates with who has CT is how many hits to the head you took and how hard they are, but not how many times did you feel symptoms and report it to a doctor and get a diagnosis.

Speaker 1 Right.

Speaker 47 So, when you survey NFL players while they're alive and then they die and you look at their brain, like, you know, most of them will say they've had, you know, between 20 and 100 to 200 symptomatic events that would be defined as concussions.

Speaker 47 Yeah, I mean, when you talk to NFL players when they retire, they'll tell you weekly they're seeing double and they're, you know, can't remember stuff, but they play through it.

Speaker 47 Other people will take the same hits and not feel much. And I think that has a lot to do with just people's, like people have different thresholds for pain.

Speaker 47 People have different thresholds for recognizing when a few of their neurons out of the 90 billion in their brain are broken.

Speaker 47 So basically the point is that CT correlates very, very strongly with number of years you play contact sports, but not with number of concussions.

Speaker 47 And so we have published that for football players, your odds of developing CT go up 30% per year. We've published in rugby players, it goes up 14% per year.
We've published in hockey players

Speaker 47 in December 2024 that it goes up 34% per year.

Speaker 1 Whoa.

Speaker 47 With the hockey study, it's probably the best example. It was zero of six hockey players who played fewer than six years.
It was 19 of 19 who played 25 years or more.

Speaker 1 Wow.

Speaker 47 And those curves look a lot like smoking and lung cancer curves. Yeah.
Essentially, one year of smoking, your odds are very, very long.

Speaker 47 But if you smoke two packs a day for 30 years, your odds are considerable.

Speaker 1 What about boxing?

Speaker 47 We haven't published on that yet. In general, there's a study published in 1969 that said the more years you box, the greater your risk.
And I'm sure that's the case.

Speaker 47 We just don't have the good specifics right now.

Speaker 1 What are other effects of CTE? So,

Speaker 1 I mean, we've we've barely touched on the idea of suicide rates going up. What are the other consequences of having this disease?

Speaker 47 So

Speaker 47 what we now know about CTE as a progressive degenerative disease is that most people will eventually develop progressive cognitive impairment that leads to dementia if they live long enough.

Speaker 47 That's pretty well accepted, and it's the tau destruction over time that is driving that.

Speaker 1 We've accomplished that.

Speaker 47 So for a lot of people, you you will see that Alzheimer's like fade over time.

Speaker 47 But what we're also learning is that a lot of people, not everybody, have severe neurobehavioral problems.

Speaker 47 So, you know, imagine like you're planting a disease in the brain in someone's teens or 20s, and it's in different parts of the frontal lobe for different people, but it's also in other places.

Speaker 47 And so it's going to affect people differently. based on a lot of different factors.
But some people seem to really go off the rails as early as their 20s, become a different person.

Speaker 47 They develop addiction issues, aggression issues. They can't hold down a job, poor executive functioning because the frontal lobe is compromised.

Speaker 47 They make bad decisions.

Speaker 47 So we do see a lot of that too.

Speaker 47 But then layered into that is that CT is not the only type of brain damage that 10,000 hits in the head will cause.

Speaker 47 So there's all these other types of brain damage that we pick up that could be contributing to some of those early stage issues.

Speaker 47 But, you know, when you think about someone like Junior Seiao, who was having mental health issues and took his life, and that is a common story, but it's not the most common outcome.

Speaker 47 The more common outcomes are the later stage cognitive problems.

Speaker 1 Okay.

Speaker 1 So, Junior Sayao, that reference might have gone by really quickly, but let's talk about him for a minute. Dan.

Speaker 48 Yeah, so Junior Sayo, I mean, he was an all-American linebacker at USC.

Speaker 48 He played in the NFL for a very long time, 13 seasons.

Speaker 1 That's a lot.

Speaker 48 Yeah, it's amazing if you make it past three years in the NFL. Anyhow, he shot himself in the chest in 2012.

Speaker 48 Prior to that, he had been for quite a long time complaining about depression and a bunch of the symptoms that we would now associate with CTE.

Speaker 48 And even then, obviously, it was 2012, so it was associated with CTE. But yeah, it's just really important to remember how real this is.
Like

Speaker 48 he probably wouldn't have done that. Right.
If he hadn't been suffering with CTE.

Speaker 1 So it bums me out the same way it bums you out that there's this really fun thing we like to watch together on Sundays.

Speaker 1 Well, now it's like five days a week, but, you know, it's a tradition and it's fun. And there's a reason to make seven layer taco dip.

Speaker 1 And I love it.

Speaker 1 And yet.

Speaker 1 Every time someone gets knocked in the head, I mean, you've been there with me.

Speaker 47 Oh, it's horrible.

Speaker 48 It's horrible. But the thing is, they get knocked in the head every play.
It's just most of the time we don't focus on it.

