Wednesday, June 8, 2016

Movie: Concussion

Concussion tells the story of Dr. Bennet Omalu, a Nigerian neuropathologist working at the Alleghany County Coroner's office in Pittsburgh under the direction of Cyril Wecht and his discovery of CTE - Chronic Traumatic Encephalopathy. Omalu was assigned to Mike Webster, a former center for the Pittsburgh Steelers when he was brought into the morgue. Webster, only fifty years old, had died after suffering from depression, amnesia and other problems. Omalu wanted to know why a man whose CT scans showed normal, had behaved so bizarrely.

The movie begins by showing Dr. Omalu working in the Alleghany County Coroner's office, focusing on his rather eccentric mannerisms including talking to the dead bodies before doing autopsies. He is not disrespectful but assures them that he wants to learn the truth about them and asks for their help. We also see Pittsburgh Steeler great, Mike Webster, behaving bizarrely. He is seen by Dr. Julian Bailes, former doctor to the Steelers who tries to calm him. Webster has no idea what is wrong with him but he knows something is wrong; he can't sleep and he hears voices. He begs Bailes to help him. Days later Webster dies and his body is taken to the Alleghany County Coroner's office.

Initially Omalu's colleagues tell him to leave the body alone and not to do an autopsy. However, Omalu is intrigued and puzzled as to why a man with a normal brain should have acted so bizarrely. Before his death we are told Webster was pulling his own teeth and superglueing them back in. The autopsy shows nothing seriously wrong with Webster so Omalu decides to order sectioning and slides of Webster's brain. He does this to strong opposition by his colleagues and is told he must pay for this out of his own pocket. His mentor, Dr. Wecht endorses the tests that Omalu requests even though Omalu reveals he has no idea what he is looking for. Omalu is shocked at what he finds - Mike Webster's brain shows serious damage. He discovers plaques of protein have formed around areas damaged by violent blows to the head. These plaques disrupted Webster's brain function affecting emotion, mood and cognitive functions.

Believing Webster to have dementia pugilistica common to boxers who received numerous blows to the head during their careers, Omalu watches football games on television and even attends various practices. What he sees are numerous instances where athletes receive blows to the head. These "hits" are rated and lauded during the games. Finally Omalu decides to talk to another doctor, Dr. Ron Hamilton who brings in Dr. Steven DeKosky. DeKosky is also shocked by the slides of Mike Webster's brain. Omalu tells him Mike Webster's position as a center was the most dangerous in football, exposing him to a constant barrage of blows that eventually permanently and seriously damaged his brain. Omalu tells Dekosky he believes there are more injured players whose doctors incorrectly believe they have early onset Alzheimers.  DeKosky decides that this research should be published and tells him to find a name for the condition he has uncovered. Omalu comes up with the name CTE - Chronic Traumatic Encephalopathy.  However, the NFL refuses to accept Omalu's research as legitimate science stating there is an "absence of clinical information." They want Omalu to retract his statements.

While Omalu's superior, Dr. Wecht supports him, he warns Omalu that he is taking on the Goliath of sports in America, the National Football League. Considered America's national game, he will face grave difficulties in having his discovery recognized and accepted by the NFL because it is a corporation with 20 million people who are addicted to the fame of football. Omalu is shocked as he naively believed that the NFL would want to know that players were being seriously injured. Omalu confirms that a second Pittsburgh Steeler player, Terry Long who committed suicide also had CTE. They decide to go public with Long's results and Omalu warns that there are many other players at risk. At this point Omalu begins to receive threatening phone calls and his house is watched. Despite this he remains undaunted in his quest to get his discovery accepted by the NFL.

It is at this point that Dr. Julian Bailes contacts Omalu and tells him he wants to help because he knows of at least twelve Steelers who have died young. He tells him the NFL has known about the concussion injuries for years but has hidden it through faulty research. Bailes tells Omalu he has uncovered the NFL's dirty secret but that he must keep going. Since CTE does not show up on a CT scan, Omalu tells Bailes this means more men have to die in order for him to prove it exists. Working together the two not only find that evidence but eventually force the NFL to accept that CTE is a legitimate disease caused by repeated concussive and sub-concussive injuries incurred by playing football.


Concussion has received mixed reviews but this movie is really quite well done. The focus is not on the football players as many might have thought, but rather on the doctor who brought to the attention of both doctors and the NFL the serious brain damage being done to NFL athlete when they a vehicle for one of Will Smith's best performances. He is understated and convincing as Dr. Omalu whom he portrays as a dignified, intelligent and determined researcher who cares about the people who enter his morgue. They are not bodies but human beings whose bodies allow him to learn the truth about their lives and how they died.Smith is supported by a fine cast including Gugu Mbatha-Raw as Prema Mutiso who plays his girlfriend and future wife, Alec Baldwin as Dr. Julian Bailes, Albert Brooks as Dr. Cyril Wecht and Eddie Marsan as Dr. Steven DeKosky.

The film seems to suggest that part of the problem Dr. Omalu had in getting his findings accepted were due to the fact that he was a black man and not an American citizen. It's probable this played a part but also that other factors as suggested in the film were more significant. Pro football in the United States is a hugely lucrative business and anything even hinting at the dangers of playing the sport would be considered a serious threat to a multi-billion dollar sports industry. In the end, Dr. Omalu is seen given a presentation at an NFL players meeting where he tells those in attendance that he understands the excitement and the power of the game but that there are also dangers that need to be recognized. To this day he remains convinced that the way America plays football is different from years ago and it is leading to serious head injuries. There's no doubt the much larger athletes in the sport have played a critical part in changing the nature of the injuries suffered from tackles.

Although the film has caused some to question Omalu's claim that he discovered CTE, there is no doubt that Concussion comes at a time when the seriousness of concussions is being re-evaluated. Doctors are discovering that concussions whether incurred in sports or in accidents have long term consequences. It is an area of research with many unanswered questions. There is significant recognition that the brain needs time to heal, that rest is imperative. Hockey player Sidney Crosby, ironically also a member of a Pittsburgh sports team, suffered two significant hits to his head in January of 2011 and was diagnosed with a concussion.  Crosby initially experienced no symptoms after the first hit, but a second hit coming four days later resulted in a serious concussion . He was off ice for three months but when he tried to return to train, he again suffered concussion symptoms and was forced to discontinue his training. Crosby attempted to return to play in November of 2011 but his symptoms returned and he was sidelined again. He did not return to regular play until March of 2012. Eric Lindros, considered a potential great in hockey never really lived up to his potential due to at least eight serious blows to his head. Lindros spoke about how the concussions affected his career and his life outside of hockey in this article from Macleans Magazine in 2011.

In 2016 we recognize concussions as the serious injury they are thanks in part to the work of doctors like Omalu. Trainers and coaches are required to follow specific protocols after a head injury and doctors now treat concussions seriously.

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