October 16, 2024 • 52 mins
It's football season! Arpita tells the story of a pathologist who publicized some of the dangers facing NFL players. Come for the football, stay for Dr. Omalu's surprising motives.
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Episode Transcript
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(00:11):
Hi everyone, and welcome back tothe Smart Tea podcast, where we
talk about the lives ofscientists and innovators who
shape the world.
How are you doing Arpita?
Arpita (00:20):
I'm good.
I am so thrilled it is no longer95 degrees in the city.
That was not, that was not myfavorite.
Aarati (00:28):
Yeah.
Arpita (00:29):
That was tough.
Aarati (00:31):
Yeah.
I'm the opposite.
I love, I love the hot weather,but yeah, San Francisco, it's
like unnatural for SanFrancisco.
Arpita (00:41):
It is unnatural for San Francisco.
I, I can't.
I want it to be 60 degreesalways, which it is now, but
that, that heat wave was toughfor me.
I was, sweating in my apartment.
All the windows are open.
And I was like, I can't do this.
Aarati (00:56):
Yeah.
You remind me of, uh, my littleworms that were very particular
about the weather when I was ingrad school and our experiments
would not work if the weatherwas not perfect for some reason.
If it was warm and sunnyoutside, all the experiments
would work.
If it was rainy, they were justnot happy and so the weather
(01:20):
conditions had to be perfect.
It was such a pain.
Arpita (01:22):
I have a very narrow homeostasis.
Is the conclusion here.
Yeah.
Can't be too sleepy.
Can't be too hungry.
Can't be too cranky.
Can't be too hot.
I'm really just a, I'm just aworm.
I'm just a worm.
Aarati (01:36):
That's what.
That's the great thing aboutworking from home, I feel like,
because you can maintain thathomeostasis so much easier.
You have like snacks withinreach and like, you know, your
pets are within reach of anytime you need like emotional
support.
Arpita (01:51):
Yeah, I never get ready.
Aarati (01:53):
Yeah, in the office, it's like, oh, I can't eat at
like this time.
It's not lunchtime yet.
I have to keep working.
I'm cold or warm or something.
It's so hard in the office.
Arpita (02:05):
Yeah, it's true.
It's true.
How are you?
You went on a little trip.
Aarati (02:10):
I did.
Yes, I went to visit my friendin SoCal again.
So I went to visit her for thatone off Las Vegas trip.
And then a week later, it washer son's birthday, so I went
down again, like a week laterto, yeah, to help with
decorating the house and all ofthat kind of stuff.
So it was really fun.
(02:30):
Yeah, it was.
Arpita (02:31):
Did you have a nice birthday?
Aarati (02:33):
Yeah, it's like a two year old's birthday.
He's at the phase right nowwhere he's obsessed with Mickey
Mouse.
So we were, you know, decoratingthe whole house with Mickey
Mouse balloons.
And we had little headbands thathad like the two ears on top,
um, for everyone to wear.
So
Arpita (02:48):
That's really cute.
Aarati (02:49):
Yeah.
It's like one of the few wordshe can say is Mickey.
So, okay.
We know we know.
Arpita (02:57):
Keep your priorities straight for sure.
Aarati (02:59):
Yeah.
Yeah.
But it was, it was really good.
So it was fun.
I'm, I'm glad I went, um,although the drive down there is
so long and we are drivingthrough like, 95 degrees
weather.
I was like, if I blow a tire outhere, I'm screwed.
Arpita (03:15):
So, oh my god, I would cease to exist.
Aarati (03:17):
Yeah.
So, so hot.
And they live in the middle ofthe desert, I think I mentioned
before too, so on his birthdayit was definitely over 100
degrees.
So, thank god for AC.
Arpita (03:30):
Yeah, I think that's the big thing is, Like, there is no
AC in San Francisco because it'snever hot, and so when it's hot
outside, it's whatevertemperature is outside is also
inside my apartment, so there'sno, like, reprieve, you know,
you're just sweating andmelting.
Aarati (03:47):
Yes, I think the Bay Area...
Arpita (03:49):
Makes me seem like a baby, but, like, if you lived in
these 110 degree places with noAC, you would agree with me.
Aarati (03:56):
No, but that's, that's what I think.
I think the Bay Area has alwayskind of just been temperate.
And so I think at most peoplewill have heating.
Yeah.
And now AC is something thatpeople are like having to add to
like their homes.
They're like having to buy itand install it in their homes
because it's climate change andwhatnot.
But you know, we've never, wedon't usually have these really
(04:19):
hot days.
So.
Arpita (04:21):
Yeah.
Aarati (04:22):
Yeah.
Oh, also though, we were talkingabout worms earlier and I was
very excited to see that theNobel prize was given in
physiology and medicine to twoworm scientists.
I was like, yes, C elegansgetting their spotlight shown on
them.
(04:43):
Um, but I was especially excitedbecause that paper about micro
RNAs in C.
elegans was like the foundationof my PhD.
It's like the first paper that Iwould have had to read.
Yeah.
It was like the basis for all mywork kind of.
Um, I wasn't working with, um,micro RNA is necessarily, but
(05:03):
like, yeah, I was working with,RNA interferencee and silencing.
And so it's related.
And so it's like, this wasdefinitely the first paper that
kind of talked about that.
And so it was definitely one ofthe first papers that I read.
And so I was like, Oh my gosh, Iknow those people don't know
them.
(05:25):
I haven't met them, but I'veread their paper.
I know who they are.
Their names are familiar.
It's like very exciting.
So yeah!
Arpita (05:32):
That's really funny.
Um, no, I love that.
When I saw that headline, thefirst thing that I saw, I
somehow didn't process micro RNAand I just saw mRNA.
And I was like, wait, have wenot known about this for a
really long time?
Messenger, messenger, messengerRNA.
And then I was like, Ooh, I'mback now.
I was like, I got it.
Aarati (05:52):
Yeah.
For me though, like, and maybeit's because I studied it, but I
was like, micro RNAs we've knownfor a really long time, like,
how has this not gotten theNobel Prize before this?
And then I saw that they likediscovered it in the 90s.
And I was like, yeah, that'sstill been a really long time.
I guess it just took.
This long for us to reallyunderstand how ubiquitous they
(06:14):
are and how like important theyare.
There's just so many micro RNAsnow and they're being used for
so many things.
Um,
Arpita (06:23):
So many therapies too.
Aarati (06:25):
Exactly.
And preventative care and earlydiagnosis and things like that.
So I think just kind of theweight of that discovery has
finally hit home, I guess.
So I was glad that it was.
Finally, I, I just kind of hadthe like, wait, it hasn't been
recognized already?
Yeah,, so I'm really glad itfinally got its due.
Arpita (06:47):
Yeah, no, that was awesome.
I, it's kind of fun to have itbe Nobel prize season.
Aarati (06:52):
Yes, definitely.
Um, so speaking of amazingscientists, uh, who are we doing
today?
Arpita (06:59):
Okay, so we're, I have a theme this week.
Aarati (07:02):
Oh, excellent.
I love a theme, you know.
Arpita (07:04):
Uh, well, we are, um, fully in NFL season and I
decided to do a scientist whohas gotten a lot of notoriety
from the NFL and this is Dr.
Bennet Omalu.
Who is the person who broughtCTE to the limelight.
(07:25):
So
Aarati (07:26):
What is CTE?
Arpita (07:27):
We're going to find out.
And I, you, I think you'veprobably heard of this.
Um, he was an interestingcharacter in this story.
Turned out to be a little bitmore crazy than I was expecting.
So I'm excited to jump into it.
Okay.
So, Bennet Ifekandu Omalu wasborn in Nigeria in September
(07:48):
1968, and he was born in themiddle of the Nigerian Civil
War.
So the war forced his family toleave their gated compound that
they had in their village, butthen eventually at the end of
the Civil War, they were able tocome back and they had a pretty,
pretty comfortable lifestyle.
Um, his mom was a seamstress andhis dad was a civil engineer and
(08:12):
like a pretty big communityleader.
Aarati (08:14):
I just wanted to say real quick, um, I'm really glad
you're doing someone who's notan American or not European
because I feel like, a lot of, alot of scientists that kind of
have the limelight shone on themare from the western world.
And so I'm really, really gladyou're doing someone from
Nigeria.
That's amazing.
Arpita (08:34):
It was not really intentional, but great.
Aarati (08:36):
Yeah.
Arpita (08:36):
Okay, he was the sixth of seven children.
And he was super smart.
He was accepted to the federalgovernment college when he was
12.
And then when he was 15, hestarted medical school at the
University of Nigeria.
And this is a little bitdifferent.
So he graduated with abachelor's of medicine and
surgery and MBBS in 1990.
Um, and so when he was done withthat, he did a clinical
(09:00):
internship and three years ofservice work in another city
called Jos.
And so Nigeria was having, um, alot of political conflict around
this time, and so there was apresidential candidate named
Moshud Abiola, and he was tryingto bring, like, a lot of change
and democracy to the country,and he lost the presidency in
(09:23):
1993, and Bennet started to feelreally cynical about the
Nigerian government and itsfuture, so he started thinking
about emigrating.
So a few years later in 1994, hecame to Seattle and he started
working on a fellowship inepidemiology at the University
of Washington.
And very soon after that, hemoved to New York City where he
(09:45):
started working at ColumbiaUniversity's Harlem Hospital
Center, and he did a residencyin anatomic and clinical
pathology.
Aarati (09:55):
Wow.
Arpita (09:55):
This is just his background here.
Aarati (09:57):
Okay.
Arpita (09:58):
Okay.
So now his story kind of getsinteresting.
So once he's done all thistraining, he moves to Pittsburgh
because now he's a pathologist.
So he's training under thisworld renowned pathologist named
Cyril Wecht at the countycoroner's office.
And while he was working there,he did an autopsy in 2002, and
(10:19):
his patient was Mike Webster,who was, uh, formerly a center
for the Pittsburgh Steelers.
And so, Mike, after his NFLcareer, died really suddenly at
the age of 50.
And it was after several yearsof struggling with cognitive
issues like intellectualimpairment, mood disorders,
(10:42):
depression, drug abuse, and hehad several suicide attempts.
Um, and his cause of death waslisted as a heart attack, but
Bennet was like,"I don't know,something seems kind of weird
here."
Aarati (10:54):
Yeah.
Arpita (10:54):
And he looks at Webster's brain as part of a
normal autopsy.
And it looked pretty normal, butbecause he had some suspicions,
Bennet then conductedindependent, uh, tissue analyses
and he suspected that MikeWebster suffered from something
called Dementia Pugilistica.
(11:14):
I did not think about sayingthis out loud.
Hold on.
Aarati (11:19):
Dementia
Arpita (11:21):
Pugilistica.
Yeah, I was right.
Okay.
Aarati (11:23):
Yeah?
Okay.
Arpita (11:23):
Okay.
Aarati (11:24):
I do think I know where this is going.
I think I have heard of.
Arpita (11:27):
You have.
Aarati (11:27):
I don't, I don't follow football at all really, but I
have heard of traumatic braininjuries and kind of the
controversy around this.
So yes.
Arpita (11:37):
Yeah.
Oh yeah.
So.
He suspected that Mike Webstersuffered from Dementia
Pugilistica, which is a specifictype of dementia that comes from
repeated blows to the head.
And up until this point, it wasseen in boxers who
understandably had this.
So he sliced and stained thebrain tissue samples, um, and he
(12:01):
found large accumulations of tauprotein in his brain, um, and
these accumulations can affectthings like mood, emotions, and
executive functions, and it'sreally similar to the way we
think of accumulation of betaamyloid protein, which is what
we see in Alzheimer's disease.
Aarati (12:20):
Right.
So tau protein is associatedwith these kind of mood
disorders and...
Arpita (12:27):
Yeah, elevated tau protein.
Aarati (12:29):
Elevated tau protein, the same way that beta amyloids
are or elevated beta amyloidlevels are associated with
Alzheimer's.
Okay.
So it's like a marker of kind oflike, yeah.
Okay.
Kind of like a marker of thatdisease.
Arpita (12:43):
Exactly.
So in healthy brains, tauprotein is a structural protein,
so it helps give shape andstructure to neurons and their
axons.
