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Chris Nowinski
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Dan
This is just how my voice sounds.
Chris Nowinski
Just say it like you mean it. Okay.
Dan
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Chris Nowinski
Oh, my.
Dan
Requires upfront payment, taxes and fees. Extra terms and exclusions apply. Visit boostmobile.com for full on our terms and sweeps details. Welcome back to the Dream. Last week, I almost let our guest, Meredith lynch go off on a tangent about how football, the NFL in particular, has been infiltrated by private equity. I'll just add that it recently entered the NFL. What? Yes. How do you gut the NFL? Like, how do you ransack the NFL? It's called CTEs. Jane Marie. Unbeknownst to Meredith, we had already conducted the interview you're about to hear with a former player and current neuroscientist who's trying to make cte. Not a thing.
Chris Nowinski
My name is Chris Nowinski. I'm a behavioral neuroscientist who got interested in studying the brain after I damaged mine from too many years of playing football and professional wrestling.
Dan
Why, you might ask yourself, does Jane care about football? Well, first, I like to watch it. I like football players names and their butts. They have the funniest of both. I also like how thrilling it is, you know, when players make a touchdown and they're doing a dance. I feel like I'm doing a dance the whole time I'm watching a football game.
Jane Marie
You're also screaming at the screen and yelling about the rules. Think on, old man.
Dan
Well, because I'm right. The rules don't make any sense. And I am born of a champion football player. My father played for Bo Schembechler at the University of Michigan until I was born, when he decided being a dentist was a better path than getting cte. It wasn't a thing yet, but he had an inkling. He actually said that it was about his knees. He had exercises with Beau at the University of Michigan where my dad had to stand still and the entire team had to run at him and quote, unquote, try to break his knees. What? Like that was an exercise he had to do.
Jane Marie
These are the kinds of things that were still around when I played football.
Dan
Yikes.
Jane Marie
Yeah.
Dan
And you were a baby.
Jane Marie
I was too Small to play the offensive line, but considered not athletic enough to play anything else. And because I was always on like JVB or whatever, we basically were the scout team for the actual football team, which meant I used to go up every day against this guy that was a grown ass man.
Dan
About your age.
Jane Marie
No, no, he was a senior.
Dan
Well, I mean, in high schools. In high school you said a grown ass man, but like, different from you.
Jane Marie
Grown ass man for a high schooler. He would growl at me every single play and practice.
Dan
That's kind of sexy, though.
Jane Marie
Sure, if you're not.
Dan
If you're not about to get run over.
Jane Marie
Yeah, it would have been super sexy if it was sexy, but it wasn't sexy. Cause you're wearing the itchiest, scratchiest, grossest clothes and you have this man across from you who wants to destroy you.
Dan
Yeah, yeah, I like it.
Jane Marie
I don't know, like one of the best players on the team.
Dan
This all still sounds sexy to me.
Jane Marie
My head didn't like it, I can tell you that much.
Dan
Okay, Dan, we can't tell if you have CTE yet because as we'll learn from Chris, you can only diagnose it after death.
Jane Marie
That's true. And I think that there are worse concussions that I've had since I stopped playing football.
Dan
Oh, my God. You've made some really dumb decisions about what to do with your noggin. Dan's dad is even more embedded in football. The dude moved to Italy to coach American style football and is basically every coach you see on a kid's movie about sports. But there's an icky side of football. The that really grinds my gears. And as we always say in every episode of the Dream, why is this a thing? How is this a thing? What's happening? Chris might have an idea.
Jane Marie
Should I create a little grind? My gears drop.
Dan
Yes.
Jane Marie
What show was it again?
Dan
Family Guy. Peter Griffin.
Chris Nowinski
You know, that really grinds my gears.
Dan
Tell me first of all, like, how you got into playing football.
Chris Nowinski
Yeah. I grew up outside Chicago, and I remember first getting excited about football in seventh grade because some friends were playing and it looked cool. And my mother forbid me from playing until high school. And why is that? My mom was worried about injuries. It wasn't necessarily brain injuries back then because we didn't talk about brain injuries in football. But she knew it was more dangerous in other sports. Sports for the rest of my body. But I convinced her that I could do it in high school. So I signed up for football summer camp and then joined the freshman Team and learned quickly that it was a fun sport and I had the right body type for it. And so I was a two way starter and captain to the team within a week.
Dan
Within a week?
Chris Nowinski
Yeah. Well, I mean, you have to pick the starters right away. So I was the biggest, one of the biggest guys in the team and I could run, memorized the playbook in a day on defense. And so the coach thought, hey, well, you're middle linebacker and you call the plays.
Dan
So tell me how your football career went.
Chris Nowinski
My football career was modest. As a recruit, I was a sort of low level division one, but also the Ivy League was interested in the academies. And I ended up choosing to play at Harvard University where I had a decent career. I ended up as a senior, as a second team All Ivy defensive tackle.
Dan
So you're playing football for Harvard and first of all, Harvard, you said the Ivy Leagues were looking at you. So you were like this star football player and the smartest kid in your class.
Chris Nowinski
I think I didn't end up number one in my class. I was top 10.
Dan
Okay.
Chris Nowinski
I slept my way through calculus BC and did not get an A. So, yeah, so, I mean, I was a highly recruited athlete. I, I did care about school and I did try hard and I did have the scores to get into Harvard independently. I was also recruited as a basketball player to play places, but I chose football because I thought it looked, it was cooler.
Dan
So then you graduate college with what? And what's the next plan? What year was this when you graduated college?
Chris Nowinski
So this. So, so, so 1999. I'm actually, you know, one of four guys on my team that are getting looks from NFL scouts. And so we're all trading together, all thinking one of us was definitely gonna be drafted, the other three had a chance or to get free agent signings. I ended up not getting drafted, not getting signed, which was a blessing. And I had a consulting job lined up in the life sciences industry from a summer internship. But the owner of that firm suggested to me over one conversation, like, hey, if you don't get drafted, this job's always going to be here. But I think you'd make a great pro wrestler. And it was spurred by the fact that we were both fans and we both watched it, but I didn't know that he had this sort of weird history where he knew a lot of the people in senior levels of pro wrestling. And so when I didn't get drafted, he immediately made some phone calls. And suddenly I get a call from J.J. dillon, who used to manage the Four Horsemen and Ric Flair and those guys who ran talent for wcw. And they said, hey, we want to fly you down to Atlanta and give you a tryout with Mr. Wonderful, Paul Orndorff. And I was like, okay. So literally two weeks before I graduate, I'm flying to Atlanta and getting beaten up by Mr. Wonderful for a day, who at the end of it says, yeah, you could probably do this. You know, you should think about it as a career.
