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Omalu is now convinced that brain injury is responsible for many of the inexplicable antics observed in high-level football players. "Most CTE sufferers die from either suicides or accidental overdoses," he says. "CTE is responsible for most, if not all, of the absurd behavior these players show."
CTE has been a hot topic in sports news during the past year. In October 2009, Malcolm Gladwell published an exposé in The New Yorker documenting its prevalence among former football players. Shortly thereafter, Congress held hearings into the NFL's approach to minimizing the risk of the disease and caring for retired players. As news spread, it eventually found its way to Melissa Brymer, who was still puzzling over what could be responsible for her estranged husband's actions. "When I Googled [CTE] and researched it, I started crying," she says. "That was the moment I said, 'This is Chris.'"
The depression, the anger, the paranoia, the inability to think straight: Brymer exhibited the classic profile of an ex-football player suffering from CTE, down to his homeless wanderings, which were eerily similar to those of fellow offensive lineman Webster.
No one will know for sure if Brymer has CTE until he dies. The disease has been diagnosed only in dead people; the procedures scientists use to identify it in the brain — slicing and staining neural tissue to reveal the tau protein — can't be safely performed in a living human being. Research is under way to identify biological indicators of CTE in the living, perhaps in spinal fluid, but nothing has panned out. For ex-football players struggling with CTE-like symptoms, doctors can only offer a guess, based on their medical histories, as to what's wrong. Even then, there is no cure.
"There's no way to know whether this guy has CTE or not from what you're telling me, but there's certainly enough to suspect it's there," says Robert Cantu, a prominent brain researcher at Boston University. "I can tell you that he fits the profile, so he would be highly suspect for CTE."
Chris Nowinski, a former Harvard football player who runs the Sports Legacy Institute in Boston, says, "You're talking about a guy who is successful in two careers and suddenly develops cognitive and emotional problems that ruin his whole life. At this point in somebody's life, that doesn't have a lot of other causes. People can lose their minds in midlife and develop problems, but it seems to happen to a lot of former football players."
While Brymer acknowledges that his years as an offensive lineman involved "a lot of head-banging," he says he never reported a concussion. No matter: Repeated head trauma over long periods — most of it probably suffered in practice, not during games — is believed by researchers to be the likely cause of CTE, rather than isolated concussions.
In response to questions about football and brain trauma, Tim Tessalone, a spokesman for Brymer's alma mater, issued this statement: "USC takes the issue of concussions, head trauma, and brain injury in athletics very seriously. Our athletes are cared for by USC's best doctors and athletic trainers, and our medical staff stays on the cutting edge of the latest developments in the area. USC follows and supports the NCAA guidelines regarding concussion and brain injury education, prevention, reporting, treatment, and management."
Not all are convinced of a link between football and brain degeneration. Mitch Berger, a UC San Francisco neurosurgeon who chairs an NFL subcommittee on the health of retired players, thinks football's risks to the brain have been overhyped.
"In all of professional football, I think there are somewhere around 11 or 12 confirmed cases of CTE. Now, think about that. There are a lot of people who have played football, and most of them have no problems," he says. "It's still a mystery. All we know is that there are football players who have played professionally, as well as in college, who have CTE. We really don't know, other than these anecdotal cases, whether there is an association or link between playing professional football and CTE." One of the problems with existing research, he says, is that there have been no studies in a control population of healthy former players — the dissected brains in which CTE has been discovered came from those with known histories of mental and emotional problems.
As to a link between Brymer's breakdown and his football career, Berger says, "It's going to be a very impossible thing to try to prove."
He's right, as Brymer has begun to find out.
The couple looked out of place in the gallery of Department 22 of San Francisco's Hall of Justice, tanned, attentive, both with full heads of blond hair starting to turn silver. The man was tall, with long limbs and broad shoulders, and reclined in his cramped, folding wooden chair. The woman stared straight ahead. When defendant Chris Brymer was led into the courtroom for a bail-reduction hearing before Judge Charles Haines, she craned her neck to see him.
Rebecca Young, managing attorney in the felony division of the public defender's office, was making a special appearance on Brymer's behalf. Solis, his full-time attorney, was out of town. Young gestured to the couple behind her when she introduced her client. "His parents have driven up to support him," she said. Robert and Wendy Brymer, whose son was in the dock, watched silently.
At issue that August morning was a defense motion urging Haines to release Brymer on his own recognizance without having to post bail, or at least reduce bail from the $200,000 at which it had been set. In the motion, Solis argued that Brymer's predicament should be examined in light of his mental problems.
"Mr. Brymer began to develop comprehension and communication problems, possibly related to a degenerative brain condition from his years as a professional football player," she wrote. "There are a number of recent studies that have conclusively proven a direct link between head injuries sustained in football and degenerative brain disease. ... Despite his efforts to seek medical treatment for his brain injury, Mr. Brymer's condition worsened."