Bennet Ifeakandu Omalu is a Nigerian-born American. I discovered him through the film Concussion. Starring Will Smith, it follows a forensic pathologist who comes to America from Nigeria with great dreams, and shows how his life changes after performing an autopsy on a former American football legend. Suddenly, despite being right, he finds himself in serious trouble. Imagine coming all the way from Nigeria to America, studying in centres of science out of a love of knowledge and self-development. You then use scientific evidence to demonstrate that American football, one of the country’s national sports, causes permanent damage to players, leaving them vulnerable to suicide, depression and violence after retirement. You pay for all the tests and other costs of trying to prove it out of your own pocket. Then, when your findings reach the papers, the state and the FBI come after you. For upsetting the wealthy people in a multimillion-dollar sports industry, you lose your job, your employer comes under pressure, you have to move to another state, and your wife miscarries your first child amid the stress. Your own colleagues mock you and turn against you. Yet in the end, you succeed and make the NFL and the public acknowledge it. Bennet Omalu is a great idealist and a fighter who achieved that. Such examples are particularly rare in healthcare. We are honoured to translate and share information we found about him online.
To return to Concussion: its subject is wonderful, but the film has been heavily softened and trimmed so as not to encourage opposition to the United States or its government. There are many scenes where Omalu proudly describes becoming an American citizen as a dream. The pressure placed on him is handled very superficially. Of course, anyone familiar with similar cases can imagine how ruthless governments and capital become in such situations. At heart, Bennet Omalu was an idealist prepared even to risk death to demonstrate the truth of what he had found and believed in.
After watching, I asked myself this: why did the American state and scientists in healthcare wait until 2002 for a Nigerian pathologist named Bennet Omalu to identify this risk in a game played for years? How many people had died before then from this disease associated with American football? Were none of them given autopsies? Did the hundreds of suicides accumulated over years among retired players of the same sport never trouble any authority or scientist? Questions, questions. A healthcare industry programmed to serve capital and itself, and its corrupt participants, heads bowed in submission and drifting further from their oath every day. For me, Omalu’s emergence from such an industry made him even greater. To describe the diagnosis roughly, as viewers will also see in the film: the brain floats in fluid inside the skull. Presumably, evolution provided that flexibility to reduce damage from sudden movements and jolts. Each impact to an American football player’s helmet can make the brain strike the skull. Extend that over years and thousands of impacts can damage the brain and produce this abnormality. After retirement, it can manifest as hearing unexplained voices, depression, violent behaviour and suicide. Nor was the finding insignificant: in a later study, CTE was found in 87% of 202 deceased players whose brains had been donated for research. This was not a rate established for all players.
Whatever the circumstances, medicine needs idealists. It is a need we must never stop pursuing if humanity is to live more peacefully, healthily and fairly.
Born on 30 September 1968 in Nigeria, Omalu was the sixth of seven children. His mother was a seamstress and his father a respected engineer with standing in their community. His full family name, meaning ‘the one who knows and speaks’, is Onyemalukwube. Omalu started primary school at three and entered medical school at the University of Nigeria, Nsukka, at 16. He finished medical school and obtained his medical and surgical qualification at 22. After completing his clinical internship and working as a doctor in his country for three years, he went to America on a scholarship, completing epidemiology training at the University of Washington in 1994 before specialising in anatomic pathology at Columbia University’s Harlem Hospital.
With training at different universities and qualifications in several fields, Omalu began working as a forensic pathologist in Pittsburgh and directed his research towards neuropathology. At the time of writing, he is a professor in the Department of Pathology at the University of California, Davis.
Omalu’s life began to change while he was working as a forensic pathologist in Pittsburgh. When he arrived at work on the morning of 24 September 2002, on the metal table where a different person lay silently each day, he found the cold, dead body of Mike ‘Iron Mike’ Webster, a legend of the Pittsburgh Steelers.
