By Dr. Bennet Omalu
Early in the fifth century, an ascetic monk from the east felt compelled to travel to Rome, a city he had never visited before. He arrived to find huge crowds all moving in one direction. Since he did not know why the Spirit had led him to the city, he decided to follow the crowd. He quickly became caught up in the festive mood that permeated the crowds. His sense of expectation rose as the push of the crowds led him to the coliseum, where he sat down with the rest of the people and waited to see what might happen next. He did not have to wait long. Two gladiators came out into the arena and began fighting with swords and shields. Telemachus had never seen such a sight. Horrified by the sight, he stood on his seat and shouted, “In the name of Christ, stop!” No one paid any attention to him. The rest of the crowd cheered at the top of their lungs as the two gladiators began to draw blood from each other.
As the crowd cheered, Telemachus ran down from his seat and jumped into the arena. He went straight to the two gladiators, shouting, “In the name of Christ, stop!” The fighting men ignored him until he put himself between them. When the crowd saw him interfering with their entertainment, they began to boo and shout for him to get out of the way and let the show continue. Telemachus would not budge. “In the name of Christ, stop!” he shouted again. The crowd went from annoyed to enraged. A gladiator pushed Telemachus to the ground. As he lay in the dirt, the angry mob surged toward him. One man threw a stone at him, striking him in the chest. Another stone came flying in—and then another and another.
He shielded himself with his arms, but the flurry of stones was too strong. Telemachus tried to get up from the ground but was knocked back down as a rock struck him in the head. A stream of blood spurted out. The blood only seemed to stir up the anger of the mob even more. “In the name of Christ, stop!” he said one last time. The stones continued to rain down, even after the small monk stopped moving. When it was clear he was dead, the anger of the crowd turned to revulsion over what they had done. Those who had cheered for blood felt very different when it covered their own hands. Saint Telemachus could not stop the gladiator combat show in the Roman Coliseum that day, but his death ultimately moved Emperor Honorius to ban the fights forever.
I did not set out to be a modern-day Telemachus when I started writing my first Chronic Traumatic Encephalopathy (CTE) paper. I had not taken up the cause of telling the world, or at least America, the inherent dangers of football. At the time, the paper was nothing more than the final step to fulfill the promise I had made to the late Pittsburgh Steeler Mike Webster, not a crusade.
As I wrote in the last chapter, the hardest part of writing the paper was getting started. Until I came up with a name, words refused to come. Once I settled on CTE, the words seemed to fly out. I completed the first draft of the paper in a little over a month. While I made multiple revisions based on editorial input from my coauthors and the editors at the journal that published it, the bulk of the paper is the same as that original draft. I truly believe my writing was guided by God Himself. Right around the time the movie Concussion was released, I went back and reread the CTE paper for the first time since its publication. To be honest, I nearly fell over when I read it. This came out of me? I thought in amazement. This paper is too good to have been written by me! I was floored by its audacious scientific originality, creativity, and innovation.
The Bennet Omalu of today could not write such a beautiful piece. At that time, I was still filled with youthful idealism and hope. When I wrote that paper, I believed it would truly make a difference, that it would spark a genuine dialogue within the football community that would result in a game that protects its players. I boldly spoke my mind and made the type of strong assertions Dr. Wecht had taught me to make whenever I spoke as an expert in a court case. My boldness was based on truth. I had no reason to be anything but forthright. I did not take a side in the paper. Truth does not have a side. Truth is truth. It is up to us to conform to truth; truth does not conform to us.
The paper focused on one case—that of Mike Webster. Many more former football players probably suffer from CTE. However, because there had not yet been a concerted effort to look for the presence of CTE in the brains of former football players, we have no way to know how widespread this disease might be. I assumed many of those connected with football would be anxious to know more, since I also assumed they surely had the players’ best interests at heart. Yes, I was young and very naive.
After completing the first draft, I set the paper aside for a short time and then went back and made revisions. I sent copies to Drs. DeKosky and Hamilton, along with Dr. Wecht. I also sent a copy to Ryan Minster and Ilyas Kamboh, both of whom were in the Department of Human Genetics at the University of Pittsburgh. These men were my coauthors on the paper. Each of them suggested changes. Some I accepted, while some I did not. I sent the final draft back to them all. We went back and forth until we had a manuscript we were all proud of.