Dan
Did you think of it as a real sport at the time?
Chris Nowinski
No. No. So I had dabbled in theater.
Dan
Here we go.
Chris Nowinski
Yeah. So I was in west side Story in high school as Diesel and. And had fun doing it, and then did a little bit of drama and sketch comedy in college. So I did enjoy performance. I really enjoyed the physicality of, like, how difficult it was to actually do what those people did in a ring. So I sort of wasn't ready to give up on athletic pursuits. And I was really bored sitting in a cubicle, you know, renting my brain to the life sciences industry. And so I said, all right, I'll give it a shot, because I had this nice golden parachute.
Dan
Can I ask you to talk about not getting drafted? I feel like the dream of going to the NFL is very much a part of the American fabric of kids growing up in football and then getting this big payday. Do you remember how you felt around that time?
Chris Nowinski
I was fine with it, so I never considered myself an NFL prospect. And I didn't enjoy football as much because at that point in my career, it had gotten very painful.
Dan
Oh.
Chris Nowinski
Like, I was getting shots in my shoulder. I played my entire senior year with a really badly sprained ankle and coming off of a wrist fracture where I couldn't bend it backwards. And so I was fine not continuing, but I knew I couldn't turn down. Like, no one turns down the opportunity to go to the NFL. You are attracted to the dream. Like, it's really hard to turn down. You know, telling people you're in the NFL makes you a God in certain populations, but it had never been my lifelong dream. I never thought I was good enough.
Dan
So that's not what you were aiming for?
Chris Nowinski
No.
Dan
What were you aiming for?
Chris Nowinski
I had no idea. That's why I went into pro wrestling.
Dan
Tell me how that happened.
Chris Nowinski
Yes. I mean, like, you know, you're. When. When you're in college, you know, people have their jobs they go into. And I just never had a real plan. I just didn't have something I was passionate about. So I had this really nice consulting job and I went and did it. The reason I didn't sign with WCW right away is I needed shoulder surger with a six month recovery. So they said, call us at the end of six months. So I did the job and lost £50 and, you know, found out I had abdominal muscles after being a fat lineman my whole life. And when I was ready to go, WCW was going out of business. And so suddenly this door was closed. Like within a year of that, they were bought by wwf. So I found out that Killer Kowalski ran a pro wrestling school 20 miles away north of Boston. And so I started going to Killer Kowalski's nights and weekends while working.
Dan
Forgive me, I know that name sounds a little bit familiar to me, but who is Killer Kowalski?
Chris Nowinski
The Killer. The Killer Killer was like the legendary wrestler from the, you know, 50s, 60s, 70s, 80s. He, he was famous for, you know, tearing a guy's ear off with his knee. It was, it turns out it was an accident. But you didn't tell anyone that. It was just legend, right? But he was, you know, just a guy with a thick Polish accent who is just the nicest vegetarian you've ever met named Killer. So, yes, I went to Killer Kowalski school. While I was, you know, trying to then, like, pay my dues and work my way up through the independents, WWF announced that they were partnering with MTV to do a reality show, sort of Real world meets Survivor. 13 people live in a house, fight for a contract. And so I decided if the door was open, I might as well send it a tape.
Dan
Thirteen wrestlers in a house looking for a WWF contract on tv when the.
Chris Nowinski
Last one standing gets a three year contract with wwe. And this was back when reality shows were real, so you couldn't talk to anybody. You know, you handed over your phone, you never knew what the next day was gonna bring. It was kind of crazy. But, you know, I was runner up. And being Chris Harvard was very interesting.
Dan
I saw that your wrestling name had Harvard in it and I was like, is he gonna be one of those guys that went to Harvard? And then everything is Harvard, you know, like you try to find a way to say that you went to Harvard.
Chris Nowinski
Yeah, no, we love that. And we play with that all the time. You know, you want to. Yeah, you want to. You want to know if a guy went to Harvard, you know, he'll tell you. And when I started calling me Chris Harvard, I should have realized like, all right, as a wrestling character, Chris Harvard's never going to be the underdog, you're going to be the bad guy. Then I learned the show, started editing me as the bad guy.
Meredith Lynch
Oh.
Chris Nowinski
And it gave me this nice boost into that future career because people actually thought I was a horrible person.
Dan
What do you mean, the boost into the career? Like, because wrestlers, it's better if you're bad.
Chris Nowinski
So wrestlers, fans have to care about you. Neither have to really like you or really hate you. If you're in between, they don't care about you.
Dan
Right, Right.
Chris Nowinski
So the world is divided into baby faces and heels, good guys and bad guys. When you're a wrestling character like the Undertaker, people knew he wasn't dead.
Dan
Right.
Chris Nowinski
But with Chris Harvard, people didn't know if I was really that arrogant Ivy League jerk or I was an okay person. Like, literally even in the, in the locker room.
Dan
I love the idea of this character, though.
Chris Nowinski
Yeah. I mean, it was such great creative freedom.
Dan
Yeah.
Chris Nowinski
To just say and do whatever you want and just, you know, get a microphone and insult people. You know, A friend of mine just made me realize that for the first time in history, Iowa State is being graced by an actual Harvard graduate. That's true.
Dan
First time in history.
Chris Nowinski
It's quite a little institution of higher learning you guys have going for you here. You know, we had a little chat at Harvard for people like you. That's all right. That's okay. You'll all work for us. Awesome day. I love that one.
Dan
So you move on from that, you're runner up, but it sounds like you got a contract anyway.
