The Football Conundrum When Life and Death Is No Longer a Metaphor

by Neil H. Buchanan

After the New Year's weekend of college bowl games, I was planning to write a column here on Dorf on Law exploring the increasingly callous attitude that our society is showing toward the health and futures of the very young men who play those games.

Before I could do so (and before I ended up having to take last week off for unrelated reasons), however, the dangers of playing American football suddenly became Topic A not just on sports shows but more generally across the country.  Last Monday, early in one of the most widely watched games of the NFL season, Damar Hamlin of the Buffalo Bills pro football team went into cardiac arrest and nearly died.

Several silver linings quickly emerged out of this scary situation, but the bigger picture is still quite depressing.

On the plus side, there was an immediate outpouring of support for Hamlin and his family from around the country and the world.  As fate would have it, Hamlin is an absolutely model citizen who is apparently loved by everyone who knows him, and his charitable efforts are now benefiting from people's very human need to try to do something, anything, when the fragility of life becomes so salient.  There is the mildly cynical possibility that this is simply redirected charitable dollars, but that seems unlikely, given the intensity of the public's reaction.

Second, the game did not go on.  Reports indicate that both teams, Hamlin's Bills as well as their opponents that night, the Cincinnati Bengals, immediately recoiled at the idea of resuming the game.  Players and coaches on both sides had seen a 24-year-old man almost die before their eyes, and they put aside their "warrior mentality" and forgot about football in the moment.  Even more surprisingly, the game was soon outright canceled, as the overall vibe associated with picking up where things had left off was simply too much for people to tolerate.  With barely a sour side note (not related to Hamlin), the league came up with a good-enough solution to allow the season to end on schedule this past weekend and for the playoffs to begin without forcing either team to play an unacceptable game.

Third, there has since been a genuine and honest public discussion about violence in football.  Even more amazingly, this discussion has continued even though it quickly became clear that the particular medical emergency that nearly killed Hamlin was a vanishingly-unlikely fluke.  Rather than saying that "we can't control whether a person gets hit by lighting," the discussion quickly moved to the grim realities of the damage that football players endure in pursuit of glory and riches.  I will explore only a tiny bit of that violent reality shortly.

Much to my surprise, a fairly large number of reactions that I came across included authors in one way or another saying, as I invariably do when I write my occasional football-themed pieces here on Dorf on Law (most recently here), that they hate themselves for loving football.  It turns out that even people with a lot more investment in football than I have ever felt (including one fellow Michigan fan) are at best conflicted about their love of the sport.

The sad part of this is, of course, that nothing will change.  If Hamlin's injury had been a part of normal play, I suppose that some rule changes would have quickly been adopted to mitigate the specific risks and harms from that specific injury, but nothing else would have changed.  Under these unprecedented circumstances, however, there is not even the opportunity to react to one particular aspect of the overall orgy of violence.

I do, however, think it is worth assessing just how much damage is being done in the name of entertainment and "team spirit."  Before Hamlin's situation understandably took over the headlines, my plan was to write a column commenting on the violence specifically in the two College Football Playoff semifinal games, which were played on December 31.  In both games, there were plays in which a player hit another player with extreme force in helmet-to-helmet contact.  In both games, the plays were reviewed by the officials but ruled not to be illegal, and the commentators in both games essentially said, "Yeah, no foul, bummer for the guy who got hit."

On the merits, I think the officials blew both calls.  One of the only good things to have happened in football in the last decade or so is the prohibition on helmet-to-helmet hits, which has involved training players to change their fundamental techniques for blocking and tackling.  Played at full speed, there will of course be contact and judgment calls, but I thought it was rather clear in both cases that the plays should have drawn penalties.  It was disturbing that the attitude -- even on a concussion-related matter, which is rightly seen as the most important health issue facing football players -- has so quickly become treated with blase carelessness.

More broadly, one of the two plays in question unquestionably altered the game, with one of Ohio State's premier wide receivers having to be removed from the remainder of the game because he was hit too hard in the head (again, in a fashion that was deemed to be legal).  To their credit, Ohio State's staff "took away his helmet" and would not allow him to return to the field, which meant that the team had to play most of the game without one of their best players -- and the team ended up losing an achingly close nail-biter.

The commentators did frequently bring up the absence of that receiver, but that was only the tip of the iceberg.  They noted that Ohio State's best tight end had also been pulled from the game because of an injury, and they further pointed out that the wide receiver who left the game in concussion protocol was in fact the third best player at his position for the Buckeyes, but neither of the two original starters have been able to play for months because of injuries of their own.

My reaction to all of that was to think about how excited nearly everyone has been -- I would go so far as to describe people as virtually salivating -- about the upcoming expansion of the college playoffs to add two more rounds of games.  As it stands, the regular season has been expanded within my lifetime from 10 to 11 to 12 games, and then conference championship games were added in between the regular season and the bowl games.  The current 4-team format in the playoff means that the players on both TCU and Georgia played 15 games this season.  In a couple of years, the teams that make the final matchup will end the season having played 16 or 17 games.  Even the players who are still able to stand (some only barely) when it is all over will be paying the price for the rest of their lives.