So it helps them stay the waythey should be with these like
long, drawn out, um, axons andfor them to hold their shape and
form these connections.
But too much of this isassociated with all of these
(13:05):
other disorders.
Aarati (13:06):
Okay.
Okay.
Gotcha.
Arpita (13:09):
And so Bennet reported and he said, quote,"These
abnormalities were not somethingthat I thought I should be
seeing in a 50 year old man."End quote.
And so he is a little bitconcerned about this and he runs
it by some of his colleagues andthe departments of neurology and
neuropathology at the Universityof Pittsburgh.
And they agree that the taupattern was pretty unusual.
(13:32):
So he publishes his findings inthe journal Neurosurgery in 2005
in a paper titled ChronicTraumatic Encephalopathy in a
National Football League Player.
Aarati (13:43):
Oh, so he just did this on one player and published a
paper on it.
Okay, I would have thought hewould have...
I don't know.
I guess you can't really do thatkind of diagnosis on people who
are still living like he had tocut out a piece of their brain.
Right?
So,
Arpita (14:00):
Right.
Um, you do bring up aninteresting point here in which
that he did this on one person.
So let's just bookmark that.
Aarati (14:07):
It's an n of one.
I would have...
and that's why I'm surprised.
I'm like, Oh, he was able topublish something with the n of
one.
Arpita (14:13):
I'm assuming he kind of did it as a case study.
I didn't actually read this,this paper specifically, but I'm
assuming he published it as acase study, but regardless.
Aarati (14:21):
Yes.
He probably mentioned that thiswas seen in boxers as well, like
this is, he probably made thatconnection already.
Arpita (14:28):
Right.
Okay.
So in this paper, Bennet callsfor further study of this
disease.
So he said, quote,"We hereinreport the first documented case
of long term neurodegenerativechanges in a retired football
player consistent with chronictraumatic encephalopathy, CTE.
This case draws attention to adisease that remains
inadequately studied in thecohort of professional football
(14:50):
players with unknown trueprevalence rates," end quote.
So, he published this in 2005thinking that NFL doctors would
be really happy to read it and,you know, improve, um, you know,
protection and help prevent thisfrom happening more in the
future.
But initially, the paper didn'treally get a lot of attention.
(15:13):
But in May 2006, the members ofthe NFL's Mild Traumatic Brain
Injury Committee, alsoabbreviated to the MTBI, called
for the paper's retraction.
And they wrote a letterrequesting that the retraction
characterize Bennet'sdescription of CTE as, quote,
completely wrong, and called thepaper's paper, quote, a failure.
(15:36):
However, the researchers stoodtheir ground.
Aarati (15:39):
I'm really shocked by, like, all of that.
I'm first of all shocked by thefact that there already is a
mild traumatic brain injurycommittee in the NFL.
Like, even, even at this point,before he's even, like, he's
just started to publish papers,they've already formed a
committee knowing that...
Arpita (15:58):
The committee existed.
Aarati (15:59):
Yeah, like, it already existed, but that
Arpita (16:01):
Yeah.
Aarati (16:01):
Why does it exist except for the fact that this has been
happening?
People know that this is a thingso there has to be a committee
around it.
So it's like already, Youalready know this is a dangerous
sport.
You already have a committeeabout it Yeah, you already have
that but then on top of that toreject his paper and just be
like this has no merit It's likeyou're the freaking committee
(16:22):
for it! What do you mean?
Arpita (16:26):
It doesn't make any sense if anything it sort of
like made it a little bit worseas we will see.
Um, so the same year, 2006,another football player, Terry
Long, committed suicide and hewas 45 and he was also found to
have elevated levels of tauprotein in his brain, which
Bennet said, quote, a 90 yearold brain with advanced
(16:47):
Alzheimer's end quote.
Same as Mike Webster, Bennetclaimed that Terry Long's
football career had caused laterbrain damage and depression and
mental health problems.
Bennet also found evidence ofCTE in the brains of a few other
NFL players, JustinSturzelchick, Andre Watters, and
(17:08):
Tom McHale, and he published afollow up paper in the same
journal, Neurosurgery, and itwas published in November 2006.
Aarati (17:16):
Sorry, had all of those people died?
Arpita (17:18):
All these people died, separately.
Aarati (17:20):
Oh, my gosh.
Arpita (17:21):
Yeah, it like within several years of each other,
like one died in 2004, one in2006, one died in 2008, and they
all died very young, likebetween 35 and 45.
Aarati (17:30):
Oh, my gosh.
35 and 45.
Holy crap.
Arpita (17:33):
Yeah, super young.
So he, he published a paper,including findings of all of
these different people.
So, the MTBI committee continuedto discredit his research as
flawed and did not acknowledge alink between the sport,
football, and brain damage informer players.
(17:53):
However, Bennet gained a reallyimportant supporter in a man
named Dr.
Julian Bales, who was thechairman of neurosurgery at the
West Virginia School ofMedicine, and he was also
importantly a former teamphysician for the Steelers.
So Dr.
Julian Bales, um, and a lawyernamed Bob Fitzsimmons and Bennet
(18:18):
all founded the Sports LegacyInstitute to continue studies of
CTE.
Aarati (18:23):
This is just crazy to me.
It's just so crazy that he'sbeing met with so much
resistance when all you have todo is watch any football game
and see how they like smack intoeach other and be like, yeah,
that could definitely cause someinjury.
Um, I don't even have to knowanything about football to see
that that could be a dangerousactivity.
Arpita (18:44):
Problem.
Yeah.
Aarati (18:46):
Yeah.
It's not that far of a stretchto see that that could
potentially cause some braindamage.
And maybe you should beprotecting against that.
Yeah,
Arpita (18:58):
Totally.
So the NFL continues to evadethis and deny that it's a
problem.
But Bennet and his supportershad a victory when Mike
Webster's family was awarded asignificant settlement in
December 2006 from the NFL.
Aarati (19:13):
And that was the first guy, right?
Arpita (19:15):
The first guy.
Aarati (19:16):
The first guy who, um, he studied.
Arpita (19:19):
Correct.
Yep.
The first guy.
For the following June, the NFLcommissioner, Roger Goodell
convened a quote"ConcussionSummit" to discuss the issue
with the NFL's MTBI committeechair, Dr.
Ira Kasson and told the press,quote,"In my opinion, the only
scientifically valid evidence ofa chronic encephalopathy in
(19:40):
athletes is in boxers and insome jockeys," end quote.
So the NFL just like doesn't.
Really get behind CTE at all.
Aarati (19:53):
That's, yeah, like I said, like, that's crazy.
I mean, again, all you have todo is watch them and see, like,
how violent the sport is andhow, like, you know, that's
insane.
It's also just kind of crazy whythere's so much pushback against
it.
Like what is, what is the dealwith the pushback when, uh, when
(20:17):
a scientist tells you, Hey, thiscould be a potential problem,
maybe we should take steps tomitigate this problem.
I don't know, like maybe lookinto better helmets or changing
the rules so that, you know,there's not as much head contact
or something.
Like, can we work with this?
I'm like, what is the pushbackto just implementing that
(20:39):
anyway, it's the kind of thesame thing I see with climate
change is like, okay, even ifyou don't believe it's a thing,
even if you don't believe thattraumatic brain injury is
happening, is there a downsideto just investing in, you know,
designing better helmets or youknow, changing the rules
slightly so that you cannotsmash head on into something,
(21:03):
you know, like I just don'tunderstand the intense pushback.
If, if anything, you're justmaking it safer.
Why is there a problem?
Arpita (21:14):
I think, I mean, it's, I think it's really just money is,
I mean, obviously it's thebiggest thing, right?
It's like their, their, theirprofit margins on this are so
high and the NFL generates likebillions of dollars in revenue.
And so if you're, if you'reputting money into something
else or admitting that whatyou're doing is dangerous or has
a problem, then there is achance that you are going to,
you know, lose your fan base.
(21:34):
There's a chance that, you know,people are going to come out
against this.
So if you continue to deny andsay that your sport is actually
safe, then you're maintainingthe status quo, which I think is
the biggest thing here.
Because it's based on a fanbase.
It's right.
It's like you have to the entirerevenue stream is based on
people.
Being excited about it.
And so if there's reason tobelieve that their favorite
players are in fact, you know...
Aarati (21:55):
In harm's way?
Arpita (21:56):
In harm's way, right.
It's like, that's, that's goingto ruin it.
Aarati (22:00):
Yeah, I would just do it on the downlow then.
I feel like I'm maybe being verynaive, but
Arpita (22:06):
it's a little naive, but I understand.
You're an idealist.
Aarati (22:09):
Every, yeah, like every year or whatever you design new
helmets anyway, like thedecoration change or the color
schemes change, just, you know,put in a few safety measures
into that new helmet quietly.
It doesn't, you can call it astyle element.
I don't know.
Arpita (22:24):
Oh, sweet Aarati.
Aarati (22:25):
I know.
Arpita (22:26):
Sweet, sweet Aarati.
Aarati (22:26):
I'm just like, I just want the world to be a good and
safe place.
Why is that too much to ask?
Arpita (22:34):
Okay, so back to Bennet.
Bennet moved to California in2007 and he started a new job as
chief medical examiner, uh, inSan Joaquin County.
Um, and he continued some postgrad education, um, and earned
his MBA in 2008.
He also published his firstbook, Play Hard, Die Young,
(22:56):
Football, Dementia, Depression,and Death.
A really fun title.
Aarati (23:00):
Yeah.
Arpita (23:01):
Um, and he advanced the study of CTE by branching out to
athletes from other sports aswell as war veterans.
Aarati (23:10):
Oh, wow.
Arpita (23:11):
And then by 2009, his work on CTE was finally starting
to gain traction.
He was profiled in GQ, whichreally detailed his efforts to
raise awareness of footballrelated brain injuries, and then
especially highlighted the NFL'srefusal to cooperate.
So the NFL commissioner, as aresult of this, and other
(23:32):
executives were then called totestify before a house judiciary
committee, which then started anoverhaul of the MTBI and rule
changes to enhance safety aswell as a lawsuit that was
brought forth by thousands offormer players against the NFL.
Aarati (23:47):
Oh, wow.
So he's really blowing this upnow.
He's like, fine, if you're notgoing to just do this
internally, I'm going to justtake it to the public and make
sure that people know aboutthis.
Yeah, good for him.
Arpita (24:01):
So the NFL then didn't publicly acknowledge the link
between concussions sustained infootball and long term
neurological effects untilDecember 2009, which was seven
years after Bennet's originaldiscovery in Mike Webster.
But even up until 2013 at theannual meeting of the American
Academy of ClinicalNeuropsychology, the AACN, this
(24:22):
included a debate between twosports concussion experts which
looked at the validity or evenlike the existence of CTE.
And then finally, in March 2016,the NFL's Senior Vice President
for Health and Safety Policytestified before Congress that
the NFL now believed that thereis a link between football and
CTE.
And then in 2016, the AmericanMedical Association awarded
(24:44):
Bennet with their highest honor,the Distinguished Service Award,
for his work on CTE.
Aarati (24:51):
Hi everyone, Aarati here.
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Okay, back to the story.
Wow.
So how long did that take themto like, from when he first
(25:35):
published?
It was over 10 years, right?
Arpita (25:37):
Yeah.
11 years.
Cause the first paper was 2005.
So this story eventually reachedHollywood and Will Smith landed
the starring role in the 2015movie Concussion.
And Will Smith spent a lot oftime learning his distinct
Nigerian accent and intonationand his mannerisms and received
a lot of acclaim for this role.
(25:59):
So, for Bennet, the release ofconcussion served as the
ultimate validation for all ofhis years of hard work.
He was also the lead author in apublished study in November 2017
that for the first timeconfirmed CTE in a living
person.
So, with some of his colleagues,he found that a radioactive
chemical tracer called FDDNPbinds to tau proteins, which is
(26:24):
detectable by a PET scan andassociated with some of the
other distinctive uh,topographical distribution
characteristics of CTE.
So they tested this and over adozen, just a dozen, former NFL
players and then this wasconfirmed after former
linebacker Fred McNeil passedaway and it was confirmed post
(26:46):
mortem.
