Compromise Reigns at Summit on Concussions

By Les Carpenter
Washington Post Staff Writer
Wednesday, June 20, 2007

ROSEMONT, Ill., June 19 -- They sat shoulder-to-shoulder on a dais in a hotel conference room, the dissenting minds on concussion research together at last. For months these doctors exchanged occasional harsh words and tongue-clucking critiques of each other's thoughts on the long-term effects of concussions and the merits of the NFL's policy.

But when they got together under the lights of a news conference at the NFL's concussion summit Tuesday, the bickering stopped.

"The more you sit with these people, you see how you share the same opinions even though each person has been presented as a polar opposite," said Mark Lovell, the founder of the sports medicine concussion program at the University of Pittsburgh Medical Center. "The difference is that in the scientific community, what we have are cordial scientific disagreements that can appear to be over-exaggerated if it is outside the community.

"We disagree with each other all the time. That's part of science. It's just not usually in the media."

It had gotten bad. Many of the members of the NFL's mild traumatic brain injury committee have been publicly skeptical of new concussion research. And in turn they have been attacked as being unreceptive to new science by the outside doctors. Yet Tuesday, each side seemed willing to accept the other's work.

For instance, Julian Bailes, the chairman of the neurosurgery department at West Virginia University, has been taken by the research of Bennett Omalu, a Pittsburgh area forensic pathologist. Omalu has studied the brains of four dead NFL players who played in Pennsylvania -- Mike Webster, Andre Waters, Terry Long and Justin Strzelczyk -- and has discovered dead neurons that are often found in boxers who had severe head trauma. It may be the first evidence to show that football concussions might lead to dementia in players after retirement.

But Joseph Maroon, a professor of neurosurgery at the University of Pittsburgh Medical Center and also the Steelers' team neurosurgeon, seemed less sure of the connection than Bailes. With Bailes sitting nearby, he ran through a list of other possibilities for the dead neurons that include steroids, drug abuse, amphetamines and even rat poison and antifreeze, which Long used to kill himself.

Rather than snap a defense, Bailes nodded ruefully and said, "I agree we don't know the exact cause."

And Maroon, in the spirit of conciliation, said Omalu's research had brought important data to light that needed to be examined more.

Some tension did simmer in the privacy of the doctors' presentations, which were closed to reporters. Much of the contention came over Omalu's research, which many on the league's concussion committees question as incomplete and needing a control sample of non-athletes for comparison.

But even with the occasional spats, most of the doctors seemed to agree that the discussion was helpful and the exchange of opinions was a good thing.

As they left the conference, many of the doctors who have been critical of the league seemed to have a sense of guarded optimism that the NFL took the event seriously. Each team was required to send a team doctor and two trainers, and attendees were given a giant folder filled with concussion research.

They were encouraged by the opening remarks of Commissioner Roger Goodell, who told them "medical decisions must always take priority over competitive concerns."

A common criticism by doctors and some players over the years is that the league does not want to know how serious concussions are for fear of diluting the product. Those detractors have criticized NFL studies that seem to indicate there are no long-term effects from concussions.

Tuesday's conference seemed to pacify many of them.

Robert Cantu, the chief of neurosurgery at Emerson Hospital in Massachusetts, said he was encouraged by the rhetoric and thought Goodell seemed sincere in addressing concussion issues. So far the commissioner has required all teams to do baseline testing to measure each player's normal brain function to be compared against a similar test after a concussion. He also has initiated a whistle-blower program, in which players can complain anonymously if they feel they are being pressured to play too soon after a concussion.

Players have treated the whistle-blower program with suspicion, worrying that if it isn't implemented correctly their complaints won't remain anonymous. On Tuesday, Ernie Conwell, a free agent tight end who has played for several teams, said he wonders if players are going to feel comfortable reporting concussions to trainers if they think they will undergo extra testing and might be kept from games.

"Nobody wants to be labeled with a soft head," he said.

This, after Conwell admitted to four "documented concussions" in his career and several other possible concussions. Former Redskin Troy Vincent, who also attended the meeting, said he has had as many as 50 or 60 incidents that might be defined as concussions.

As he said this, Conwell simply smiled and nodded.

"When you ask a player on the sideline if he wants to go back in the game, he says yes," Texans tight end Mark Bruener said. "If you establish guidelines for all 32 teams, you protect the player from himself."

Tuesday was not for drawing up a leaguewide policy determining when a player should be kept from playing. That comes later, and the doctors who have been skeptical of the NFL's concussion policies say this is when the proof of the league's commitment will be measured.

Until then, they left the hotel, boarded buses for the airport and chose to remain optimistic.