Channel 4 News investigates how head injuries in collision sports can lead to lifetimes of misery for former players – and what is being done to help them.
George Visger is 52 years old. He played pro American football for the San Francisco 49ers. And he took a lot of big hits.
Now he carries a series of yellow notebooks around with him, where he writes down everything that he does every day – otherwise he will not remember.
“I have 28 years of these. My whole days are in here. It goes minute by minute for me – you know, 12.30 to 12.37, I was at this site and I spoke to Ron. I have everything in them. These are my memories basically,” he told Channel 4 News.
My wife says she hates what football has done to our lives. George Visger
As well as severe memory loss, Mr Visger also suffers depression and seizures, and has anger management issues. He has hydrocephalus – or “water on the brain” – which drains through a tube in his skull. If this fails, within 24 hours he falls into a coma and needs emergency surgery.
He has already had nine brain surgeries – one so life-threatening that he was read the last rites – and takes a checklist of medications.
Mr Visger and many of the scientists who have studied the damage to his brain believe his football career is the cause.
“It’s had a terrible toll. My wife says she hates what football has done to our lives,” he said.
Mr Visger is not the only former National Football League player suffering in this way. American football is one of the most physically demanding combat sports. Full body tackles are regular, big hits to the head are common, and concussion is a daily occurence – and players say the padding and helmets don’t help, only encouraging people to hit harder.
For years scientists have known about “punch drunk” syndrome, coined to describe the problems suffered by boxers immediately after fights, as well as their long-term issues from a lifetime of blows. It’s a condition similar to this, officially called chronic traumatic encephalopathy (CTE), which they now think is affecting NFL players.
Dr Robert Cantu is one of the world’s leading experts on CTE. As co-director of Boston University’s Centre for the Study of Traumatic Encephalopathy, he has studied the brains of 50 former NFL players, donated after their deaths. He says almost every brain showed signs of the degenerative brain disease, which is caused by head trauma.
“Every time there is a significant hit, it could be making it worse,” Dr Cantu told Channel 4 News.
Probably his most famous case is that of Dave Duerson, a ferocious NFL player known for hitting with his head. He killed himself in February this year.
“Can you imagine? He thought he might have this problem so he shot himself in the chest so that his brain would be preserved, and that’s what he said he was doing,” said Dr Cantu.
The sad case of Mr Duerson, who had moderately advanced CTE, is one of several which has finally brought home the risks of concussion to the NFL. A series of concussion lawsuits, including one launched last month which could become the first ever class action and includes two-time Super Bowl winner Jim McMahon, have also added to the pressure.
An NFL spokeswoman told Channel 4 News it would “contest any claims of this type” and said there was now a series of regulations in place about concussion and head injuries.
But while the NFL is beginning to improve protection for its players against the risks, there are questions being asked about CTE in other combat sports.
Three ice hockey players in north America have been found dead since May. They were all enforcers – the roughest players in an already rough game.
The three players – Derek Boogaard, Rick Rypien, and Wade Belak, who died last week – regularly dropped their gloves to fight on the ice, taking beatings and facing fights hundred of times.
The deaths of both Mr Rypien, who is known to have battled depression, and Mr Belak were reported in the United States as suicide. Mr Boogaard died of an accidental overdose of alcohol and prescription painkillers.
Now experts are considering whether their deaths could be linked to head trauma, or at the very least the stress of playing in such a violent game.
Dr Cantu told Channel 4 News: “It doesn’t matter what the trauma is from – football, hockey, or it can be in accidents. It is still trauma.”
It’s a fear which is now stalking rugby, another one of the world’s most brutally physical sports.
Dr Cantu said: “There are some cases in the world’s literature on this from rugby but there just haven’t been a lot of rugby players studied, and I bet when that has happened, I bet you will find fairly significant incidences of head trauma in rugby.”
Players themselves told Channel 4 News it is an issue that needs considering.
Rugby league player with Harlequins, Luke Dorn, said: “We focus too much on the physical aspect. But we don’t think about the head knocks, the knock-outs you get, and what sort of physical affect that might have on the brain and the overall state of mind and mental health in the future. That’s something that is really concerning.
“This new research will be great for players, and the more we can learn about it the better we will be at preventing it and helping players that may be suffering with it.”
Rugby league and rugby union’s ruling bodies both have regulations in place to try and protect players suffering with concussion. They also do tests after injuries. But rugby league’s “macho” culture can stop people in the top flight from admitting they are hurt, insiders told Channel 4 News.
It’s a sport of warriors. So part of what we’re doing is trying to get these warrior-like rugby league players saying, it’s OK to talk. Brian Carney, State of Mind campaign
That is one of the reasons why this weekend, rugby league is playing the first ever “State of Mind” round. It is not directly linked to CTE awareness, but organisers hope that it will de-stigmatise talking about mental health problems in rugby. They say it is a step in the right direction.
Brian Carney, a former player and now Sky Sports rugby league commentator, told Channel 4 News: “Rugby union and rugby league are two sports where most players don’t have headgear, and when they get concussed on the field, they almost feel obliged to get up and play on… It’s a sport of warriors. You go into training and put on this game face and you can’t show weakness on the field,” he said.
“That tends to cross over off the field, and you don’t want to show weakness, and talking about it can be considered weakness. So part of what we’re trying to do is get these warrior-like rugby league players saying it’s OK to talk.”
State of Mind was set up last year after one of Mr Carney’s close friends, ex-rugby league player and Great Britain international Terry Newton, committed suicide after he was given a two-year doping ban. The 31-year old’s sister had also recently died of pneumonia following heroin addiction, and it is thought Mr Newton became depressed both by her death and by what he saw as the end of his career.
Mr Carney said he hoped that a campaign like State of Mind would help stop this from happening ever again, and highlight the services which are available, such as counselling.
He said: “I lost a very good friend, Terry Newton, who committed suicide. I think everything would point towards him suffering severely. I look back now and wish that I was a bit better equipped and maybe recognised what he was going through and helped him.”