Chris Nowinski
Yeah. So I go do the Indies for six months, traveling the world, and then they gave me a tryout at Wrestlemania.
Dan
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Dan
And we're back with Chris Nowinski. So now you're achieving another American dream, being on tv.
Chris Nowinski
Yeah.
Dan
Were you excited about that part of it?
Chris Nowinski
Well, yeah, when I, when I made debuted on Monday night raw in June 2003, it was, it was very cool. It was, it was cool to be just in a building wrestling in front of 20,000 people, you know, walking the street, have people recognize you and tell you they hate you. It was great.
Dan
How long did you do that?
Chris Nowinski
So start to finish. First time in the ring to the end was just under three years and I was just on TV for just over a year.
Dan
Why did you quit?
Chris Nowinski
Because I got kicked in the head in a match. It's really my fault. But his foot hit my head and I got a really bad concussion that I didn't realize was a concussion. And I kept wrestling for weeks with a damaged brain that kept getting more damaged to the point that it never quite recovered. And I couldn't actually perform the job because I couldn't remember matches. And I, I couldn't get my heart rate up without feeling sick. So I retired from post concussion syndrome.
Dan
What did you feel like when you first got kicked in the head? You said you didn't know you had a concussion. Was it not painful enough?
Chris Nowinski
No, I just, I just didn't know. I mean, like, at that point, like there was no such thing as concussion education for athletes. And so concussion was Defined by a doctor telling you you had a concussion. I was never knocked out. I never had enough symptoms that I'd ever gone being seen by a doctor for a suspected concussion.
Dan
Okay.
Chris Nowinski
When I got kicked, I blacked out. Like, I couldn't remember the rest of the match, you know, so one of the important things about keeping a wrestling match safe is, you know, how it's supposed to end. And you know, when you're supposed to improvise, you know, when you're supposed to hit marks. And I couldn't remember the script. And so I remember telling the other wrestlers, like, what's next? What's next? What's next? And they just would tell me. And so it was fine for the show's purposes, but I didn't realize that losing your ability to remember where you are and what you're doing was a concussion.
Dan
Right.
Chris Nowinski
And then I had a really, just massive headache that wouldn't go away.
Dan
Yeah, I've had a head injury. Just full disclosure, and I've talked about it on our show before, but I had what they call a diving accident. I fell out of an open staircase onto my head on a cement floor. So samesies.
Chris Nowinski
Yeah, part of the club. How are you feeling today?
Dan
I'm good. My big cluster migraines have gone away as I get older, but I still have ocular migraines. But other than that, I'm okay, I think, for now, until we find out that I have cte.
Chris Nowinski
How long ago was it?
Dan
Oh, I was a kid. I was six or seven.
Chris Nowinski
You're not going to get CD from that.
Dan
Oh, good. Okay. Well, don't tell me how you know that yet. Okay, so you. So you have this concussion. Well, how did you feel your prospects were going forward when you had to quit the wwe?
Chris Nowinski
Well, my prospects in wrestling were good. I mean, actually looking at a magazine, I was named 2002 Newcomer of the Year by Raw magazine. And that was a year where we're like, you know, Brock Lesnar's floating around. John Cena know some real big stars. That was my class.
Dan
I forgot John Cena was a real WWE guy. And bt, I know, I know, he's.
Chris Nowinski
Such a legend now. But. No, back then, he was a guy, you know, still trying to find his way, like me. So, no, I mean, they assumed that I would be. Have a career like those guys had, but it didn't. It didn't work out that way. And what'd you do next? You know, they tried to send me doctors, put Humpty Dumpty back together again. The eighth doctor I see is Dr. Robert Cantu, who is the first doctor to help me appreciate that this was a concussion. And it wasn't my first concussion. And I'd had a ton of concussions over my career, and I just. By not ever recognizing them or taking time off, I turned what would have been a recoverable injury into something that he's not sure if I'm ever going to get better from. That was about three months after the concussion, and I was like, wait a second, I'm a Harvard grad, and I didn't know that every time I got kicked in the head and tackled somebody and the sky would change colors or I couldn't remember where I was, that that was a brain injury and I needed to rest it like I would any other injury. Like, that sort of insight blew me away. And the fact that he didn't know it was going to happen to me long term either was also concerning. And so I wasn't happy with the answers that I had. And so basically I took what he told me and it led me to going to the Harvard Medical School library and starting to read every study ever on concussions to try to find if there was something I could learn that would help me get better or figure out what was going to happen to me. And that idea of the fact that there was all this knowledge out there that we weren't being told as athletes, and the fact that I screwed up my own brain out of my own ignorance, you know, I said, hey, Doc, why is no one telling athletes this? And he was like, well, I try to tell people, but no one listens to doctors. You have a platform. Maybe you can convince them. And so I decided to write a book. That was my big idea. Is I, as a pro wrestler, going to write a book about complex neuroscientific and cultural issues around this injury? I wrote this book, Head Games Football's concussion crisis, in 2006. And one of the things is I sort of told the story of, hey, we're missing all these concussions. Athletes aren't telling doctors how they feel because we don't know any better. And all the people who are retiring due to concussions aren't getting better. When you go find them, they're still struggling. And there's this. Called it a concussion cris. We're just not acknowledging this invisible injury because it's invisible and no one's talking about it.
Dan
Yeah.
Chris Nowinski
And as I did that research, I also learned after reading the studies that the NFL had gotten into the research game, but they were publishing big Tobacco, like studies saying everything was fine while they were putting people knocked unconscious right back into the game. And that really pissed me off. And so I wrote a chapter calling them big Tobacco and exposing how these studies were so stupidly designed. And I got a $4,000 advance because no one wants to read a book like this. And I had to buy $21,000 worth of liability insurance for my accusations I made against the NFL. But it was something I believed in. And I realized that people were actually dying because of this. And basically my penance for damaging my Harvard educated brain was to try to take a stab at changing the culture on this.
Dan
Well, I've seen your story on TV about the book. I mean, I feel like it's a very well known kind of expose. It did open up this criticism though, of the NFL. Can you tell me about that?