Aarati (26:48):
Okay, so they actually diagnosed him while he was still
alive, and then once he died,they were able to do the full
autopsy and kind of confirm theresults.
Arpita (26:59):
So, since then, and since all this research has sort
of come out in like the earlyaughts, CTE has been established
as a progressive degenerativedisease.
Brain disease that's associatedwith head trauma.
It's not limited to football orboxing.
It's been found in athletes whoplayed soccer, hockey, rugby,
mixed martial arts, and even BMXbike riding.
(27:20):
And outside of sports, CTE hasalso been reported in military
personnel, um, particularlythose exposed to blast injuries,
and it's even seen in people whohave been exposed to domestic
violence.
It's basically a problem in anyindividual who's been exposed to
some kind of head trauma.
So most of what we know suggeststhat imaging technologies may be
able to detect CTE in livingpeople based on that paper from
(27:44):
2017 that I was talking about.
But the only proven and likeofficial way to diagnose this
condition is through an autopsy.
Um, But while you're living, CTEproduces a range of neurological
symptoms, including depression,memory loss, confusion, impaired
judgment, impulse controlissues, aggression,
(28:04):
Parkinsonism, and eventuallyprogressive dementia.
And some people with CTE haveeven attempted suicide, as we
mentioned.
Aarati (28:12):
Yeah, that's so scary.
Um, if they, are able todiagnose it in people and maybe
you're getting to this, but ifthey're able to diagnose it in
people while they're living, isthere any treatments that they
can have?
Arpita (28:25):
Not right now.
Yeah, not right now.
Aarati (28:29):
Oh my gosh.
So it's kind of like a deathsentence almost like if you have
these symptoms and you do thisPET scan and they figure out
that your tau levels areelevated, you're It's kind of
like you might die early.
It sounds like, yeah.
Oh, that's so...
that would be heartbreakingnews.
I feel like for anybody
Arpita (28:51):
And it's not super clear.
So we're going to get into thediagnosis a little bit more.
Um, so symptoms of CTE can,well, first of all, they're
really broad, right?
Like all those things that Ilisted could be theoretically
anything, right?
It could be.
a tumor.
It could be, you know what Imean?
It could be literally anything.
Um, and symptoms of CTEgenerally go unnoticed until
(29:11):
years or even decades after thebrain trauma has occurred, or
the person has even stoppedplaying sports.
So sometimes it can be reallyhard to connect the two.
Um, and CTE has also beendocumented in people as young as
17, according to a 2016 study inJAMA.
Um, and just like you asked,symptoms can be managed, but the
(29:32):
condition itself can't be cured.
So the biggest thing isminimizing risk.
Aarati (29:37):
So it can't, it can't be reversed, but you can kind of
prevent it from getting worse?
Arpita (29:43):
You can specifically manage the symptoms is really
the biggest thing.
So if you've got like vestibularstuff you can do vestibular
training.
If you have, you know,dizziness, you can manage that,
but like the underlying causecan't be changed.
Aarati (29:57):
Okay, like our brain naturally will deteriorate as we
get older and older, right?
So I feel like first of all,it's irreversible, but then
naturally it would, it would getworse.
And the only thing you can do ismanage your symptoms.
That sucks.
Arpita (30:12):
Totally.
so, increased awareness of CTEhas started, like, a whole field
of new research, partly becausea lot of players and their
families have donated brains ofat risk people after they've
passed away.
So, to help identify patterns,there's been an effort to start
the CTE Center through BostonUniversity, which has a brain
bank of over 600 specimens andtissue samples.
Aarati (30:35):
Whoa, a brain bank.
Never heard of that before.
That's cool.
That reminds me of that scene inYoung Frankenstein.
Have you seen that movie?
It's a funny movie with GeneWilder, and he's Dr.
Frankenstein, and he's trying tobuild Frankenstein's monster,
um, and he asks his henchman,Igor, or sometimes pronounced I-
(30:56):
gore, to go get him a brain andthen Igor gets him a brain and
he puts it in the monster andthe monster comes to life and
it's like going nuts like goingberserk and he's like, what's
going on?
Like, what brain did you get me?
You were supposed to get me likethis amazing scientist brain or
something because this guy wassupposed to be like the monster
(31:16):
was supposed to be anintellectual, you know, but he's
clearly not and Igor is like,"Itwas Abby someone" and he's like,
"Abby someone?" He's like, yeah,Abby, Abby normal.
And it's like, are you tellingme how I put an abnormal brain
into this?
It just reminded me of that.
(31:37):
Like you went to the brain bankand you got an abnormal brain
for my monster.
Arpita (31:41):
That's really funny.
Aarati (31:43):
You idiot.
Yeah.
It's a funny movie.
It's a good one for Halloween.
It's hilarious.
Arpita (31:49):
Good spooky movie.
Aarati (31:50):
Yeah.
Arpita (31:51):
Okay, so talking about overall exposure.
You don't need to have aconcussion in order to be at
risk for CTE, so a hit to thehead that doesn't cause symptoms
or that can't be diagnosed withstandard clinical tests can
still increase long term braindamage.
So something that researchershave been exploring is the
potential dangers of cumulativesub concussive hits or blows
(32:15):
that don't cause diagnosablesymptoms.
So a concussion is defined as ahit to the head that results in
clinical symptoms.
So something like this wouldcause your brain to move within
the cerebrospinal fluid, whichkind of acts like a cushion.
So your brain is hitting theinside of the skull, often
multiple times.
And this can result in thingslike headache, dizziness,
(32:36):
disorientation, difficultyfocusing your eyes, trouble
concentrating.
Remembering things, cryingeasily, feeling issues, or
having any sleep problems.
Um, but contrastingly, a subconcussive hit doesn't look like
anything.
It doesn't produce clinicalsymptoms.
So there isn't a real way tomeasure or diagnose it.
And there's no way to look attwo different sub concussive
(32:58):
hits and say, Oh, this one wasdangerous.
And this one wasn't the onlyrisk factor that we have is the
duration of these Repeated hits,so like the duration of contact
play or exposure to contactsports, and essentially the
cumulative nature of those hits.
This doesn't make concussionsunimportant.
So if you get a concussion, youprobably have had many more
(33:22):
subconcussives.
blows.
So we don't have anunderstanding if there is a
threshold to concussions orsubconcussions that results in
CTE.
So it's like, if you get thisnumber and now you're at a risk,
or if you get this number,you're at a higher risk because
We don't really have that kindof data, and it's also
challenging because based on anautopsy, not everyone who has
(33:46):
had a history of head traumadevelops CTE or CTE symptoms.
So in some studies, boxers withhead injuries only have CTE of
autopsy 17 percent of the time.
However, the reverse, everyonewho has had CTE, on autopsy have
had repeated blows to theirhead.
Aarati (34:06):
That makes sense.
I'm surprised the number is solow though.
Only 17%.
Arpita (34:11):
That was one study that I found.
Aarati (34:12):
Wow.
Arpita (34:13):
So I don't think it's always quite that low.
Um, I also think it reallydepends on the sport and how
likely they are to get like areally bad concussion, which is,
you know, mild traumatic braininjury.
Aarati (34:26):
Yeah, that makes sense.
I feel like there must besomething also in terms of like
football, boxing, rugby, youwould kind of get a lot of
repeated hits to the head,whereas other some of the other
sports you were mentioning, likebeing a jockey, I feel like that
would only happen if you likefell off the horse or something.
(34:47):
And so hopefully that wouldn'thappen all the time.
Yeah.
Arpita (34:51):
So that makes sense.
Aarati (34:52):
Yeah, I'm assuming people are also kind of studying
the differences in the headinjuries in those kinds of
cases.
Arpita (35:01):
No, that that makes a lot of sense.
I think you're right.
Okay, and this is where Ithought this way got really
interesting.
So, some researchers say thatthe data that Bennet has
presented are compelling, butnot definitive.
So, one researcher at BU, whichI discovered BU has, like, one
of the best concussion clinicsin the country.
Aarati (35:21):
Oh, really?
Arpita (35:21):
Um, said that in science, we try to have controls
and recruit randomly forstudies.
Research on CTE to date hasn'tbeen random.
It's been people calling auniversity or someone like Dr.
Omalu and saying, I want you tohave my brain.
Such volunteers often havesymptoms, which boosts the
chances that investigators willfind abnormalities and
potentially skew theirconclusions.
(35:43):
Researchers emphasize that thereis an ongoing need for
perspective and longitudinalstudies.
These would follow randomplayers over time and observe
who does and does not developCTE symptoms or have evidence of
disease in their brain.
Comparisons would then be madebetween players between
different outcomes, people whoplay different positions, and
people in general population orthose who aren't exposed to head
(36:06):
trauma.
And it's really likely thatthere are not only different
thresholds or recurrent blows tothe head, but that there's also
genetic factors and other thingsthat affect your resistance or
vulnerability to developingCTEs.
It's not actually random,obviously.
Aarati (36:20):
Yeah, that just seems like so much effort because you
would have to follow thesefootball players for years
throughout their career and kindof make a note of every time
they got hit in the head....
Arpita (36:37):
oh, yeah.
Aarati (36:37):
...from anything, you know, either from...
Arpita (36:40):
totally.
Aarati (36:40):
...smashing into another player, smashing into a wall,
smashing into the field, likeanything that could, you know,
potentially have hit their head.
I don't know.
That just seems kind of like areally intensive study, isn't
it?
Arpita (36:56):
Sure.
But you know, who collects somuch recording of all of their
players playing football?
The NFL, the NFL cash, also theNFL.
So it's like if you wanted to,
Aarati (37:07):
If you wanted to.
Yeah, that's what I was going tosay.
Yeah.
So I was like, first of all,Instead of starting this study
now, why don't we go back andlook at all the recordings?
Arpita (37:15):
Every single tape of a play, every single play ever.
Yeah, it exists.
Aarati (37:20):
Yeah, it already exists.
All these recordings exist.
I feel like that's a little biteasier.
But I've, I also was wonderingabout like animal models, like
can they do this in mice or ratsor something.
And I mean, obviously, now I'mhaving an image of mice playing
football, which is kind ofhilarious.
But I mean, could they, I feellike they must some, some
(37:44):
researchers must study this inanimal models, right?
Arpita (37:48):
So, fun fact, the first lab that I worked in, um, as
like a baby, baby scientistbefore I was even a grad
student, um, was a TBI lab andwe used mice and it was actually
so horrible.
I really hated it so much, butwe would basically like
stabilize the mouse's head inthis like little chamber and
they would like have like um,like a padding on both sides to
(38:11):
keep its head still and we wouldgive them TBI.
So there was a little pistonthat applied like a certain
amount of pressure and force,and we would give them like a
very pointed TBI and then studyit.
And it was really sad, but yeah,yes.
To answer your question, we cangive mice TBI.
Yes.
Aarati (38:29):
And then you can study that.
Yeah, I feel like...
Arpita (38:32):
I didn't like it.
Aarati (38:33):
Yeah.
No, I mean, this is why, like, Idrew the lines at working with
worms, but
Arpita (38:40):
Like, I get it.
It's like important research,but like, I was like, this is
not.
Aarati (38:43):
Yeah.
Yeah.
But I feel like that.
That also might yield a littlebit more information faster than
sitting down and watching like20 years worth of NFL tapes.
I mean, you know, already justto watch those tapes is a huge
endeavor.
Um, And then to follow currentfootballers would be another
(39:06):
huge endeavor and take a lot oftime and a lot of money.
So,
Arpita (39:11):
Right.
Yeah, if you want to, you could.
Aarati (39:13):
If you wanted to, you could.
Yeah.
But I was just saying likeanimal models might, you know,
help shed a little bit of lighta little bit faster and then
maybe we could refine or what'sthe word like streamline our
studies and human
Arpita (39:26):
Our studies.
Aarati (39:26):
Yeah, because we would know kind of more exactly what
we're looking for.
Arpita (39:31):
No, I agree with that.
I think that's true.
Aarati (39:33):
And the NFL could fund that research in mice or
whatever animal model.
That would work too.
In my perfect world, I was goingto say.
In my perfect ideal, likerainbow world.
Arpita (39:48):
Literally never going to happen.
But yeah, we can hope.
