Area’s contribution to ‘Concussion’ opens door to study, understanding

Cyril Wecht remembers that September morning in 2002 when he received a call from the family of former Steelers center Mike Webster asking the Allegheny County coroner for an autopsy.

Webster, who played for 17 years in the NFL, had died at the age of 50 of a heart attack. His decade-long struggle to adjust to life after football had become well-known: It was reported that he sometimes slept in his car, that his marriage had ended and that he had lost a lot of money in bad investments.

“Dr. Bennet Omalu was the pathologist on call,” Wecht said. “And he did the autopsy.”

It was that autopsy that led the Nigerian-born Omalu to discover in Webster’s brain evidence of chronic traumatic encephalopathy (CTE), a condition found in those with a history of repetitive brain injuries. And it was that discovery, and Omalu’s subsequent clashes with the NFL, that led to the production of the movie “Concussion,” filmed in Pittsburgh, and starring Will Smith as Omalu, and Albert Brooks at Wecht.

The film is scheduled to be released in December, but a trailer for the movie — which opens with an expansive shot of Heinz Field — was released last week.

“Dr. Omalu didn’t know football from baseball from basketball,” Wecht recalled. “But he became quite interested in the case of Mike Webster.”

Omalu, a forensic pathologist who now works as the chief medical examiner in San Joaquin County, Calif., and as a professor in the UC Davis department of medical pathology, had a special interest in neuropathology, which Wecht encouraged him to pursue at the University of Pittsburgh Medical School.

“Because of his special interest in neuropathology, he kept looking at the case of Mike Webster, and of other Steelers, including Terry Long (who committed suicide in 2005),” said Wecht, a member of Pittsburgh’s Jewish community who has been a forensic pathology consultant in many high-profile deaths, including those of Elvis Presley and JonBenet Ramsey.

Omalu identified “some microscopic features in these brains that had not been identified previously,” said Wecht. “He put it all together with the clinical history of these people who had psychological and emotional problems after their football careers that culminated in their deaths.”

Omalu prepared a paper describing his findings, which Wecht co-authored and was published in “The Journal of Neurological Science.”

“After it became published, it became a matter of national attention,” said Wecht. “But these initial findings and publications were rebuffed and ignored by NFL officials and a special committee that provided services to the NFL football teams.”

The condition is not limited to football players, according to Wecht, but also is seen in those who have experienced repetitive head hits from soccer, hockey and wrestling.

Other scientists have pursued Omalu’s findings, Wecht said, and CTE is now being studied “more and more.” Attempts are being made to obtain the brains from more former football players, because CTE is not a condition that can be diagnosed definitively until one has died and his brain can be examined.

“CTE does not present itself even with CAT scans or MRIs,” Wecht explained. “And you can’t diagnose it with biopsies.”

Wecht noted that despite Omalu’s findings, CTE is not a universally accepted condition.

“There are some respected, responsible academic people who are not rejecting the concept, but who are saying that more studies are needed,” he said.

Micky Collins, clinical and executive director of the UPMC Sports Medicine Concussion Program — the largest such program in the country — is one academic who does not find Omalu’s connection of repeated brain trauma and CTE to be compelling.

“There isn’t a lot of science at this point to understand whether a concussion in and of itself is causing that condition, or if there are other factors causing it,” Collins said. “There are no studies examining a large cohort of athletes with repetitive head injuries and understanding if there are other factors playing a role.

“As scientists, we don’t fully understand the construct that is called CTE, and whether concussions result in this condition. There could be other neurological variants, and other factors, such as depression.”

The UPMC Sports Medicine Concussion Program sees more than 18,000 concussions a year, according to Collins.

“We do not see this occurring in our clinic, and we actually feel strongly that concussion is a fully manageable and treatable condition,” he said. “We see patients improving and doing very well. The point is, we have effective treatments that manage these symptoms in most patients.”

Collins said he is “concerned” that there is so much focus on the topic of CTE and sports-related concussions, and that more focus on the topic will arise as a result of the film.

“I’m worried,” he said. “What happens is I have had children in my clinic that have been told by a neurologist that he thought they had CTE. Think about that diagnosis. As an adolescent, your life stops. And then we find out the patient had a condition that is fully treatable. There have been incredible advances in treatment, and that’s the story that is not being told.”

But Omalu’s findings may, in fact, affect “hundreds of thousands of kids,” Wecht said.

“What if — as well may be — it is shown that CTE is a definite entity?” he said. “Maybe parents will not allow their little girl or little boy to play sports. I have two grandchildren who are active in soccer, two who play football, and one who plays hockey. I think about this as a grandparent. I did not think about it when my three boys were playing high school football.”

“Concussion,” which was produced by Sony, also stars Alec Baldwin and David Morse. Wecht served as a technical consultant on the film. He recently attended a screening in New York, and while he met actors Smith, Baldwin and Morse, he did not meet with Brooks, who portrays him in the film.

“Alec Baldwin said that some actors choose not to meet and come to know the person they portray,” Wecht said. “They feel like that may obfuscate their portrayal.”

While Brooks — who is also Jewish — has created a “good character,” Wecht said, Brooks’ interpretation does not coincide directly with the forensic pathologist’s actual personality.

“For better or worse, I’m a little bit more outspoken,” said Wecht. “I’m a little bit aggressive. I’m not as calm and tactful and diplomatic as Albert Brooks is in the movie. If I do meet him, I might tell him that if I had been more like he portrayed me, I may have gone on to be the first Jewish president.”

Toby Tabachnick can be reached at tobyt@thejewishchronicle.net.