Speaker 1 Anyway, it's thrilling and also sickening. And I have a lot of cognitive dissonance around my feelings around football.
So yeah, Junior Sayo is a very famous case.

Speaker 47 We really are concerned with these early, these early deaths. of people with CT who have radical changes to who they are.

Speaker 47 We actually just published within the last month that one of the predictors of who really struggles is family history of psychiatric and mental health diagnoses.

Speaker 47 What we found is that when people have that sort of latent, so they have whatever environmental or genetic predisposition for mental health or psychiatric issues, if you also get CTE, it really unlocks it.

Speaker 47 And between the ages of 40 and 60, we see in those people more aggression than we'd expect to see alone or just by genetics or just by having CT.

Speaker 47 But when you combine those two things, you see really strange behaviors.

Speaker 47 And so, you know, when I think about people like Chris Benoit, who was the third brain I coordinated, who was a wrestler I knew for five years, who seemed fine until he killed his wife, seven-year-old son and himself.

Speaker 47 Oh my God. He was 40 years old when that happened.
And we have a lot of those types of stories where people just radically change into their 40s.

Speaker 47 And I, you know, at this point, I think a lot of that is due to they develop CTE and they have these other risk factors

Speaker 47 waiting to become unleashed.

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Speaker 1 Back to our conversation with neuroscientist Chris Nowinski.

Speaker 1 We kind of skipped over going back to school and what your career became after you wrote the book. Can you tell me about that?

Speaker 47 So once the Andre Waters story went out, and then there was another brain, Justin Strelzik, that I tracked down, and he had CTE or four for four, I realized that CTE was going to get everyone to take concussions seriously because it made invisible concussions visible.

Speaker 47 You could see the brain damage, but also we need to figure out what the hell is going on with CTE.

Speaker 47 And so, in having these conversations with families, I realized that they were luckily trusting me to sign over the brains to me or the doctors, but there's really, this needs to be institutionalized.

Speaker 47 So, I said, all right, we're going to create a charity that's going to do this outreach and families can trust that no one's profiting from their loved one's brain but then also we need to find the best medical scientific team out there at an academic center and create a partnership at a brain bank so that became boston university ct center so that was dr and mckee uh bob stern that we we partnered with and i said i'm going to get you brains will you study them and do all the work and luckily they said yes they saw the public health value so that was 2008 and then i have an office at the medical school where i'm literally spending most of my days tracking obituaries, tracking families down, making the pitch, trying to build this thing.

Speaker 47 And then they mentioned to me, all right, well, as long as you're in the building, do you want to go attend some classes?

Speaker 47 Basically, the idea was the shine was going to wear off of this late 20s ex-athlete figuring this out.

Speaker 47 And if I wanted to make sure I was making the right choices and play a larger role in the research, I needed a doctorate. And so I started doing a PhD part-time.

Speaker 47 in behavioral neuroscience while still trying to build up the foundation.

Speaker 47 And I'm glad I did because before I was just trusting what the smart people were telling me now I have some independent thoughts. Oh, good.

Speaker 1 And you were still right.

Speaker 47 And I was still lucky I listened to the right people. I mean, that was what it was, what it came down in the early days.

Speaker 47 That's the one special thing that, since I haven't dropped Harvard in like 10 minutes, one special thing about Harvard is it did help you recognize who the true smart people were.

Speaker 47 Because we all walk into that place thinking we're the smartest person in our high school.

Speaker 47 Then you get to see what real genius genius looks like right and so i could tell who was real and who was fake and i i picked the real people and that's what made this happen because a lot of the other people who were around in those days are gone you know and so um anyway that's how i work in harvard there okay in a dream world in an ideal world what do you want to happen with this issue practically speaking what do you want to change

Speaker 47 what i've what i've been working on today is we need to get to a point where we can diagnose ct in life

Speaker 47 not just to help the families who are struggling and aren't getting answers, but so that we can get the life sciences industry off the sideline and actually running clinical trials trying to cure this thing.

Speaker 47 So that is that is sort of what my five-year plan is: we're getting very close to learning how to diagnose the living people and what has to happen next.

Speaker 47 And what's been hard is that along this way, I mentioned I was one of four guys who were training for the NFL in college.

Speaker 47 One of those guys who did get to the nfl and was my roommate that summer died and he drank himself to death and we studied him and he had stage two ct and i was not able to help him when things got bad and the alcoholism was just too bad he wouldn't go into rehab we didn't have answers to what was happening but i you know i think we all knew he must have been young He yeah, he was 44, 45.

Speaker 47 So I need to cure like my generation and hopefully we'll help some of the guys that that are older than me, but it's a race.

Speaker 47 And then on the flip side is I hope we bring sanity back into youth sports where we actually think about what's best for the kids and we're willing to have those difficult conversations of, well, soccer's just fine for a 12-year-old without heading.

