How multiple research groups and the NFL battled over Junior Seau’s brain to lead the science of concussions.
Outside the Lines: Mind Control - ESPN ESPNOTL Outside the Lines: Mind Control By Steve Fainaru and Mark Fainaru-Wada ESPN: Home | OTL Recommend0 Tweet0 Comments0Email Print Mind Control How multiple research groups and the NFL battled over Junior Seau's brain to lead the science of concussions. Outside the Lines by Steve Fainaru & Mark Fainaru-WadaILLUSTRATION BY ROBERTO PARADA 04/29/13 SAN DIEGO -- Inside the autopsy room of the San Diego County medical examiner's office, Bennet Omalu, a forensic pathologist, carefully sliced Junior Seau's brain with a long knife. It was late morning on May 3, 2012; Seau's autopsy, which began just after 9, was nearly over. Omalu wore dark blue scrubs, rubber gloves and a clear plastic face mask as he went about his work in the cool, windowless room, picking up half of Seau's brain and placing it in a small tub filled with formaldehyde and water. Omalu, 44, was the first researcher to identify brain damage in a former NFL player. When he published his results, in July 2005, the NFL attacked him and insisted he was wrong. His research has since been vindicated many times over, with each new discovery of the crippling neurodegenerative disease in a dead football player. Omalu arrived at Seau's autopsy with a special "brain briefcase" he carries on such occasions. His intention was to fly Seau's brain back to San Francisco that night and share it with a Nobel Prize-winning researcher who also coveted the valuable specimen. Just then, the medical examiner's chaplain, Joe Davis, walked into the room. "Houston, we have a problem," Davis said. Seau's son Tyler had just called, Davis told Omalu and Craig Nelson, the deputy medical examiner. REPORTING PARTNERSHIP ESPN reporters Mark Fainaru-Wada and Steve Fainaru are writing a book about football and brain injuries, scheduled to be published in 2013 by Crown Archetype, a division of Random House. PBS' "Frontline," in partnership with ESPN's "Outside the Lines," is producing a documentary based on the reporters' research. This article is a product of these partnerships. STORIES BU researchers consulted with law firms » CTE found in living players » NFL reports remain inconsistent » New cases of CTE in football players » Mixed messages on brain injuries » The Mike Webster disability case » "I talked to the NFL," Tyler Seau, then 22, told the chaplain. The league, he said, informed him that Omalu's "research is bad and his ethics are bad." Tyler was in a rage. Omalu "is not to be in the same f---ing room as my dad!" he screamed. "He's not to f---ing touch my dad! He's not to have anything to do with my dad!" Omalu left and returned home, his brain briefcase empty. From that point on, the NFL played a powerful role in determining what happened to Junior Seau's brain -- who studied it and where. In the hours, days and weeks after Seau shot himself in the chest with a .357 Magnum revolver -- the shocking end to the life of one of the most admired players in history -- the league muscled aside independent researchers, ignored a previous commitment to Boston University and directed Seau's brain to the National Institutes of Health -- four months before the NFL donated $30 million to that institution for concussion and other research. The NFL's intervention in the fate of Seau's brain -- the most prized specimen yet in the race to document the relationship between football and brain damage -- was part of an aggressive strategy to dictate who leads the science of concussions. By shunting aside Omalu, whose discovery sparked the concussion crisis; Boston University researchers, the leading experts on football and brain damage; a Nobel laureate; and other suitors, the league directed Seau's brain away from scientists who have driven the national debate about the risks of playing football -- the central issue to the NFL's future. ENLARGE Still stunned about his father's death, Tyler Seau almost immediately began fielding a barrage of requests from researchers interested in studying his father's brain. ESPN "Outside the Lines" and "Frontline" pieced together the odyssey of Seau's brain from interviews, documents and private emails. What emerges is essentially a scientific backroom brawl in which the NFL prevailed over a half-dozen researchers vying for Seau's brain. To the league and the Seau family -- and even some of the losers -- this was the best possible outcome. The NFL ended an ugly free-for-all that brought added pain to Seau's relatives, who received unsolicited calls from brain researchers, including Omalu, within hours of his death. With researchers unwilling to share tissue and bad-mouthing one another to Seau's family, the intervention by league representatives led to a blind study by one of the most respected research institutions in the country. Five specialists consulted by the NIH found what Omalu himself suspected: Seau suffered from chronic traumatic