Aarati (39:51):
I know.
Arpita (39:52):
Okay, so now we get to the part of the story where
things really take a left turn.
Um, so as of 2020, Bennet haswithdrawn from the CTE research
committee and has turned himselfinto an evangelist, kind of.
So he travels the world and hesells this really distorted
version of what scientists knowabout CTE and contact sports.
(40:15):
So he does paid speakingengagements, expert witness
testimony, and in several booksthat he has authored, he
portrays CTE as an epidemic andhimself as a crusader fighting
not against just the NFL, butalso against the medical science
community, which he claims istoo corrupted to acknowledge the
clear cut evidence that contactsports destroys lives.
(40:37):
He's built a really lucrativecareer as an expert witness for
hire in lawsuits, and he chargesa minimum of 10, 000 per case.
And his speaking engagementshave an average of 27, 500 each.
Aarati (40:52):
Oh my goodness.
Arpita (40:53):
So, as we now know, CTE should definitely be taken
seriously and studied more.
And as much as we do know that,the brain science community and
the neurosurgery committee has areally wide consensus that
Bennet routinely exaggerates hisaccomplishments and dramatically
overstates the risk of CTE incontact sports.
(41:15):
And this really fuelsmisconceptions about the
disease.
Um, and so this was from aWashington Post paper, and like
a deep dive into CTE and thenspecifically into Bennet's role
in this disease.
So, during some of the speakingengagements that he has, he
offers statistics that aredistorted and they cultivate a
(41:37):
reputation that he is like thepremier expert on the disease,
even though he has not beeninvolved in the research in many
years at this point.
And according to, you know,doctors and concussion
researchers, his definition ofCTE is outdated.
Too broad and describescharacteristics that can be
(41:57):
found in normal healthy brainsand one expert at Stanford said,
quote,"My God, if people wereactually following his criteria,
the prevalence of this diseasewould be enormous.
There's absolutely no evidenceto support that." End quote.
Aarati (42:11):
So according to him, like 80 percent of the human
population probably has CTE fromsomething or another.
He's just really just overblownit completely.
Arpita (42:20):
Completely overblown it.
So when he's asked to refutethese allegations, Bennet says
that the naysayers are fromsports leagues who are
bolstering fake news.
And I was like, oh my god, deargod.
Aarati (42:32):
Here we go with the theories and the conspiracies
and muddying the waters.
Arpita (42:38):
And I was like, I can't with this right now.
Um, and so Bennet is a deeplyreligious man and he believes
that he is on a mission from Godand he views scientists who
question him with suspicion andhostility.
And he says, quote,"As aChristian, I believe after death
there is judgment," end quote.
And he told a lawyer in adeposition one time when asked
(42:59):
about experts who raised doubtsabout his theories he says,
quote,"They will all answer forthis on judgment day", end
quote.
I'm like, okay, you're a crazyperson.
Aarati (43:07):
Wow.
Yeah, no, I mean, it is the jobof scientists to question
everything.
Arpita (43:12):
For sure.
Aarati (43:13):
Even if another scientist is saying it, you have
to go through and validate that.
You have to go ask questions.
That's the job of a scientist.
And I really have a problem withpeople mixing their faith with
things where faith does notbelong.
Like, faith in science?
No.
Faith in government?
No.
Like, stop, stop mixing thesethings.
(43:33):
Like, it's fine to have yourfaith, you know, you do you in
that regard.
But....
Arpita (43:38):
But saying that you're not going to go through
something because you justbelieve it's to be, believe it's
true on face value, because Godsaid so, is just not the
scientific method.
That's the biggest problem here.
Aarati (43:49):
Yeah, and not letting anyone question you.
Like, a good scientist shouldinvite questions and would be
happy to be like, Oh, that partof what I was saying is wrong.
And now we know a little bitmore about that and I'm happy to
say that in that one specificthing, I was wrong, but now we
know more and I will change myview and I will change what I'm
(44:11):
saying.
And they would be thrilled bythat.
A good scientist, I feel like
Arpita (44:16):
I don't know if they'd be thrilled.
But yeah, they would at least beopen to the idea.
Aarati (44:19):
They would be.
Or they would be accepting.
They would be accepting and belike, okay, Okay.
I was wrong about this onething.
The evidence points in adifferent direction.
I will amend my views becausethat's how science works, right?
We all think one thing.
We get evidence to the contrary.
We all amend our views.
That's kind of
Arpita (44:35):
I think this is still a little bit too idealistic, but
in general.
At the very least, the journalwould retract your paper, so
that's how that's how it shouldwork.
Aarati (44:44):
Oh, I'm just talking about like a little thing, you
know, like, just not the wholeCTE concept in general, not the
whole traumatic brain injuryconcept in players in general,
but just like, if you did havean idea that a specific thing
was causing it, or there was aspecific symptom that was, you
know, Associated with CTE andthen it turns out that no, you
(45:06):
can't really say that, thenokay, amend your views.
But you don't have to changeyour whole entire message.
Arpita (45:13):
As much as this really surprised me about his overall
story.
Um, just the fact that he kindof seems a little bit strange
now, it's actually not like thisleft turn happened overnight.
So shortly after the first paperwas published in 2005, um, a
team at BU published a paper onCTE and they referenced Bennet's
(45:33):
paper.
Um, and Bennet was definitelynot the first person to describe
CTE, even though he claims thathe was.
Um, it had been documented inother sports before and he
wasn't like the person to namethis disease.
He just discovered it in afootball player and then it went
viral, so to speak.
Aarati (45:51):
Got it.
Arpita (45:51):
And in his, in Bennet's memoir slash autobiography he
falsely accused the first authorof this BU paper for trying to
take credit for his discovery,which was like, definitely not
his discovery.
Um, and most alarmingly inrecent news as of 2022,
(46:12):
scientists, uh, have looked athis 2006 paper where he
describes more tau than doctorswould expect to find in the
brains of all those footballplayers.
But for reasons that he did notexplain and chooses not to
explain, for the paper heselected images that could have
come from the brain of a 50 yearold, like, healthy man or like
(46:35):
someone who is healthy.
Aarati (46:36):
Oh wow.
Arpita (46:37):
So just like you said.
Aarati (46:38):
Yeah.
Arpita (46:39):
Someone who's a little bit older, not that 50s old, but
you would expect some tangles,right?
It's just like a process ofaging.
So it's like definitely not tosay that Mike Webster or some of
these other football playersdidn't have CTE, but it's more
that the evidence that Bennethas presented in his papers is
not consistent with a CTEdiagnosis.
Aarati (46:58):
Yeah.
Arpita (46:58):
So it's a little weird.
Aarati (47:01):
And I think that's the problem.
Like, once you start punchingholes, like the whole thing
falls apart.
Arpita (47:05):
The whole thing falls apart.
Yep.
Yeah.
And so this story is like stillkind of unfolding.
So Bennet continues to believethat every single person who
plays for the NFL will suffersome degree of CTE.
And this might be true thatthere's like a higher likelihood
of NFL players getting headinjury.
There just isn't any.
enough data to make this kind ofclaim.
And in recent years, like youmentioned, the NFL actually has
(47:26):
started taking concussion muchmore seriously.
And to their credit, they havebeen, you know, put more effort
in making like customizedhelmets and like working on
biomechanics of this stuff.
And their reasons are, you know,money motivated, right?
These players make them a lot ofmoney.
So if they get concussions thatare no longer able to play,
they're no longer able togenerate this kind of revenue.
Regardless, they're stillputting a lot more effort into
(47:48):
player safety.
Aarati (47:49):
Yeah.
And I bet the fans also were abig push behind that.
Like once the fans got wind thatthey're like you were saying,
like their favorite player mightbe in danger, then they're going
to put pressure on the NFL to belike, Hey, make sure our players
stay safe.
Yeah.
You need to be doing somethingabout this.
Arpita (48:07):
And this actually happened, um, just a few weeks
ago.
The, Miami Dolphins, quarterbackwho has had many, many
concussions, uh, is now out forthe season because he's had
another concussion.
So it's like, this stuff comesup, like, all the time.
Um, and, you know, Bennet isalive and well.
So he's 51.
He lives in Sacramento with hiswife and his two children.
(48:29):
He works part time as anassociate professor at the
University of California, Davis,but most of his income comes
from being an expert witness.
Uh, and during a, depositionlast year, he testified that he
earned over 900, 000 in 2018.
So like, He's just printingmoney based on his CTE
(48:49):
situation.
But like I mentioned, thisWashington Post paper was like
really revealing that like thescientific community does not
respect him.
His papers have potentially alot of holes in them.
And this isn't to say that, youknow, CTE isn't real or that we
shouldn't think about headtrauma as something that's real.
It's more that this has beenoverblown.
(49:12):
And he, yeah.
You know, I think got a lot ofattention for being a
whistleblower, which, like, hewas, right?
It's like, yes, like, I do thinkthis is something that required
more attention, but the way thathe has portrayed this as
something that everyone whoplays a contact sport is going
to have is just, you know, fearmongering.
Aarati (49:32):
Yeah, I can see that.
I can see how like people kindof knew it was a thing.
But then once he connected it tofootball, football has such like
a massive fan base, like in away that boxing doesn't have
Arpita (49:47):
Like, he poked a bear.
Aarati (49:48):
Yeah, like people knew about it in boxing.
But like, you know, you haveyour boxing fans and you know,
but like football is just likecrazy in America.
It's just huge in America.
Yeah.
And so once you blow the whistleon something in football, it's
just going to get blown up sobig.
And then I think he got a tasteof that it sounds like almost,
(50:09):
and then he just kept on tryingto blow it up and blow it up and
blow it up.
And it's like, okay, yeah, you,you made a big splash.
Arpita (50:16):
You're no longer a scientist, right?
And this point you're no longera scientist.
And that's, yeah, that's thestory of Bennet.
Oh my gosh.
Aarati (50:24):
Amazing.
That's, it's kind of sad in away that he's gone so far
afield, astray, you know, um,but you said he's still at UC
Davis?
He's a professor at UC Davis?
Arpita (50:38):
Yeah, he's like super part time.
I think he just maintains anappointment there, but.
Yeah.
Okay.
It's like, he's reallycontroversial in science because
scientific community doesn'treally respect him.
But yet he's still like printingmoney, basing all the, doing all
these speaking engagements.
And he is still like in thepress.
Like when I was Googling hisname, it's like, he comes up on
press articles.
Like he's saying words out thereto the press, but that doesn't
(50:58):
mean that they're accurate.
Aarati (51:00):
I gotcha.
Gotcha.
Yeah.
It is, it is kind of like that,where do you draw the line
between science andsensationalism kind of thing?
Exactly.
You know, everyone wants scienceto be really sexy and amazing
and, you know, just this huge.
Arpita (51:16):
And he's delivering.
He's delivering on that.
He is, right?
It's like something that's, youknow, beloved.
Aarati (51:21):
But you can't do that without accuracy.
And that's the problem.
Arpita (51:25):
Totally.
That is the problem.
Yeah, I know.
It's, it's really quiteinteresting.
Like, the controversy aroundthis is like multifold, right?
It's like him versus the NFL,like him versus the scientific
community.
He also has, like, a milliondegrees, and so he does have the
credibility of having, like, alot of letters behind your name,
and it's like, that does not ascientist make, but, you know,
(51:46):
it, it does work.
does help, you know, the publiceye that you have some, at least
on paper credibility.
Aarati (51:53):
Yes.
Arpita (51:53):
It's like a Dr.
Oz situation.
Aarati (51:55):
Yes.
Oh yeah.
Good, good connection.
Yes, absolutely.
Well, great story.
That was amazing.
I've definitely heard of thiskind of thing before.
I don't follow football at all,but even I know about this story
in general.
So really, really fascinating tohear about him.
(52:15):
Great stories.
Thanks for listening.
If you have a suggestion for astory we should cover or
thoughts you want to share aboutan episode, reach out to us at
smarttpodcast.
com.
You can follow us on Instagramand Twitter at smarttpodcast and
listen to us on Spotify, Applepodcasts, or wherever you get
(52:36):
your podcasts and leave us arating or comment.
It really helps us grow.
New episodes are released everyother Wednesday.
