In an interview with UC Davis Medicine magazine, Bennet Omalu touched on how he dealt with adversity during his discovery of chronic traumatic encephalopathy or CTE, how he proposes handling youth collision sports, the intersection of his religious and scientific backgrounds, how a business degree played a part in the name “CTE,” and how the condition could affect perception of pathology as a profession. Excerpts:
Q: You first reported cases of CTE in NFL players, and your discovery drove national discussion and debate about the risks and tradeoffs of football and other collision sports. How does it feel to make a discovery of such influence and import? Did you ever envision being on the national stage like this?
A: No, I never envisioned it and it was never my objective. What motivated me was simply to search for the truth. And also empathy. I’m an immigrant; I came to America and realized I could get as much education as I could in here in the U.S. In 2002 when (NFL Hall of Fame lineman) Mike Webster died, no one could actually explain the profile of his life after football. When he died, on TV people were ridiculing him, pretty much making fun of him and other retired NFL players who, for whatever reason, did not do so well after retirement. So when I heard their stories, I was a bit intrigued. I wondered if their profiles could be due to brain trauma.
So by serendipity, Mike Webster was on my autopsy table. His brain looked normal, but I was not satisfied. As a forensic pathologist, I’m also Catholic, and my faith teaches me when the physical body is dead, your spirit or soul lives on. So I speak to my patients. I spoke to Mike Webster and promised him I’d get to the bottom of this, I’d find out what happened to him. I didn’t think he was just “a loser.”
So when his brain looked normal by naked eye examination, I took the brain home with me. No one really believed what I was doing, but I believed what I was doing. And the rest is history…
Like I said in the (Frontline/PBS) “League of Denial” interview, I wish I never met Mike Webster to be honest with you. What (discovery of CTE) has done to me is exposed me to man’s inhumanity to man. It exposed me to individual greed, individual ambitions... I wanted to live a good simple life, raise my family and die a peaceful death, and not get ensnared by vanities. This has exposed me to something I never aspired to become part of. The limelight, I’m not really enjoying it.
Q: The NFL did not look fondly upon your work on CTE, and the resulting conflict is expected to be a cornerstone of the upcoming movie. What was it like to take on such a large, powerful and popular organization? And how did you get through that kind of adversity?
A: Faith. When all this started – it sounds very contradictory to scientists like me – but like Pope Francis says, faith and science go hand in hand, they complement each other. It was by faith that I ignored the might of the NFL. I believed deeply inside me that I was on the side of the truth. Like my father told me when I was getting my degrees, he warned me, “Look Bennet, I hope you’re not getting all these for the purposes of self-aggrandizement or ego. That would be very dangerous. But if you’re getting all this education so you can use your talent as equity to enhance the lives of other people, that would be beautiful.”
So when I encountered these retired NFL players, and I visited them and their families, I realized they were very poor in spirit. They were also poor in other dimensions. I started seeing the bigger picture... These players are used as expendable assets, and once they retire they are pretty much dumped, they pass into oblivion. No one pays attention to them.
I did not have money, but my knowledge and specialized education was equity I could use to make a difference in the lives of other people. As a Christian I wanted to use science as a tool of love and charity. Because that was a higher calling than myself, I stood firmly. From a Biblical perspective, Jesus would tell you repeatedly “do not be afraid.” If that was my faith, why would I be fearful of the NFL? I’d be in denial of my faith.
I have a M.B.A. from Carnegie Mellon. I was watching the response of the NFL. Their response to me and to the subject (of CTE) from a business and branding perspective was very poor. I think they were blinded by their arrogance. They chose to delegitimize me and dismiss me and marginalize me, because in their minds I was a non-entity, someone of no consequence. They underestimated me, and in doing that they lost control of the message and goodwill.
Q: Do you feel vindicated, and is the movie part of that?
A: I don’t think it’s about vindication – I think the players themselves are being vindicated. Mike Webster, Terry Long (suicide), Andre Waters (suicide). Chris Benoit, the WWE wrestler who killed himself and his wife, I did his brain. These people were regarded as bad people, evil people, but CTE has vindicated them, and even other NFL players who are still alive. So I think the movie celebrates the players and their families and emphasizes the importance and value of education –so that when you make the decision to play, you’re making an informed decision.
On a professional level, I was even more attacked by fellow doctors than the NFL. No one talks about that. Fellow doctors vilified me, dismissed me and called me names, even to today and even fellow pathologists. They suggested I was fraudulent, primitive, not sophisticated, radical. But again it’s not about vindication; it’s about the truth and being a messenger of the truth. The truth has been vindicated.
Q: Since that first autopsy in 2002 and your naming of CTE, what is the general overall status of research and understanding about CTE?
A: Where I think we have failed woefully is actually propagating the truth. For one, I always hear the media say concussions cause CTE. That’s a fallacy, inaccurate. What causes CTE is blows to the head. And then blows to the head can cause subconcussions, concussions, post-concussion syndrome, posttraumatic encephalopathy [PTE] and chronic traumatic encephalopathy [CTE]. It’s a spectrum, a continuum of syndromes caused by blows to the head. A concussion is a manifestation of blows to the head.
