Weeks after suffering what would be the last concussion of an athletic career filled with them, the towering, bearded Kosta Karageorge left his Columbus, Ohio, apartment in the middle of a frigid night. The college wrestler and football player had been distraught, his family said, reeling from his last head injury. At 1:30 a.m., shortly before disappearing into the night, he shot off a final note to his mother, Susan.
“If I am an embarrassment,” he wrote her, “but these concussions have my head all f—ed up.”
After he didn’t turn up the next day, his family contacted police, saying the 22-year-old was missing. “We’re very concerned that he’s not himself and that he maybe doesn’t know what’s going on,” sister Sophia told the Columbus Dispatch. “Every time he’s had a concussion, he’s been evaluated and listened to his trainers. He’s been properly taken care of by OSU the entire time he’s been an athlete for them. But … his repercussions from them have been long-term or delayed after the fact.”
Karageorge was found dead in a dumpster near his apartment on Sunday of an apparently self-inflicted gunshot wound. Authorities don’t yet know what precipitated his suicide, especially given the frequency of suicides among college students generally. But if Karageorge’s death had anything to do with his history of concussions, it would reflect a growing body of research suggesting links among concussions, student athletics and suicide.
In late July, the NCAA set aside $70 million for a medical monitoring fund after determining football players are three times more likely to develop chronic traumatic encephalopathy (CTE), which can leave its victims depressed, disoriented and suicidal. Worse, an NCAA report found, “under-reporting of concussions is likely to be higher in football than in other contact sports, since football offers more in-game ‘down time’ during which the immediate symptoms of concussions can subside.”
Though widely reported, the science of CTE remains little understood, and the condition is difficult to diagnose, the report added.
What’s better understood: the link between depression and concussions – especially among the young. One study published in the Journal of Adolescent Health in January of this year found repeatedly concussed teens are three times more likely to develop depression. A separate paper, published in PLoS One last spring, suggested teens with a history of head injury are at “significantly greater odds” of attempting suicide and “engaging in numerous violent behaviors.”
Echoes of those findings sounded one morning in April of 2010, when a popular University of Pennsylvania football player named Owen Thomas hanged himself at his apartment. He had no history of depression, but nonetheless became suicidal after suffering a sudden mental collapse, friends told reporters at the time. Months later, doctors announced his brain carried traces of CTE, making him the first and youngest collegiate football player to be found with the condition.
“He loved to hit people,” his mother told the New York Times at the time. “He loved to go into practice and hit really hard. He loved to intimidate. It’s kind of sad. We all love football. We all love watching. We all love these great hits.”
But what are the consequences of those hits? One study, published in Clinics in Sports Medicine in 2005, analyzed 71 athletes who had either contemplated or committed suicide in the past several decades. Nearly half were found to be football players. More than 60 of the athletes were men. And the median age was 22. One such player was a Duke lineman named Ted McNairy, who committed suicide years after playing.
“The postconcussive syndrome as a potential factor in suicidal behavior is not an insignificant one” among young football players, the paper said. “Of the 1.5 million high school players in the United States, 250,000 have a concussion in a given season. … Concussions on the field are probably underreported, both because they can be subtle, and because of football’s ‘rub-dirt-on-it’ ethos.”
But even if not reported on the field, concussions are finding their way into the courtroom. Months after the NCAA agreed to provide $70 million for testing to settle several consolidated concussion lawsuits, a former high school quarterback sued the Illinois high school sports governing body. The suit called concussions in high school football “an epidemic.” The former player, Daniel Bukal, who last quarterbacked for Notre Dame College Prep in 2003, claimed he had suffered from migraines and memory loss for years after he left the gridiron.
“Football is in danger in Illinois and other states – especially at the high school level — because of how dangerous it is,” said Chicago attorney Joseph Siprut, who represents the former quarterback. “If football does not change internally, it will die. The talent well will dry up as parents keep kids out of the sport – and that’s how a sport dies.”