See you next time!
Hi everyone, and welcome back tothe Smart Tea podcast, where we
talk about the lives ofscientists and innovators who
shape the world.
How are you doing Arpita?
Arpita (00:20):
I'm good.
I am so thrilled it is no longer95 degrees in the city.
That was not, that was not myfavorite.
Aarati (00:28):
Yeah.
Arpita (00:29):
That was tough.
Aarati (00:31):
Yeah.
I'm the opposite.
I love, I love the hot weather,but yeah, San Francisco, it's
like unnatural for SanFrancisco.
Arpita (00:41):
It is unnatural for San Francisco.
I, I can't.
I want it to be 60 degreesalways, which it is now, but
that, that heat wave was toughfor me.
I was, sweating in my apartment.
All the windows are open.
And I was like, I can't do this.
Aarati (00:56):
Yeah.
You remind me of, uh, my littleworms that were very particular
about the weather when I was ingrad school and our experiments
would not work if the weatherwas not perfect for some reason.
If it was warm and sunnyoutside, all the experiments
would work.
If it was rainy, they were justnot happy and so the weather
(01:20):
conditions had to be perfect.
It was such a pain.
Arpita (01:22):
I have a very narrow homeostasis.
Is the conclusion here.
Yeah.
Can't be too sleepy.
Can't be too hungry.
Can't be too cranky.
Can't be too hot.
I'm really just a, I'm just aworm.
I'm just a worm.
Aarati (01:36):
That's what.
That's the great thing aboutworking from home, I feel like,
because you can maintain thathomeostasis so much easier.
You have like snacks withinreach and like, you know, your
pets are within reach of anytime you need like emotional
support.
Arpita (01:51):
Yeah, I never get ready.
Aarati (01:53):
Yeah, in the office, it's like, oh, I can't eat at
like this time.
It's not lunchtime yet.
I have to keep working.
I'm cold or warm or something.
It's so hard in the office.
Arpita (02:05):
Yeah, it's true.
It's true.
How are you?
You went on a little trip.
Aarati (02:10):
I did.
Yes, I went to visit my friendin SoCal again.
So I went to visit her for thatone off Las Vegas trip.
And then a week later, it washer son's birthday, so I went
down again, like a week laterto, yeah, to help with
decorating the house and all ofthat kind of stuff.
So it was really fun.
(02:30):
Yeah, it was.
Arpita (02:31):
Did you have a nice birthday?
Aarati (02:33):
Yeah, it's like a two year old's birthday.
He's at the phase right nowwhere he's obsessed with Mickey
Mouse.
So we were, you know, decoratingthe whole house with Mickey
Mouse balloons.
And we had little headbands thathad like the two ears on top,
um, for everyone to wear.
So
Arpita (02:48):
That's really cute.
Aarati (02:49):
Yeah.
It's like one of the few wordshe can say is Mickey.
So, okay.
We know we know.
Arpita (02:57):
Keep your priorities straight for sure.
Aarati (02:59):
Yeah.
Yeah.
But it was, it was really good.
So it was fun.
I'm, I'm glad I went, um,although the drive down there is
so long and we are drivingthrough like, 95 degrees
weather.
I was like, if I blow a tire outhere, I'm screwed.
Arpita (03:15):
So, oh my god, I would cease to exist.
Aarati (03:17):
Yeah.
So, so hot.
And they live in the middle ofthe desert, I think I mentioned
before too, so on his birthdayit was definitely over 100
degrees.
So, thank god for AC.
Arpita (03:30):
Yeah, I think that's the big thing is, Like, there is no
AC in San Francisco because it'snever hot, and so when it's hot
outside, it's whatevertemperature is outside is also
inside my apartment, so there'sno, like, reprieve, you know,
you're just sweating andmelting.
Aarati (03:47):
Yes, I think the Bay Area...
Arpita (03:49):
Makes me seem like a baby, but, like, if you lived in
these 110 degree places with noAC, you would agree with me.
Aarati (03:56):
No, but that's, that's what I think.
I think the Bay Area has alwayskind of just been temperate.
And so I think at most peoplewill have heating.
Yeah.
And now AC is something thatpeople are like having to add to
like their homes.
They're like having to buy itand install it in their homes
because it's climate change andwhatnot.
But you know, we've never, wedon't usually have these really
(04:19):
hot days.
So.
Arpita (04:21):
Yeah.
Aarati (04:22):
Yeah.
Oh, also though, we were talkingabout worms earlier and I was
very excited to see that theNobel prize was given in
physiology and medicine to twoworm scientists.
I was like, yes, C elegansgetting their spotlight shown on
them.
(04:43):
Um, but I was especially excitedbecause that paper about micro
RNAs in C.
elegans was like the foundationof my PhD.
It's like the first paper that Iwould have had to read.
Yeah.
It was like the basis for all mywork kind of.
Um, I wasn't working with, um,micro RNA is necessarily, but
(05:03):
like, yeah, I was working with,RNA interferencee and silencing.
And so it's related.
And so it's like, this wasdefinitely the first paper that
kind of talked about that.
And so it was definitely one ofthe first papers that I read.
And so I was like, Oh my gosh, Iknow those people don't know
them.
(05:25):
I haven't met them, but I'veread their paper.
I know who they are.
Their names are familiar.
It's like very exciting.
So yeah!
Arpita (05:32):
That's really funny.
Um, no, I love that.
When I saw that headline, thefirst thing that I saw, I
somehow didn't process micro RNAand I just saw mRNA.
And I was like, wait, have wenot known about this for a
really long time?
Messenger, messenger, messengerRNA.
And then I was like, Ooh, I'mback now.
I was like, I got it.
Aarati (05:52):
Yeah.
For me though, like, and maybeit's because I studied it, but I
was like, micro RNAs we've knownfor a really long time, like,
how has this not gotten theNobel Prize before this?
And then I saw that they likediscovered it in the 90s.
And I was like, yeah, that'sstill been a really long time.
I guess it just took.
This long for us to reallyunderstand how ubiquitous they
(06:14):
are and how like important theyare.
There's just so many micro RNAsnow and they're being used for
so many things.
Um,
Arpita (06:23):
So many therapies too.
Aarati (06:25):
Exactly.
And preventative care and earlydiagnosis and things like that.
So I think just kind of theweight of that discovery has
finally hit home, I guess.
So I was glad that it was.
Finally, I, I just kind of hadthe like, wait, it hasn't been
recognized already?
Yeah,, so I'm really glad itfinally got its due.
Arpita (06:47):
Yeah, no, that was awesome.
I, it's kind of fun to have itbe Nobel prize season.
Aarati (06:52):
Yes, definitely.
Um, so speaking of amazingscientists, uh, who are we doing
today?
Arpita (06:59):
Okay, so we're, I have a theme this week.
Aarati (07:02):
Oh, excellent.
I love a theme, you know.
Arpita (07:04):
Uh, well, we are, um, fully in NFL season and I
decided to do a scientist whohas gotten a lot of notoriety
from the NFL and this is Dr.
Bennet Omalu.
Who is the person who broughtCTE to the limelight.
(07:25):
So
Aarati (07:26):
What is CTE?
Arpita (07:27):
We're going to find out.
And I, you, I think you'veprobably heard of this.
Um, he was an interestingcharacter in this story.
Turned out to be a little bitmore crazy than I was expecting.
So I'm excited to jump into it.
Okay.
So, Bennet Ifekandu Omalu wasborn in Nigeria in September
(07:48):
1968, and he was born in themiddle of the Nigerian Civil
War.
So the war forced his family toleave their gated compound that
they had in their village, butthen eventually at the end of
the Civil War, they were able tocome back and they had a pretty,
pretty comfortable lifestyle.
Um, his mom was a seamstress andhis dad was a civil engineer and
(08:12):
like a pretty big communityleader.
Aarati (08:14):
I just wanted to say real quick, um, I'm really glad
you're doing someone who's notan American or not European
because I feel like, a lot of, alot of scientists that kind of
have the limelight shone on themare from the western world.
And so I'm really, really gladyou're doing someone from
Nigeria.
That's amazing.
Arpita (08:34):
It was not really intentional, but great.
Aarati (08:36):
Yeah.
Arpita (08:36):
Okay, he was the sixth of seven children.
And he was super smart.
He was accepted to the federalgovernment college when he was
12.
And then when he was 15, hestarted medical school at the
University of Nigeria.
And this is a little bitdifferent.
So he graduated with abachelor's of medicine and
surgery and MBBS in 1990.
Um, and so when he was done withthat, he did a clinical
(09:00):
internship and three years ofservice work in another city
called Jos.
And so Nigeria was having, um, alot of political conflict around
this time, and so there was apresidential candidate named
Moshud Abiola, and he was tryingto bring, like, a lot of change
and democracy to the country,and he lost the presidency in
(09:23):
1993, and Bennet started to feelreally cynical about the
Nigerian government and itsfuture, so he started thinking
about emigrating.
So a few years later in 1994, hecame to Seattle and he started
working on a fellowship inepidemiology at the University
of Washington.
And very soon after that, hemoved to New York City where he
(09:45):
started working at ColumbiaUniversity's Harlem Hospital
Center, and he did a residencyin anatomic and clinical
pathology.
Aarati (09:55):
Wow.
Arpita (09:55):
This is just his background here.
Aarati (09:57):
Okay.
Arpita (09:58):
Okay.
So now his story kind of getsinteresting.
So once he's done all thistraining, he moves to Pittsburgh
because now he's a pathologist.
So he's training under thisworld renowned pathologist named
Cyril Wecht at the countycoroner's office.
And while he was working there,he did an autopsy in 2002, and
(10:19):
his patient was Mike Webster,who was, uh, formerly a center
for the Pittsburgh Steelers.
And so, Mike, after his NFLcareer, died really suddenly at
the age of 50.
And it was after several yearsof struggling with cognitive
issues like intellectualimpairment, mood disorders,
(10:42):
depression, drug abuse, and hehad several suicide attempts.
Um, and his cause of death waslisted as a heart attack, but
Bennet was like,"I don't know,something seems kind of weird
here."
Aarati (10:54):
Yeah.
Arpita (10:54):
And he looks at Webster's brain as part of a
normal autopsy.
And it looked pretty normal, butbecause he had some suspicions,
Bennet then conductedindependent, uh, tissue analyses
and he suspected that MikeWebster suffered from something
called Dementia Pugilistica.
(11:14):
I did not think about sayingthis out loud.
Hold on.
Aarati (11:19):
Dementia
Arpita (11:21):
Pugilistica.
Yeah, I was right.
Okay.
Aarati (11:23):
Yeah?
Okay.
Arpita (11:23):
Okay.
Aarati (11:24):
I do think I know where this is going.
I think I have heard of.
Arpita (11:27):
You have.
Aarati (11:27):
I don't, I don't follow football at all really, but I
have heard of traumatic braininjuries and kind of the
controversy around this.
So yes.
Arpita (11:37):
Yeah.
Oh yeah.
So.
He suspected that Mike Webstersuffered from Dementia
Pugilistica, which is a specifictype of dementia that comes from
repeated blows to the head.
And up until this point, it wasseen in boxers who
understandably had this.
So he sliced and stained thebrain tissue samples, um, and he
(12:01):
found large accumulations of tauprotein in his brain, um, and
these accumulations can affectthings like mood, emotions, and
executive functions, and it'sreally similar to the way we
think of accumulation of betaamyloid protein, which is what
we see in Alzheimer's disease.
Aarati (12:20):
Right.
So tau protein is associatedwith these kind of mood
disorders and...
Arpita (12:27):
Yeah, elevated tau protein.
Aarati (12:29):
Elevated tau protein, the same way that beta amyloids
are or elevated beta amyloidlevels are associated with
Alzheimer's.
Okay.
So it's like a marker of kind oflike, yeah.
Okay.
Kind of like a marker of thatdisease.
Arpita (12:43):
Exactly.
So in healthy brains, tauprotein is a structural protein,
so it helps give shape andstructure to neurons and their
axons.
So it helps them stay the waythey should be with these like
long, drawn out, um, axons andfor them to hold their shape and
form these connections.
But too much of this isassociated with all of these
(13:05):
other disorders.