Speaker 47 You know, they can still learn the game, be fine, play the ball off their chest. Like, why do we need to start exposing them to brain injuries and potential CTE? Right.

Speaker 47 You know, just to get them more ready for their high school team and then more ready for their college team. Like, we're doing sports wrong.

Speaker 47 And the problem is we're fighting of the privatization of youth sports. So, you know, if you join a club soccer team, like they're not going to tell you there's any risk to the game.

Speaker 1 Right, right. Because they're not affiliated with your school or the public school system or any of that.
Yeah.

Speaker 47 And so I don't know how we win that battle. Like, you know, we, we, you know, we, we've had certain wins here and there.

Speaker 47 You know, we got heading banned before age 11 in soccer, but we are creating more CT cases now than we ever have before.

Speaker 1 Because we have more people participating in sports or?

Speaker 47 Yeah.

Speaker 47 We have more people playing sports. We have more people playing more sports.
So, you know, when I grew up, soccer was a one season a year sport, maybe two.

Speaker 47 Now kids are playing four seasons a year on two teams.

Speaker 47 I can't believe kids play in their high school team and a club team the same season. Football is something that when in the 1960s, Pop Warner was not even a national organization.
Right.

Speaker 47 And so there are very few kids, people starting at five. Now we have tons of people starting at five.
And those people have a much greater risk of CT.

Speaker 47 So the problem is we're playing more sports than we have before we're starting younger and we're only now starting to in some sports create age minimums to start hitting a kid in the head 300 times a year oh my god but it's not happening fast enough we now have you know

Speaker 47 almost 10 college football players who died in their 20s with stage three cte that are worse than say they were the small hard-hitting tough guys on their teams who started playing in single-digit years and their lives were over by 20.

Speaker 47 And they were just fought, you know, addiction, mental health, couldn't hold jobs, families.

Speaker 47 So bigger, stronger, faster is also making this worse than it was before. So we're facing a wave and we're facing an industry that doesn't want to acknowledge it.

Speaker 47 There's a lot of people making a lot of money not to slow the party down.

Speaker 1 Right.

Speaker 1 So is the answer like Rihanna should not play the Super Bowl?

Speaker 47 Even that, like, it's, that's not her battle.

Speaker 1 I know.

Speaker 47 Right. Like, you realize like that's the, that's your opportunity as as an artist to be seen in front of the largest group in the world.
Like you're crazy to turn that down.

Speaker 47 I mean, I, like, trust me, I think about all the time, do I ask people in those positions to risk their financial future to try to raise awareness of this tragedy?

Speaker 47 And the answer is no. I mean, it's like, and here's the hardest part.
The people that are most at risk for this, like current NFL players, right? We've proven at least 10% of them have it.

Speaker 47 It's multifold worse than that.

Speaker 1 There's no question about it, right?

Speaker 47 But not a single current NFL player is talking about CT or advocating for CT research or

Speaker 1 really? Not one?

Speaker 1 No.

Speaker 1 How do we find that person? How do we, what do I we've tried over the years?

Speaker 47 Uh, there have been people who've like pledged their brain during the season, or what they've learned is that no one you get punished for talking about CT because the coaches will start to think, oh, he's not going to stick his head in there anymore.

Speaker 47 He knows too much. Oh,

Speaker 47 and so

Speaker 1 you know, you find so gross. I'm sorry,

Speaker 1 so gross.

Speaker 47 The players are punished for talking about it or for advocating for themselves outside of through their unions.

Speaker 47 So, it's this weird, silent thing that the people most at risk are not engaged on this issue, and they're most of them are in denial.

Speaker 1 Is it just toxic masculinity?

Speaker 47 No, no, no, no, no, I mean, you know, I wrestle with my four-year-old son every day, but also with my six-year-old daughter.

Speaker 47 Like, you know, there's right, there's nothing wrong with wanting to play a sport and collide with people, especially when it's not giving you immediate feedback that it's hurting you.

Speaker 47 Your brain doesn't have pain nerves.

Speaker 47 So you literally can't know that you're damaging your brain until it's too late.

Speaker 47 Women are doing this too.

Speaker 1 We just don't talk about it.

Speaker 47 We've identified the first two CT cases in female athletes. They were both 28.
They both died by suicide. One played rugby and Aussie football in Australia.
One played soccer in the U.S.

Speaker 47 We're not talking about that either.

Speaker 1 Right.

Speaker 47 And trust me that I've had conversations with high-profile former female athletes.

Speaker 47 They don't want to be the bearer of bad news for this too, because this is finally the shot that women can make a great living off of sports.

Speaker 47 And no one wants to suddenly bring this dark cloud of what are we doing to ourselves here. But I once had a conversation with two women on the women's national team from the 90s.

Speaker 47 One of them refused to head the ball in the 90s and was one of the best players in the world.