And those lives might not be as long as they would hope.  I will get to that in a moment, but I will first share a quick anecdote from many years ago to illustrate that the violence of football is injurious not only in a cumulative way but also in a split second.  I will offer some details here from memory, which I concede might be inaccurate in various ways.  Fact-checking is not the point here, however, so please indulge me.

In the early 1980's, Yale's football hero was a runing back named Rich Diana.  Diana was, I believe, the all-time career leading rusher for a team with a very long history of great runners.  By then the Ivy League had moved down a level in college football's hierarchy, but Diana was so good that he actually made the final cut to be on the NFL's Miami Dolphins in his first year out of college.  He was not a starter, so he was put on what was tellingly known as the "suicide squad," that is, the kickoff teams that involve people being able to get up to full speed before launching themsleves into each other.

During training camp for what would have been his second season, Diana quit.  He explained that he had just had a major scare involving what he described as an absolutely standard hit during practice.  (In this way, there is a similarity to Damar Hamlin's injury last week, which followed a hit that did not in the moment seem remarkable.)  Diana was temporarily unsure if he was going to be able to get up and walk; and when he realized that he was not permanently disabled by the hit, he got up and walked -- and he walked.

As it happened, Diana had been accepted into Yale Medical School and had deferred enrollment while he pursued his NFL dream.  He was thus able to walk off the field and into a very productive and lucrative profession.  I am guessing that he is nearing the end of a long and satisfying career.  Of course, this raises a host of class-related issues for the players who do not have options remotely like Diana's, but that is the subject for another day.

I happen to remember the Diana situation's details, but there are countless stories of players who cut short their careers to save their bodies and minds.  Barry Sanders, a Heisman Trophy winner later in the 1980's, retired early from the NFL when he decided that he had had enough.  Nine years ago, a 24-year-old named Chris Borland took flak from people when he retired after one (very successful) year in the NFL, with macho poseurs saying that he "quit," which is of course the ultimate insult.  More along the lines of Diana's situation, former Penn State and Cincinnati Bengals star Mike Reid retired back in the 1970's to become a Grammy-winning musician and composer.

In some of those situations, the now-former players were explicitly worried about how frequently career-ending injuries happen, with one play completely changing everything.  In others, the idea was that the physical punishment of football at some point becomes too much, too dangerous, too frightening.  The problem is that it is never clear exactly when one should stop, until it is too late.

How bad is it?  Leaving aside anecdotes, what does the stat sheet say?  In a New York Times piece tellingly titled, "Football Is Deadly, but Not for the Reasons You Think," a former college player who is now a neuroscientist provided data that shocked even me.  I had long known that the average NFL career is only three years and that the Department of Labor has documented that pro football is one of the most dangerous of all occupations.  The Times's op-ed, however, offered jaw-dropping facts that we should all take seriously.

Here is a subset of the most surprising facts presented therein:

  • "According to a 2019 study from Harvard University, N.F.L. players are 2.5 times as likely to have cardiovascular diseases listed as an underlying or contributing cause of death as Major League Baseball players."  (This was provided after the author offered examples of seven former players who died of heart problems, with their ages at death running from 42 down to 26!) 
  • "N.F.L. players ages 25 to 39 have about three times the rate of arthritis as the general public."
  • A study indicates that the incidence of CTE, a result of traumatic brain injuries, is "more than 10 times what it is in the general population." 
  • "N.F.L. players are three times as likely to die of amyotrophic lateral sclerosis and 3.5 times as likely to die of Parkinson’s disease as Major League Baseball players."
  • "N.F.L. players in their 50s are 10 times as likely to be diagnosed with dementia as the general population."
  • The risk of traumatic brain injuries "is also shared by college football, high school and even youth players, all of whom are exposed to the risk, the vast majority without any financial upside — and in the case of children, without informed consent."

In other words, no matter how bad anyone might have thought it was, it is almost unimaginably worse.  People are dying very young, directly because of playing football.  And even those who do not die have to endure the physical and psychological effects of spending most of their remaining years in a weird kind of painful limbo.  The Ohio State player who had to leave the semifinal game with a head injury is the son of a former NFL star receiver, and although there are no reports that the father is showing signs of dementia, that 50-year-old's thirteen years in the NFL (and four years at the top level of college football) are a ticking time bomb -- just as it is for everyone who plays the sport.

When the evidence started to emerge a decade ago about brain injuries (evidence that the NFL apparently hid with all of its considerable might), one player said something like this: "We all knew when we signed up that we wouldn't be able to walk after our playing days ended, but we never imagined that we wouldn't be able to recognize our kids!"  Again,  the seasons are getting longer, the players are getting bigger (which is worse for them and their opponents), and no one seems to notice or care.

This is life and death, literally.  Go team!