Your Brain Health Episode 16

Introduction: This is Your Brain Health with noted Neuroscientists, Dr. Kristen Willeumier. Your Brain Health explores strategies to maximize your cognitive functions through life. Here’s Dr. Kristen Willeumier.

Dr. Kristen Willeumier: Welcome to Your Brain Health on Radio MD. I’m Dr. Kristen Willeumier. Today I’m honored to have my dear friend Merrill Hodge here to discuss his new book, Brainwashed, The Bad Science Behind CTE and the Plot to Destroy Football. Now that’s quite an impactful title, Merrill, and I’m so excited to have you on today to learn more about the book and the passion you have in the mission to support the sport you love. So welcome to the show.

Merrill Hodge: Well that’s good to meet you Kristen, especially with somebody like you. So I’m excited.

Host: You’re wonderful. So for those of you who don’t know Merrill I’m going to give you a brief introduction. He’s a former NFL running back who worked as an ESPN Analyst for 21 years, being a part of one of the longest running NFL shows on TV called NFL Matchup, active in concussion research and in the preventing and treatment of brain injuries. Merrill testified at a congressional hearing on head injuries and football in the Fall of 2009 and was then appointed to the NFL Mild Traumatic Brain Injury Committee in January of 2010, which initiates research and advises the NFL and best practices for concussion prevention and management. He’s also served on the NFLs Return to Play Subcommittee, which deals with head, neck and spine cases. So Merrill, you have an incredible background here and I’m so excited to kind of dive in and learn more about why you wrote the book. So let’s start with just sharing with the audience which NFL teams you played for.

Merrill Hodge: I actually, I was drafted by the Pittsburgh Steelers in 1987 and in 1994 I actually signed as a free agent. I went to the Chicago bears. I signed a three year deal to go play there where my credit career ended in the first year. But ironically they were my two favorite teams as a kid.

Host: I love that, and of course I’m from Chicago, so I’m a die hard Bear fan.

Merrill Hodge: Go Bears.

Host: And go bears. And I think the audience would appreciate, share with them who your roommate was when you were a Pittsburgh Steeler.

Merrill Hodge: Well, when I first got there Mike Webster was my roommate. And that was like rooming with your dad. Webby had been in the league for 13 or 14 years at that time. You know, I’ve been watching him as a kid, so it was, and he, we turned out to be very good friends. He is, he was obviously one of the greatest football players ever, but he was such a character, fun guy. I mean, I really tried to model everything on and off the field the way Webby did it. Great. A great, a great leader.

Host: He’s clearly now one of the probably best known people in terms of CTE, given that he was the first player to ever to have been with CTE by Benne Demalo. So you have such a unique perspective given that you know him very well. And were you surprised when that diagnosis came out?

Merrill Hodge: Well, I was surprised with how it was presented because he had heart issues. That’s what he died of. He had a stent in his heart. He had a lot of physical issues which is what he died of. And I think people think he died of CTE and nobody’s ever died of CTE. So I was disturbed that it was sold in that manner and that’s probably what bothered me more than anything, you know, I mean and not understanding what CTE was, you know, that started part of my search and confusion, but him passing away was the disturbing part and then how they sold it as if that was his cause, which had nothing to do with it. And they failed to report the real facts and truth about his death was probably the most disturbing thing.

Host: I think that sort of gives us the impetus into why you wrote the book. But before we get to that, can you also share with the audience your career ending concussion? Because actually I think that’s important for people to hear.

Merrill Hodge: Well, you know just to give you a little bit of history Kristen, I actually was one of the first group of players ever in NFL history to be doing cognitive testing with the Pittsburgh Steelers. They’d been doing it since 1991 as a voluntary basis. Why that’s important is in 1991, the Steelers were already doing some things that were outside the box trying to advance in how you cared for the injury. They had a neuropathologist on staff, Dr. Joe Maroon. Then I went to Chicago and actually they didn’t have a neuropathologist on staff and they weren’t doing cognitive testing. I went there in 94.

