Dr. Bennet Omalu, Mike Webster, and the Discovery of CTE

If you were to see Mike Webster in the late 90s, sleeping at a train station or living out of his car, you'd probably never think that he played 17 seasons in the NFL, was a four-time Super Bowl champion, was a member of the Pro Football Hall of Fame. Webster was living like a vagabond, engulfed in financial debt, depression, dementia, and severe joint and muscle pain from years of anchoring the Pittsburgh Steelers' "Iron Curtain" offensive line. Of all people, Dr. Bennet Omalu certainly wouldn't recognize Webster; Omalu, who was born and raised in Nigeria, had little knowledge of or interest in football before one morning in September of 2002.

Dr. Bennet Omalu

Dr. Omalu was a physician and forensic pathologist, working at the Allegheny County Coroner's Office in Pittsburgh. While arriving at work one morning, he was surprised to find TV news vans outside and commotion around the office. He asked what was going on, and one of the technicians reported that Mike Webster had passed away. When Dr. Omalu reponsed that he didn't know who Webster wars, his Pittsburgh coworkers looked at him with shock. Webster, who passed away at 50, was only 15 years earlier the most dominant center in the NFL, and one of the most well-known people in the city.

Dr. Omalu reviewed Webster's case file. Webster, who had died in a hospital from a heart attack, had already had his death certificate signed by a physician. Normally, Dr. Omalu would not have to perform an autopsy under these circumstances. However, a physicain had also listed "Post-concussion syndrome" as a contributory factor in Webster's death. Since post-concussion syndrome is a traumatic disease, and therefore categorized as an accidental manner of death, Webster's death also fell under the jurisdiction of the medical examiner.

As Dr. Omalu became aware of Webster's recent history of depression, erratic behavior, amnesia, and dementia, he started to think that Webster may have been inflicted with Alzheimer's disease. However, although his behavior matched common signs of the disease, Webster's brain showed no physical signs of Alzheimers. Confused and intrigued, Webster took samples of the brain to study, and also sent samples to the University of Pittsburgh brain lab. When the tissues returned from the brain lab, Dr. Omalu noticed abnormal proteins in the brain and neurofibrillary tangles that were similar yet distinct from what we normally be seen in a patient with Alzheimer's disease.

For the next few months, Dr. Omalu combed through numerous scientific papers, looking for writings about brains similar to Webster's. In an interview with Frontline, he described: "In the literature, everybody was giving it descriptive names, like nobody gave it generic names. Nobody had the, I could say the courage to give it a specific disease, identify it as a specific disease entity, describe the pathology." Omalu decided to give this pathogenic concept a name, calling it "Chronic Traumatic Encephalopathy," or CTE: chronic" meaning the disease is long term, "traumatic" meaning caused by physical injury, and "encephalopathy" meaning abnormal brain function or brain disease.

Mike Webster (52)

For the next several years, Dr. Omalu, along with colleagues at the University of Pittsburgh, continued to study Webster's brain. In July 2005, a little under three years after Webster's death, they published "Chronic traumatic encephalopathy in a National Football League player" in in the medical journal Neurosurgery. Dr. Omalu recollected with Frontline: "I was excited. I thought the football industry would be happy with our new discovery. I thought naively that discovery of new information, unraveling new information, redefining concepts, I thought the football industry would...turn it into some type of utility, some type of utility function to enhance the game." However, his studies were met with strong backlash by the NFL. He was a young, virtually unknown physician from Nigeria perceived to be be attacking the American way of life, and NFL doctors sent him letters demanding his paper be retracted. Dr. Omalu was worried about the very future of his career. However, after former Steelers guard Terry Long, who had been a teammate of Mike Webster, committed suicide in 2005, Dr. Omalu had the chance to study Long's brain as well. He also spoke with Long's wife, who stated that Terry Long had exhibited many of the same mental symptoms as did Webster. After finding the same neurological damage in Long's brain as he'd seen in Webster's, Omalu doubled down a published another paper as a follow up to the first.

Dr. Omalu's discoveries generated a cascade of scientific research, media coverage, reactions from the NFL, and public attention that have revolutionized the way people look at football and concussions in the past decade and a half. His discoveries gained even more national attention a couple years ago with the movie Concussion, which stars Will Smith as Dr. Omalu and tells a narrative strongly based on Omalu's real experiences studying CTE and fighting against backlash from the NFL. Overall, the discovery of CTE is so significant because it reveals that concussions not only cause brain damage in the acute sense, but that repetitive brain trauma occurring over a long period of time can lead to dementia, depression, and other symptoms later in life. In addition to former football players, CTE has also been identified in combat veterans, and professional athletes of various other sports such as hockey, wrestling, and boxing, among others.