Chris Nowinski
Yeah. So what sort of happened next was sort of how things changed was book comes out on October 06. No one cares. But I've learned that the way that you can see long term effects from concussions was this disease, Chronic traumatic encephalopathy, what we now call cte, that we used to call punch drunk because it was well known in boxers 100 years ago. But no one ever looked outside of boxing to see what was going on. And somebody, as somebody who was hitting the head 10,000 times at this point, I knew that, you know, your brain can't tell whether it's a football helmet or a fist that's punching in your head, your brain's going to feel the same thing. So two NFL players have been studied. I interviewed the doctor who did those who was in the concussion movie. And a month later, Andre Waters, who I grew up watching strong safety for the Philadelphia Eagles, takes his life. In his mid-40s, he was known as being a hard hitter. And so I ended up assuming that someone was going to mention ct, that it was known, but no one did. So I called the medical examiner in Hillsborough County, Florida, got a hold of him and said, hey, are you going to study this guy for ct? And he told me no. And basically over a series of conversations, I convinced him that he should be studied. And he told me how you get someone studied, which was having to call their family and get permission. And so I did that.
Dan
How was that call?
Chris Nowinski
I had wrote out a script and I was sweating profusely because I just, you know, couldn't imagine having to make this call, especially not being a doctor at that point. But none of the doctors would do it. I did ask Everyone else if they would call. And nobody was comfortable calling a mom who's in her 80s who just lost her son to suicide to ask. You may not be aware of this, but his brain is still available for study, even though you just left his funeral. So, anyway, you know, I think it took something to make that call, but the reason I keep doing it is because his family was so amazing. They were actually just appreciative that somebody cared why Andre died.
Dan
Yeah.
Chris Nowinski
And they saw his behavior changes. They knew something was wrong with him. And so after they vetted me and said, all right, we believe in what you're trying to accomplish here. We'll let you study when you die from unknown causes. They will keep tissue and blood for future analysis in case anything else is learned. So basically, five parts of his brain were still available in the medical examiner's office while the rest of them was buried.
Dan
And so what did they find?
Chris Nowinski
So Andre had CTE, and he was the third of three NFL players to have CTE. Two of the three had killed themselves in their mid-40s. Mike Webster was famously known to be homeless and terrible mental shape when he died of a heart attack at 50 or so. So the deal I made was, look, if you know, these first two cases were published in the journal Neurosurgery, which regular people don't read, and no one had known about it, and it had never been a national news article. But I knew the power of the media. And I said, if people are killing themselves because they have this disease and the NFL is covering it up, people need to know. And there's a reporter named Alan Schwartz who at the time had written some columns on baseball statistics for the New York Times, who I'd been introduced to when I was writing the book by a mutual friend. He took a great interest in what I was writing and had guided me, a literary agent, and introduced me around New York because he believed that I had something. I called him and I said, hey, I've got this CT case. I think it's a really important story. What do I do with it? And he said, you're right. This is something New York Times should be interested in. Let me make some calls. And he calls me back and he goes, the editorial staff's asked to see you in New York next week.
Dan
Oh, wow.
Chris Nowinski
So I hop a train from Boston to New York, and I go with him to the New York Times building and sit down with the editors and say, this is the story. NFL players are getting this punch drunk disease, and the NFL is covering it. Up and someone needs to say something. And Jason Stallman, who was a deputy sports editor at the time, what he said to me was, where? The New York Times. How do we not know about this?
Dan
Right?
Chris Nowinski
And I said, well, it's because it's being covered up. I don't blame you, because I didn't know about it either. And I was out there banging my.
Dan
Head for a long time.
Chris Nowinski
So they went for it, and they put it on the front page of the New York Times the week before the super bowl. And they hired Alan Schwartz full time to start covering this issue. And he ended up writing 200 articles in the Times exposing this huge issue with concussions and cte.
Dan
Amazing. First of all, what do doctors see when they look at a brain that they suspect has cte? What's there or not there?
Chris Nowinski
When someone has cte, what you will see is a pattern of brain cell death that is specific to the disease. You have a protein in your brain cells. It basically holds your axons open, you know, so there's tunnels inside that molecules are moving around. Basically, what we've learned is that when you stretch an axon quickly and traumatize it, that protein can start to fall apart and it sort of crumbles, and then you find clumps of it. The protein is called tau. It's well known because it's one of the hallmarks of Alzheimer's disease and about 15 other diseases. But with CTE, it's in a peculiar place. It's around blood vessels, and it's at the bottom of the valleys of the surface of your brain. It's called the sulcal depths of the cortex.
Dan
Okay.
Chris Nowinski
What we've learned essentially, is that because of the shape of your brain, if you rapidly move a brain that has these hills and valleys on the surface, the strain is most felt at the bottoms of those valleys. And so basically, what you're seeing is evidence of injury. And once the injury is there, for some reason in some people, it just starts spreading after you stop. Getting hit in the head is.
Dan
Are these what we would call plaques?
Chris Nowinski
They're not the plaques, okay?
Dan
It's different.
Chris Nowinski
That's the other hallmark of Alzheimer's that people are learning how to treat or get out of the brain. But we're talking about the other one, tau protein, which is much, much harder to deal with because it's inside the cells.
Dan
Fascinating. How long had science known that that's what you look for in a head injury? How new was that science?
Chris Nowinski
Well, it wasn't really that well associated with head Injury. It was known that acutely you'll see some elevated tau, but it goes away. When we first discovered punch drunk, we didn't even know what tau was. Punch drunk. In the 1950s, we described as certain things you'd see in a brain. But it wasn't until the late 70s, early 80s that we even could find an antibody that stained this tau protein and made it visible. So it was sort of a new thing. There was no science on really what to look for. There was an extrapolation from studies done decades before to say, this is CTE. But when we're talking 2007 right now, it wasn't until 2015, because of our work, that the National Institutes of Health actually first published this is what CT is. So at that point we can look back and go, yeah, we were right, but it was speculative back then.
Dan
Can you quantify the problem of CTE or potential cte, like, how many concussions does your average football player or wrestler suffer in their career?