Now the question was where to submit the finished paper for publication. I believed there was only one logical choice: Neurosurgery, the same publication in which the NFL concussion committee presented its research. The journal’s editor at the time, Michael Apuzzo, was a professor of neurosurgery at the University of Southern California. Under his direction, the journal had added a sports section that featured articles on sports and the brain. Since Neurosurgery had already published NFL papers focusing on football and concussions, it seemed the logical place to submit my paper.
From what I observed in the review process, I believe my paper went through many reviewers—possibly up to eighteen—not two or three. Why so many? I do not know. All of them sent comments to me. While many were positive and asked legitimate scientific questions that I needed to clarify, others had a decidedly negative tone. Many of them did not want to see my paper published, but the reasons they gave were not scientifically valid. Some of the negative comments questioned my credentials. They insinuated that I was a no-name and a quack. Who is Omalu? they essentially asked, and why should we take seriously the research conducted by nothing more than a government employee doing autopsies in Pittsburgh?
The attitude expressed by these reviewers speaks to one of the fallacies of accepted scientific research. Today, the scientific community yields to established, experienced professors in university settings to guide research, review research papers, and determine whose research is funded. The result is a complete lack of innovative approaches to old problems. Instead, we are stuck with conformational intelligence, where the same approach is used over and over.
The seemingly endless process of back-and-forth with the many reviewers left me very frustrated. I suspected that none to several of those reviewing my paper were trauma neuropathologists. Many of their comments made it clear they may not have been adequately educated on the pathology of neurotrauma. The process of answering their questions and objections took three to four times the amount of time it took to write the paper itself. My responses were more than five times the length of the paper. Yet no matter how much I wrote, more questions came.
My patience began to wear thin. Gradually, without my knowing it, a simmering anger arose within me. I could not believe this was happening in America. In all fairness, some of the reviewers were good to me and commended me for my work. A minority remained vehement that the paper should never be published and that Omalu should not be trusted because his assertions are dangerous.
However, to the credit of Dr. Apuzzo, Neurosurgery ultimately decided to publish my paper. They included some of the comments from reviewers, but most of those included were positive. One in particular stood out. Dr. Donald Marion, a neurosurgeon from Boston, gave some very constructive comments. Given what happened next, he was an angel from God to me, encouraging me when I could have easily drowned in a sea of doubt.
Finally, I received a copy of the volume 57, number 1, July 2005, issue of Neurosurgery. I opened to page 128 and just stared at the article. I did not reread it. I had read it enough times during the editorial process. Instead my thoughts turned to Mike Webster and his family. You’ve been vindicated, Mike, I thought. After reading this, people will know you did not want the life into which you descended. Football did that to you. I hope this gives you rest.
And then I closed the journal and set it on a shelf. I never could have imagined that this was going to be deemed one of the most influential case reports in sports medicine. When I closed the cover of Neurosurgery, I did not imagine that paper would come to define so much of my life and my life’s work. In my mind, it was very much like the other papers I wrote both before and after Mike. I had discovered something in the brain of Mike Webster and now I had reported it. That afternoon I went back to work and completed another autopsy then filed my reports on it, just as I did every day. The Mike Webster paper was just another day at the office, not a life-defining moment.
Then the NFL stepped in.
One morning several weeks after the publication of “Chronic Traumatic Encephalopathy in a National Football League Player,” my phone rang. Dr. Wecht’s secretary was on the phone. She only called when there was a problem or when Dr. Wecht needed me. As expected, she said, “Cyril needs to reach you. May he call you at this number?” she asked.
“Of course,” I said.
A few minutes later, the phone rang again. “Bennet,” Dr. Wecht said in an anxious tone of voice. He was usually very loquacious, but not this morning. “I just got off the phone with an editor from Neurosurgery.”
“Is everything alright?” I asked.
“No. The NFL sent them a letter demanding that your paper be retracted. They want you to say you made the whole thing up.”
I sat there stunned for a moment. “What did the editor say to them?” I asked.
“Dr. Apuzzo has set up a review committee to address their concerns and determine if it should be retracted.”
