League of Denial: The NFL, Concussions and the Battle for Truth

by Mark Fainaru-Wada, Steve Fainaru

“PROFESSIONAL FOOTBALL PLAYERS DO NOT SUSTAIN FREQUENT REPETITIVE BLOWS TO THE BRAIN ON A REGULAR BASIS.”
So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new A chronic brain disease that was driving an alarming number of players -- including some of the all-time greats -- to madness.
League of Denial reveals how the NFL, over a period of nearly two decades, sought to cover up and deny mounting evidence of the connection between football and brain damage.
Comprehensively, and for the first time, award-winning ESPN investigative reporters Mark Fainaru-Wada and Steve Fainaru tell the story of a public health crisis that emerged from the playing fields of our 21st century pastime. Everyone knew that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know – and what the league sought to shield from them – is that no amount of padding could protect the human brain from the force generated by modern football; that the very essence of the game could be exposing these players to brain damage.
In a fast-paced narrative that moves between the NFL trenches, America’s research labs and the boardrooms where the NFL went to war against science, League of Denial examines how the league used its power and resources to attack independent scientists and elevate its own flawed research -- a campaign with echoes of Big Tobacco’s fight to deny the connection between smoking and lung cancer. It chronicles the tragic fates of players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives; and former Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents and private emails, this is the story of what the NFL knew and when it knew it – questions at the heart of crisis that threatens football, from the highest levels all the way down to Pop Warner.

Genres: Sports, Nonfiction, Science, Football, Audiobook, Medicine, History

399 pages, Hardcover

First published January 1, 2013

Reviews

[David · Rating 5 out of 5]

Everybody sucks. Everybody in this book just sucks. The NFL sucks. The NFL got stuck in their little damn castle, deny-deny-deny, and even when all their own doctors told them that some of their players had severe brain damage, and they finally loosen up their tight-ass wallets to give some money to the families, even then just deny deny nope no concussion problem in our league deny deny yep we are funding a helmet designed to reduce concussions (which every not-employed-by-the-NFL scientist says is a flawed pipe dream, BTW) but there's no concussion problem so if your son got knocked silly in a high school game that's not our problem deny deny deny. And then the people who study the brains...these assholes. Step all over themselves to prove the NFL wrong, and who cares who's toes you step on. Show Autopsy Photos of the players who's brains showed the damage? Heck yeah. (And I'm not talking the slides of the damaged brain. I'm talking photos of the deceased players, mid-autopsy, and the doctor doesn't even get why people were creeped out) Act like the worst ambulance-chasing nightmares to the families who just had a loved one die in order to make sure they secure the brain before some other research group can? Check and check. Eventually sell out to work for the company you've spent most of your career trying to convince people is harming their employees without admission or remorse? You know they did.

I know, I sound a little bitter and crazed. I get it. Look, I love football. Love it. And I've stepped over many an inconvenient fact in order to protect that love. But there has been a firestorm over the last two decades, building over the horizon, and at some point, I either have to admit that the city is burning down around me, or go down in the ashes. Every week, another report comes out that makes one question his/her fanhood. Another player knocks out his girlfriend or wife. Another player sexually assaults somebody, or beats his kids, and doesn't understand why he can't suit up on Sunday, because he's spent most of his adult life being told that because he can play a game better than 99.9% of us, he's more important. I grew up on this sport. When I was young, Sundays were about going to Grandma's for a big lunch, followed by all of us sitting around a screen to watch whatever game was on. And now...I don't hate football. I don't know that I ever could. But I do not like how it makes me feel. I do not like some of the athletes who play this sport, and how they are sheltered until they finally cross the line where people say, "Well, we can't ignore that, can we?". I hate that the small percentage of those a-holes completely overshadow the mostly decent majority of the league. And I hate that this game has become so fast, and so hard, that it is ruining player's lives, and demolishing livelihoods, and the League will not admit that it is happening despite all evidence, and will not take some of the ungodly amount of money we so easily hand over, in order to provide basic benefits to the retired players who built the empire that they sit on so high to look down on everybody. (And I'm not just talking about concussions....think about how many players need knee replacements, or have sever back or joint issues, especially from the older players who played before their salaries went to a ridiculous stratosphere) Football, right now, is not fun to watch. It's not fun to think about. It's one bad story after another, and over the last few years, I can not watch without wondering why I do pay so much attention.

And I will pay attention. Probably for the rest of my life. That's the part that makes me feel so conflicted. I think about taking the high road, let football go, but then the game's on, and.....yeah. I really do love this game. That's why I was so angry reading this book, because LoD is meticulously written, and takes a long look at everybody involved with the Concussion scandals, and it was thorough and effective. And ultimately, there is nobody that comes out well. None of the problems get solved, and nobody is really clean. And players are still getting obscene amounts of money to possibly (probably) destroy their post-football lives. And come September, I will be sitting in front of the screen, watching again. I will be trying to capture an old feeling. Don't think less of me for it.