encephalopathy, or CTE, the disease found in dozens of former players. "Obviously, the NFL wants to be real careful as to not look as though they were inserting themselves in the middle of this, where they're trying to cover something up," said Kevin Guskiewicz, one of three members of the NFL's Head, Neck and Spine Committee who helped steer Seau's brain to the NIH. "I can assure you that is not the case right now." MIND CONTROL VIDEOS Outside The Lines Jeremy Schaap on Seau's life DOCUMENTS NIH statement on Seau's CTE The NIH pathology report ESPN THE MAGAZINE Seau's life, in photos But there's a déjà vu quality to the NFL's recent strategy. A federal lawsuit filed against the league by more than 4,000 retired players and their families (including Seau's) revolves around the NFL's previous scientific exploration. The players charge that the league's original concussion committee, which was disbanded in 2009, conducted fraudulent research to hide the connection between football and brain damage. That 15 years of research has been largely discarded, even by the league. When Mitchel Berger, chairman of the department of neurological surgery at the University of California San Francisco, joined the NFL's new concussion committee in 2010, he and his colleagues "essentially started from zero," Berger said. Faced with the threat of the lawsuit and mounting concerns about the long-term health effects of the sport, the NFL is again using its vast resources to insert itself in the science of head trauma. "I guess the National Institute of Health is now involved; I guess they somehow got drafted by the NFL," said Bob Fitzsimmons, a Wheeling, W.Va., lawyer who represented Mike Webster, the first NFL player diagnosed with CTE, and co-founded the nonprofit Brain Injury Research Institute with Omalu and Dr. Julian Bailes, a prominent neurosurgeon. "They had an early draft, I think, and they drafted the NIH and paid them pretty good salary, too, from what I hear." The NFL also recently announced a $60 million research partnership with General Electric and Under Armour, and is working with the U.S. Army on concussion initiatives. An NFL spokesman, Greg Aiello, said members of the Head, Neck and Spine Committee work independently and the league played no role in directing Seau's brain to the NIH. Guskiewicz said he acted on his own as a research scientist and not under the direction of the league. The NFL Head, Neck and Spine Committee is funded by the NFL, reports to the commissioner and filters communication through the NFL's media office, which sometimes monitors interviews and correspondence with committee members. None of the committee members is paid by the league, but they submit expenses through the league office. According to Dr. Rich Ellenbogen, the committee's co-chairman, NFL Commissioner Roger Goodell sought guidance from the committee as far back as 2010 about where to direct the league's resources. The NIH was recommended. At the same time, Ellenbogen and other committee members discussed employing the NIH as a scientific clearinghouse for research into football and brain damage. Seau's death became a catalyst for turning the NFL's vision into reality. Several research groups competed to study Junior Seau's brain after he died. Did the NFL help pick the winner? IN THE FINAL months of his life, Seau had become unrecognizable to those closest to him. He rarely saw his four children and frequently disappeared on partying and gambling binges, spending tens of thousands of dollars at a time. His erratic moods, inattentiveness and inexplicable bursts of anger had caused his most trusted confidante, Bette Hoffman, the head of his charitable foundation whom Seau called "Mom," to quit and change her phone number to avoid his calls. In San Diego, Seau was still beloved as a great athlete and local ambassador who raised millions of dollars for disadvantaged kids through the Junior Seau Foundation. His smile and charisma, which lit up the entire city, seemed undiminished. But to those who loved him, he was obviously in trouble; many now believe his car crash off a cliff in 2010 was a suicide attempt. ENLARGE As word spread that Seau's girlfriend had found him shot in the chest, Seau's extended Samoan family, friends, neighbors and San Diego Chargers fans descended on the house. Reuters/Mike Blake As word spread on May 2 that Seau's girlfriend had found him shot in the chest on a queen-sized bed at his beachfront home in Oceanside, Calif., Seau's extended Samoan family, friends, neighbors and San Diego Chargers fans descended on the house. Nelson, the deputy medical examiner, arrived at 11:46 a.m. A medical examiner investigator's report described the scene: "There was bedding lying on the floor on the left side of the bed as I faced it. On top of the bed were pillows stained with blood. The fitted sheet on the bed was blood stained. A gray stocking cap and a Smith & Wesson Model 19-5 .357 magnum revolver … lay on its left side with five live rounds in the