The legendary player’s body had been found in a van in Pittsburgh, where Bennet lived. Since Webster was known to have attempted suicide several times before, many assumed that was the cause. Others said it was a heart attack. In any case, the suspicious death led prosecutors to request an autopsy, to be performed at the centre where Bennet worked.
Bennet began with his usual care and precision. The organs he examined, tests he performed and MRI showed nothing unusual, yet something bothered him. It was Mike’s medical history. His life had begun to change after retirement. He had undergone numerous examinations over a long period for forgetfulness, stress, depression and a tendency towards violence. Routine brain imaging, including CT and MRI, had shown no problem: no shrinkage like that seen in Alzheimer’s, and no obvious injury that could explain the effects. In other words, apparently nothing was wrong. So why had such severe symptoms appeared?
For Bennet, a person didn’t simply lose their mind for no reason. Something must have triggered it. Yet his tests had revealed no more than previous doctors had found. Everything looked normal. An endlessly nagging curiosity drove him to order additional tests, this time looking at the molecular level. He would examine certain proteins in Mike’s brain. Among the proteins that might explain the problems in Mike’s medical history was tau. The results showed an excessive accumulation of tau in his brain. Tau accumulation was associated with other diseases, but Mike’s situation was different. Bennet was confronting the relationship between American football and a disease previously described in boxers. Questions remained to be answered.
Bennet devoted himself completely to finding the answers. He researched late into the night, and when colleagues began looking at him as though he were mad, he decided to continue part of the work at home. In the end, he made a remarkable discovery.
Bennet diagnosed Mike with chronic traumatic encephalopathy (CTE). Broadly speaking, the disease involved repeated severe impacts to the head, an accumulation of tau protein and subsequent degeneration of brain tissue. Over time, to put it simply, the brain began to shrink as CTE developed. Symptoms included memory loss, dementia, confusion, depression and behavioural problems. These explained Mike’s psychological and neurological symptoms. In short, by considering his medical and sporting history, Bennet brought evidence of this disease in American football players into the medical literature.
Bennet’s discovery was published in Neurosurgery under the title ‘Chronic Traumatic Encephalopathy in a National Football League Player’.
As soon as the paper appeared, all hell broke loose in the American press.
While the scientific world applauded Omalu’s discovery, American football officials threatened him, declared him an ‘enemy of football’ and forcefully demanded that he call the finding a mistake and retract it.
Bennet refused to abandon his findings. In subsequent years, he performed autopsies on other players who had died and found further evidence for his work. He observed CTE in the brains of retired American football players including Terry Long, Andre Waters, Justin Strzelczyk and Tom McHale. Before their deaths, these players had experienced psychological and neurological symptoms similar to Mike’s.
The latest of the suicide cases examined by researchers at the time of writing was that of a 27-year-old who had been arrested as a murder suspect and imprisoned, and who, following his acquittal on some of the charges, died by suicide in a Massachusetts prison in April 2017: the former player Aaron Hernandez. His autopsy revealed severe CTE, and his brain was found to resemble that of a 60-year-old.
Throughout this period, NFL officials did everything they could to discredit Bennet’s findings, to the point that he received death threats. But he never gave up, defending the truth to the end along this difficult road.
Over the years, other researchers working on the subject examined donated brains from 202 people who had played football for roughly 15 years, finding CTE in 177 of them, or 87%.
The same research team reported that, among the NFL players in its study, 111 in total, the brain samples showed signs of the disease in all but one case. These findings supported Bennet’s work. They did not establish the prevalence of CTE among all players.
So, after all these findings, what is the NFL now doing?
The campaign of pressure against Omalu and his colleagues ten years earlier failed, and management eventually had to accept Bennet’s work, however reluctantly. What precaution did they take after accepting it? The answer was ‘modern helmets’. Introduced this season, these helmets supposedly reduce brain damage thanks to their flexible structure! However, Omalu is far from convinced: ‘There is no equipment that can prevent a condition like this.’
We thank him for his contributions to humanity and medicine.
Mr Omalu, we respect you and your struggle. Thank you.
