Head Cases

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In 2007 The New York Times hired Alan Schwarz largely on the basis of his initial freelance reporting for the paper on the problem of head injuries in professional football. Since then, Schwarz’s persistent coverage has helped make the issue—which had been kicking around the edges of sports journalism for twenty years—part of the national conversation, prompting two congressional hearings and a sea change within the National Football League on how it deals with head injuries. After years of denying that concussions can produce long-term health consequences, including dementia, the league did an about-face in December and agreed to financially support research into concussions by the Center for the Study of Traumatic Encephalopathy at Boston University, one of its harshest critics. That came on top of rule changes announced in November that prevent players exhibiting any signs of a concussion from returning to either a game or practice on the same day as the injury occurred, and then not without clearance from an independent brain-injury expert. CJR’s Brent Cunningham spoke to Schwarz in November.

CJR: How did you get on this story?

Schwarz: Like many big journalism projects, this one fell out of the sky. A friend of mine was friends with a professional wrestler, Chris Nowinski, who had sustained several concussions both as a wrestler and as member of the Harvard football team. And this young man was writing a book about concussions and about the severity of them in the summer of 2005, and our mutual friend told him that I had written my first book the previous summer, that it did very well, and that maybe I could give him some advice on his book. So we met and I looked at his manuscript and it was fantastic. And we became friendly and I believed in his project. I guess very few people did because the following December, 2006, when he had taken it upon himself to investigate the [former Eagles defensive back] Andre Waters suicide, and he found out that in fact Waters did have this terrible brain damage, he called me back—we hadn’t spoken in maybe a year—and he said, “Alan, you’re the only one who took me seriously. What do you think I should do with this finding?” I was not on staff at the Times. I had contributed a good deal to the sports section over the previous ten years, and I knew this was something they’d be interested in, and I set up a meeting between me, the sports editor Tom Jolly, and Chris and this was early January ’07. Tom immediately saw how important this was. After the meeting I took Tom aside and said I totally understood if he wanted to have a staff person handle this. He said that it was my story, and I will be forever grateful for that trust, because I did do the Waters story and then [former Patriots linebacker] Ted Johnson wanted me to write his story, and the topic became part of a national sports debate, almost immediately. The Times hired me virtually on the spot.

CJR: I would say that it became part of a national debate largely on the strength of your reporting.

Schwarz: Well, yes and no. Because it’s always been known that hitting one’s head over and over and over and over and over again is dangerous. And to many doctors the leap from suggesting that what happens to boxers might happen to football players is not a particularly significant leap. And yet there has been great resistance on the part of a certain segment of doctors to allowing that connection to be made. So I think what you have is the collision of something some experts find so reasonable and what some people just don’t want to consider possibly being true. What if football is really that dangerous? There are an awful lot of dominoes that fall from that. It’s a very difficult problem. It is very difficult to know what era of football is dangerous. Just because we find out that a lot of players from ’60s, ’70s, and ’80s have brain damage, doesn’t mean the current players will incur that damage.

CJR: Is it simply a matter of better equipment?

Schwarz: The equipment is better. The awareness of the injury and the possible severity of it is higher, particularly among medical staff, but also among players. Players aren’t as foolhardy and unaware and uneducated as they were twenty or thirty years ago. But of course the speed of game is much higher, players are larger—but helmets are better. So it’s hard to know. By no means do my articles about retired players speak directly to the safety or lack thereof of today’s game. I think it’s a very important distinction that a lot of people aren’t making.

CJR: But even as awareness of these injuries has grown, what comes through in the articles is that the warrior culture is still very much intact from the pros on down to little leagues.

Schwarz: Absolutely. I do think, though, that more players are more aware than ever that, “Hey, if I get knocked unconscious or I get really dazed I should come out and have a doctor look at me.” Or that they should just be more careful and not treat it so cavalierly. Does it still happen? Of course. I don’t know to what extent, but I can tell you that it certainly happens less. How much less? I don’t know. I try to be very careful about making the distinction between what we know about football from the ’60s, ’70s, and ’80s and what we believe to be true today.

CJR: Do you ever hear from current players?