cylinder and one spent round near the right-sided head of the bed as I faced it, and next to a pillow." Seau was placed on a gurney in a body bag and brought down to the garage. Only his head was exposed. The house was warm and filled with police, medical personnel and family, and decorated with Seau's trophies and memorabilia: his Chargers MVP trophy, game photos, a New England Patriots helmet signed by the team. The crowd outside had swelled to some 400 people. Seau's family opened the garage for a spontaneous public viewing. One by one, for nearly an hour, the tearful crowd filed past; some bent over to kiss Seau's forehead or cheek. "It was a pretty intense moment," one witness said. "I looked down and I was like, 'Man, that's Junior Seau.' There's nobody that looks like him. It really affected me, the enormity of it." As Tyler Seau looked down, he felt pain and regret. Like the rest of his siblings, he had been fighting for his father's attention, dealing with the absences and volcanic bursts of anger. "I guess the hardest thing was just there was just no closure," he said, crying softly during an interview. When the viewing ended, Seau's body was taken away. Tyler was still at the house when his cellphone rang. At first it was difficult to hear; reception at the beach house was spotty. But soon he could make out the thickly accented voice. It was Bennet Omalu, introducing himself and expressing his condolences. He had a request. Dr. Bennet Omalu, chief medical examiner in San Joaquin County, Calif. ESPN OMALU WAS A 36-year-old junior pathologist at the Allegheny County Coroner's Office in Pittsburgh when he identified Webster, the Hall of Fame Steelers center, with CTE. That discovery forever changed how people look at football and continues to haunt the NFL. Omalu is now chief medical examiner in San Joaquin County, Calif. But in many ways, he is still a foreigner, especially in the closed world of concussion research, which is dominated by older, white men. A devout Catholic and native of Nigeria's Igbo tribe, he blends science and mysticism and is prone to hyperbole and indiscretion. Omalu believes he can communicate with the spirits of the people he autopsies. In 2009, he displayed photos of Webster lying on the autopsy table during a meeting of the NFL Players Association in Palm Beach, Fla., stunning many of the players, scientists and widows in attendance. No one has been able to discredit Omalu's research, however. When Bailes, the neurosurgeon who helped found the Brain Injury Research Institute with Omalu and Fitzsimmons, heard that Seau had killed himself, he phoned Omalu immediately. "Please it is vital you get to the Seau family. I think they will give you/us the brain if you directly speak to them and play the nobel price (sic) card :)"- Dr. Bennet Omalu to Stanley Prusiner "We need to secure this brain," said Bailes, the co-director of NorthShore Neurological Institute in Evanston, Ill. To many, Seau's brain was the premier specimen in concussion research. At stake were research dollars and the prestige of diagnosing Seau, who was 43 at the time of his death and the most significant player thrust into the NFL's concussion crisis. Seau was a certain Hall of Famer who spent 20 years in the NFL. He combined strength and speed to become one of the game's most physical players. The fact that he never had a diagnosed concussion raised more questions for the NFL and scientists seeking to study his brain. Omalu and Bailes called Tyler Seau together. "We introduced ourselves, explained what we were doing, about CTE, that we would like him to grant us consent to examine his father's brain," Omalu said. He described Tyler as "very polite" and receptive during the call. But Tyler said he felt pressured by Omalu. "He was very pushy and he really wanted me to make a decision that night. He pretty much said that we have to do it now because if it's not done the right way we could lose a lot of the tissue and things like that." Omalu faxed Tyler a consent form to harvest his father's brain. Emails obtained by "Outside the Lines" and "Frontline" show that Tyler initially was prepared to sign. At 8:38 that night, he informed Omalu: "my guy is on his way here right now so I can sign it and fax it back to you." An hour later, Tyler wrote that Omalu needed to talk to David Chao, the San Diego Chargers doctor, to "cross our Ts and dot our Is before proceeding." Tyler said he called Chao for advice because "he was my dad's team doctor 13 years. They were pretty close." Chao has come under criticism in and out of the medical community for issues unrelated to Seau's care. DeMaurice Smith, the executive director of the NFL Players Association, called for Chao to be replaced as team doctor over allegations of malpractice and negligence. Earlier this year, a panel of independent doctors established under the collective bargaining agreement exonerated Chao. ENLARGE Tyler Seau reached out to San Diego Chargers team doctor David Chao, right, before