[Kirk · Rating 5 out of 5]

I'm going to start with an anecdote that isn't in this book. Last year my local MLB team, the Oakland A's, drafted Kyler Murray, a two-sport college star. It was a risk, because his other sport was (American) football, he was sure to also be drafted by the NFL, and if he chose the latter, the A's would get nothing for their trouble. The rare college athlete to be in this position usually chooses football, for one obvious reason: big money, right away. In baseball, you first endure a few seasons in the minor leagues, where the pay compares unfavorably to an entry-level job at McDonald's. And young male sports stars not much over 20 aren't usually big on delayed gratification. So the A's rolled the dice--and ultimately lost, when Murray chose football. But in the months before he made his decision, I read an article that quoted an A's official who, while acknowledging the obvious reasons they might lose out, added, "on the other hand, he might want to remember his own name when he's 50." It was just an offhand remark, but it stuck with me. Right now the NFL is like people who deny global warming. It's the most popular American sport by far, it makes billions, in any recent calendar year most of the highest rated TV programs for the year are individual NFL games (8 out of the 10 highest ratings is not uncommon). So football isn't going away anytime soon, but a clock is now ticking. If you want a comparison, look at boxing. As recently as the '70s it was a huge sport with giants like Ali, Frazier, Foreman, Norton, written about extensively, pay-per-view telecasts raked in money. Now? It's on the fringes, sportswriters mostly ignore it, and most people couldn't name more than two or three current boxers (if that) if you paid them.

Concussions, greed, ruthless indifference, lies, are what this book documents. It starts with the saga of Mike Webster, a center for the Pittsburgh Steelers, a legend and Hall of Famer, whose life post-football became a nightmare of headaches, depression, memory loss, constant physical pain, a completely altered personality (mood swings, flying into a rage at a moment's notice), and severe cognitive decline. He lost his marriage, his home, his dignity, ended up frequently homeless or living in his truck, and finally died of a heart attack at 50. A young Nigerian pathologist, Bennet Omalu, happened to be assigned his autopsy, He was possibly the only sentient adult in the Pittsburgh area who could utter the sentence, "Who is Mike Webster?" Omalu had never watched a football game in his life. His colleagues told him, and Omalu remembered seeing some reports on TV about some local sports hero's sad decline. He also noted that the death certificate mentioned "post-concussion syndrome", though the cause of death was a heart attack. After a moment's pause, Omalu made the unusual decision to "fix the brain" (soak it in formaldehyde) for further study. No one knew it at the time, but this was a critical moment in the history of the NFL, and in Omalu's life.

Omalu diagnosed C.T.E. (Chronic Traumatic Encephalopathy) in Mike Webster's brain, not a new disease, but never before associated with pro football, and usually only found in much older people. Eventually he found the same in several more deceased football players, and would eventually write an article for a medical journal about his findings. In the beginning he thought his discovery would be welcomed, and the NFL would value the information and move to make football safer, or at the least make the players more informed of the risks. Well, no. Think tobacco executives and cancer. The NFL waged a sustained campaign of denial, misinformation, deflection, and attacked Omalu specifically. They formed a committee, the Mild Traumatic Brain Injury Committee, which was largely made up of doctors who were not neurologists, were employed by NFL teams, and which was headed by, wait for it, a rheumatologist. This committee submitted papers on their "research" to a medical journal called Neurosurgery; this particular medical journal's editor in chief happened to be a consultant for an NFL team. The results were what you would expect. They essentially asserted than brain damage was something that just didn't happen to football players, and that there were too many unknowns about concussions to draw any real conclusions. Again, substitute the words 'cancer' and 'cigarettes' for the words 'brain damage' and 'concussions' and you might recognize the playbook.

There's so much more in this book I could get into. There are many, many players on the medical side, some as intrepid in taking on the NFL as Omalu. (It isn't a case of just one man making a discovery; several others were looking into issues re: concussions in football at the same time.) Many of these would team up. Others were quite simply bootlickers for the NFL who willingly put any integrity in their profession aside in favor of rubber stamping the NFL's denials. And others are somewhere in between. In particular, Joe Maroon, Mark Lovell, and Kevin Guskiewicz are baffling figures who don't fit into the slot of hero or villain; they start out as some of the original dissenters from NFL orthodoxy, but over time get co-opted by accepting positions on NFL committees to study the issue and gradually come to be seen as parroting the NFL line; they are a cautionary tale of power and access corrupting. But for many readers, myself included, Omalu will be the one you root for the most, the immigrant who stumbled on a seismic discovery and got steamrolled for it. He isn't a saint, he can be too flamboyant and unfiltered for his own good, but the attacks on him will enrage you. And the rivalries between different groups of neurologists, who are essentially on the same side but let ego and ambition lead them to work against each other, will depress you. But this is a tremendous, fascinating medical story, assuredly told by the authors, journalists Mark Fainaru-Wada and Steve Fainaru.

The nature of NFL players is another factor in the story. They play, and love, a violent game, and their nature is not to complain about injury, stemming from both a macho mindset and the reality that if they can't suit up, they can be easily replaced. The attitude is encapsulated by Gary Plummer, a linebacker for the SF 49ers:

I had been playing football since I was eight years old, and there is nothing more revered in football than being a tough guy. I prided myself on being a tough guy. I encouraged others to be tough guys. I did some horrendously stupid things in my career--like having surgery on Tuesday and playing on Sunday twice. I would never give you specific names, but there are hundreds of guys who had more talent in one hand than I had in my entire body, but because they weren't tough, they couldn't play in the NFL. The coaches have euphemisms. They'll say, 'You know, that guy has to learn the difference between pain and injury.' Or: 'He has to learn the difference between college and professional football.' What he's saying is the guy's a pussy and he needs to get tough or he's not going to be on the team. It's a very, very clear message and literally hundreds of guys that I played with were just pussies.