Second, as a society we evolve. Humanity in 1850 is less intelligent than in 2015. We have greater access to knowledge and information. We’re more intellectually sophisticated, if not more intelligent. So, we give up less-intelligent ways of the past and adopt more intelligent ways. In the 1960s and 70s we smoked on airplanes and in enclosed spaces. Today we don’t, and children aren’t allowed to smoke. Because we know it damages a developing brain, children aren’t allowed to drink alcohol. Asbestos, we now know it causes cancer so we don’t use it anymore in industrial products.
Knowing what we know now about repeated blows to the head, why do we continue to let our children expose themselves to activities that would damage their brains? If you give a child a bottle of beer to drink in a restaurant, or a cigarette, you could be indicted for child endangerment. Why then in this day and age do we continue to expose our children intentionally to risk of permanent brain damage by letting them play high-impact contact sports like football, ice hockey, judo, karate, wrestling, boxing?
America is the land of the free, and you are free to do whatever you want to do. I’ll be the first to fight and die for you to preserve your rights and liberties. Take for instance smoking; if I educate a patient “do not smoke,” and they choose to smoke, I will strongly defend that patient’s right, liberty and freedom to smoke if he or she wants to smoke. But children are still minors; they don’t have the capacity to make such decisions. So why don’t we wait – just like with cigarettes and alcohol –and let children become adults and reach the age of consent, and then look at the information we have and make the decisions for themselves?
Knowing what we know now as a society, we must act. I’m very passionate about it. I believe America is the most intelligent society on earth, a land with the best concentration of brilliant minds. But look at me – I’m a lousy foreigner from Nigeria. Why was it me that came up with this concept? I’m not the most intelligent or sophisticated person. So there’s something going on. Are we being blinded or letting ourselves be intoxicated by football? There are longstanding public health and financial consequences on the society that no one talks about.
Q: Do you think CTE can be either prevented or cured in football and collision sports someday?
A: Until you can definitively diagnose CTE in living people, you cannot test different modalities of management. You may not cure it, but at least control it like you can control HIV. From a business perspective and a leadership perspective, given the intellectual capacity of Americans, we will identify some modality of treatment soon. But until we do, prevention is the best cure.
I hear some people say “take the head out of the game.” Do you think you can play football without the head? Another fallacy, they tell you we are looking at helmet technology. Helmets do not prevent concussions or subconcussions. In fact the helmet increases the mass of the head and the momentum of impact, therefore larger amounts of energy are being transferred to the brain.
And I start to wonder, these are such basic concepts, why aren’t we figuring it out as a society? The only answer is that we are intoxicated by this subculture of violence.
Q: Do you think discovering CTE has heightened the profile of pathology as a profession?
A: I think so. When I started (with CTE), neurosurgeons and orthopedic surgeons dismissed me and made fun of me, that I wasn’t a “real doctor.” This is a platform for pathologists to reintroduce ourselves to society. We can fight for the truth. We can establish the truth.
Just like the branding I did for CTE, names matter a lot. I think it’s high time we changed the name of our specialty. “Pathology” has a negative connotation. Decades ago my specialty was known as “morbid anatomy.” I think we should change our name to make it more sophisticated and more in line with good health. Call ourselves “laboratory physicians.” Many times I tell people I’m a pathologist and they say ‘What’s that, did you go to medical school?’ As a “laboratory physician” everyone knows what you do – you’re a physician who works in the lab.
Why CTE has become successful is the name. When I was giving it a name there were things I thought about because of the business foundation I have. Give it a very sophisticated name that will make you sound very erudite, but yet let it have a very short acronym that everyone will remember. I wanted to penetrate society. I wanted to educate people. You need to have a strategy.
And back then I was also afraid. “What if we’re wrong?” So give it a name that’s generic but yet specific. “Chronic traumatic encephalopathy” simply means something long-term associated with trauma, and encephalopathy means “bad brain.” If someone proved me wrong, I had the wiggle room to get out of it.
Also, the 5-year-old kid in school will remember “CTE.”
Q: What’s your experience been like working with our pathology department and its students? Do you draw from your experiences when teaching?
A: The UC Davis pathology department has been wonderful to me. I’m deeply grateful and hopeful. I’m giving a lecture this week. I’m very pragmatic. I share my firsthand experiences with students – not textbook stuff, but the real, firsthand experiences.
I also share the business aspects of pathology. I tell students what will make you a successful physician is your ability to manage people and manage your organization and circumstances. Because at this level, everyone’s intelligent, smart. I emphasize that a lot – learning how to communicate and how to talk to people and how to influence people, including your patients.
Q: How does it feel to be the subject of a Hollywood film, with a major star playing you? What’s that experience been like for you?
A: Many people think it’s “sexy,” but it was overwhelming and very intense. You need to be at the top of your game and it’s demanding because you are working with brilliant people. I was involved at every step and it’s no joke, no child’s play, dealing with all of the sociopolitical aspects.
Q: What’s daily life like for you these days?
A: It’s overwhelming… not fun. It’s very intrusive. I’m becoming more introverted, more family oriented. My joy is just get home, lock my door, spend time with my kids and my wife and do what families do.