”Chief Zee,” the longtime, unofficial Redskins mascot, in 201(Photo by Ray K. Saunders /The Washington Post)

Matt Hoyer, the grandson of a Menominee Indian, is a medical student at the Johns Hopkins University School of Medicine.

Zema Williams was enjoying a warm September day in South Philadelphia. A 40-year-old man, he sat on a bench in his traditional Native American outfit — a red fringed shirt embroidered with blue and a matching feathered headdress — and took in the sights of a city turning toward fall. Without warning, two men grabbed Williams from behind. They ripped his shirt and swiped his headdress, seemingly trying to undress him in place. Onlookers broke up the ambush, but not before his self-esteem, like his clothes, was left in tatters. His scalp naked and baking in the late summer sun, he didn’t wait long before limping home.

He shuffled through the parking lot, like a peacock lost in the desert. A van cut in front of him, and when the door opened, his assailants jumped out, accompanied by two more men. There was nowhere to hide, no one to save him this time. They ripped off his remaining clothes, smashed his eye socket and broke his leg, leaving him featherless and flightless in this lonely city.

His injuries landed him in the hospital, and, as is the case for too many Native Americans, it was only the beginning. He spent much of the rest of his life crippled by poverty and failing health until his death at age 75.

But Williams wasn’t Native American. He was a black man in costume, the self-appointed unofficial mascot of the Washington Redskins. His assault in the parking lot of Philadelphia’s Veterans Stadium in 1983 was only a more serious rendition of the antics that took place in the stands and on the sidelines of football stadiums around the country for decades. “Chief Zee,” as he referred to himself, rose to prominence in 1978 after Monday Night Football cameras caught him playfully attacking a Cowboys fan. The two grown men played cowboys and Indians on national television, like a twisted Stanford Prison Experiment remake.

As Williams discovered, people internalize imagery that reinforces their worldview, and it can be difficult to distinguish between caricatures trading blows from a distance and a confrontation to be had when they meet that image themselves. For Native American children, this is an unfortunate reality that plays out in schools across the United States. According to the American Psychological Association, Native American mascots “establish an unwelcome and often times hostile learning environment for American Indian students that affirms negative images/stereotypes that are promoted in mainstream society.” As one California high school student describes, “One of our school’s biggest rivals is the Calaveras Redskins. . . . The most offensive stuff doesn’t even come from the Redskins. It comes from their rival schools, mine included. I have heard my own friends yelling around me, ‘Kill the Redskins!’ or ‘Send them on the Trail of Tears!’ ”

Reliance on these images not only hinders the public’s understanding of Native Americans but also limits the ways that Native Americans see themselves. The mascots are constant reminders of all that Native Americans have been or ever will be in the eyes of others: ancient, angry, primal. Dreams of college or a white-collar job or financial independence suffocate in the racist smoke. In the context of generational poverty, rampant alcohol and substance addiction, a broken Indian Health Service and scarce educational opportunities, it is perhaps not surprising that Native American youths hold the nation’s highest suicide rate. Perhaps it is not surprising that so many would like the team name changed.

Yet here we are, in the middle of yet another football season, and we’re still playing cowboys and Indians. While Chief Zee no longer roams the stands, his seat has been filled by countless others who call themselves “Chief,” “Pocahontas” and “Yellow Canoe.” If you ask football executives about their biggest concern for the sport’s next decade, they might say on-field health. Perhaps they should worry more for the health of those outside the stadium.