I wondered if this had been the original plan all along—if they had only agreed to publish my paper to embarrass me. Now it made sense. By holding me up to professional ridicule, they would send a message to other doctors across the world that you don’t mess with the National Football League. If my paper was retracted and all my science debunked, then my career was as good as done. No one would ever touch me or the question of CTE ever again. Panic started to set in—panic and anger. But then I remembered the words of Saint Paul:
We know that all things work for good for those who love God, who are called according to his purpose… If God is for us, who can be against us?… What will separate us from the love of Christ? Will anguish, or distress, or persecution, or famine, or nakedness, or peril, or the sword?… No, in all these things we conquer overwhelmingly through him who loved us. For I am convinced that neither death, nor life, nor angels, nor principalities, nor present things, nor future things, nor powers, nor height, nor depth, nor any other creature will be able to separate us from the love of God in Christ Jesus our Lord. — Romans 8:28,31,35,37-9 (NIV)
Once I calmed down, I realized I had the least to lose from this battle. My coauthors were far more established than me. I was only three months out of my training as a neuropathologist when I conducted the Mike Webster autopsy. I was a neophyte. But Drs. Wecht, DeKosky, Hamilton, and Kamboh had their names and reputations on the line. I wondered if they regretted becoming associated with this no-name Nigerian doctor.
“So what should we do, Cyril?” I asked.
Dr. Wecht laughed. “Don’t worry about these idiots,” he said. He actually used a much more colorful term, which is Dr. Wecht for you. “Don’t let them intimidate you or silence you. Dr. Marion is going to call you later. Listen to him, and do whatever he asks you to do.”
“I will,” I said. I hung up the phone and whispered to myself, What have I done? Tears rolled down my face. I knew I had done nothing wrong against anyone. Everything I had done that led up to this moment, from ordering the fixing of Mike Webster’s brain to the extensive study of the slides of his brain to all of my research into brain disease and ultimately in publishing this paper—all of it was driven by my desire to have justice for Mike and restore his humanity. And now I was under attack. My career and the careers of those who had stood with me were all at stake. I knew what I had to do. I had to stand firm on the truth. Truth will not be moved or intimidated by those who seek to silence it.
I had never set out to become a modern-day Telemachus. My goal was never to be the voice of an outsider who points out what no one else was able to see because their eyes were clouded by conformational intelligence. If the NFL had simply ignored my first paper, I may never have become the one running out into the football arena and crying out, “In the name of Christ, stop!” But once they demanded a retraction, that was exactly who I became. I had no choice. I had to be the voice for those who could no longer speak for themselves.
Truth Doesn’t Have a Side follows the journey of neuropathologist Dr. Bennet Omalu, who uncovered the truth about brain damage in American football players, and his battle against those who would silence him. Read this incredible story that is changing the course of high-impact sports and could change the course of sports culture forever.
One day in 2002 the fifty-year old body of former Pittsburgh Steeler and hall of famer Mike Webster was laid on a cold table in front of pathologist Dr. Bennet Omalu. Webster’s body looked to Omalu like the body of a much older man, and the circumstances of his behavior prior to his death were clouded in mystery. But when Omalu cut into Webster’s brain, it appeared to be normal. Something didn’t add up.
It was at this moment, Omalu studying slides of Webster’s brain tissue under a microscope, that the world of contact sports would never be the same: the discovery of Chronic Traumatic Encephalopathy. CTE can result in an array of devastating consequences including deterioration in attention, memory loss, social instability, depression, and even suicide. And Omalu’s discovery of CTE in the brain of an American football player has become the catalyst of a blazing controversy across all contact sports.
At the center of that controversy stands the unlikely Dr. Bennet Omalu, a Nigerian-born American citizen, a mild-mannered, gentle man of faith. It is fascinating that it would take someone on the outside of American culture to make this amazing discovery, and refuse to let it be kept hidden. Dr. Omalu began his life in strife, growing up in war-torn Nigeria. But his medical studies in forensic pathology proved to be a lifeline. It fed his natural curiosity and awakened within a deeper desire to always search for the truth. Who would have thought that such an unexpected character would play such a role in bringing to life this world-changing data?
In Truth Doesn’t Have a Side, discover the truth about CTE: Its causes and symptoms, how we might keep our children safe and guide professional athletes when CTE sets in. The problem of CTE is coming to light with each new story about an athlete’s concussion problem, and we are likely facing dramatic changes to professional sports. You’ll be inspired by Dr. Bennet Omalu a man driven by his love and concern for the welfare of all people, and his professional vow to speak the truth.
Dr. Bennet Omalu is the Nigerian-American neuropathologist who discovered and named chronic traumatic encephalopathy (CTE) in American football players, other athletes, and military veterans. He is the chief medical examiner of San Joaquin County, California, and a clinical professor at the University of California, Davis. The Hollywood film Concussion, staring Will Smith, highlights his amazing story. Dr. Omalu’s new book Truth Doesn’t Have a Side provides intimate details of his life and the battle that followed his discovery of CTE. Bennet and his wife have two children and reside in Sacramento, California.