The authors tell the post-career stories of many players, and the sameness to Webster's is alarming and depressing. Pain, depression, memory loss, cognitive issues, divorce, financial problems, early death. Often by suicide, and here's a thing: it became almost a pattern that players who fell into this hellscape would kill themselves with a gunshot to the chest. Sparing the brain, and sometimes with instructions for their brain to be donated for study. Meanwhile, the NFL would embrace holy grails like developing a helmet that would prevent concussions, ignoring the neurologists who told them, correctly, that this couldn't be done. One of the more tragic stories is that of Dave Duerson, a Chicago Bears defensive back who, when other players and doctors testified to Congress about concussions, also testified but in defense of the NFL, asserting ludicrously that since his dad had Alzheimers but never played football, that meant that concussions didn't cause brain damage. Duerson's post-football life fell apart in the familiar way, ending with his suicide by gunshot to the chest, and a note pleading to donate his brain for study. It was. It had C.T.E. Later it's mentioned that Duerson had a radio show, and that he did a show where he ranted for an hour against the NFL instituting new rules in an effort to make the game safer, railing that they were 'sissifying' the game. This was years after his own symptoms had caused his life to fall apart. Something struck me about the date of the radio show. I flipped back several pages to check again the date of his death. Duerson committed suicide just four months after doing that radio show.

There's a telling conversation in the book when Omalu and several colleagues convince Joe Maroon, an original dissenter but now on the MTBI Committee and towing the NFL's line, to look at slides under a microscope that show C.T.E. in an autopsied brain:

Maroon: "Where do you think this is going?"
Omalu: "To be honest, I don't know. But I think many, many more players have this disease than we have acknowledged."
Maroon: "Do you understand the impact of what you're doing?"
Omalu: "Yes."
Maroon: "Do you really understand the impact of what you're doing?"
Omalu: "Yes."
Maroon, a few minutes later: "Bennet, do you really understand the impact of what you're doing?"
Omalu: "Okay, what is the impact?"
Maroon tilted his head back. "If only 10 percent of mothers in America begin to conceive of football as a dangerous game, that is the end of football."

[Chris · Rating 5 out of 5]

Originally published here.

So here goes: my favorite sport is barbaric; it is destroying its players brains; Its prime pro league is doing everything it can to champion wealth above health; it may not be fixable.

The crux of League of Denial is that an increasing amount of dead football players appear to have brains riddled with chronic traumatic encephalopathy (CTE), a degenerative brain disease. An unfortunate amount of those deaths were self inflicted or premature, due to the disease. Worse, it does not seem that CTE is linked to one big hit, but to repeated small-medium-large hits and improper diagnoses or insufficient recovery times leading to players returning to the field before they are healed. Worse still, due to the huge amount of money on the line and the hyped up over-the-top machismo of football culture that demands a man be able to take a hit or give one (lest he take an unassailable hit to his manhood), the players falsely report their symptoms as much as possible and clamber to get back into the game.

This would be bad enough, especially the notion that it is merely repeated hits as the cause, an unerring staple of the sport, that is leading to broken brains. But on top of all this, the NFL, in a modern day bid to mimic Big Tobacco, is refusing to admit that football causes brain damage. They have been discrediting legitimate scientists, publishing propaganda, buying out dissenters, burying evidence, and propping up false science committees with silly names (the mild traumatic brain injury committee) for decades. Their efforts have had cascading effects; skewed studies have led to equipment manufacturers scamming high schools with “concussion-lessening” helmets that do not change a thing. The players recently settled a 765 million dollar suit with the NFL, which was tragic and foolhardy, because now we will never know just how much the NFL covered up.

SI.com has published an article written by Seahawk’s cornerback Richard Sherman where he proclaims that football is a dangerous sports but the players know the risks and he complains about newer rules like not being allowed to hit a defenseless receiver. It’s sadly ironic because shortly before he shot himself in the chest (to preserve his brain for study), Bear’s great Dave Duers was on his radio show railing against the same rules, whining about the “wussification” of the NFL. Prior to ending his life, Duers typed out a treatise explaining the dementia and madness he felt in his later years, where he was described as a “different man” by friends and family. His deathnote / final text messages urged his ex-wife and fiancee to donate his brain to the NFL for study. On top of that, Sherman (and everyone else) does not know the true risks of football because the NFL still refuses to admit to brain damage and study.

Brain damage is horrifying, regardless of its source. You would be right to condemn a man who shoves his wife, who explodes into inexplicable fits of paranoid rage at the drop of a hat. Yet how do we account for it, how do we address it when these are sudden changes in middle age, when there is a very high chance they are a result of brain damage due to playing football? These aren’t outsiders, they’re endemic. Of fifty four brains of players that neuropathologist Anne McKee has studied, fifty two had signs of CTE.

I love football. A great game is intoxicating. Acquaintances or people who have otherwise known my company only outside of football games express shock and bemusement at my change of tone, demeanor, and frenzied enthusiasm when first watching a game with me. The book goes at lengths to show that the vast majority of the dissenters, the people raising a stink about safety and combating the NFL, are like me. They love football too.

“The game was part of him, part of his American story. That’s the thing about football, why it’s different from cigarettes and coal dust and not wearing your seat belt and a whole range of other things that have been proved bad for us. We love football. Americans by the millions are complicit in making this sport what it has become, for better or worse. The outcome of the NFL’s concussion crisis will affect the country. But it will be determined not by the “enemies” or “opponents” of football but by those in love with the sport; the players, the fans, the advertisers, the book writers, the moms and dads and kids. Even the scientists.”

