You, Me and CTE

Summary

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The Dream – "You, Me and CTE"

Podcast: The Dream
Host: (Dan), with Pace Case and Bachelor Clues
Guest: Chris Nowinski
Release Date: August 1, 2026
Episode Theme:
A gripping interview with Chris Nowinski — former Harvard football player, WWE wrestler, and leading concussion/CTE activist — exploring the unseen dangers of sports-related brain injuries, the cultural mystique of the "American Dream," the hidden epidemic of CTE, and the fight to change sports and public health policy.

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Main Themes

• The hidden crisis of concussions and Chronic Traumatic Encephalopathy (CTE) in sports, especially football and wrestling.
• Nowinski’s journey from athlete to activist and neuroscientist after his career-ending traumatic brain injury.
• The cultural forces that encourage high-risk athletic behavior and the difficulty of changing those norms.
• The need for improved education, policy, and awareness to prevent brain injuries, especially among youth.
• The ongoing cover-ups and denial by sports organizations, and the slow cultural shift toward transparency.

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Episode Breakdown

1. Identifying a Concussion: Signs, Symptoms, and Overlooked Warnings

[00:56], [45:21]

• Concussion symptoms: What you feel (e.g., headache, double vision). Only you know if you don’t tell.
• Concussion signs: What observers can spot: loss of consciousness, fencing response (arms out), staggering, and especially a newly recognized sign — the spontaneous head shake after impact.
  • Quote:

    "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."
    — Chris Nowinski, [01:10]

  • Fencing response: “Someone gets hit and they're unconscious with their arms out, or they get up and they fall over.” — Nowinski, [01:34]
  • Spontaneous Head Shake:

    “It needs to be one of those signs you pull people out and evaluate them on... 72% of the time, it was because they were having concussion symptoms and they were trying to reset their brain.”
    — Chris Nowinski, [46:05–47:10]

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2. Chris Nowinski's Journey: Athlete, WWE Star, and Accidental Activist

[01:45–12:49], [16:44]

• Football beginnings: Grew up outside Chicago. Mother was concerned about injuries but allowed high school football. Rapidly became a team captain.
• Harvard football: Modest but impressive career as a two-way starter, second-team All-Ivy as a senior.

  "I, I did care about school and I did try hard and I did have the scores to get into Harvard independently... but I chose football because I thought it looked, it was cooler." — Nowinski, [03:31]

• The NFL dream: Was considered for drafting but didn’t make it. Had a consulting job lined up instead.
• Pro wrestling leap: After a suggestion from a boss, he trained at Killer Kowalski’s wrestling school, joined a WWE/MTV reality show (runner-up), and debuted as "Chris Harvard."

  “As a wrestling character, Chris Harvard's never gonna be the underdog, you're gonna be the bad guy.” — Nowinski [09:22]

• Rise and abrupt end:
  Wrestled with WWE, found success and recognition, then suffered a career-ending concussion after a kick to the head.

  “I got a really bad concussion that I didn't realize was a concussion. And I kept wrestling for weeks with a damaged brain... to the point that it never quite recovered.”
  — Nowinski, [11:17]

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3. The Brain Injury That Changed Everything: From Ignorance to Advocacy

[11:57–16:12]

• No concussion culture:

  “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 just didn't know.”
  — Nowinski, [11:57]

• Could not remember matches, persistent headaches. The eighth doctor finally diagnosed him properly, labeling it post-concussion syndrome.

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4. Research, Revelation, and Going Public: Writing Head Games

[16:44–20:10]

• Realized athletes (even at Harvard level) lacked basic concussion knowledge.
• Began reading every study he could find; shocked to discover the NFL was publishing misleading research, compared it to “big Tobacco.”

  “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.” — Nowinski, [19:25]

• Published Head Games (2006) despite little interest and took personal financial risk, motivated by a desire for penance and to expose systemic danger.

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5. CTE, NFL Cover-ups, and the Power of the Media

[20:18–24:54]

• Learned about CTE: chronic brain degeneration, historically studied in boxers but ignored in football.
• Andre Waters’ suicide led Nowinski to personally contact the family and arrange brain study (since doctors wouldn’t).
• Discovery of CTE in NFL players — only gained traction after Nowinski brought it to the New York Times.

  “NFL players are getting this punch drunk disease, and the NFL is covering it up, and someone needs to say something.”
  — Nowinski, [24:05]

• Result: Front-page NYT coverage; journalist Alan Schwartz published over 200 articles, igniting the national conversation.

---

6. Science of CTE: What the Brain Shows, and What Risks Matter

[25:04–27:45], [27:58–31:03]

• Pathology:
  “When someone has CTE, what you will see is a pattern of brain cell death that is specific to the disease... The protein's called tau.” — Nowinski, [25:04–26:00]
• Discovered that risk is not about number of diagnosed concussions, but years of exposure to head impacts (even ones with no symptoms).
  • "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." — Nowinski, [28:35]
  • Risk quantification: For football, odds of developing CTE go up 30% per year played; 14% for rugby, 34% for hockey ([28:50–30:23])
  • Cumulative exposure, not single big injuries, is the true culprit.