Aarati (13:06):
Okay.
Okay.
Gotcha.
Arpita (13:09):
And so Bennet reported and he said, quote,"These
abnormalities were not somethingthat I thought I should be
seeing in a 50 year old man."End quote.
And so he is a little bitconcerned about this and he runs
it by some of his colleagues andthe departments of neurology and
neuropathology at the Universityof Pittsburgh.
And they agree that the taupattern was pretty unusual.
(13:32):
So he publishes his findings inthe journal Neurosurgery in 2005
in a paper titled ChronicTraumatic Encephalopathy in a
National Football League Player.
Aarati (13:43):
Oh, so he just did this on one player and published a
paper on it.
Okay, I would have thought hewould have...
I don't know.
I guess you can't really do thatkind of diagnosis on people who
are still living like he had tocut out a piece of their brain.
Right?
So,
Arpita (14:00):
Right.
Um, you do bring up aninteresting point here in which
that he did this on one person.
So let's just bookmark that.
Aarati (14:07):
It's an n of one.
I would have...
and that's why I'm surprised.
I'm like, Oh, he was able topublish something with the n of
one.
Arpita (14:13):
I'm assuming he kind of did it as a case study.
I didn't actually read this,this paper specifically, but I'm
assuming he published it as acase study, but regardless.
Aarati (14:21):
Yes.
He probably mentioned that thiswas seen in boxers as well, like
this is, he probably made thatconnection already.
Arpita (14:28):
Right.
Okay.
So in this paper, Bennet callsfor further study of this
disease.
So he said, quote,"We hereinreport the first documented case
of long term neurodegenerativechanges in a retired football
player consistent with chronictraumatic encephalopathy, CTE.
This case draws attention to adisease that remains
inadequately studied in thecohort of professional football
(14:50):
players with unknown trueprevalence rates," end quote.
So, he published this in 2005thinking that NFL doctors would
be really happy to read it and,you know, improve, um, you know,
protection and help prevent thisfrom happening more in the
future.
But initially, the paper didn'treally get a lot of attention.
(15:13):
But in May 2006, the members ofthe NFL's Mild Traumatic Brain
Injury Committee, alsoabbreviated to the MTBI, called
for the paper's retraction.
And they wrote a letterrequesting that the retraction
characterize Bennet'sdescription of CTE as, quote,
completely wrong, and called thepaper's paper, quote, a failure.
(15:36):
However, the researchers stoodtheir ground.
Aarati (15:39):
I'm really shocked by, like, all of that.
I'm first of all shocked by thefact that there already is a
mild traumatic brain injurycommittee in the NFL.
Like, even, even at this point,before he's even, like, he's
just started to publish papers,they've already formed a
committee knowing that...
Arpita (15:58):
The committee existed.
Aarati (15:59):
Yeah, like, it already existed, but that
Arpita (16:01):
Yeah.
Aarati (16:01):
Why does it exist except for the fact that this has been
happening?
People know that this is a thingso there has to be a committee
around it.
So it's like already, Youalready know this is a dangerous
sport.
You already have a committeeabout it Yeah, you already have
that but then on top of that toreject his paper and just be
like this has no merit It's likeyou're the freaking committee
(16:22):
for it! What do you mean?
Arpita (16:26):
It doesn't make any sense if anything it sort of
like made it a little bit worseas we will see.
Um, so the same year, 2006,another football player, Terry
Long, committed suicide and hewas 45 and he was also found to
have elevated levels of tauprotein in his brain, which
Bennet said, quote, a 90 yearold brain with advanced
(16:47):
Alzheimer's end quote.
Same as Mike Webster, Bennetclaimed that Terry Long's
football career had caused laterbrain damage and depression and
mental health problems.
Bennet also found evidence ofCTE in the brains of a few other
NFL players, JustinSturzelchick, Andre Watters, and
(17:08):
Tom McHale, and he published afollow up paper in the same
journal, Neurosurgery, and itwas published in November 2006.
Aarati (17:16):
Sorry, had all of those people died?
Arpita (17:18):
All these people died, separately.
Aarati (17:20):
Oh, my gosh.
Arpita (17:21):
Yeah, it like within several years of each other,
like one died in 2004, one in2006, one died in 2008, and they
all died very young, likebetween 35 and 45.
Aarati (17:30):
Oh, my gosh.
35 and 45.
Holy crap.
Arpita (17:33):
Yeah, super young.
So he, he published a paper,including findings of all of
these different people.
So, the MTBI committee continuedto discredit his research as
flawed and did not acknowledge alink between the sport,
football, and brain damage informer players.
(17:53):
However, Bennet gained a reallyimportant supporter in a man
named Dr.
Julian Bales, who was thechairman of neurosurgery at the
West Virginia School ofMedicine, and he was also
importantly a former teamphysician for the Steelers.
So Dr.
Julian Bales, um, and a lawyernamed Bob Fitzsimmons and Bennet
(18:18):
all founded the Sports LegacyInstitute to continue studies of
CTE.
Aarati (18:23):
This is just crazy to me.
It's just so crazy that he'sbeing met with so much
resistance when all you have todo is watch any football game
and see how they like smack intoeach other and be like, yeah,
that could definitely cause someinjury.
Um, I don't even have to knowanything about football to see
that that could be a dangerousactivity.
Arpita (18:44):
Problem.
Yeah.
Aarati (18:46):
Yeah.
It's not that far of a stretchto see that that could
potentially cause some braindamage.
And maybe you should beprotecting against that.
Yeah,
Arpita (18:58):
Totally.
So the NFL continues to evadethis and deny that it's a
problem.
But Bennet and his supportershad a victory when Mike
Webster's family was awarded asignificant settlement in
December 2006 from the NFL.
Aarati (19:13):
And that was the first guy, right?
Arpita (19:15):
The first guy.
Aarati (19:16):
The first guy who, um, he studied.
Arpita (19:19):
Correct.
Yep.
The first guy.
For the following June, the NFLcommissioner, Roger Goodell
convened a quote"ConcussionSummit" to discuss the issue
with the NFL's MTBI committeechair, Dr.
Ira Kasson and told the press,quote,"In my opinion, the only
scientifically valid evidence ofa chronic encephalopathy in
(19:40):
athletes is in boxers and insome jockeys," end quote.
So the NFL just like doesn't.
Really get behind CTE at all.
Aarati (19:53):
That's, yeah, like I said, like, that's crazy.
I mean, again, all you have todo is watch them and see, like,
how violent the sport is andhow, like, you know, that's
insane.
It's also just kind of crazy whythere's so much pushback against
it.
Like what is, what is the dealwith the pushback when, uh, when
(20:17):
a scientist tells you, Hey, thiscould be a potential problem,
maybe we should take steps tomitigate this problem.
I don't know, like maybe lookinto better helmets or changing
the rules so that, you know,there's not as much head contact
or something.
Like, can we work with this?
I'm like, what is the pushbackto just implementing that
(20:39):
anyway, it's the kind of thesame thing I see with climate
change is like, okay, even ifyou don't believe it's a thing,
even if you don't believe thattraumatic brain injury is
happening, is there a downsideto just investing in, you know,
designing better helmets or youknow, changing the rules
slightly so that you cannotsmash head on into something,
(21:03):
you know, like I just don'tunderstand the intense pushback.
If, if anything, you're justmaking it safer.
Why is there a problem?
Arpita (21:14):
I think, I mean, it's, I think it's really just money is,
I mean, obviously it's thebiggest thing, right?
It's like their, their, theirprofit margins on this are so
high and the NFL generates likebillions of dollars in revenue.
And so if you're, if you'reputting money into something
else or admitting that whatyou're doing is dangerous or has
a problem, then there is achance that you are going to,
you know, lose your fan base.
(21:34):
There's a chance that, you know,people are going to come out
against this.
So if you continue to deny andsay that your sport is actually
safe, then you're maintainingthe status quo, which I think is
the biggest thing here.
Because it's based on a fanbase.
It's right.
It's like you have to the entirerevenue stream is based on
people.
Being excited about it.
And so if there's reason tobelieve that their favorite
players are in fact, you know...
Aarati (21:55):
In harm's way?
Arpita (21:56):
In harm's way, right.
It's like, that's, that's goingto ruin it.
Aarati (22:00):
Yeah, I would just do it on the downlow then.
I feel like I'm maybe being verynaive, but
Arpita (22:06):
it's a little naive, but I understand.
You're an idealist.
Aarati (22:09):
Every, yeah, like every year or whatever you design new
helmets anyway, like thedecoration change or the color
schemes change, just, you know,put in a few safety measures
into that new helmet quietly.
It doesn't, you can call it astyle element.
I don't know.
Arpita (22:24):
Oh, sweet Aarati.
Aarati (22:25):
I know.
Arpita (22:26):
Sweet, sweet Aarati.
Aarati (22:26):
I'm just like, I just want the world to be a good and
safe place.
Why is that too much to ask?
Arpita (22:34):
Okay, so back to Bennet.
Bennet moved to California in2007 and he started a new job as
chief medical examiner, uh, inSan Joaquin County.
Um, and he continued some postgrad education, um, and earned
his MBA in 2008.
He also published his firstbook, Play Hard, Die Young,
(22:56):
Football, Dementia, Depression,and Death.
A really fun title.
Aarati (23:00):
Yeah.
Arpita (23:01):
Um, and he advanced the study of CTE by branching out to
athletes from other sports aswell as war veterans.
Aarati (23:10):
Oh, wow.
Arpita (23:11):
And then by 2009, his work on CTE was finally starting
to gain traction.
He was profiled in GQ, whichreally detailed his efforts to
raise awareness of footballrelated brain injuries, and then
especially highlighted the NFL'srefusal to cooperate.
So the NFL commissioner, as aresult of this, and other
(23:32):
executives were then called totestify before a house judiciary
committee, which then started anoverhaul of the MTBI and rule
changes to enhance safety aswell as a lawsuit that was
brought forth by thousands offormer players against the NFL.
Aarati (23:47):
Oh, wow.
So he's really blowing this upnow.
He's like, fine, if you're notgoing to just do this
internally, I'm going to justtake it to the public and make
sure that people know aboutthis.
Yeah, good for him.
Arpita (24:01):
So the NFL then didn't publicly acknowledge the link
between concussions sustained infootball and long term
neurological effects untilDecember 2009, which was seven
years after Bennet's originaldiscovery in Mike Webster.
But even up until 2013 at theannual meeting of the American
Academy of ClinicalNeuropsychology, the AACN, this
(24:22):
included a debate between twosports concussion experts which
looked at the validity or evenlike the existence of CTE.
And then finally, in March 2016,the NFL's Senior Vice President
for Health and Safety Policytestified before Congress that
the NFL now believed that thereis a link between football and
CTE.
And then in 2016, the AmericanMedical Association awarded
(24:44):
Bennet with their highest honor,the Distinguished Service Award,
for his work on CTE.
Aarati (24:51):
Hi everyone, Aarati here.
I hope you're enjoying thepodcast.
If so, and you wish someonewould tell your science story,
then check out Sykom.
That's S- Y- K- O- M, and it's ascience communications company
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(25:13):
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science.
Okay, back to the story.
Wow.
So how long did that take themto like, from when he first
(25:35):
published?
It was over 10 years, right?
Arpita (25:37):
Yeah.
11 years.
Cause the first paper was 2005.
So this story eventually reachedHollywood and Will Smith landed
the starring role in the 2015movie Concussion.
And Will Smith spent a lot oftime learning his distinct
Nigerian accent and intonationand his mannerisms and received
a lot of acclaim for this role.
(25:59):
So, for Bennet, the release ofconcussion served as the
ultimate validation for all ofhis years of hard work.
He was also the lead author in apublished study in November 2017
that for the first timeconfirmed CTE in a living
person.
So, with some of his colleagues,he found that a radioactive
chemical tracer called FDDNPbinds to tau proteins, which is
(26:24):
detectable by a PET scan andassociated with some of the
other distinctive uh,topographical distribution
characteristics of CTE.
So they tested this and over adozen, just a dozen, former NFL
players and then this wasconfirmed after former
linebacker Fred McNeil passedaway and it was confirmed post
(26:46):
mortem.
