No-brainer (eBook)

Foreword

‘That which doesn’t kill you makes you strong.’

I am Dr. Judith Gates, wife of Bill Gates. I am a great grandmother: mother of two sons, grandmother of two girls, great grandmother to two precious little boys. Liam was two and a half when Luca was born and, eager to show his skills as a big brother, he reached out to hold Luca. His mum gently intervened: ‘You can’t pick him up ‘cos he’s delicate.’ Savouring and practising this newly discovered word, delicate, Liam carefully placed his finger on Luca’s forehead. ‘Delicate forehead’ he pronounced with conviction. How true. His words resonate and mobilise my actions.

The brain is fragile. That has been proven scientifically. Repetitive head impacts are identified as the cause of Chronic Traumatic Encephalopathy, CTE, a progressive, incurable brain disease which claims victims to dementia 20 to 30 years after their initial exposure to brain trauma. CTE is a disease which appears in middle to old age but which begins in the brains of the young.

Ex-professional footballers are five times more likely to develop dementia than those in the general population. But the disease is not just limited to the professional game, not just limited to the old. On autopsy, CTE has been found in the brains of young people who have never played for a professional team, it has been found in the brains of both men and women. CTE does not discriminate. It is a disease which can affect anyone who ever heads a football.

Conversations with today’s players highlight a fundamental misunderstanding. They assert that ‘Dementia was caused by the old heavy leather balls.’ The balls of today weigh the same but travel faster. Increased velocity and similar weight mean that today's players experience similar head impacts and are in as great a danger as players in the past. CTE is here to stay unless we take action. The cumulative intensity of head impacts is the cause. Precaution, prevention and protection are the only cure

I co-founded Head for Change, a charity involved with both football and rugby, and was instrumental in organising the first football match in the world which experimented with the rules of heading. International media coverage enabled 50 million people to read about a game in which heading was banned. Now, in order to better meet football’s specific needs, I have founded a charity focusing exclusively on football. Head Safe Football is for every player who has ever headed a ball, irrespective of age or gender, grassroots or professional. Our logo, an elephant standing on a ball, symbolises the elephant in the room, namely chronic traumatic encephalopathy, CTE, a progressive and incurable brain disease wholly caused by repetitive head impacts and insufficiently addressed by the footballing community. Head Safe Football is pioneering Football United v CTE in which HeadSAFE Trailblazers pilot HeadSAFE practices within their own football community. We work to protect the players of today from becoming the victims of tomorrow.

No-brainer outlines my fight to make sport safer. Whilst striving to offer support to affected past players and their families, I fight to raise awareness and provide education to prevent this brutal disease from affecting players of the future.

A story has no beginning and no end. Arbitrarily one chooses a moment of experience at which to begin and a moment of history at which to stop. Any story is just a chosen piece of the whole.

No-brainer is a book of separate, yet interwoven, stories, in which each active participant group plays a part in the current epidemic of brain disease in football. The protagonists line up.

There is CTE, the disease itself, with a long and chequered history of recognition, denial and obfuscation. Research has a key role. It has been dominated by the Concussion in Sport Group (CISG), a group aligned with the sporting governing bodies. And then we have the sporting governing bodies themselves, each with a powerful corporate commitment to the business of football. These groups with positional power have the influence to disrupt rational analysis and action. Collectively, their power is virtually unstoppable. Yet surely, the interests of the players themselves should be key, but theirs are the voices which are having to fight to be heard. Footballers beware.

At the core of No-brainer is the ongoing story of CTE, Chronic Traumatic Encephalopathy, the incurable brain disease caused by blows to the head, the brain disease which reduces its victims to the description harshly, but honestly, captured by the title of the book. No-brainer.

CTE presents a range of symptoms, involving mood, cognition and ultimately physical decline. Often spanning decades after initial damage, it is a protracted death sentence that slowly, but inexorably, takes away every facet that made a person who they were, reducing them to a shell of their former self. First identified in boxers in the 1920s, known then as punch drunk, it has been found in brains of players of contact sports, players both young and old. Although often evidencing itself in later years, it is a disease which starts in youth. CTE is harsh, it is cruel, it is brutally unremitting. But it is preventable by following one simple edict. Be head safe, protect your brain, prevent CTE.

Woven around the CTE story is the story of research into this brutal disease. The Concussion in Sport Group (CISG) has been at the forefront, producing consensus statements on the issue, usually every four years since 2002.

Comprised of members with established links to the sporting governing bodies, their consensus statements were recently described by a DCMS parliamentary inquiry as conservative rather than precautionary. Namely, they are protective of the sports as distinct from being protective of the players. These CISG statements have dominated the international narrative on concussion in sport, from both a legal and a practical perspective, and have influenced the attitudes and actions of decision makers. The CISG group has recently been mired in scandal concerning plagiarism and misrepresentation. Not only did they selectively control research, but theymisquoted it.

The sporting governing bodies in football have their own influential stories. Overseeing and seeking to maintain a billion pound industry, conflict of interest is inevitably endemic. And there are further stories within these stories.

The Premier League, by dint of its financial clout, has the power to direct the actions of other groups and apparently uses it. The Football Association is subject to ongoing legal proceedings for negligence for failing to protect players from permanent brain injury. How do they exercise a ‘duty of care’ whilst at the same time minimising change?

The PFA Charity, now renamed the Players Foundation, sits with over £50 million in assets. It is the focus of a regulatory alert and an ongoing Charity Commission Inquiry. Involved observers wait with deep interest for this drawn-out investigation to finally publish its findings. After a decade of close involvement between the PFA Union and the former PFA Charity, they now describe themselves as separate entities. However, it must be noted that the PFA Union still continues to be predominantly funded by monies from the Premier League, rather than from member subscriptions. This raises the unavoidable and uncomfortable question. How can a union be independently focused on member needs when funded by the employers of its members?

Against this perfect storm, this backcloth of money and power, are the everyday stories of footballing families, wives, sons, daughters of former professional footballers, each painfully struggling with individual personal tragedies, each trying to make sense of the global and corporate forces which dominate. As they witness the ongoing disintegration of a loved family member they try, often desperately, often bewildered, to access financial support for those suffering for what has been described by coroners as an industrial disease.

In a world of acronyms, the KISS principle has gained traction. ‘Keep it Simple, Stupid.’ Yet, in the footballing world of profound complexity and competing interests, where does one find simplicity? Simplicity, rationality, for victims of football-related dementia would be financial support for care from a game awash in cash on the basis that their disease was caused by their profession. Simplicity, rationality, for present and future players would be education as to the now irrefutable recognition of repetitive head impacts as a causal factor of CTE. Simplicity, rationality, to meet a duty of care to players would be modification of rules and practices to reduce heading, particularly in training. We now know heading is dangerous. We do not know what level of heading is safe. Let’s not be stupid about this. Let’s simplify the complex to arrive at actions which protect the players. This is what I am fighting for.

This book, by highlighting the stories of the various protagonists, teases out competing and complex interests, revealing them for what they are. A desire to maintain the status quo at any price, with a canny eye on profitability and corporate interests. Prioritising protecting a...