Speaker 47 And she just said, yeah, I just knew it was a bad idea. I didn't like it.
That wouldn't happen now, right? Because now you would get pushed out. Back then, because

Speaker 47 there wasn't so much money on on the line, you had some autonomy.

Speaker 1 Right. So I don't know.

Speaker 47 There's no easy answers here. I don't blame anyone for what they're doing.
And they have also been fed misinformation their whole career.

Speaker 1 Right.

Speaker 47 Their whole career, they've been told this is safe.

Speaker 1 Well, you're doing great work to try to fix that.

Speaker 1 I feel like the conclusion here is money is evil.

Speaker 1 And no.

Speaker 1 Well, okay. I'll call you back if I have any questions.

Speaker 47 We didn't get into the concussion sign you need to look for, which is the

Speaker 1 concussion.

Speaker 1 Okay, tell me everything I need to know about identifying whether I'm having a concussion or whether someone else is having a concussion, especially if I'm watching a football game.

Speaker 47 If you're watching a football game, what you're looking for are what we call signs of concussions. Basically, concussions are defined by signs and symptoms.
Symptoms are what you feel.

Speaker 47 Like, so when I got hit in the head and I would see double and my head hurt, that's a symptom. But if I didn't tell anybody, no one would know about it.

Speaker 47 And that's how concussions continue to skate by undiagnosed.

Speaker 47 But there's signs that you see, like the fencing response, where someone gets hit and they're unconscious for their arms out, or they get up and they fall over. That's a sign of a concussion.
Okay.

Speaker 47 It's a sign that their brain's malfunctioning. We just discovered a new sign that we've all known about for a long time, but was never in the protocols and we haven't been using to pull people out.

Speaker 47 And that's when someone gets hit in the head really hard. And a few seconds later or a minute later, they start shaking their head violently back and forth.

Speaker 1 Okay.

Speaker 47 That quick shake back and forth.

Speaker 1 Shaking the water.

Speaker 47 It's kind of reset in your brain.

Speaker 47 It's been around forever, but we missed

Speaker 47 that it needs to be one of those signs you pull people out and evaluate them on.

Speaker 47 So Tua Tunga Vailoa did it twice, the famous concussion where they left him in the game and said it was his back injury.

Speaker 47 And that forced me to stop complaining about it on social media about the head shake and actually do a study.

Speaker 47 So we surveyed nearly 400 young former athletes, showed them video of it happening and say, did you ever do this head shake after getting hit in the head?

Speaker 47 And what were you experiencing when you did it?

Speaker 47 And 72% of the time, it was because they were having concussion symptoms and they were trying to reset their brain, stop the double vision, stop the feeling of floating, stop the ringing in their ears, you know, whatever it was.

Speaker 1 And so we named this.

Speaker 47 spontaneous headshake after a kinematic event or S-H-A-A-K-E.

Speaker 47 And now we're advocating for everyone to put it in their protocols.

Speaker 47 So anyway, so if you see someone get hit in the head and they shake their head back and forth violently, which is when you recognize it from cartoons and movies, that is usually a concussion. Okay.

Speaker 47 But it's not 100% diagnostic like getting knocked out. And therefore, people are still playing through that all the time.

Speaker 1 Oh my God. So this is going to be a fun weekend of watching football.
Right, Dan?

Speaker 1 Are we, did I miss anything else? Is there something else you're itching to talk about or are we good?

Speaker 47 Oh, on this, on this issue? yeah, no, I think, no, I mean, you, you, you know what you're doing, you know what you need to hear your story.

Speaker 47 So, I'm happy to, I appreciate you doing it, and I'm just, you know, happy to, happy to share my perspective and thank you for uh, yeah, giving this a little bit more visibility because it is a hard thing to convince people on.

Speaker 1 Yeah, well, thank you for sharing your knowledge and coming on the show. I appreciate it.

Speaker 47 It was my pleasure.

Speaker 1 Take care, Chris.

Speaker 47 All right, thanks. You too.

Speaker 1 That's it for this week. Hope you're loving the new format, just weekly chit-chatting and hearing me in your face a lot more often.

Speaker 1 Thank you so much to Chris Nowinski. I'm excited to see where his work takes us as a society.

Speaker 1 We have a tip line open. Call us at 323-248-1488.
323-248-1488. And leave us a message about anything that you think is funky out there.
What's going on, guys? Talk to me.

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Speaker 29 Hey, I'm Paige DeSorbo, and I'm always thinking about underwear.

Speaker 31 I'm Hannah Berner, and I'm also thinking about underwear, but I prefer full coverage.

Speaker 33 I like to call them my granny panties.

Speaker 30 Actually, I never think think about underwear. That's the magic of Tommy John.

Speaker 35 Same, they're so light and so comfy, and if it's not comfortable, I'm not wearing it.

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