It’s true. Football props up entire communities in America — the sole recreation other than substance abuse to many economically depressed areas. It sits upon a pedestal with God and Church as the only escape to youth in some urban communities. And like the protagonists of Shirley Jackson’s The Lottery and Rajesh Parameswaran’s I am an Executioner, We the People, are responsible in part for the violence and brain obliterating nature of football. It exists as it does today because we willed (watch) it. And it will only survive if the fans push for safety and brain damage to be acknowledged and addressed. And that is hard. There is no simple fix like banning horse collar tackles or chop blocks. Even after reading League of Denial, I’m still pissed a few days after my Patriots lost to the Jets in OT due a stupid new rule. A stupid new rule amended to the rulebook to help player safety. What is wrong with me?

And not being able to push your fellow linemen on field goal attempts (the new rule) is hardly going to solve the concussion crisis. There will need to be more drastic changes, and the question is: can you maintain the essence of the sport with whatever needs to be taken out?

[Deacon Tom (Feeling Better) · Rating 4 out of 5]

This is an important book about an incredibly important subject that impacts America’s most popular sport.

The author gives an in-depth, sometimes, too technical, presentation that makes it very difficult to argue against it. Additionally, he thoroughly makes a case for the crookedness of the NFL leadership.

I enjoyed this book, but in a macabre way I hated this book because of what happened to the stars of my youth .

I recommend this very important book.

[Amanda · Rating 5 out of 5]

Unputdownable. I know that's not really a word, but that's what it is.

My boyfriend asked me to pick this up for him when I headed to the bookstore the other night, and I obliged. However, he reads one book at the time, while I am more likely to read a minimum of five, and he was still working on something else. Honestly, I didn't think the book would interest me. I'm not a football fan. I wasn't raised in an athletic household. He is a rabid fan, and I've just figured I might as well learn a few things about the game since it's always on our TV. But after I brought it home the other night, I started reading the intro out of curiosity. I figured it would be enough to tell me that I wasn't interested and would result in it being put down and waiting for him. False.

This book was well-written and intriguing. It seemed to have its ducks in a row. The story is both inevitable (I mean seriously... How could people have thought that 300 pound guys slamming their heads into each other wouldn't cause the same kinds of permanent damage that it was causing to their bodies?) and tragic. Players on every level and fans are passionate about the game. Nobody wants to think that it's killing them or that the organization running it at the top is falsifying research and looking out only for itself and its financial interests, but that is exactly what is happening.

Is it happening to everybody? Probably not to everyone, but it is happening at an alarming level. Is this the kind of life or fate that I would want for anybody that I cared about... or even my worst enemy for that matter? Absolutely not. Have my boyfriend's dream of raising a future Hall of Famer just been dashed? They sure have. I hope I don't ever have to tell my kids that I don't want them participating in something that they have their hearts set on, but I really and truly do not want my kids playing football, especially after reading this book.

[Bro_Pair أعرف · Rating 5 out of 5]

The book is terrific, and, surprisingly, scarier than the much-acclaimed PBS "Frontline" documentary the authors also made. Why scarier? Well, to be frank -- the doctors who come off as heroic in the documentary are a little more....human, here, for better or worse. I hate to be cynical - but the possibility that things are a little more complicated than a David versus Goliath story compels me. The NFL's money taints everything, including even the ostensible research of CTE - the one million dollars the NFL gifted to the BU brain bank, and their resident wheeler dealer Chris Nowinski, does not seem quite as innocent as it first seemed.

This book asks some hard questions which need to be repeatedly asked, again and again. We are far from the conclusion of this story, and it's going to be much dirtier and with fewer clean hands than Hollywood would have us believe.

[Noa Kossmann · Rating 5 out of 5]

This book took me a long while to read. Not because it’s boring but because it’s so much information that truly frustrates you. As someone who likes watching football, and is in healthcare and sees brain injuries (not all traumatic) on a daily basis, the NFL’s willingness to keep itself running is disgusting. I’ve never seen a corporation put so much effort into hiding the truth, even today! They talk about a training camp in 2011 where they have doctors saying nothing is indefinitely confirmed relating to CTE and recurrent concussions??? The stories about the players, their families, doctors, lawyers, all of them just have you heart broken. I could keep going but in short, the NFL is so corrupt and if you like brain injuries or football/sports you should DEFINITELY read this book!

[Liesl · Rating 3 out of 5]

I don't know if I can view or enjoy football to the same extent after finishing this book. I was already aware of the link that exists between this sport and brain damage, but reading in detail about how these players deteriorated so rapidly into madness was eye-opening and heartbreaking. Just about everyone involved in this ongoing investigation is awful. The doctors and scientists are doing valuable work, but are fractured over what amounts to petty grievances instead of forming a powerful united front, and their behavior over securing brains for study immediately after personal tragedy is appalling. The NFL comes out looking the worst, first by repeatedly denying the issue with concussions while sweeping it under the rug, and then by throwing money at the problem to make it go away without any sort of major public acknowledgement. Absolutely sickening. While my emotions certainly were stirred while reading, I can't say that the authors created a compelling narrative to follow; there is too little included about the science behind concussions in favor of covering the politics of everyone involved. I ended up having the same problem with this book as I did with The Big Burn: Teddy Roosevelt and the Fire that Saved America; both cover topics of interest to me, but the material is presented in too dry of a manner that caused my attention to diminish after a while.