Chris Nowinski
Great question. So there's two things to quantify. One is the disease, and one is risk for the disease and the disease itself. There are Dr. Ann McKee, who's really led all this work and is the neuropathologist that I send all our 1600 brains to, that we've helped recruit for. She's created a four stage system. And so you know when you're in your teens or twenties and you get it, you have these tiny lesions in the frontal lobe and that's stage one, and then they spread. By the time you get to stage four, usually 30 to 50 years later, it's everywhere throughout the brain. In terms of your risk, that's something that we need to figure out. So what we have learned is that it's not the number of concussions that predict cte. And the reason it doesn't is because when you're getting hit in the head all the time, you are getting microscopic brain damage or subclinical traumatic brain injury that you can't feel. And so what correlates with who has CT is how many hits to the head you took and how hard they are, but not how many times did you feel symptoms and report it to a doctor and get a diagnosis.
Dan
Right.
Chris Nowinski
So when you survey NFL players while they're alive and then they die, and you look at their brain like, you know, most of them will say they've had, you know, between 20 and 100 to 200 symptomatic events.
Dan
Oh, my God.
Chris Nowinski
Yeah. I mean, when you talk to NFL players, when they, when they Retire, they'll tell you weekly they're, you know, seeing double, and they're, you know, can't remember stuff, but they play through it. Other people will take the same hits and not feel much. And I think that has a lot to do with, you know, just people's like, people have different thresholds for pain. People have different thresholds for recognizing when a few of their neurons out of the 90 billion in their brain are broken. So basically, the point is that Connecticut correlates very, very strongly with number of years you play contact sports, but not with number of concussions. And so we have published that for football players, your odds of developing CT go up 30% per year. We've published in rugby players, it goes up 14% per year. We've published in Hockey Players in December 2024 that it goes up 34% per year.
Dan
Whoa.
Chris Nowinski
With the hockey study is probably the best example. It was 0 of 6 hockey players who played fewer than 6 years. It was 19 of 19 who played 25 years or more.
Dan
Wow.
Chris Nowinski
And those curves look a lot like smoking and lung cancer curves.
Dan
Yeah.
Chris Nowinski
Essentially one year of smoking, your odds are very, very long. But if you smoke two packs a day for 30 years, your odds are considerable.
Dan
What about boxing?
Chris Nowinski
We haven't published on that yet. In general, you know, there's a study published in 1969 that said the more years you box, the greater your risk. And I'm sure that's the case. We just don't have the good specifics right now.
Dan
What are other effects of cte? So we've barely touched on the idea of suicide rates going up. What are the other consequences of having this disease?
Chris Nowinski
So what we now know about CT as a progressive degenerative disease is that most people will eventually develop progressive cognitive impairment that leads to dementia if they live long enough. That's pretty well accepted. And it's the tau destruction over time that is driving that. We've published that. So for a lot of people, you will see Alzheimer's, like, fade over time. But what we're also learning is that a lot of people, not everybody, have severe neurobehavioral problems. So, you know, imagine like, you're. You're planting a disease in the brain in someone's teens or 20s, and it's in different parts of the frontal lobe for different people, but it's also in other places. And so it's going to affect people differently based on a lot of different factors. But some people seem to really go off the rails as early as their 20s become a different person, they develop addiction issues, aggression issues, they can't hold down a job. Poor executive functioning because the frontal lobe is compromised. You know, they make bad decisions. So we do see a lot of that too. But then layered into that is that CT is not the only type of brain damage that 10,000 hits the head will cause. So there's all these other types of brain damage that we pick up that could be contributing to some of those early stage issues. But, you know, when you think about someone like Junior Seau who was having mental health issues and took his life, and that is a. It's a common story, but it's not. It's not the most common outcome. The more common outcomes are the later stage cognitive problems.
Dan
Okay, so Junior Seau, that reference might have gone by really quickly, but let's talk about him for a minute. Dan.
Jane Marie
Yeah, so Junior Seau, I mean, he was an all American linebacker at usc. He played in the NFL for a very long time. 13 seasons.
Dan
That's a lot.
Jane Marie
Yeah, it's amazing if you make it past three years in the NFL. Anyhow, he shot himself in the chest in 2012. Prior to that, he had been for quite a long time complaining about depression and a bunch of the symptoms that we would now associate with CTE. And even then, obviously it was 2012, so it was associated with CTE. But yeah, it's just really important to remember how real this is. Like, he probably wouldn't have done that.
Dan
Right.
Jane Marie
If he hadn't been suffering with cte.
Dan
So it bums me out the same way it bums you out that there's this really fun thing we like to watch together on Sundays. Yeah, well, now it's like five days a week, but, you know, it's a tradition and it's fun and there's a reason to make seven layer taco dip. And I love it. And yet every time someone gets knocked in the head, you've been there with me.
Jane Marie
Oh, it's horrible.
Dan
It's horrible.
Jane Marie
But the thing is, they get knocked in the head every play. It's just most of the time we don't focus on it anyway.
Dan
It's thrilling and also sickening. And I have a lot of cognitive dissonance around my feelings around football. So, yeah, Junior Seau is a very famous case.
Chris Nowinski
We really are concerned with these early deaths of people with CT who have radical changes to who they are. We actually just published within the last month that one of the predictors of who really struggles is family history of psychiatric and mental health diagnoses what we found is that when people have that sort of latent, so they have whatever environmental or genetic predisposition for mental health or psychiatric issues. If you also get CTE, it really unlocks it. And between the ages of 40 and 60, we see in those people more aggression than we'd expect to see alone or just, just by genetics or just by having ct. But when you combine those two things, you see really strange behaviors. And so, you know, when I think about people like Chris Benoit, who was the third brain I coordinated, who was a wrestler I do for 5 years, who seemed fine until he killed his wife, 7 year old son and himself, oh my God, he was 40 years old when that happened. And we have a lot of those types of stories where people just radically change into their 40s. And I, you know, at this point, I think a lot of that is due to they develop CTE and they have these other risk factors right, waiting to become unleashed.
Dan
Here come the ads.
Chris Nowinski
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Dan
That sounds like a threat.
Chris Nowinski
Then how do you think we should say it? Unlimited talk, text and data for just.