Schwarz: The reaction from players has been overwhelmingly positive. Current and former. At least what we’ve heard from these players. Of course, I don’t know how many are harboring feelings that they aren’t sharing with us. The reaction from retired players has been overwhelmingly positive because we are showing how the game was more dangerous than many people realized and these are gentlemen who got hurt on the job and don’t feel like they’ve been fairly compensated for it. The wives and families—I get calls every week from wives crying about their husbands. So it has been very positive because a lot of people believe this has been the NFL’s dirty little secret for a long time and we have made it more okay to discuss it openly. Now, do players who believe that their roster spots are in danger speak about this stuff openly? No, but it is better than it was.

CJR: What has been the reaction from the NFL?

Schwarz: I think that the NFL’s reaction to our work is very clearly evidenced in their comments that are included in the articles. And I can’t speak for them. I will not characterize the nature of their response.

CJR: Have they attempted to persuade you guys to drop the story?

Schwarz: They have repeatedly complained to the highest levels of the editors at The New York Times that we should not be doing what we’re doing. They have complained about us collectively and me personally. The Times is very careful about the latitude it gives its writers, and I have not been told, ever, that what I was doing was inappropriate. The feeling within the building that I get is that this is what a newspaper is supposed to do: apply scrutiny to areas that really matter and that haven’t gotten the scrutiny that they deserve. We’ve been credited with saving lives with this story—specifically teenagers. There’s no question that rules have been changed because of the awareness and conversation that we’ve catalyzed regarding this injury and these risks. We have never once—never—even suggested that football should not be played. All we have done is say these are the risks if you don’t play it safely, and this is how one can play the game more safely. Beyond that it is a decision for adults to make in the National Football League, for young adults to make in college, and for parents to make on behalf of their children who are under the age of eighteen.

And I’d like to say that I get a lot of credit for the work that we’ve done, but this is so much more of a team effort here than a single byline atop stories can possibly convey. They trusted me to go out and do a good job and to do the right job, and have been integral in the directions the reporting has gone. It’s very humbling to be here and be allowed to pursue the story. How many media outlets today, with all the budget problems, would devote what’s probably been half a million dollars and a good chunk of three years of an employee’s time to a single story? Not many.

CJR: What have you learned, in the course of your reporting, about what it will take to make the game safer?

Schwarz: A lot of experts believe that improvements to helmets will be important but not necessarily revolutionary over the next ten years. There are some coaches who are uneducated about this injury, and some foolish ones, but the era of the Neanderthal coach who sends his players out to slaughter has passed in general. The amount of medical care that is given to college and pro players is very high, and it would be quite a stretch to suggest that those doctors are just company “yes men.” Now, are some, probably? Yes. In the same way that the worst things that people think about journalists are probably true sometimes. Some people do make up quotes. Does that mean, though, that a majority, or even 2 percent do? No. In high school football the coaches’ response and the medical care are not what they should be, but it’s getting better.

CJR: For the high schools, though, that’s often a matter of resources, right?

Schwarz: Yes, but I’ve never heard a school say, “You know what, the budget’s really tight, so we can’t afford helmets this year. We’re going to play without helmets.” You can’t do that. The question that is fair to ask is this: Is high school football too dangerous to play without a physician or athletic trainer properly trained in the diagnosis and treatment of brain injuries on the sideline? In the same way you can’t play football without a helmet, can you play football without a doctor? Those are things that different states are considering, and even Congress is considering various ways that the federal government can get involved in this issue.

My main point, though, is that far more than ever, the biggest opportunity to make football safer lies with the players themselves. They must respect when they sustain anything that feels like a concussion. I don’t care how much of a warrior you want to be, I don’t care what the score is, I don’t care what the standings are. If you get a brain injury, come out of the game and go, hopefully, to the trainer or doctor on the sideline and get checked out and realize that you cannot mess with it.

CJR: Do you think that’s realistic?

Schwarz: There more opportunities for players to do that now than there were three years ago, and I think we deserve some credit for that. But far more has to be done to teach the kids that it’s okay to put down the sword and get yourself checked out. It’s not war. It’s not win at all costs. It is a game. It is an important game for a lot of people and communities and it’s meaningful. But I don’t know any parent who would say, “It’s worth my kid getting killed or put into a coma for two weeks because East Side High is leading by four.” So the question is, how do we teach them before the game starts? And how do we make them feel it is okay to act on that knowledge after the game starts? That’s the adults’ responsibility and it’s going to take a long time to change the football culture, to say, “Hey, wait a minute, we’ve gone a little too far with this warrior thing.” That doesn’t happen overnight.

