The discovery of Chronic Traumatic Encephelopathy eventually led to the creation of various media narratives about what it is, how it’s developed, and what it means. In many respects, those characterizations gave ignored that, as a matter of medical science, not nearly enough was and is known about how it develops, what it means to have it, and the short- and long-term consequences and complications associated with it.
The effort by some in the media to put the CTE cart before the horse has caused plenty of players to worry unreasonably about whether their brains have become ticking time bombs, destined to eventually implode into one of various serious conditions. Now, one of the leading peer-reviewed medical journals is calling on doctors and others to dial back the presumptions that have been perpetuated regarding CTE.
“Contrary to common perception, the clinical syndrome of CTE has not yet been fully defined, its prevalence is unknown, and the neuropathological diagnostic criteria are no more than preliminary,” declares The Lancet. “We have an incomplete understanding of the extent or distribution of pathology required to produce neurological dysfunction or to distinguish diseased from healthy tissue, with the neuropathological changes of CTE reported in apparently asymptomatic individuals. Although commonly quoted, no consensus agreement has been reached on staging the severity of CTE pathology. A single focus of the pathology implicated in CTE is not yet sufficient evidence to define disease.”
In other words, doctors still don’t know nearly enough about getting it, having it, and living with it. And some doctors and researchers all too often fail to acknowledge this fact.
“Unfortunately, the uncertainties around the clinical syndrome and the pathological definition of CTE are not acknowledged adequately in much of the current research literature or related media reporting, which at times has resembled science by press conference,” the article explains. “Too often an inaccurate impression is portrayed that CTE is clinically defined, its prevalence is high, and pathology evaluation is a simple positive or negative decision. This distorted reporting on CTE might have dire consequences. Specifically, individuals with potentially treatable conditions, such as depression or post-traumatic stress disorder, might make decisions on their future on the basis of a misplaced belief that their symptoms inevitably herald an untreatable, degenerative brain disease culminating in dementia.”
It’s no surprise that former players jump to CTE conclusions, when so much of the comments from certain doctors and researchers focus not on the lack of medical evidence to understand it but on the dire warnings and predictions made by persons who, coincidentally or not, have seen a sharp rise in their individual profiles and profitability based on the taking of prematurely aggressive positions about the dangers of CTE.
“We propose that the principle of, first, to do no harm, is used when communicating on CTE, whatever the platform,” the article concludes. “In particular, the many remaining uncertainties should always be acknowledged. Otherwise, the risk of doing harm is very real.”
This is a message to all doctors, reminding them of the fundamental underpinnings of the Hippocratic oath. Primum non nocere. First, do no harm.
Amen to that. Too many former players experience anxiety, stress, and depression not as a result of having CTE but simply from the fear associated with the condition, fear sparked by statements made publicly and privately by doctors. That fear that causes many former players to constantly wonder whether today is the day that they will begin an inevitable descent into the gradual loss of cognitive functioning, culminating in Alzheimer’s, ALS, dementia, and/or death. The article in The Lancet represents a clear and unambiguous message to all current and former athletes who worry about the long-term effects of head trauma: Do not assume the worst, because much still has to be learned about the condition.
Some will scoff at this explanation, attributing it to a football writer who has a vested interest in the ongoing existence of professional football. Some of those who will scoff, however, have a vested interest in the death of professional football, and they seem to be all too willing to ignore plain and obvious facts — such as those articulated by The Lancet — in the hopes of either bringing about the death of professional football or witnessing it in their lifetimes.