Dan
$25 a month for the rest of your life?
Chris Nowinski
I don't know.
Dan
Until your ultimate demise.
Chris Nowinski
What if we just save forever? Okay, $25 a month. Forever.
Dan
Get unlimited talk, text and Data for just $25 a month with Boost Mobile Forever.
Chris Nowinski
After 30GB, customers may experience slower speeds. Customers will pay $25 a month as.
Unknown
Long as they remain active on the Boost Unlimited Plan. Support for this podcast and the following message is brought to you by E Trade from Morgan Stanley. With E Trade, you can dive into the market with easy to use tools, $0 commissions and a wide range of investments. And now there's even more to love. Get access to industry leading research and insights from Morgan Stanley to help guide your decisions. Open an account and get up to $1,000 or more with a qualifying deposit. Get started today@etrade.com terms and other fees apply. Investing involves risks. Morgan Stanley Smith Barney LLC Member SIPIC E Trade is a business of Morgan Stanley.
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Dan
Back to our conversation with neuroscientist Chris Nowinski. We kind of skipped over going back to school and what your career became after you wrote the book. Can you tell me about that?
Chris Nowinski
So once the Andre Waters story went out and then there was another brain, Justin Strelzyk, that I tracked down and he had CT or four for four. I realized that CTE was going to get everyone to take concussions seriously because it made invisible concussions visible. You could see the brain damage, but also we need to figure out what the hell's going on with cte. And so in having these conversations with families, I realized that they were luckily trusting me to sign over the brains to me or the doctors. But there should really, this needs to be institutionalized. So I said, all right, we're going to create a charity that's going to do this outreach and families can trust that no one's profiting from their loved one's brain. But then also we need to find the best scientific team out there at an academic center and create a partnership at a brain bank. So that became Boston University CT Center. So that's Dr. Ann McKee, Bob Stern that we partnered with. And I said, I'm going to get your brains. Will you study them and do all the work? And luckily they said yes. They saw the public health value. So that was 2008. And then I have an office at the medical school where I'm literally spending most of my days tracking obituaries, tracking families down, making the pitch, trying to build this thing. And then they mentioned to me, all right, well, as long as you're in the building, do you want to go attend some classes? Basically the idea was the shine was going to wear off of this late twenties ex athlete figure figuring this out. If I wanted to make, make sure I was making the right choices and play a larger role in the research. I needed a doctorate. And so I started doing a PhD part time in behavioral neuroscience while still trying to build up the foundation. And I'm glad I did, because before I was just trusting what the smart people were telling me. Now I have some independent thoughts.
Dan
Oh, good. And you were still right.
Chris Nowinski
And I was still. Luckily I listened to the right people. I mean, that, that what, what, what came down in early days. That's the one, one special thing that since I haven't dropped Harvard in like 10 minutes, one special thing about Harvard is it did help you recognize who the true smart people were. Because we all walk into that place thinking we're the smartest person in our high school, then you get to see what real genius looks like, right? And so I could tell who was real and who was fake. And I picked the real people. And that's what made this happen. Because a lot of the other people who were around in those days are gone, you know, and so anyway, that's how I work in Harvard there.
Dan
Okay, in a dream world, in an ideal world, what do you want to happen with this issue? Practically speaking, what do you want to change?
Chris Nowinski
What I've been working on today is we need to get to a point where we can diagnose CT in life. Not just to help the families who are struggling and aren't getting answers, but so that we can get the life sciences industry off the sideline and actually running clinical trials trying to cure this thing. So that is, that is, you know, sort of what my five year plan is, is we're getting very close to learning how to diagnose living people and what has to happen next. Got it. And what's been hard is that along this way I mentioned I was one of four guys who were training for the NFL in college. One of those guys who did get to the NFL and was my roommate that summer died and he drank himself to death. And we studied him and he had stage 2 CT and I was not able to help him when things got bad. Any alcoholism was just too bad. He wouldn't go into rehab. We didn't have answers to what was happening. But I, you know, I think we.
Dan
All knew he must have been young.
Chris Nowinski
He. Yeah, he was 44, 45. So I need to cure like my generation and hopefully we'll help some of the guys that are older than me. But it's race. And then on the flip side is I hope we bring sanity back into youth sports where we actually think about what's best for the kids and willing to have those difficult conversations of, well, soccer's just fine for a 12 year old without heading, you know, they can still learn the game, be fine, play the ball off their chest. Like, why do we need to start exposing them to brain injuries and potential cte?
Dan
Right.
Chris Nowinski
You know, just to get them more ready for their high school team and then the more ready for their college team. Like we're doing sports. Wrong. And the problem is we're fighting of the privatization of youth sports. So, you know, if you join a club soccer team, like they're not going to tell you there's any risk to the game.
Dan
Right, right. Because they're not affiliated with your school or the public system or any of that. Yeah.
Chris Nowinski
And so I don't know how we win that battle. Like, you know, we, you know, we've had certain wins here and there. You know, we got heading band before age 11 in soccer, but we are creating more CT cases now than we ever have before because we have more.
Dan
People participating in sports or.
Chris Nowinski
Yeah, yeah. We're like, we have more people playing sports. We have more people playing more sports. So, you know, when I grew up, soccer was a one season a year sport, maybe two. Now kids are playing four seasons a year on two teams. I can't believe kids play in their high school team and a club team the same season. Football is something that when in the 1960s Pop Warner was not even a national organization.
Dan
Right.
Chris Nowinski
And so there are very few kids, people starting at five. Now we have tons of people starting at five. And those people have a much greater risk of cte. So the problem is we're playing more sports than we ever before. We're starting younger and we're only now starting to in some sports create age minimums to start hitting a kid in the head 300 times a year.
Dan
Oh my God.
Chris Nowinski
But it's not happening fast enough. We now have almost 10 college football players who died in their 20s with stage three CTE that are worse than say out. They were the small, hard hitting tough guys on their teams who started playing in single digit years and their lives were over by 20 and they were just fought addiction, mental health, couldn't hold jobs, families. So bigger, stronger, faster is also making this worse than it was before. So we're facing a wave and we're facing an industry that doesn't want to acknowledge it. There's a lot of people making a lot of money not to slow the party down.