Host: Neuro surgeon and neuropsychologist. Right. Cause Dr. Maroon was a neurosurgeon who neurosurgeon.

Merrill Hodge: Okay. Yeah, there’s so many neuro, neuropathology in neurology. Dr. Cummings always corrects me on that. Yes, no, he’s a neurosurgeon. Correct. But he had a, there was a neurologist on, so I can say neurologist. What did I say?

Host: Neuropathologists.

Merrill Hodge: See, I’m so used to talking to Dr. Cummings about neuropathology world. And think you’re exactly right. And neurologist and I, he always corrects me too. So and Joe is one of the great minds in the world too, in that field.

Host: He’s brilliant.

Merrill Hodge: But what was, when I got to Chicago I was on a Monday night game and I, I had a real major concussion. When I say major concussion, I try to explain to people, you know, listen, every head trauma is serious. There’s just a couple things that identify the severity, one over the other. People always think, Oh boy, he didn’t lose consciousness though. That has nothing to do with it. I mean, really as far as severity goes it’s just part of what can happen. It’s really about cognitive recall and your cognitive state and stability. Those two things. The early results of those are indications of how severe. So this Monday night game, I don’t have any type of cognitive recall for some 10 to 12 hours. I don’t remember anything. My stability was not, was very bad initially for the first, you know, minute or so. And then it kind of cleared up cause I went back to the huddle and return to play.

Host: That’s so interesting. You had the concussion, you went back to play, but you know that you don’t recall that 10 to 12 hours after the concussion. Correct. You don’t remember anything that you did, but you saw yourself on tape, right? You saw the game later.

Merrill Hodge: Right. Well I saw it, you know, I ran another play afterwards. I don’t remember that play. There were a couple things that I remembered from that moment till the next day. But they are very sketchy, you know a particular moment when I was in the hospital getting my MRI just to make sure I didn’t have bleeding on the brain so I could fly back with the team, which I ended up doing. But here’s what really happened and I try to tell people, you got to keep things in perspective. You know, this is 1994, Kristen and too many people on this planet and in this arena, they keep throwing mud on pointing fingers and blaming that we didn’t have in 1994 what we have today. Well that’d be this like saying in 1980, why didn’t we have a, or 1970s and eighties, why we didn’t, why weren’t MRIs a bigger part of the medicine field. Why weren’t scopes being done and all of this stuff they do, knee ligaments and that done then versus what they’re done now. Okay. Well, it takes time to evolve. So being in 94, what was interesting though is the Bears didn’t have a neurologist on staff, and they didn’t do cognitive testing. So I actually got cleared over the phone to return to play five days later from the team zone medical practitioner.

Host: Unbelievable and unheard of today. Nobody would ever be cleared to play, to go back into a game without physically seeing the neurologist and having an exam done.

Merrill Hodge: Yes. Now, even in 1994, quite honestly from an NFL perspective, that was still unsettling for me, which is, I’ll get to that a second. So I got returned to play. I did, you know, people go, well, did you have any symptoms? I’m like, well, first of all, 1994 nobody told you about symptoms. I had a headache. I didn’t feel right. Like, well, why didn’t you say anything? Because I didn’t know to say anything. Okay. Do you know how many times I’ve not felt good. Had an upset stomach or a headache. You think I’m going to go in and go coach, can’t practice today, I’ve got an upset stomach, got a headache. I mean, you got to understand what you knew at that time. But I didn’t, I mean, somebody said, how’d you feel? I said, I said, I feel fine. So he cleared me to play. Now five weeks later, I take a similar blow. I end up going back to huddle again. It was my face mask was crushed across my face. My chin was cut open and it was, they were addressing my chin, trying to stop it from bleeding, get a new face mask. And they were talking to me and I guess I wasn’t responded.