signing the consent form to allow Omalu to take Junior Seau's brain. Chao talked Tyler out of signing the form. Kirby Lee/USA TODAY Sports The night of Seau's death, Omalu spoke with Chao. "That was one of the most arrogant phone calls I've ever been involved with in my life," Omalu said. "This guy was yelling, was extremely arrogant, pretty much questioning who I was." Chao declined to comment for this story. After emailing samples of his research to Chao, Omalu still believed he had "verbal consent" from Tyler to take Seau's brain. He packed for the flight from San Francisco to San Diego the following morning to do just that. By the time Nelson, the deputy medical examiner, returned from Seau's home, a half-dozen phone messages were waiting for him from researchers hoping to study the brain. One of the researchers in pursuit, emails show, was Stanley Prusiner, winner of the 1997 Nobel Prize in Physiology or Medicine. Prusiner, a 70-year-old neurologist who is director of the Institute for Neurodegenerative Diseases at the University of California San Francisco, won the award for his discovery of prions -- a class of proteins that cause brain disease. Prusiner joined Omalu in what became a tag-team approach to securing Seau's brain. Shortly after Seau's death, Prusiner, according to emails and interviews, placed calls to Davis, the chaplain at the medical examiner's office, to try to arrange a meeting with the Seau family. Prusiner's assistant also called and emailed Tyler Seau. "Please it is vital you get to the Seau family," Omalu wrote Prusiner. "I think they will give you/us the brain if you directly speak to them and play the nobel price (sic) card :)" Prusiner responded by email 12 minutes later that he planned to fly to San Diego to try to meet with the Seau family. But others, too, had begun to make bids for the specimen. The day after Seau's death, Boston University's Center for the Study of Traumatic Encephalopathy reached out to representatives of the family. Chris Nowinski, a 34-year-old former professional wrestler and concussion activist, had once worked with Omalu. When the two split acrimoniously, Nowinski merged his own group, the Sports Legacy Institute, with BU. Working with another pathologist, Dr. Ann McKee, the Boston group had diagnosed more CTE cases than any other researchers in the world. In 2010, the NFL gave Boston University $1 million, designated the center as the "preferred" brain bank of the NFL and pledged to encourage retired players to donate their brains and participate in the center's research. The open-ended agreement, signed by Jeff Pash, the NFL's general counsel and No. 2 executive, was framed on the wall of the Boston center's main office. The agreement came with no strings attached, but some researchers questioned whether Boston University had sacrificed its independence by taking money from the NFL. As Omalu made his case to Tyler Seau, he pointed out that his group didn't take a dime from the league. ENLARGE Chris Nowinski of Boston University marketed his institution to the Seaus as the NFL's officially sanctioned brain bank. AP Photo/Paul Sancya Nowinski, Boston University's brain chaser, contacted Chao, who was representing Seau's family. "The pitch is usually, 'We'd like to talk,'" Nowinski said. "We don't want people to make the ask for us." Before long, though, "there were multiple people calling" on BU's behalf, Nowinski acknowledged. "People who supported us, who had a relationship with them." The BU group touted itself to the Seaus as the NFL's officially sanctioned brain bank. The morning after Seau's death, at 5:55 a.m., Sports Illustrated NFL writer Peter King tweeted: "Dedicated researchers in Boston studying deceased players' brains for evidence of trauma attempting to obtain Junior Seau's. Hope they do." King's tweet quickly became a national news story that appeared on NFL.com, ESPN.com and other websites. Seau's family was outraged. "I think that put added pressure on the Seau family," Nowinski said. "We heard back from Dr. Chao that they were upset that they were put under that pressure." Nowinski and others at Boston University urged King to retract the tweet and apologize to the Seaus. Nowinski said the tweet was premature and was based on an earlier conversation in which he told King that BU sought all brains of deceased athletes involved in contact sports. But King, in fact, had confirmed BU's interest in Seau's brain. He refused to apologize or make a retraction. "I empathize with them and know how badly they wanted to see Seau's brain," King said in an interview. "I was sorry it put them in an awkward situation, because I believe in what they do." King issued another tweet at 11:13 a.m.: "To clarify researchers seeking Seau's brain: Info not from them. They seek to examine all ex-players who played contact sports. Every one." In some ways, the tension was understandable. If Seau's brain was to be studied, it had to be preserved. … truncated (14,418 more characters in archive)