Dan
Right. So is the answer like Rihanna should not play the super bowl.
Chris Nowinski
Even that, like it's, that's not her battle.
Dan
I know, right?
Chris Nowinski
Like you realize like that's the. It's your opportunity as an artist to be seen in front of the largest group in the world. Like, you're crazy to turn that down. I mean, like, trust me, I think about all the time. Do I ask people in those positions to risk their financial future to try to raise awareness of this tragedy? And the answer is no. I mean, it's like. And here's the hardest part, the people that are most at risk for this, like current NFL players. Right. We've proven at least 10% of them have it. It's multifold. Worse than that.
Dan
Yeah.
Chris Nowinski
There's no question about it. Right. But not a single current NFL player is talking about CT or advocating for CT research or really?
Dan
Not one.
Chris Nowinski
No.
Dan
How do we find that person? How do we. What do I.
Chris Nowinski
We've tried over the years. There have been people who like pledge their brain during the season or what they've learned is that no one, you get punished for talking about CT because the coaches will start to think, oh, he's not going to stick his head in there anymore. He knows too much. Oh, and so.
Dan
Yeah, you find your so gross. I'm sorry. So gross.
Chris Nowinski
The players are punished for talking about it or for advocating for themselves outside of through their union. So it's this weird silent thing that the people most at risk are not engaged on this issue and most of them are in denial.
Dan
Is it just toxic masculinity?
Chris Nowinski
No. I wrestle with my 4 year old son every day, but also with my 6 year old daughter. There's nothing wrong with wanting to play a sport and collide with people, especially when it's not giving you immediate feedback that it's hurting you.
Dan
Right.
Chris Nowinski
Your brain doesn't have, doesn't have pain, nerves.
Dan
Right.
Chris Nowinski
So you literally can't know that you're damaging your brain until it's too late.
Dan
Right.
Chris Nowinski
Women are doing this too. We just don't talk about it. We've identified the first two CT cases in female athletes. They were both 28. They both died by suicide. One played rugby and Aussie football in Australia, one played soccer in the U.S. we're not talking about that either.
Dan
Right.
Chris Nowinski
And trust me that I've had conversations with high profile former female athletes. They don't want to be the bearer of bad news for this too, because this is finally the shot that women can make a great living off of sports. And no one wants to suddenly bring this dark cloud of what are we doing to ourselves here. But I once had a conversation with two women on the women's national team from the 90s. One of them refused to head the ball in the 90s and was one of the best players in the world. And she just said, yeah. I just knew it was a bad idea. I didn't like it. That wouldn't happen now. Right. Because now you would get pushed out back then because it wasn't. So there wasn't so much money on the line. You had some autonomy.
Dan
Right.
Chris Nowinski
So I don't know. I. There's no easy answers here.
Dan
Yeah.
Chris Nowinski
Blame anyone for what they're doing. And they have also been fed misinformation Their whole career.
Dan
Right.
Chris Nowinski
Their whole career, they've been told, this is safe.
Dan
Well, you're doing great work to try to fix that. I feel like the conclusion here is Bunny is evil.
Chris Nowinski
Well.
Dan
Okay. I'll call you back if I have any questions.
Chris Nowinski
We didn't get into the concussion sign you need to look for, which is the.
Dan
Oh, oh. Can you tell me what a concussion. Okay, tell me everything I need to know about identifying whether I am having a concussion or whether someone else is having a concussion, Especially if I'm watching a football game.
Chris Nowinski
If you're watching a football game, what you're looking for are what we call signs of concussions. Basically, concussions are defined by signs and symptoms. Symptoms are what you feel like. So when I got hit in the head and I would see double and my head hurt, that's a symptom. But if I didn't tell anybody, no one would know about it. And that's how concussions continue to skate by undiagnosed. But there's signs that you see, like the fencing response, where someone gets hit and they're unconscious with their arms out, or they get up and they fall over. That's a sign of a concussion.
Dan
Okay.
Chris Nowinski
It's a sign that their brain's malfunctioning. We just discovered a new sign that we've all known about for a long time, but was never in the protocols and we haven't been using to pull people out. And that's when someone gets hit in the head really hard, and a few seconds later or a minute later, they start shaking their head violently back and forth.
Dan
Okay.
Chris Nowinski
That quick shake back and forth, shaking the water, trying to reset your brain. It's been around forever, but we missed that. It needs to be one of those signs you pull people out and evaluate them on. So Tuatha, Tango, Vailoa did it twice. The famous concussion where they left him in the game and said it was his back injury. And that forced me to stop complaining about it on social media, about the head shake, and actually do a study. So we surveyed, nearly 400 young former athletes showed them video of it happening and say, did you ever do this head shake after getting hit in the head and what were you experiencing when you did it? And 72% of the time it was because they were having concussion symptoms and they were trying to reset their brain, stop the double vision, stop the feeling of floating, stop the ringing in their ears, you know, whatever it was. And so we named this spontaneous head shake after a kinematic event or S H A K E. And now we're advocating for everyone to put it in their protocols. So anyway, so if you see someone get hit in the head and they shake their head back and forth violently, which is when you recognize it from, from cartoons and movies, that is usually a concussion.
Dan
Okay.
Chris Nowinski
But it's not 100% diagnostic, like getting knocked out. And therefore people are still playing through that all the time.
Dan
Oh my God. So this is going to be a fun weekend of watching football, right, Dan? Are we, Did I miss anything else? Is there something else you're, you're itching to talk about or are we good?
Chris Nowinski
Oh, on this, on this issue?
Dan
Yeah.
Chris Nowinski
No, I think. No, I mean, you know what you're doing, you know what you, what you.
Dan
Need to make a good story.
Chris Nowinski
So I'm happy to, I appreciate you doing it and I'm just, you know, happy to, happy to share my perspective and thank you for giving this a little bit more visibility because it is a hard thing to convince people on.
Dan
Yeah, well, thank you for sharing your knowledge and coming on the show. I appreciate it.
Chris Nowinski
It was my pleasure.