CJR: From a reporting standpoint, what’s been the most challenging aspect of this story?

Schwarz: Particularly, when it comes to dealing with the National Football League, you can’t fight illogic with logic. You have to find another way to do it.

CJR: What other ways have you found?

Schwarz: One of the things I bring to this story that’s important is that I have a mathematics degree. I know how to see things in numbers that the average Joe probably doesn’t.

CJR: For instance?

Schwarz: Look at a story I did on the 88 Plan data in October. That was some serious number-crunching.

CJR: This is the data from the program that the NFL and the players’ union launched in 2007 to reimburse medical expenses of retirees being treated for dementia. And a lawyer for the union presented an analysis of this data that concluded that the prevalence of dementia and other brain trauma injuries among former NFL players was basically in line with the rates for those problems in the population at large. And your article said that the union analysis was incorrect, and that in fact the data indicated that the rate among former NFL players was significantly higher than in the general population.

Schwarz: Correct. When the union did its analysis it did it in what looked like a reasonable way, but it wasn’t a reasonable way. I looked at what they did and instantly saw it was wrong.

CJR: What specifically?

Schwarz: I looked at the prevalence numbers and knew they were wrong. Not only had they taken the wrong column of data from a published chart, but they didn’t notice that it was rate per thousand rather than rate per hundred. Also, there were errors in logic and sampling. They interpreted the 88 Plan rate as being the dementia rate for all NFL retirees, and that is preposterously wrong. It is a bare minimum of a certain level of dementia, because to be on that list you had to be aware of the program and also had to have volunteered that you have the disease. There is a lot more dementia out there—either unreported or cases that don’t reach the level of severity where it qualifies for the 88 Plan. That doesn’t mean the NFL is evil. It just means that the person who did the work didn’t know what he was doing. And that’s okay. But why isn’t this stuff being done proactively by the league and the union? Why does it have to be done by The New York Times?

CJR: Would you let your son play football after what you’ve learned?

Schwarz: That’s like asking a political reporter before the election, “Who are you going to vote for?” It’s my job to cover the issue, it’s not my job to decide or even discuss how I will let the issue affect my family.

CJR: It’s not your job as a journalist, but as a human being it is difficult to avoid.

Schwarz: The point is there are certain things you don’t allow to creep into your head because it’s your job to make sure they don’t. And I really haven’t thought about it because if I were to decide that Teddy won’t play football, then the mindset with which I follow the story could come from the wrong place. It cannot come from concern about my little boy. The New York Times is not writing about this to protect Teddy Schwarz. The New York Times is writing about it to protect the 1.2 million kids who play high school football every Friday, and their 2.4 million parents. Those are the people whose opinions matter. Not mine.

CJR: Let’s assume for a minute that your son, who you said is three years old, is actually ten years old and he is clamoring to play Pop Warner football. Would the fact that you would then have to decide disqualify you from covering the story?

Schwarz: No, it wouldn’t disqualify me, though of course that’s up to my editors. But there is something about working here—and I’m not saying we’re better than everyone else, blah, blah, blah—but there is something that really inspires you to do the right thing, and to do the thing that helps you to cultivate the trust that allows readers to take you seriously. So I would probably let him play because if I didn’t it would compromise the reporting. It would compromise the trust that others and even the league may have in me. Now, I would not send him out to slaughter, but getting one concussion is not that big of a deal—it just isn’t. And to suggest otherwise is incredibly irresponsible. So if my kid gets one concussion then yeah, he doesn’t play anymore probably. But to not allow him on the field is, frankly, an overreaction. And if I didn’t allow him to play then yeah, it would be harder to cover the story, if only in my own mind. I believe that the cost to others of my not being able to cover this story as well would be greater than the cost of my kid getting one concussion and never playing again. I’m a very mathematical guy. I follow certain precepts. And those are the things that make sense to me. And I can’t tell my kid he can’t play, because then what am I going to tell the league? What am I going to tell my editors? It doesn’t work. It’s dissonant.

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Brent Cunningham is CJR’s managing editor.