[Kerry · Rating 5 out of 5]

Incredible reporting about one of the biggest issues in sports today -- head trauma and concussions. The authors, both investigative reporters for ESPN, put together a comprehensive, compelling and shocking narrative on the NFL's long denial that concussions suffered on the playing field can lead to chronic brain disease that has resulted in dementia and sometimes suicide by former professional football players. As recently as 2005, the NFL concluded in a scientific paper, "Professional football players do not sustain frequent repetitive blows to the brain on a regular basis." Anyone who has watched football in person or on TV knows this statement is absolutely ridiculous. The book chronicles the debilitating experiences of players such as Hall of Famer and Pittsburgh Steelers center Mike Webster, and former San Diego Chargers star Junior Seau, and many others. Exclusive interviews, previously unrevealed documents and private emails helped the authors lay the groundwork for this remarkable book that has convinced me of the real dangers of violent contact sports. I will never watch another NFL game, or football at any level, the same again.

[Michael · Rating 4 out of 5]

"If only 10 percent of mothers in America begin to conceive of football as dangerous, that is the end of football."

I do not get as passionate about sports as I used to. I still enjoy watching them, still feel a rush whenever the Giants or Yankees do something good. But that enthusiasm has changed over time. As I've gotten older, I've begun to feel a bit strange spending so much time and effort personally investing myself in the exploits of other people, particularly multimillionaires. I have a life of my own to live, you know. Why am I letting another Alex Rodriguez strikeout ruin my week?

A funny thing happens when you allow yourself to take a step back: you begin to experience an unsettling feeling that something is wrong here. Grown men (and women, too, but let's be real: mostly men) painting their bodies, destroying property, drinking to oblivion before and during games, all in the service of watching other people run around and play games.

Our attachment to sports teams (and their ever-changing rosters of players) is really quite absurd: Ever catch yourself referring to your favorite team as we? As in, "Can't wait until Sunday, we're going to wipe the floor with you." Or, "Our cheerleaders are hotter than yours?" At my alma mater, many of my fellow fans have apparently become honorary members of the team, because whenever we play our closest rivals, the games become ritualized tests of identity. (Never mind that had the other school accepted me, I would have happily chosen it over the school I now pledge my undying allegiance to.)

All of these things were in my mind as I read the Fainaru brothers' timely and devastating book League of Denial. We NFL fans face an existential crisis. How can we in good conscience continue to root so hard for a game that requires and rewards such physically brutal levels of play and exacts such crippling, life-long costs? A game that casts its image in wartime/military iconography and whose players and coaches treat it as a standard for manhood? (To say nothing about the recent Miami Dolphins imbroglio.)

Answer those questions, though, and you start to chip away at the all-consuming, identity-defining levels of fandom that have turned the NFL into a money-printing machine. It gets into issues of the whole reason football is so immensely popular in the first place. That we're a violent country that permits itself to vicariously take out our aggressions through these officially-sanctioned gladiator fights every Sunday. See the Raider fans in Oakland for a demonstration.

It seems self-evident that having 300-pound behemoths crash into each other dozens of times a day, year after year, probably defies human design, and yet, the NFL and its acolytes would have you believe any side effects are utterly benign. That the bone-crunching hits that for years were treated with reverence on highlight reels can be shaken off (otherwise, you're a pussy).

On the one hand, League of Denial is a standard "big corporation tries to muddy the truth with its own interpretation and damn the reputations of anyone who claims otherwise" book, one that always makes the corporation look completely tone-deaf and self-serving. It methodically lays out the prick-waving contest between the country's top neuroscientists and the lackeys put forth by the NFL (at least one of whom has no background whatsoever in neuroscience, despite the numerous "peer-reviewed" papers he had published). There's some he-said, she-said that pretty much shreds the NFL. If this is what you came for, you won't be disappointed.

But it's the book's implications that will stay with you. What this book convincingly argues is that the NFL's concussion problem is not something that can be fixed with a few rule changes and better equipment; it's a problem with the very DNA of the game. You cannot change the central problem -- furiously hitting your head against an object (i.e., another massive player) that is moving with equal or greater force -- without turning the game into something else entirely.

After watching the Frontline documentary last month, and now having read this book, I can't help but have serious misgivings about the whole enterprise, one that is so integral to the American experience that waiting for the game's popularity to run its course is a nonstarter.

So, paradoxes abound: I do not want the game to go away, and neither do most of the doctors profiled in this book (many of whom have worked for NFL teams) and yet I feel genuine unease every time I see a big hit. I am all for more stringent protections but I get frustrated with how "soft" the game has become. Just last week, a 49ers lineman hit Saints quarterback Drew Brees at a crucial part of the game and was penalized 15 yards, a hit that most NFL purists thought was good, hard-nosed football, but is now considered dangerous. In our efforts to protect quarterbacks (read: the NFL's most expensive commodities), are we not changing the essence of what football is meant to be?

These are the questions League of Denial will make you ask yourself. It's a Catch-22 situation, but it's one that must err on the side of caution, because these NFL players didn't sprout out of nothing: they came out of colleges, high schools, and grade school football fields. So this is more than a story about well-paid athletes who have made a choice to play a game that can inflict pain; it's an urgent public safety issue that could affect you the moment you (or your young child) put on a helmet.

And if all of that is true, doesn't that make all of us -- the fans, the players, the executives, all of us who love our new national pastime and cringe every time we turn on the TV and read about another 40-something ex-football player shooting himself to death -- complicit?