Dan
Take care, Chris.
Chris Nowinski
All right, thanks you.
Dan
That's it for this week. Hope you're loving the new format. Just weekly chit chatting and hearing me in your face a lot more often. Thank you so much to Chris Nowinski. I'm excited to see where his work takes us as a society. We have a tip line open. Call us at 3232-4814-8832-2348-1488 and leave us a message about anything that you think is funky out there. What's going on, guys? Talk to me.
Unknown
Support for this podcast and the following message is brought to you by E Trade from Morgan Stanley. With E Trade, you can dive into the market with easy to use tools, $0 commissions and a wide range of investments. And now there's even more to love. Get access to industry leading research and insights from Morgan Stanley to help guide your decisions. Open an account and get up to $1,000 or more with a qualifying deposit get started today@etrade.com terms and other fees apply. Investing involves risks. Morgan Stanley Smith Barney, LLC Member SIPIC E Trade is a business of Morgan.
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Podcast Summary: "Turns Out Brains Are Important. Who Knew?"
Podcast Information:
In this episode of The Dream, hosts Dan and Jane Marie welcome Dr. Chris Nowinski, a unique blend of a former professional wrestler and a dedicated behavioral neuroscientist. Chris's journey from the football fields and wrestling rings to the halls of Harvard Medical School sets the stage for a profound discussion on concussions and Chronic Traumatic Encephalopathy (CTE).
Background in Football: Chris Nowinski began his athletic career in football, detailing his rise to become a two-way starter and captain at Harvard University. Despite his prowess on the field, Chris did not consider himself an NFL prospect, stating:
"I never thought I was good enough." [01:53]
After college, a twist of fate steered him away from a potential life in the NFL and towards professional wrestling, thanks to a recommendation from a consulting job mentor.
Transition to Wrestling: Embracing his interest in performance and physicality, Chris pursued a career in pro wrestling. He recounts his experience training under the legendary Killer Kowalski and eventually participating in a reality show with WWF:
"I was runner up. And being Chris Harvard was very interesting." [12:28]
This period was marked by creative freedom and the development of his wrestling persona, Chris Harvard, which paradoxically both boosted his career and contributed to his later challenges.
Injury and Realization: Chris's wrestling career was abruptly halted by a severe concussion resulting from a kick to the head during a match. He describes the moment:
"I blacked out. Like, I couldn't remember the rest of the match." [18:13]
Unaware of the long-term implications, Chris continued to wrestle, accumulating multiple concussions without understanding their severity.
Post-Injury Struggles: Following his retirement, Chris grappled with cognitive impairments and a growing realization of the damage done to his brain. This led him to seek answers, culminating in the writing of his book, Head Games: Football's Concussion Crisis.
Authoring the Book: In Head Games, Chris exposed the NFL's handling of concussions, drawing parallels to the "big Tobacco" scandal. This bold move faced significant challenges, including publishing hurdles and securing liability insurance:
"I wrote a chapter calling them big Tobacco and exposing how these studies were so stupidly designed." [22:41]
Investigating CTE: The book laid the groundwork for Chris's deeper involvement in CTE research. He recounts persuading a medical examiner to study the brain of Andre Waters, an NFL player who had committed suicide:
"Andre had CTE, and he was the third of three NFL players to have CTE." [26:03]
This discovery was pivotal, leading to widespread media coverage and raising national awareness about the dangers of repeated head trauma in sports.
Personal Stories: Chris shares heartbreaking stories of athletes like Junior Seau and Chris Benoit, whose lives were tragically cut short, likely due to CTE:
"Junior Seau… had stage three CTE… he was just fighting addiction, mental health, couldn't hold jobs, families." [35:55]
Behavioral Consequences: CTE's effects extend beyond cognitive decline, often manifesting as severe neurobehavioral problems, including aggression, depression, and impaired executive functioning.
"When you combine family history of psychiatric issues with CTE... you see really strange behaviors." [38:56]
Research Developments: Chris delves into the scientific aspects of CTE, explaining how it is identified post-mortem by examining tau protein deposits in the brain:
"What you will see is a pattern of brain cell death that is specific to the disease." [28:14]
Despite advancements, diagnosing CTE in living individuals remains a significant challenge. Chris emphasizes the need for improved diagnostic tools to enable early detection and intervention.
Prevalence and Risk Factors: Research indicates that CTE correlates strongly with the number and severity of head impacts rather than the number of diagnosed concussions. Studies show:
"For football players, your odds of developing CT go up 30% per year." [32:30]
These statistics underscore the pervasive risk faced by athletes in contact sports.
Changing the Sports Culture: Chris advocates for a cultural shift in how contact sports are approached, particularly at the youth level. He highlights the increasing number of young athletes exposed to repetitive head trauma and calls for stricter regulations:
"We need to get to a point where we can diagnose CT in life... we're facing a wave and an industry that doesn't want to acknowledge it." [43:54]
Future Aspirations: His vision includes establishing comprehensive diagnostic protocols and fostering clinical research to find treatments for CTE. Additionally, Chris aims to promote safer sports practices to protect future generations of athletes.
Identifying Concussions: Chris provides practical insights on recognizing concussions during sports events. He introduces the concept of the "spontaneous head shake" (SHAKE) as a new diagnostic sign:
"If you see someone get hit in the head and they shake their head back and forth violently, that is usually a concussion." [51:36]
Call to Action: He urges coaches, athletes, and spectators to be vigilant and proactive in identifying and addressing concussions to prevent long-term brain damage.
The episode concludes with Dan and Chris reflecting on the importance of awareness and proactive measures in combating the CTE crisis. Chris expresses gratitude for the platform provided by The Dream to further his mission:
"Thank you for giving this a little bit more visibility because it is a hard thing to convince people on." [53:16]
The discussion underscores the urgent need for societal and institutional changes to safeguard athletes' brain health, highlighting the profound interplay between sports culture and neurological well-being.
Notable Quotes:
Key Takeaways:
This episode of The Dream serves as a poignant exploration of the hidden costs of contact sports, advocating for systemic changes to protect athletes and advance neurological research.