Beyond the ‘88 Plan’

Meet John Mackey. Tight end for the Baltimore Colts (1963-1971) and San Diego Chargers (1972). Five-time Pro Bowler. Member of the National Football League (NFL) 1960s All-Decade Team. The second “pure” tight end to enter the NFL Hall of Fame.

And he has frontotemporal dementia, a degenerative disease caused by the rapid deterioration of the frontal and temporal lobes of the brain, which Mackey injured on a goal post in his football days.

Each year in the United States, about 300,000 athletes experience sports-related traumatic brain injuries. In the NFL, approximately 100 players suffer concussions resulting from collisions averaging 98 times the force of gravity.

Now facing a growing number of football veterans with deteriorating health, the NFL is beginning an extensive study of the connection between sports-related concussions and chronic brain dysfunction. Plans to address the often devastating side-effects of a professional football career are already in the works. Yet as the NFL devotes funds to researching and treating brain disorders after the fact, the question remains whether the league is willing to make sacrifices to take the safety of its players seriously from the fore. As attention to the relationship between athletics and brain injury is on the rise, now is the time for the NFL to set a valuable safety precedent.

After former Philadelphia Eagle Andre Waters, whose extreme brain damage has been attributed to repeated concussions, committed suicide this past November, the NFL promised to “begin studying retired players later this year.” Embarking on a study that may cost as much as $3 million over several years, co-chairman of the NFL’s Mild Traumatic Brain Injury (MTBI) Committee, Dr. Ira Casson, said the study aimed to determine “whether or not a career in the NFL results in any kind of chronic brain injury.”

Yet these resolutions arrive surprisingly late, as the league has already begun to take responsibility for the declining health of its players. When Mackey’s wife, Sylvia, wrote last May to then-NFL commissioner Paul Tagliabue about the financial burden that can result from the rapid decline of retired players’ health, the league and the NFL Players Association responded by creating the “Number 88 Plan.” Named after John Mackey’s jersey number, the plan will pay up to $88,000 for each former player’s treatment of assorted types of dementia.

This plan is a noteworthy step on the part of the NFL to help remedy the consequences of an NFL career, but it appears that the league neither has been nor is being nearly as proactive with regard to encouraging and protecting the safety of players on the field.

In 1994, Chicago Bear Merril Hoge retired after suffering two concussions within 42 days. Because he was not required to have a second evaluation following his initial treatment, he returned to the field five days after his first concussion, only to suffer a hit to the same unhealed spot. Past and current players suggest that playing despite injury is implied and expected. But Hoge, wary of the danger of multiple concussions, claims that he was fortunate: “Second impact syndrome kills you...I got lucky.”

Contrary to Hoge’s apprehension, the league has historically resisted admitting the dangers exposed by predominant scientific findings. The results advertised by former MTBI chairman, Dr. Elliot Pellman, continually countered those of scientists, insisting that playing after a concussion “does not involve significant risk of a second injury either in the same game or during the season.” Yet a 2003 study of 2,905 National Collegiate Athletic Association players by North Carolina’s Center for the Study of Retired Athletes found that 91.7 percent of repeat injuries came within ten days of the first injury, and 75 percent came within seven days. Dr. Kevin Guskiewicz, the research director for the Center, states, “Some say we’re trying to paint this ugly picture…My goal is to help improve the game to make it a more safe game, regardless of what level it is.”

The recent resignation and replacement of Pellman could mark a turning point in the league’s attitudes toward safety and a movement toward Guskiewicz’s sentiments. However, the committee refuses to consider any connection between professional-level NFL research and high school or collegiate research such as Guskiewicz’s. Many fear that if the NFL’s attitudes toward safety do not change, the reverberations will be felt not just by professional football players, but by athletes of every sport and level.

The issue of safety, brain injury, and athletics is in the spotlight, much due to action by the families of NFL veterans and the NFL’s timely response. The NFL finds itself in the powerful position to set an example that can improve the quality of life of many a future athlete. Many insist that the game of football must fundamentally change to ensure safety, but to ask that much now is unrealistic and unnecessary. Possible initial policies as simple as requiring follow-up examinations after injury and sending players off the field long enough for thorough treatment and recovery, in accordance with research findings and physician recommendations, make a difference. The league should seize this opportunity to reconsider and revamp its approaches to athlete safety.

In the meantime, MTBI committee member and Baltimore Ravens team physician, Andrew Tucker, concedes that NFL teams do not follow a specific concussion treatment guideline. “You wait until symptoms resolve before a player returns to play. We’re the beneficiary of an elite-level athlete who seems to recover quicker.”

An athlete who seems to recover, only to face the grave repercussions 30 years later.





Dawn J. Mackey ’09, a Crimson editorial comper, is a biomedical sciences and engineering concentrator in Dunster House. She is the grandniece of John Mackey.