 

I don’t remember any of this. The only part I remember is they took me to the training room and Vincent Smith, a linebacker who had been hurt earlier in the game, his ankle had gotten hurt. He was in the locker room. Here’s the only thing I remember. I remember him asking me, are you okay? And I remember thinking, nah, I don’t think I’m okay. Well I fell off the training table, went into cardiac arrest. I don’t remember that, they rushed it. I guess this is all told to me cause I don’t remember any of it. They went to start to resuscitate me and I actually started to breathe again and I just got up and walked to the ambulance. So I don’t remember another thing from all of that till shoot, it was probably later late that night. Early next morning. I actually hit my head with a cast they had put on my hand. Now, I didn’t have the cast on my hand when I went in there, but I broke my hand the week before. And so based on the circumstances I was in, they knew I wasn’t going to be back playing anytime soon. So they just put a cast on my hand, which I didn’t even know.

 

I don’t even remember. So I’m making a long story short. It was really came down to improper care of that head injury. You know, which you are right today. That would never happen. And the knowledge is so much better than our protocols and even treatments. I had no treatment plan after that. And we might get into this or not, but people should know there’s fabulous treatments now. They have six areas of concussions. They cannot identify the vulnerability of where you’ve been traumatized and repair and fix that before you return to play. And my son’s living evidence of that. So I’ve seen it work in real life. So that should be, you know.

Host: What I love about your story and if people get the book, you will learn that Joe Maroon, who is the Pittsburgh Steelers neurosurgeon at the time you were playing for the Steelers, is the one who created the impact test, which stands for immediate post-concussion cognitive assessment test. And it’s what they were using back in the 90s as baseline cognitive testing to then determine if a player got a concussion. Are they ready to go back into play? And in the book you shared that it was Dr. Maroon who then spoke to you right after you got this concussion on the Bears who said, I’m sorry, but I’m not going to clear you to play. Is that accurate?

Merrill Hodge: Well, yeah. What had actually happened is I went to a neurologist in Northwestern and the Chicago Bears sent me to a guy that they used Dr. Kelly. And Dr. Kelly had, you know, an exam. Actually I got lost. I couldn’t, I didn’t know where I was in his, in the building. I was, he actually found me. I always just, I was a train wreck. And he, after he evaluated me, he’s like, he really felt I needed to take a year off and could resume play after, you know, a year off. So it’s really later on that I realized like, you know what, I had that cognitive test. I took at Pittsburgh. So I asked to go back to Pittsburgh to re retake it. Well, at that time keep in mind, Dr. Lovell was also a part of this impact development test and I went to him to protest. Then I went to Joe Maroon and it was Joe, when he got all the information, he really looked at me and he said, you know Merrill, after I’ve been looking at your baselines and keep in mind, okay, we’ll say baseline is a 10. Okay.

 

Two weeks after this last concussion, I was at fives and sixes across the board when I was, I couldn’t get back to my ten. And that was two weeks, you know, prior to that last one. And just because I hadn’t been able to recover and I was still at that baseline. That was a strong evidence to him that you just, you can’t go back into that environment. And it was, it was disturbing and unsettling. And then it was like, this part tells you what kind of state I was in. I didn’t care. So I still was not in a good state and you know, and now go back and look at it now and obviously he was spot on, but that tool helped him really make that definitive decision, which, you know, and I say tool, that’s what it is. Okay. It’s not the silver bullets, not the only thing used, but at that time it was invaluable to help you make that evaluation. And we’ve gotten so much better in so many other options now, how to evaluate, how to before kids return to play in the sport that they love.

Host: Thank you for listening to part one of my conversation with Merrill Hodge about his new book, Brainwashed. I welcome you to join me for part two.

Conclusion: You’ve been listening to Your Brain Health with Dr. Kristen Willeumier. For more information or to contact Dr. Willeumier, visit DrWilleumier.com. That’s D, R, W, I, L, L, E, U, M.com.