Aarati (26:48):
Okay, so they actually diagnosed him while he was still
alive, and then once he died,they were able to do the full
autopsy and kind of confirm theresults.
Arpita (26:59):
So, since then, and since all this research has sort
of come out in like the earlyaughts, CTE has been established
as a progressive degenerativedisease.
Brain disease that's associatedwith head trauma.
It's not limited to football orboxing.
It's been found in athletes whoplayed soccer, hockey, rugby,
mixed martial arts, and even BMXbike riding.
(27:20):
And outside of sports, CTE hasalso been reported in military
personnel, um, particularlythose exposed to blast injuries,
and it's even seen in people whohave been exposed to domestic
violence.
It's basically a problem in anyindividual who's been exposed to
some kind of head trauma.
So most of what we know suggeststhat imaging technologies may be
able to detect CTE in livingpeople based on that paper from
(27:44):
2017 that I was talking about.
But the only proven and likeofficial way to diagnose this
condition is through an autopsy.
Um, But while you're living, CTEproduces a range of neurological
symptoms, including depression,memory loss, confusion, impaired
judgment, impulse controlissues, aggression,
(28:04):
Parkinsonism, and eventuallyprogressive dementia.
And some people with CTE haveeven attempted suicide, as we
mentioned.
Aarati (28:12):
Yeah, that's so scary.
Um, if they, are able todiagnose it in people and maybe
you're getting to this, but ifthey're able to diagnose it in
people while they're living, isthere any treatments that they
can have?
Arpita (28:25):
Not right now.
Yeah, not right now.
Aarati (28:29):
Oh my gosh.
So it's kind of like a deathsentence almost like if you have
these symptoms and you do thisPET scan and they figure out
that your tau levels areelevated, you're It's kind of
like you might die early.
It sounds like, yeah.
Oh, that's so...
that would be heartbreakingnews.
I feel like for anybody
Arpita (28:51):
And it's not super clear.
So we're going to get into thediagnosis a little bit more.
Um, so symptoms of CTE can,well, first of all, they're
really broad, right?
Like all those things that Ilisted could be theoretically
anything, right?
It could be.
a tumor.
It could be, you know what Imean?
It could be literally anything.
Um, and symptoms of CTEgenerally go unnoticed until
(29:11):
years or even decades after thebrain trauma has occurred, or
the person has even stoppedplaying sports.
So sometimes it can be reallyhard to connect the two.
Um, and CTE has also beendocumented in people as young as
17, according to a 2016 study inJAMA.
Um, and just like you asked,symptoms can be managed, but the
(29:32):
condition itself can't be cured.
So the biggest thing isminimizing risk.
Aarati (29:37):
So it can't, it can't be reversed, but you can kind of
prevent it from getting worse?
Arpita (29:43):
You can specifically manage the symptoms is really
the biggest thing.
So if you've got like vestibularstuff you can do vestibular
training.
If you have, you know,dizziness, you can manage that,
but like the underlying causecan't be changed.
Aarati (29:57):
Okay, like our brain naturally will deteriorate as we
get older and older, right?
So I feel like first of all,it's irreversible, but then
naturally it would, it would getworse.
And the only thing you can do ismanage your symptoms.
That sucks.
Arpita (30:12):
Totally.
so, increased awareness of CTEhas started, like, a whole field
of new research, partly becausea lot of players and their
families have donated brains ofat risk people after they've
passed away.
So, to help identify patterns,there's been an effort to start
the CTE Center through BostonUniversity, which has a brain
bank of over 600 specimens andtissue samples.
Aarati (30:35):
Whoa, a brain bank.
Never heard of that before.
That's cool.
That reminds me of that scene inYoung Frankenstein.
Have you seen that movie?
It's a funny movie with GeneWilder, and he's Dr.
Frankenstein, and he's trying tobuild Frankenstein's monster,
um, and he asks his henchman,Igor, or sometimes pronounced I-
(30:56):
gore, to go get him a brain andthen Igor gets him a brain and
he puts it in the monster andthe monster comes to life and
it's like going nuts like goingberserk and he's like, what's
going on?
Like, what brain did you get me?
You were supposed to get me likethis amazing scientist brain or
something because this guy wassupposed to be like the monster
(31:16):
was supposed to be anintellectual, you know, but he's
clearly not and Igor is like,"Itwas Abby someone" and he's like,
"Abby someone?" He's like, yeah,Abby, Abby normal.
And it's like, are you tellingme how I put an abnormal brain
into this?
It just reminded me of that.
(31:37):
Like you went to the brain bankand you got an abnormal brain
for my monster.
Arpita (31:41):
That's really funny.
Aarati (31:43):
You idiot.
Yeah.
It's a funny movie.
It's a good one for Halloween.
It's hilarious.
Arpita (31:49):
Good spooky movie.
Aarati (31:50):
Yeah.
Arpita (31:51):
Okay, so talking about overall exposure.
You don't need to have aconcussion in order to be at
risk for CTE, so a hit to thehead that doesn't cause symptoms
or that can't be diagnosed withstandard clinical tests can
still increase long term braindamage.
So something that researchershave been exploring is the
potential dangers of cumulativesub concussive hits or blows
(32:15):
that don't cause diagnosablesymptoms.
So a concussion is defined as ahit to the head that results in
clinical symptoms.
So something like this wouldcause your brain to move within
the cerebrospinal fluid, whichkind of acts like a cushion.
So your brain is hitting theinside of the skull, often
multiple times.
And this can result in thingslike headache, dizziness,
(32:36):
disorientation, difficultyfocusing your eyes, trouble
concentrating.
Remembering things, cryingeasily, feeling issues, or
having any sleep problems.
Um, but contrastingly, a subconcussive hit doesn't look like
anything.
It doesn't produce clinicalsymptoms.
So there isn't a real way tomeasure or diagnose it.
And there's no way to look attwo different sub concussive
(32:58):
hits and say, Oh, this one wasdangerous.
And this one wasn't the onlyrisk factor that we have is the
duration of these Repeated hits,so like the duration of contact
play or exposure to contactsports, and essentially the
cumulative nature of those hits.
This doesn't make concussionsunimportant.
So if you get a concussion, youprobably have had many more
(33:22):
subconcussives.
blows.
So we don't have anunderstanding if there is a
threshold to concussions orsubconcussions that results in
CTE.
So it's like, if you get thisnumber and now you're at a risk,
or if you get this number,you're at a higher risk because
We don't really have that kindof data, and it's also
challenging because based on anautopsy, not everyone who has
(33:46):
had a history of head traumadevelops CTE or CTE symptoms.
So in some studies, boxers withhead injuries only have CTE of
autopsy 17 percent of the time.
However, the reverse, everyonewho has had CTE, on autopsy have
had repeated blows to theirhead.
Aarati (34:06):
That makes sense.
I'm surprised the number is solow though.
Only 17%.
Arpita (34:11):
That was one study that I found.
Aarati (34:12):
Wow.
Arpita (34:13):
So I don't think it's always quite that low.
Um, I also think it reallydepends on the sport and how
likely they are to get like areally bad concussion, which is,
you know, mild traumatic braininjury.
Aarati (34:26):
Yeah, that makes sense.
I feel like there must besomething also in terms of like
football, boxing, rugby, youwould kind of get a lot of
repeated hits to the head,whereas other some of the other
sports you were mentioning, likebeing a jockey, I feel like that
would only happen if you likefell off the horse or something.
(34:47):
And so hopefully that wouldn'thappen all the time.
Yeah.
Arpita (34:51):
So that makes sense.
Aarati (34:52):
Yeah, I'm assuming people are also kind of studying
the differences in the headinjuries in those kinds of
cases.
Arpita (35:01):
No, that that makes a lot of sense.
I think you're right.
Okay, and this is where Ithought this way got really
interesting.
So, some researchers say thatthe data that Bennet has
presented are compelling, butnot definitive.
So, one researcher at BU, whichI discovered BU has, like, one
of the best concussion clinicsin the country.
Aarati (35:21):
Oh, really?
Arpita (35:21):
Um, said that in science, we try to have controls
and recruit randomly forstudies.
Research on CTE to date hasn'tbeen random.
It's been people calling auniversity or someone like Dr.
Omalu and saying, I want you tohave my brain.
Such volunteers often havesymptoms, which boosts the
chances that investigators willfind abnormalities and
potentially skew theirconclusions.
(35:43):
Researchers emphasize that thereis an ongoing need for
perspective and longitudinalstudies.
These would follow randomplayers over time and observe
who does and does not developCTE symptoms or have evidence of
disease in their brain.
Comparisons would then be madebetween players between
different outcomes, people whoplay different positions, and
people in general population orthose who aren't exposed to head
(36:06):
trauma.
And it's really likely thatthere are not only different
thresholds or recurrent blows tothe head, but that there's also
genetic factors and other thingsthat affect your resistance or
vulnerability to developingCTEs.
It's not actually random,obviously.
Aarati (36:20):
Yeah, that just seems like so much effort because you
would have to follow thesefootball players for years
throughout their career and kindof make a note of every time
they got hit in the head....
Arpita (36:37):
oh, yeah.
Aarati (36:37):
...from anything, you know, either from...
Arpita (36:40):
totally.
Aarati (36:40):
...smashing into another player, smashing into a wall,
smashing into the field, likeanything that could, you know,
potentially have hit their head.
I don't know.
That just seems kind of like areally intensive study, isn't
it?
Arpita (36:56):
Sure.
But you know, who collects somuch recording of all of their
players playing football?
The NFL, the NFL cash, also theNFL.
So it's like if you wanted to,
Aarati (37:07):
If you wanted to.
Yeah, that's what I was going tosay.
Yeah.
So I was like, first of all,Instead of starting this study
now, why don't we go back andlook at all the recordings?
Arpita (37:15):
Every single tape of a play, every single play ever.
Yeah, it exists.
Aarati (37:20):
Yeah, it already exists.
All these recordings exist.
I feel like that's a little biteasier.
But I've, I also was wonderingabout like animal models, like
can they do this in mice or ratsor something.
And I mean, obviously, now I'mhaving an image of mice playing
football, which is kind ofhilarious.
But I mean, could they, I feellike they must some, some
(37:44):
researchers must study this inanimal models, right?
Arpita (37:48):
So, fun fact, the first lab that I worked in, um, as
like a baby, baby scientistbefore I was even a grad
student, um, was a TBI lab andwe used mice and it was actually
so horrible.
I really hated it so much, butwe would basically like
stabilize the mouse's head inthis like little chamber and
they would like have like um,like a padding on both sides to
(38:11):
keep its head still and we wouldgive them TBI.
So there was a little pistonthat applied like a certain
amount of pressure and force,and we would give them like a
very pointed TBI and then studyit.
And it was really sad, but yeah,yes.
To answer your question, we cangive mice TBI.
Yes.
Aarati (38:29):
And then you can study that.
Yeah, I feel like...
Arpita (38:32):
I didn't like it.
Aarati (38:33):
Yeah.
No, I mean, this is why, like, Idrew the lines at working with
worms, but
Arpita (38:40):
Like, I get it.
It's like important research,but like, I was like, this is
not.
Aarati (38:43):
Yeah.
Yeah.
But I feel like that.
That also might yield a littlebit more information faster than
sitting down and watching like20 years worth of NFL tapes.
I mean, you know, already justto watch those tapes is a huge
endeavor.
Um, And then to follow currentfootballers would be another
(39:06):
huge endeavor and take a lot oftime and a lot of money.
So,
Arpita (39:11):
Right.
Yeah, if you want to, you could.
Aarati (39:13):
If you wanted to, you could.
Yeah.
But I was just saying likeanimal models might, you know,
help shed a little bit of lighta little bit faster and then
maybe we could refine or what'sthe word like streamline our
studies and human
Arpita (39:26):
Our studies.
Aarati (39:26):
Yeah, because we would know kind of more exactly what
we're looking for.
Arpita (39:31):
No, I agree with that.
I think that's true.
Aarati (39:33):
And the NFL could fund that research in mice or
whatever animal model.
That would work too.
In my perfect world, I was goingto say.
In my perfect ideal, likerainbow world.
Arpita (39:48):
Literally never going to happen.
But yeah, we can hope.