I dock some points for the writing, which can be plodding and repetitive in places. But their research is impeccable and it's presented cleanly and in a riveting, page-turning narrative. It's guaranteed to make you watch the games each Sunday a little more nervously.

[Taylor · Rating 4 out of 5]

Playing football is hurting people. That's hard for me to say, as a football fan, but it's hurting people, and there's undeniable truth that that is so.

Bennet Omalu, the subject of the recent Will Smith movie Concussion, recently compared football to cigarettes, and that comparison is apt for so many reasons, not the least of which is the industry-funded cover-up about the truth of just how dangerous they are.

I would like to think that we are very near the tipping point in the connection between CTE and football where even the NFL is going to have to admit how harmful it is, but we're obviously not there yet.

League of Denial illustrates this connection in a thorough, well-vetted route, from the early days of concussion studies (even the medical community did not think concussions were a big deal until the '80s or so), through to present times. The writers are ESPN writers and have no stake in any of these stories - which is important because there are so many competing interests here.

Even moving just beyond the NFL's appalling behavior to try and minimize the studies done on CTE and football, there's an unbelievable amount of infighting in the science community, to the point that you have scientists reaching out to families to ask for brains immediately after a loved one has died, because they want to beat out a rival researcher. I expected the NFL to do some ugly, dirty things - and oh boy do they - but I was rather appalled at the behavior of some of these scientists, too. At times while reading this, you have to wonder if some of this would've come to light in a much stronger way had there been more cohesion and collaboration in the field. Part of the reason I chose this book over Omalu's is because I wanted an unbiased portrayal, and a bigger picture look. I do worry that Omalu's got an agenda - which isn't to say that I necessarily disagree with it, but particularly after reading this, I do think he has one.

This isn't to say I'm trying to lay the blame on science here, it obviously lies on the NFL, which basically followed the cigarette industry handbook of how to fund studies, bury science, seduce people with money, push people around, etc. Still, you have scientists who are one minute fully behind the CTE-football connection, and who are working for NFL the next (but also a few in the opposite direction)!

If there's anything difficult about League of Denial (aside from the content, that is), it's that there are so many people involved, and it's hard to keep them all straight. I felt like I needed some kind of family tree like in the ASOIAF/Game of Thrones books.

Football is too big to die right now, but that won't always be true. The game has to evolve if it wants to continue. Whether that evolution means fewer contact practices, more practices with dummies, I don't know. Something has to change, and I think something will. To revisit the cigarette comparison, people still smoke despite incontrovertible proof that it kills you. I think that will also be true of playing football, what with it also giving people the ability to make millions (cigarettes just rely on that whole addictive thing). I don't have answers, but the longer these studies continue, the more football players are found to have CTE, the more people they're going to lose. Something needs to change.

[Misha · Rating 4 out of 5]

I couldn't put this book down. Wonderfully written.

[Sophia · Rating 4 out of 5]

wow... kind of knew the basic idea of CTE and concussions but I will truly never see football in the same light. I will never give my $ to the NFL. really well written and well researched

[Mr. Stoner · Rating 5 out of 5]

So I have read a review or two about this book after reading this book, and it really worries me because, currently, there is two styles of football being played around the country, old school (use the head and suck it up) and new school (take the head away and report concussions). While this exists, the old school players will continue to play "hard" and receive praise, but the new school players will receive praise for tackling the "new" way, but still be told to suck it up! Now what everyone needs to understand is that does matter! The praise and glory are what the players seek, whether they admit it or not, the adulation of playing the rough sport as they grow up is an adrenaline rush, as is making the big tackle, block, play, or touchdown. We feed into that obsession in a way that provides the kids an adrenaline rush that they seek to replicate, drug free, I might add, and we are okay with it because they are reaching that high playing a sport that we love. We watch the sport religiously whether we admit it or not. I don't want to see it end but one can not deny the obvious, it causes concussions. BUT just as importantly, the line men are sustaining injuries standing 1 foot away from their opponent too. No big hits occurring at high speeds, but short bursts at low speeds but multiple times (50-60) per game. Whether you teach "old" or "new" techniques, you will probably sustain a concussion, especially as a lineman!
I don't have an answer as to whether or not an adult, let alone a kid should or should not play the sport, but I do believe they should be informed about that decision. The NFL legitimately hid that information from it's own players, even when they knew. Then they denied it. It kind of makes me sick. As do the doctors that chased down dead bodies to get their brains. But again I understand why they did it, when the NFL was trying to keep them quiet. Even though there is justification for what many of these people did, it doesn't make it right. Irresponsibility and blame exist and can be spread around evenly with the NFL, doctors, and even us fans! Again, no answers here, but a lot of emotions laid in turmoil for me, considering the fact that so much knowledge existed, but was so negligently reported and dismissed with the only idea to protect the league!
I have my own demons as I watch my son and friend's sons play and know how it has effected my father who played with the leather helmets in another era altogether. Let alone the fact that my concussions, (while I know not if any occurred on the football field & definitely know of 3 that occurred on the baseball field) have left me physically fine but where do I stand with this? I love watching the kids play and enjoy that sport, as they learn some valuable life lessons. However, again at what cost? My emotions are in turmoil over my part in cheering on kids that will almost certainly receive a concussion at some point, and a sport I love to watch! What is the answer? None, provide them with the facts and let them choose? I don't know?
Great book for the facts that needed to be scoured and reported, but a hell of a hard read because it involved a great deal of emotional attachment!

