Ex-Bear: Football’s concussion risk exaggerated
Injury ended career, but he blames treatment, not game
Merril Hoge said teams at every level now treat concussions with far more caution, reducing the risk of long-term issues.
Merril Hoge is an odd emissary for the message that football’s concussion risk has been exaggerated. Hoge, a bull-necked former running back for the Chicago Bears, saw his NFL career end because of the injury, and later sued the team doctor for allegedly mishandling his care.
But Hoge, who went on to a 21-year career as an ESPN analyst, has just written a book whose title sums up his contrarian take: “Brainwashed: The Bad Science Behind CTE and the Plot to Destroy Football.”
Hoge and a contributor, Boston University neuropathologist Dr. Peter Cummings, argue that some scientists have linked football and CTE, the dementialike disease formally known as chronic traumatic encephalopathy, without proper evidence. They also fault journalists for repeating the findings without acknowledging the limitations of the science.
In a recent interview with the Tribune, Hoge, 53, said he separates his personal experience from his conviction that CTE is overhyped and has no proven connection to football.
“The science community is screaming … ‘We don’t know what causes it, and we don’t know what it causes,’ ” he said. “But when you see a headline, that is not what you see. … That is what drove me to write the book — the truth of the science versus what you see in the headlines.”
Hoge spent seven seasons with the Pittsburgh Steelers before joining the Bears as a free agent in 1994. He suffered one concussion in a preseason game after colliding with Kansas City Chiefs defensive end Derrick Thomas, and just over a month later got a second in a game against the Buffalo Bills.
That concussion was so severe that Hoge blacked out and briefly went into cardiac arrest, he says. His memory and cognition were so dysfunctional after the blow that a doctor refused to clear him to play, forcing him into retirement.
His post-concussion symptoms, which included depression and “brain fog,” lingered for two years. He describes having to tape notes to the bottom of a television camera so he could keep his thoughts in order while working for ESPN.
But Hoge views those problems as a sign that his treatment was bungled, not that football is inherently dangerous. He sued the Bears’ team physician, saying the doctor had not conducted a proper examination before allowing him to resume play after the preseason concussion (he won a $1.5 million judgment, but says he ultimately settled for $500,000).
Hoge said teams at every level now treat concussions with far more caution, reducing the risk of long-term issues. When it comes to CTE, which has been diagnosed in more than 200 former players, Hoge and Cummings are skeptics.
“Right now, all you can really say about the pathology people are calling CTE is that it’s a staining pattern from this protein, tau, in the brain,” Cummings said. “We have no idea how it gets there, why it gets there and we have no idea what symptoms, if any, it produces in people.”
The two take particular aim at researchers from Boston University’s CTE Center who have found the disease in the brains of many high-profile players. In one paper issued last year, the center diagnosed CTE in 99 percent of the brains they received from deceased former NFL players, and in 91 percent of those from ex-college players.
The paper noted that the finding can’t be extended to all football players, given that the brains might have come only from people who showed signs of neurological problems. But Hoge says that caveat was lost in the media coverage.
“That’s a little like walking into an Alzheimer’s disease brain bank, testing the brains for Alzheimer’s, and then saying, ‘99 percent have Alzheimer’s!’ ” he writes in the book. “That tells you nothing about the cause or the risk of me or you getting Alzheimer’s if we play football.”
A spokeswoman for the CTE Center said the researchers were unavailable for interviews. But experts outside the center, including those at the Centers for Disease Control and Prevention, the Mayo Clinic and numerous universities, agree with the same premise — that the leading culprit behind CTE appears to be repetitive head trauma.
“It has thus far only been reported in people who’ve received hundreds or thousands of blows to the head,” said Dr. Julian Bailes, director of neurosurgery and co-director of NorthShore University HealthSystem Neurological Institute. “It’s certainly associated with that, with the provision that there’s a lot that hasn’t come together to complete the picture.”
Still, Bailes said Hoge’s book “adds to the discourse” — he even contributed a blurb — and is a helpful reminder that there are multiple viewpoints on CTE.
Critics point to one study “Brainwashed” doesn’t mention: a 2015 paper from the Mayo Clinic comparing people who played contact sports and people who didn’t.
Using brain samples from subjects who suffered neurodegenerative disorders before death, researchers found CTE in about a third of people who participated in contact sports, particularly football. They didn’t find it at all in the brains of nonathletes.
Cummings said the study was flawed for two reasons: It relied on obituaries to confirm a subject’s sports history, possibly missing ex-athletes whose participation wasn’t noted; and it used brain samples of different thicknesses to make preliminary and final judgments on who had CTE.
“If you talk to any neuropathologist, they will say that using that a (thicker) section creates … a real high risk of false positive staining,” Cummings said.
But the researcher who led the study, Kevin Bieniek, disputed those critiques. He said relying on obituaries was meant to avoid “recall bias,” in which family members inaccurately remember details of a person’s life. And the thicker brain slices were used only to confirm CTE cases the Mayo Clinic had already diagnosed.
Bieniek did agree, though, that football should not be viewed as the sole risk factor for CTE. He said it has been found in people who participated in other rough sports, in members of the military, and even in people who were the victims of repeated domestic violence. “It doesn’t necessarily matter how (the head trauma) is being sustained,” he said.
Nonetheless, Hoge says football unfairly gets most of the blame for CTE, even though its rules, customs and equipment have evolved to minimize the number and severity of head impacts.
The game is safer now than it has ever been, he said, but that has gone unappreciated by those who have attempted to curb the sport, including Illinois legislators who earlier this year tried unsuccessfully to impose a ban on tackle football for kids younger than 12.
“There are just some kids that are born and love to play football,” Hoge said. “And not just boys — girls too. Why rob them of that opportunity when there is no scientific evidence whatsoever that says they are going to be harmed by playing a contact sport?”
Merril Hoge testifies in 2009 before the House Judiciary Committee about brain injuries in football.