Correction: An earlier version of this review misstated the last name of a Massachusetts physician. He is Robert Cantu, not Robert Bantu. The review also misspelled the last name of Chris Nowinski and incorrectly referred to him as a former NFL player; he played football in college. This version has been corrected.

Along with their friends from the Flat Earth Society, people in football forever maintained a cherished belief: that there were rarely any concussions in their noble sport. Players would not report headaches, coaches wanted their stalwarts back in action pronto, team doctors wanted to please coaches, and fans just wanted to see more smashmouth. Unlike the other prime American team sports, baseball and basketball, football is not just about winning, but about proving manhood. And so, as Linda Carroll and David Rosner explain in their thoughtfully passionate and comprehensive study, “The Concussion Crisis,” the “macho culture permeating the country insisted that the way to deal with a bump on the head was just to dust yourself off and keep going as if nothing happened.”

Consequently, even though it has been more than a century since President Theodore Roosevelt threatened to ban the game in order to keep the flower of Ivy League knighthood from maiming one another, and even though helmets morphed into brain battering rams, and even though players have grown larger and faster, the authors show that, until as late as 1984, nobody much considered the fact that, heavens to Betsy, our favorite sport was turning into a mind game. Only then did Robert Cantu, a physician in Massachusetts who paced the sidelines of boys’ games, begin to sound some alarm. Hello: Heads were colliding out there.

As research has advanced, doctors have discovered that while football is the most fertile concussion breeding ground — with the outcome even earning its own pathological title, “gridiron dementia” — many other seemingly benign sports threaten the mental well-being of our children. American girls, for example, suffer three times more basketball concussions than boys, and more than twice as many soccer concussions. The beautiful game that soccer moms fancy for their dear offspring is not patty-cake; as brutal as our football may be, at least we don’t try to score by employing our heads as clubs.

Carroll and Rosner intersperse their more technical chapters (which are effectively written for the understanding of lay readers) with sad profiles of those who’ve sustained football concussions that have led to disability, shattered lives, insanity and early death. But, mercifully, substantive research has increased. Thanks to Chris Nowinski, who played college football, who has been collecting brains from families of deceased players, pathologists are now able to study the damage. Moreover, because concussions are the “signature wound” of the Iraq and Afghanistan wars, considerably more attention has been paid to the subject. Even the NFL — which, with brain injuries, for so long mimicked the tobacco industry’s denial of cancer — has finally acknowledged the cruel reality that playing the sport is simply not amenable to maintaining intelligence.

Given the warrior mentality of those who scrimmage, it should not be surprising that players themselves are often most resistant to the sissifying of their game. Kevin Mawae, an all-pro center and head of the players union (a position that at least suggests he still possesses all his marbles) reacted to the new anti-concussion rules by grousing that “the skirts need to be taken off in the NFL offices.” Of course, Mawae has hard-boiled company. The National Hockey League has “dismissed any suggestion of penalizing head-on checks.” Nor is there evidence that either fans or TV networks are particularly sympathetic to reduced cerebral mayhem. During these hard times, when the NFL might well be the most unthreatened business in America, the bloodlust factor appears to be a major bulwark of its unstoppable popularity.

‘The Concussion Crisis: Anatomy of a Silent Epidemic’ by Linda Carroll & David Rosner (Simon & Schuster)

As Carroll and Rosner emphasize, concussions are often undetectable. They aren’t born just from those bombastic crashes that television savors for its highlight reels. Cumulative jolts can ultimately inflict as much damage. One study found that, counting both games and practices, some college linemen endure up to 1,800 head hits per season. And because the human brain is not fully developed until its carrier body escorts it into its mid-20s, children are even more vulnerable. Almost 5 million boys play youth league and high school football — virtually all of them in this pigskin-lovin’ nation — and studies have shown that almost half of adolescent gridders have sustained concussions, a third of them on multiple occasions.

“The Concussion Crisis” is quite a devastating testament. It lays it all out and forces us to ponder how a civilized people can blithely accept an entertainment that does such damage to young men’s minds. I remember talking to an old boxer who pointed out to me that his sport was the only one where the participants didn’t want their sons to follow them into the game. Only the very desperate enter the ring, risking a trip down “queer street.” One lays “The Concussion Crisis” down wondering, likewise, where future American gridiron gladiators will come from; surely not from families who read this book.

Frank Deford is an author and NPR sports commentator. His most recent novel is a 1930s love story, “Bliss, Remembered.“


Anatomy of a Silent Epidemic

By Linda Carroll and David Rosner

Simon & Schuster. 320 pp. $26