[David · Rating 4 out of 5]

A fairly explosive investigation of the NFL’s concussion crisis, League of Denial is comprehensive and well-researched exposé of a problem that the NFL knew about and tried to cover up.

Football is a violent sport, full of thousands on “mini-collisions” and is stands to reason that this would have an effect on the men who played. There is the heart-breaking tale of Mike Webster, Steelers Hall of Fame Center who, after enduring a career of blows to the head, had a completely altered personality and could no longer function in society. There is “The Vanilla Guy” Steve Young, who swore he didn’t retie because of concussions but the evidence suggests otherwise. Linebacker Junior Seau is one of many who retired from the game and wound up killing himself, his autopsied brain showing the tell-tale signs of damage caused by concussions from playing football.

I’m giving short shrift to many of the stories in this near 400 page tome, but those three are fairly prominent.

The science for the effect that concussions have on the NFL players is still in an early stage, but the book details how the league went about silencing its detractors and casting doubt on the people who were trying to ring the alarm on the league’s problem. Bennet Omalu, the Nigerian pathologist (who was played by Will Smith in the “Concussion” movie) discovered the link between football and what he termed CTE, or chronic traumatic encephalopathy, and for his trouble he was left out of the NFL’s Mild traumatic Brain Injury Committee. Then there is Ann McKee, a neuropathologist (and Packers fan) who became the unofficial spokesperson for CTE. Each put up with resistance from people making their living off the NFL who have a vested interest in denying that the crisis is caused by their game.

This book is about 5 years old and I don’t know how much has changed, but after reading this I am pretty convinced that there is simply no way to eradicate the danger that the game puts players in. And the players are the ones who suffer because even with big contracts and big money, many sacrifice their health and their bodies to earn that money.
Essential reading. My review only scratches the surface.

[Liz · Rating 4 out of 5]

I don’t think I would consider myself a football fan, but I can enjoy the social aspect of it (going to games in college, watching games at a bar with friends, Super Bowl parties, etc). I can appreciate how important football is to others - it’s truly it’s own world, culture, and escape for some people.

Overall, I wasn’t shocked by the recent research findings or the effects of CTE on the players and their families. However, I was appalled by how much the NFL has covered it up over the years. Also by how much they continue to be shady to protect their insane profits. Disgusting. Irresponsible. Shameful. I would love for their top execs to come spend a few weeks around people with brain injuries - maybe they could even spend time with them at home to better understand the devastating effects on their families.

Anyway, very good read. I’m always happy to see more public information about head injuries (and awareness of speech therapy!) Also yay to the scientists who are out there fighting against the big bully NFL.

[Barbara Humphrey · Rating 4 out of 5]

This book was eye opening about the concussion issues in the NFL. Before last year with all the craziness in our country was the first year I didn't watch any NFL games. I'm surprised to say I didn't miss it at all. Back to this book -- the data and the stories of players who suffered from multiple and repeated concussions was staggering. What was shocking to me was how the teams did everything in their power to keep their players playing even when they knew they were not well enough to be in there. Too often they listened to the players themselves and let them return to the game after having a serious concussion earlier in the day. The subjects mentioned the most was Mike Webster, Pittsburgh Steelers, Troy Aikman of the Dallas Cowboys, Junior Seau of the San Diego Chargers just to name a few. The Webster story is probably the most tragic. What that man suffered after all those injuries was so, so sad. I'll leave it at that. If you have any interest in this subject I highly recommend you read this book.

[Kat V · Rating 4 out of 5]

This book will really hit home how serious CTE is. I love football so much but this is so hard for me. This whole story is heartbreaking. It’s detailed and well-told but it feels a little disjointed in the way that it skips around sometimes. It gets better as it goes on but I still wouldn’t give it 5 stars because I wouldn’t recommend it to someone who doesn’t care about neuropathology or football. 4.2 stars.

[Amanda Grinavich · Rating 4 out of 5]

I'm a hockey fan who began to get curious about CTE when a number of guys began committing suicide or experiencing nasty side effects from concussions. That drove me to be interested in my alma mater BU's CTE program. Which then drove me to this book. Very educational, very eye-opening, and very, very sad. I hope that things can progress where these types of injuries become diminished in the game. Until then .. is it really worth it?

For anyone interested in the subject, you'll see that BU's latest study got coverage. 110/111 football player brains they examined had CTE: https://www.nytimes.com/interactive/2...

[Scarlett Sims · Rating 4 out of 5]

So, you probably don't need more reasons to dislike the NFL, but here is a history of the league's issues with concussions and brain damage and the effect it has had on former players. The authors draw parallels between the NFL and tobacco companies who knew how dangerous their product was and yet continued to fund studies that discredited the opposition while supporting their own position.

From reading the book, I would say the evidence is pretty damning, aside from one thing, which is that there has been no comparison of players' brains to brains of people who haven't played. To my knowledge, the patterns they see haven't been seen in a non-players brain, but they just can't get the funding to conduct these studies and the NFL won't fund them, for obvious reasons. While not every player has a completely traumatic story, the ones that do are really heartbreaking and the authors use that to maximum dramatic effect. The book also has a corresponding Frontline special that I'm interested in watching.

