'Football on trial': America's pride or America's shame?

Dr. Paul Butler voted to ban football in his New Hampshire school district, while Dr. Doug Swift won two Super Bowls before turning his attention to medicine.

On Tuesday night, three accomplished doctors from three very different backgrounds convened at the College of Physicians of Philadelphia to discuss the issue of head injuries in football.

The talk, entitled “Football: America’s Pride or America’s Shame?” featured Doug Swift, MD, who won two Super Bowls with the Miami Dolphins of the 1970s before turning his attention to medicine as an anesthesiologist; H. Branch Coslett, MD, professor in neurology at the Hospital of the University of Pennsylvania; and Paul Butler, MD, a retired surgeon who gained fame—or notoriety, depending on your stance—by voting to end football in his local school district, where he served as a board member.

The title of the talk “America’s Pride or America’s Shame?” didn’t seem to leave much room for a middle ground, but in the end the highlight of the presentation was its non-judgmental approach to accepting that there is a large gray area in the entire discussion. Football players, coaches, doctors, even opponents of the sport were able to walk away saying they’d learned something, and hopefully with a greater understanding of the other side of the debate.

Each presenter gave an individual presentation lasting about 15 minutes, with Dr. Coslett leading off. He spoke at length about Chronic traumatic encephalopathy (CTE) and what we’ve learned about the condition since it became widely associated with retired football players. His answer? We haven’t learned enough.

Dr. Coslett offered an opinion that the condition is ‘grossly underdiagnosed’, showing a statistic that some 50 percent of retired boxers present signs of CTE. But the statistics led to the most interesting portion of his talk.

“Why those 50 percent, and not the other 50 percent?” he asked. “Well, we don’t know just yet. That’s the next step—the work that will go into finding the risk factors for CTE, and who might be at greater risk for developing CTE.”

Only then will people be able to make more informed decisions about football on an individual basis. “Should you play football? Maybe, maybe not,” concluded Dr. Coslett. “But if we could see the probability of that person developing CTE, that decisions becomes much easier.”

Dr. Doug Swift’s talk began with a proclamation from George Stade, a great admirer of the game of football. “Among sports, [football’s] mode is violence, and violence is its special glory.”

Throughout his talk, Dr. Swift’s love and fondness for football—both as a whole and for his own career—was evident. But his skepticism was also apparent, as he admitted that the question of why someone should play football was “hard for me to answer.”

Dr. Swift did, however, speak of the role football played in helping him to pursue other goals in life. “It helped me get into college, and I feel that playing in the NFL helped me when it came time to apply to medical school,” he said. “For me, football and education went hand-in-hand.”

Dr. Paul Butler is another former football player—albeit one who holds a different opinion on today’s game. While he never played in the NFL, Dr. Butler spoke of his love for the game before declaring, “Football is on trial.”

Throughout the presentation, the current controversy was compared to the early 20th century, when President Teddy Roosevelt led a crusade to clean up the game of football after some 19 player deaths plagued the 1905 college season.

However, Dr. Butler chose to focus on the past 12 years or so, starting with the death of former Pittsburgh Steeler Mike Webster in 2002. Webster’s brain tissue would be examined by Dr. Bennet Omalu, and Webster would become the first football player diagnosed with CTE.

In 2012, Dr. Butler garnered attention by proposing to ban football in his New Hampshire school district. “Unlike other sports, you cannot take the head out of football,” he declared. “To do so would be to reduce the game, essentially, to flag football. It would be fine with me, but I think many fans romanticize and watch for those big hits.”

Dr. Butler has two sons in their early 40s, and said he would have actively encouraged each to pursue football as a youngster, had they been so inclined. “But that was years ago, the early 1990s,” he clarified. “Today, I would do everything in my power to encourage them otherwise.”

Perhaps the overall tone of the talk was captured in the final comments from Dr. Coslett in response to an audience member’s question whether he would encourage someone to play football. “People are now aware of the risks,” he reasoned. “Now, it’s up to each person to decide what they want to do with that awareness.”

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