Aarati (39:51):
I know.
Arpita (39:52):
Okay, so now we get to the part of the story where
things really take a left turn.
Um, so as of 2020, Bennet haswithdrawn from the CTE research
committee and has turned himselfinto an evangelist, kind of.
So he travels the world and hesells this really distorted
version of what scientists knowabout CTE and contact sports.
(40:15):
So he does paid speakingengagements, expert witness
testimony, and in several booksthat he has authored, he
portrays CTE as an epidemic andhimself as a crusader fighting
not against just the NFL, butalso against the medical science
community, which he claims istoo corrupted to acknowledge the
clear cut evidence that contactsports destroys lives.
(40:37):
He's built a really lucrativecareer as an expert witness for
hire in lawsuits, and he chargesa minimum of 10, 000 per case.
And his speaking engagementshave an average of 27, 500 each.
Aarati (40:52):
Oh my goodness.
Arpita (40:53):
So, as we now know, CTE should definitely be taken
seriously and studied more.
And as much as we do know that,the brain science community and
the neurosurgery committee has areally wide consensus that
Bennet routinely exaggerates hisaccomplishments and dramatically
overstates the risk of CTE incontact sports.
(41:15):
And this really fuelsmisconceptions about the
disease.
Um, and so this was from aWashington Post paper, and like
a deep dive into CTE and thenspecifically into Bennet's role
in this disease.
So, during some of the speakingengagements that he has, he
offers statistics that aredistorted and they cultivate a
(41:37):
reputation that he is like thepremier expert on the disease,
even though he has not beeninvolved in the research in many
years at this point.
And according to, you know,doctors and concussion
researchers, his definition ofCTE is outdated.
Too broad and describescharacteristics that can be
(41:57):
found in normal healthy brainsand one expert at Stanford said,
quote,"My God, if people wereactually following his criteria,
the prevalence of this diseasewould be enormous.
There's absolutely no evidenceto support that." End quote.
Aarati (42:11):
So according to him, like 80 percent of the human
population probably has CTE fromsomething or another.
He's just really just overblownit completely.
Arpita (42:20):
Completely overblown it.
So when he's asked to refutethese allegations, Bennet says
that the naysayers are fromsports leagues who are
bolstering fake news.
And I was like, oh my god, deargod.
Aarati (42:32):
Here we go with the theories and the conspiracies
and muddying the waters.
Arpita (42:38):
And I was like, I can't with this right now.
Um, and so Bennet is a deeplyreligious man and he believes
that he is on a mission from Godand he views scientists who
question him with suspicion andhostility.
And he says, quote,"As aChristian, I believe after death
there is judgment," end quote.
And he told a lawyer in adeposition one time when asked
(42:59):
about experts who raised doubtsabout his theories he says,
quote,"They will all answer forthis on judgment day", end
quote.
I'm like, okay, you're a crazyperson.
Aarati (43:07):
Wow.
Yeah, no, I mean, it is the jobof scientists to question
everything.
Arpita (43:12):
For sure.
Aarati (43:13):
Even if another scientist is saying it, you have
to go through and validate that.
You have to go ask questions.
That's the job of a scientist.
And I really have a problem withpeople mixing their faith with
things where faith does notbelong.
Like, faith in science?
No.
Faith in government?
No.
Like, stop, stop mixing thesethings.
(43:33):
Like, it's fine to have yourfaith, you know, you do you in
that regard.
But....
Arpita (43:38):
But saying that you're not going to go through
something because you justbelieve it's to be, believe it's
true on face value, because Godsaid so, is just not the
scientific method.
That's the biggest problem here.
Aarati (43:49):
Yeah, and not letting anyone question you.
Like, a good scientist shouldinvite questions and would be
happy to be like, Oh, that partof what I was saying is wrong.
And now we know a little bitmore about that and I'm happy to
say that in that one specificthing, I was wrong, but now we
know more and I will change myview and I will change what I'm
(44:11):
saying.
And they would be thrilled bythat.
A good scientist, I feel like
Arpita (44:16):
I don't know if they'd be thrilled.
But yeah, they would at least beopen to the idea.
Aarati (44:19):
They would be.
Or they would be accepting.
They would be accepting and belike, okay, Okay.
I was wrong about this onething.
The evidence points in adifferent direction.
I will amend my views becausethat's how science works, right?
We all think one thing.
We get evidence to the contrary.
We all amend our views.
That's kind of
Arpita (44:35):
I think this is still a little bit too idealistic, but
in general.
At the very least, the journalwould retract your paper, so
that's how that's how it shouldwork.
Aarati (44:44):
Oh, I'm just talking about like a little thing, you
know, like, just not the wholeCTE concept in general, not the
whole traumatic brain injuryconcept in players in general,
but just like, if you did havean idea that a specific thing
was causing it, or there was aspecific symptom that was, you
know, Associated with CTE andthen it turns out that no, you
(45:06):
can't really say that, thenokay, amend your views.
But you don't have to changeyour whole entire message.
Arpita (45:13):
As much as this really surprised me about his overall
story.
Um, just the fact that he kindof seems a little bit strange
now, it's actually not like thisleft turn happened overnight.
So shortly after the first paperwas published in 2005, um, a
team at BU published a paper onCTE and they referenced Bennet's
(45:33):
paper.
Um, and Bennet was definitelynot the first person to describe
CTE, even though he claims thathe was.
Um, it had been documented inother sports before and he
wasn't like the person to namethis disease.
He just discovered it in afootball player and then it went
viral, so to speak.
Aarati (45:51):
Got it.
Arpita (45:51):
And in his, in Bennet's memoir slash autobiography he
falsely accused the first authorof this BU paper for trying to
take credit for his discovery,which was like, definitely not
his discovery.
Um, and most alarmingly inrecent news as of 2022,
(46:12):
scientists, uh, have looked athis 2006 paper where he
describes more tau than doctorswould expect to find in the
brains of all those footballplayers.
But for reasons that he did notexplain and chooses not to
explain, for the paper heselected images that could have
come from the brain of a 50 yearold, like, healthy man or like
(46:35):
someone who is healthy.
Aarati (46:36):
Oh wow.
Arpita (46:37):
So just like you said.
Aarati (46:38):
Yeah.
Arpita (46:39):
Someone who's a little bit older, not that 50s old, but
you would expect some tangles,right?
It's just like a process ofaging.
So it's like definitely not tosay that Mike Webster or some of
these other football playersdidn't have CTE, but it's more
that the evidence that Bennethas presented in his papers is
not consistent with a CTEdiagnosis.
Aarati (46:58):
Yeah.
Arpita (46:58):
So it's a little weird.
Aarati (47:01):
And I think that's the problem.
Like, once you start punchingholes, like the whole thing
falls apart.
Arpita (47:05):
The whole thing falls apart.
Yep.
Yeah.
And so this story is like stillkind of unfolding.
So Bennet continues to believethat every single person who
plays for the NFL will suffersome degree of CTE.
And this might be true thatthere's like a higher likelihood
of NFL players getting headinjury.
There just isn't any.
enough data to make this kind ofclaim.
And in recent years, like youmentioned, the NFL actually has
(47:26):
started taking concussion muchmore seriously.
And to their credit, they havebeen, you know, put more effort
in making like customizedhelmets and like working on
biomechanics of this stuff.
And their reasons are, you know,money motivated, right?
These players make them a lot ofmoney.
So if they get concussions thatare no longer able to play,
they're no longer able togenerate this kind of revenue.
Regardless, they're stillputting a lot more effort into
(47:48):
player safety.
Aarati (47:49):
Yeah.
And I bet the fans also were abig push behind that.
Like once the fans got wind thatthey're like you were saying,
like their favorite player mightbe in danger, then they're going
to put pressure on the NFL to belike, Hey, make sure our players
stay safe.
Yeah.
You need to be doing somethingabout this.
Arpita (48:07):
And this actually happened, um, just a few weeks
ago.
The, Miami Dolphins, quarterbackwho has had many, many
concussions, uh, is now out forthe season because he's had
another concussion.
So it's like, this stuff comesup, like, all the time.
Um, and, you know, Bennet isalive and well.
So he's 51.
He lives in Sacramento with hiswife and his two children.
(48:29):
He works part time as anassociate professor at the
University of California, Davis,but most of his income comes
from being an expert witness.
Uh, and during a, depositionlast year, he testified that he
earned over 900, 000 in 2018.
So like, He's just printingmoney based on his CTE
(48:49):
situation.
But like I mentioned, thisWashington Post paper was like
really revealing that like thescientific community does not
respect him.
His papers have potentially alot of holes in them.
And this isn't to say that, youknow, CTE isn't real or that we
shouldn't think about headtrauma as something that's real.
It's more that this has beenoverblown.
(49:12):
And he, yeah.
You know, I think got a lot ofattention for being a
whistleblower, which, like, hewas, right?
It's like, yes, like, I do thinkthis is something that required
more attention, but the way thathe has portrayed this as
something that everyone whoplays a contact sport is going
to have is just, you know, fearmongering.
Aarati (49:32):
Yeah, I can see that.
I can see how like people kindof knew it was a thing.
But then once he connected it tofootball, football has such like
a massive fan base, like in away that boxing doesn't have
Arpita (49:47):
Like, he poked a bear.
Aarati (49:48):
Yeah, like people knew about it in boxing.
But like, you know, you haveyour boxing fans and you know,
but like football is just likecrazy in America.
It's just huge in America.
Yeah.
And so once you blow the whistleon something in football, it's
just going to get blown up sobig.
And then I think he got a tasteof that it sounds like almost,
(50:09):
and then he just kept on tryingto blow it up and blow it up and
blow it up.
And it's like, okay, yeah, you,you made a big splash.
Arpita (50:16):
You're no longer a scientist, right?
And this point you're no longera scientist.
And that's, yeah, that's thestory of Bennet.
Oh my gosh.
Aarati (50:24):
Amazing.
That's, it's kind of sad in away that he's gone so far
afield, astray, you know, um,but you said he's still at UC
Davis?
He's a professor at UC Davis?
Arpita (50:38):
Yeah, he's like super part time.
I think he just maintains anappointment there, but.
Yeah.
Okay.
It's like, he's reallycontroversial in science because
scientific community doesn'treally respect him.
But yet he's still like printingmoney, basing all the, doing all
these speaking engagements.
And he is still like in thepress.
Like when I was Googling hisname, it's like, he comes up on
press articles.
Like he's saying words out thereto the press, but that doesn't
(50:58):
mean that they're accurate.
Aarati (51:00):
I gotcha.
Gotcha.
Yeah.
It is, it is kind of like that,where do you draw the line
between science andsensationalism kind of thing?
Exactly.
You know, everyone wants scienceto be really sexy and amazing
and, you know, just this huge.
Arpita (51:16):
And he's delivering.
He's delivering on that.
He is, right?
It's like something that's, youknow, beloved.
Aarati (51:21):
But you can't do that without accuracy.
And that's the problem.
Arpita (51:25):
Totally.
That is the problem.
Yeah, I know.
It's, it's really quiteinteresting.
Like, the controversy aroundthis is like multifold, right?
It's like him versus the NFL,like him versus the scientific
community.
He also has, like, a milliondegrees, and so he does have the
credibility of having, like, alot of letters behind your name,
and it's like, that does not ascientist make, but, you know,
(51:46):
it, it does work.
does help, you know, the publiceye that you have some, at least
on paper credibility.
Aarati (51:53):
Yes.
Arpita (51:53):
It's like a Dr.
Oz situation.
Aarati (51:55):
Yes.
Oh yeah.
Good, good connection.
Yes, absolutely.
Well, great story.
That was amazing.
I've definitely heard of thiskind of thing before.
I don't follow football at all,but even I know about this story
in general.
So really, really fascinating tohear about him.
(52:15):
Great stories.
Thanks for listening.
If you have a suggestion for astory we should cover or
thoughts you want to share aboutan episode, reach out to us at
smarttpodcast.
com.
You can follow us on Instagramand Twitter at smarttpodcast and
listen to us on Spotify, Applepodcasts, or wherever you get
(52:36):
your podcasts and leave us arating or comment.
It really helps us grow.
New episodes are released everyother Wednesday.
See you next time!
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