[Dan · Rating 5 out of 5]

4.5 stars

[Ellie Ramsay · Rating 5 out of 5]

so so good. such a good balance between science and story-telling. just found out this book is also a film/documentary so I’ll be watching that soon too 👊

[Jennifer · Rating 5 out of 5]

Football has always been a matter of complete indifference to me, until 3 years ago when my 9 year old son said he wanted to play. For the first time, I started paying a little attention, and what I began hearing about concussions concerned me. But we signed him up. At the first parents' meeting with the coaches, all of my worries were assuaged. They assured us that they had received all of the latest information and training regarding concussions DIRECTLY from the NFL, and that there was absolutely nothing to fear, because as long as enough time was allowed for a concussion to heal completely, there would be no long-term effects.

One week later, I watched Frontline's League of Denial on Netflix.

It was stunning and horrifying to understand that the NFL was outright lying to youth league coaches, so that the coaches could then spread the misinformation to parents.
That was the end of football for our family, and though I was left with a burning curiosity whenever I caught wind of an NFL/concussion story in the news, it never occurred to me to read the book.
But it showed up as a recommendation on my library Overdrive app this week, so I decided to give it a go. The fact that I am as clueless about football as Bennet Omalu, yet I could not put this book down, is a testament to how gripping and well-written it is. Whether you have a stake in football or not, this is an excellent read!

[Mac McCormick III · Rating 5 out of 5]

This is a book that was hard to put down. It also hit like a sledgehammer. It clearly shows that the National Football League didn't just ignore a problem that caused deaths in retired players, it chose to ignore that problem. Furthermore, the NFL didn't just deny that the problem existed, it campaigned against those that tried to tell it and the football community that the problem existed.

League of Denial is well written and seems to be well researched. It would be easy to write it off saying the authors weren't objective enough, but it's hard to make that claim when the NFL wasn't cooperative. The book brings up problems with and among "the Dissenters" and it's clear that you could question the motivations of some on both sides of the issue. That isn't something that was made clear in the PBS Frontline show associated with the book.

I am a life long football fan, but after reading this book I am seriously questioning my love of the sport. Can the danger of traumatic injuries be mitigated? Is it worth ruining the post-football life of our football heroes for a Sunday afternoon of entertainment?

[Chris · Rating 4 out of 5]

Very sobering book on the NFL's avoidance of a problem. Paul Tagliabue treated the problem as nonsense and whining and left this problem for Goodell. The chapter on Junior Seau is at the end and it's a heartbreaking read. Spurred on by macho many of the guys who ridiculed players for retiring or quitting ended up killing themselves. The authors also go into how football almost ended as a sport in 1905 due to deaths. It took Teddy Roosevelt and numerous rules changes to enable football to survive. This book is all about shoot the messenger and then the messengers fighting over brains like ghouls. It's pretty sad. And it was just amazing how folks could interpret scientific data and come out with 180 degree conclusions. I didn't allow my boys to play football and I'm glad I didn't. I don't think I can watch the NFL with the same degree of love and enthusiasm after I've read what Mike Webster and many of the other players went through at their hands.

[Greg Messel · Rating 4 out of 5]

"League of Denial" traces the history of the battle over head injuries being suffered by NFL football players. It actually is impacting all football players. It has become a battle between scientists and those in the league who are denying the seriousness of the problem. It's a clear chronicling of the slow realization that something is going very wrong with many older football players who are now suffering dementia, personality changes and constant pain.
Two ESPN investigative reporters take us back to the early dawning of the realization that concussion and blows to the head are not like a sprained ankle. The case studies of stars like Steve Young, Troy Aikman and Mike Webster are among those highlighted in this fascinating book.

[Patricia · Rating 5 out of 5]

A quote from p. 318: "With former NFL stars shooting themselves in the chest to spare their brains and thousands of players suing the league...." The authors tackle the history of the discovery of the relationship between chronic traumatic encephalopathy and the concussions and repeated hits that football players experience. This book does an excellent and fact-supported job of explaining the price that football players may pay for their devotion to the sport. I found the story infuriating, poignant, interesting from a medical standpoint and I am left with hope that the battle for the truth will prevail.

[Paul · Rating 5 out of 5]

Brilliant, riveting, and infuriating account of how one of the largest corporations in America did (and is doing) all it could to suppress concussion/CTI discoveries. Shocking that the NFL doesn't have their employees best interests at heart, I know.

[Judy Collins · Rating 5 out of 5]

Well Done! Review to follow.

[Marco G · Rating 5 out of 5]

Oh my God this was such an excellent book. I say that as a fan of the NFL but you don't need to be a fan to really enjoy this wonderful work. It's about how the NFL tried to cover up the connection between concussions and brain damage throughout the 90s and 2000's. It centers around Mike Webster, possibly the greatest center to ever play the game for the Pittsburgh Steelers, and many other players whose brains or sought after to study once they died. It's epic in it's scope but incredibly enjoyable. You have to feel bad for these warriors they're treated like meat while the owners profit immensely from this popular game. The only drawback I found while reading this was the sheer number of names involved in the story. But that is more than counterbalance but how I relished every word in this book. I can tell how much I enjoy book how often I reread certain sentences paragraphs. I kept reading certain passages over and over I tried very hard to commit to memory many of the details. I'm a huge fan of the NFL as are many of the people in this book that strived to bring the connection to light and also those who tried to elevate biased research to disprove and discredit any research connecting brain damage to concussions. Many people opposed to the connection profited immensely from their association to the NFL. Bringing this to light makes it a very important read and adds many layers of context to my fandom. I came away feeling bad for the players and maybe more certain I would not want my son to play. It's a violent sport and nobody forces them to play but it's a crime how the NFL worked very hard disprove any connection.