Could concussions actually kill football?

-- If the sport of football ever dies, it will die from the outside in. -- Jonah Lehrer

If an increasing number of economists and trend analysts are to be believed, we may one day look back at something like Colt McCoy's concussion against the Pittsburgh Steelers in 2011 as one of many galvanic events that blew football apart, and reduced the country's most popular sport to a marginal pastime. It's unlikely that such a colossal financial concern as football could be killed off entirely, but as Malcolm Gladwell first wrote in the New Yorker in 2009, it's not crazy to think that an increasing number of player concussions -- and the NFL's real lack of concern about those injuries despite its public face -- could have Americans looking at football very differently down the road.

Gladwell's article, which compared football to dogfighting and revealed some truly horrifying information about the effects of concussions on the minds and bodies of football players (even more than has already been revealed through other outlets), was dismissed in most football circles as the nerdy ramblings of a weird-haired Englishman who doesn't understand the game. But Gladwell understood the common threads of different competitive dangers well enough to make some interesting connections.

In one way or another, plenty of organizations select for gameness. The Marine Corps does so, and so does medicine, when it puts young doctors through the exhausting rigors of residency. But those who select for gameness have a responsibility not to abuse that trust: if you have men in your charge who would jump off a cliff for you, you cannot march them to the edge of the cliff—and dogfighting fails this test. Gameness, Carl Semencic argues, in "The World of Fighting Dogs" (1984), is no more than a dog's "desire to please an owner at any expense to itself."

Okay -- that's one, and football fits that suit to a degree. But let's pass Gladwell by and look at two articles recently written for Grantland, ESPN's "boutique" website. A piece by Jonah Lehrer, entitled "The Fragile Teenage Brain" and quoted above, reported estimates indicating that up to two million football players, from the high school level up, suffer concussions every season -- and those are the concussions that are actually reported. For those unaware of what those concussions can do to kids, Lehrer lays it all out.

In 2002, a team of neurologists surveying several hundred high school football players concluded that athletes who had suffered three or more concussions were nearly ten times more likely to exhibit multiple "abnormal" responses to head injury, including loss of consciousness and persistent amnesia. A 2004 study, meanwhile, revealed that football players with multiple concussions were 7.7 times more likely to experience a "major drop in memory performance" and that three months after a concussion they continued to experience "persistent deficits in processing complex visual stimuli." What's most disturbing, perhaps, is that these cognitive deficits have a real-world impact: When compared with similar students without a history of concussions, athletes with two or more brain injuries demonstrate statistically significant lower grade-point averages.

At the NFL level, there are dangling issues still unresolved. Colt McCoy's concussion is perhaps paramount among them because of the obvious nature of the injury, the team's initial reluctance to diagnose it, and the league's lukewarm reaction to the idea that McCoy had suffered a head injury at all. From our initial report of the incident, when McCoy was knocked into another zip code by Pittsburgh Steelers linebacker James Harrison in early December:

When Harrison led with his helmet into McCoy's facemask in the fourth quarter of that game, McCoy left the game for just two plays before returning to action. Hidden in that narrative was what happened to McCoy when he came back in the game — it was clear that the kid got his bell rung pretty good, and that's where the story becomes confusing.

After the game, McCoy told reporters that he couldn't remember the hit, but Browns coach Pat Shurmur said that McCoy was "fine to go back in." After the game, the media was asked to turn the lights off in their cameras. Why? Well, sensitivity to light is one of the most obvious concussion symptoms.

More germane to this story was the reaction of McCoy's father, Brad, a longtime high school coach in Texas.

"I talked to Colt this morning and he said, 'Dad, I don't know what happened, but I know I lost the game. I know I let the team down. What happened?'

"He never should've gone back in the game," the elder McCoy continued. "He was basically out [cold] after the hit. You could tell by the ridigity of his body as he was laying there. There were a lot of easy symptoms that should've told them he had a concussion. He was nauseated and he didn't know who he was. From what I could see, they didn't test him for a concussion on the sidelines. They looked at his [left] hand.''

Now, think about that. If a high school coach is outraged about the treatment of his son at the hands of the NFL, how do you think the "average" parent is going to feel about letting his or her child play at a level where finances dictate a less stringent series of protocols?

[Related -- Brain Trauma And The Future Of Youth Football In America]

The second article for Grantland on this subject, written by Tyler Cowen and Kevin Grier, and entitled, "What Would the End of Football Look Like?" brings the concept of liability into the equation. Picture a large subset of schools already in hock from a budget standpoint, and imagine how easy it would be for many of those schools to drop football altogether if the financial risks outweigh the potential rewards.

The most plausible route to the death of football starts with liability suits. Precollegiate football is already sustaining 90,000 or more concussions each year. If ex-players start winning judgments, insurance companies might cease to insure colleges and high schools against football-related lawsuits. Coaches, team physicians, and referees would become increasingly nervous about their financial exposure in our litigious society. If you are coaching a high school football team, or refereeing a game as a volunteer, it is sobering to think that you could be hit with a $2 million lawsuit at any point in time. A lot of people will see it as easier to just stay away.

More and more modern parents will keep their kids out of playing football, and there tends to be a "contagion effect" with such decisions; once some parents have second thoughts, many others follow suit. We have seen such domino effects with the risks of smoking or driving without seatbelts, two unsafe practices that were common in the 1960s but are much rarer today. The end result is that the NFL's feeder system would dry up and advertisers and networks would shy away from associating with the league, owing to adverse publicity and some chance of being named as co-defendants in future lawsuits.

Now, there are some slightly unrealistic Armageddon scenarios in the piece written by Cowen and Grier, as intriguing as the article is. Their contention that Napster was eventually brought down by legal constraint fails to recognize that file-sharing is far more common now than it was a decade ago, due primarily to the number of sites employing servers in areas of the world where the rules don't seem to apply. And businesses die all the time without any lack of moral imperative behind the losses.

That said, the hypothetical presented by the authors isn't entirely nuts if a series of dominoes fall entirely the wrong way.

This slow death march could easily take 10 to 15 years. Imagine the timeline. A couple more college players — or worse, high schoolers — commit suicide with autopsies showing CTE. A jury makes a huge award of $20 million to a family. A class-action suit shapes up with real legs, the NFL keeps changing its rules, but it turns out that less than concussion levels of constant head contact still produce CTE. Technological solutions (new helmets, pads) are tried and they fail to solve the problem. Soon high schools decide it isn't worth it. The Ivy League quits football, then California shuts down its participation, busting up the Pac-12. Then the Big Ten calls it quits, followed by the East Coast schools. Now it's mainly a regional sport in the southeast and Texas/Oklahoma.

It's just as easy to put forth the proposition that colleges, starting with the small and less profitable, would bail from the game if lawsuits were the new loss leaders. And at the NFL level, there are an increasing number of suits against a league still reluctant to admit that it willfully ignored  the effects of head injuries far too long despite an avalanche of data proving the long-term effects.

At this point, the NFL faces at least 20 separate concussion lawsuits by former players who say they were misrepresented. And some of those plaintiffs have combined to make their efforts more formidable.

The language on either side is fairly boilerplate. The players allege that the NFL knowingly lagged behind in concussion awareness for the financial betterment of the game without a thought to the personal consequences. The league, led by well-paid mouthpiece Roger Goodell, maintains that such awareness has always been a league priority.

Colt McCoy and his father, two men who have been bonded by the game throughout their lives, would most likely disagree.

Isaac Asimov once told Howard Cosell that in his opinion, robot players would one day replace humans in football. If the nightmare scenarios recently painted come true someday, we may look upon Asimov's option as a most appealing saving grace.

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