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7. Effects and Consequences of CTE: The Human Toll

[31:03–33:48]

• CTE consequences:
  • Eventually leads to progressive cognitive impairment, dementia.
  • Early: aggression, addiction, executive dysfunction, personality change — can be extreme (e.g., Chris Benoit tragedy).
  • Family history of psychiatric illness is a risk factor for worsened behavior—when combined with CTE, can trigger alarming symptoms in one’s 40s.
    • "One of the predictors of who really struggles is family history of psychiatric and mental health diagnoses... when you combine those two things, you see really strange behaviors."
      — Nowinski, [33:56]

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8. Building a Legacy: The BU Brain Bank and Pursuing Diagnosis and Cure

[36:05–39:31]

• Founded the Concussion Legacy Foundation and BU CTE Center to institutionalize brain donation and research.
• Personally called bereaved families; recognized the importance of ethical outreach.
• Began part-time PhD in behavioral neuroscience.
• The big goal: Develop tools to diagnose CTE in living people so treatment/clinical trials can be attempted.

  "We need to get to a point where we can diagnose CT in life... That's 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."
  — Nowinski, [38:35]

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9. Youth Sports, American Culture, and the Challenge of Change

[39:33–42:05]

• Early participation = higher risk: Kids’ sports more intensive and year-round than ever; children starting tackle sports at 5 dramatically increases lifetime CTE risk.
• Systemic issues: Privatized youth sports less likely to give risk information; an entire industry profits from maintaining the status quo.

  "We are creating more CT cases now than we ever have before because we have more people participating in sports... 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."
  — Nowinski, [41:18–42:05]

---

10. Barriers, Gender, and the Way Forward

[42:05–45:03]

• Cultural silence:
  • NFL players do not speak out, face covert punishment for advocating, and fear for their careers.

    "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."
    — Nowinski, [43:03]

  • Not just “toxic masculinity”—even women’s sports are affected but rarely discussed. The first two female athlete CTE cases were 28-year-olds who died by suicide ([43:53–44:15]).
  • Financial incentives, misinformation, and cultural denial inhibit change in both men’s and women’s sports.

    "Their whole career they've been told, this is safe." — Nowinski, [45:02]

---

Notable Quotes and Memorable Moments

• On why he became an activist:

  “Basically, my penance for damaging my Harvard-educated brain was to try to take a stab at changing the culture on this.” — Nowinski, [19:49]

• On the “shame” of cultural denial:

  “NFL players are getting this punch drunk disease, and the NFL is covering it up, and someone needs to say something.” — Nowinski, [24:05]

• On CTE risk:

  “CTE correlates very, very strongly with number of years you play contact sports, but not with number of concussions.” — Nowinski, [28:35]

• On the motivation behind youth sport changes:

  "We're doing sports wrong... We have more people playing more sports, starting younger, and we're only now starting... to create age minimums to start hitting a kid in the head 300 times a year." — Nowinski, [41:00]

• On cultural complicity in sports:

  "There's a lot of people making a lot of money not to slow the party down." — Nowinski, [42:05]

• On gender and CTE:

  “Women are doing this too. We just don't talk about it.” — Nowinski, [43:59]

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Key Timestamps

| Time | Section/Insight | |----------|-------------------------------------------------------------| | [00:56] | Identifying concussion signs and symptoms | | [01:45] | Nowinski’s entry into football and wrestling | | [11:15] | Career-ending concussion and lack of concussion education | | [16:44] | Realization of athlete ignorance; research begins | | [19:24] | Calling out the NFL’s “big Tobacco” approach | | [20:18] | Bringing the CTE story to the public via the NYT | | [25:04] | Explanation of CTE pathology and diagnosis | | [27:58] | Quantifying the risk — years played vs. number of concussions| | [31:03] | Effects of CTE: cognitive, behavioral, psychiatric | | [36:05] | Creating the brain bank and pursuing real research | | [38:35] | The future — diagnosing and treating living patients | | [41:00] | Youth sports, hyper-specialization, and rising risk | | [42:05] | Barriers: silence, complicity, and culture | | [43:53] | Gender, CTE, and the cost of progress | | [45:21] | Recap of concussion signs and the new “head shake” protocol |

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Conclusion

Chris Nowinski’s journey from Ivy League football player to pro wrestler to leading CTE activist exposes the grim reality hidden behind the American sports dream. Through shocking data, personal stories, and hard-won insight, he demonstrates how cultural myths, financial incentives, and willful ignorance perpetuate a legacy of invisible, irreversible brain damage for generations of athletes — and why urgent action and honest conversation are needed to change the game.

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Transcript

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[Chris Nowinski]

We didn't get into the concussion sign you need to look for, which is the can you tell me what a concussion?

[Interviewer (Dan)]

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.

[Interviewer (Dan)]

Okay.

[Chris Nowinski]

It's a sign that their brain's malfunctioning.

[Interviewer (Dan)]

Tell me, first of all, like, how you got into playing football.

[Pace Case]

Yeah.

[Chris Nowinski]

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 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 of the team within, you know, a week.

[Interviewer (Dan)]

Within a week?

[Chris Nowinski]

Yeah. Well, I mean, you have to pick the starters right away. So I was the biggest, you know, one of the biggest guys in the team and I could run and I memorized the playbook in a day on defense. And so the coach thought, hey, well, you're middle linebacker and you call the plays.

[Interviewer (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.

[Interviewer (Dan)]

So you're playing football for Harvard and first of all, Harvard, you said that 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.

[Interviewer (Dan)]

Okay.

[Chris Nowinski]

I, 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.

[Interviewer (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 training 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.

[Interviewer (Dan)]

Did you think of it as a

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real sport at the time?

[Chris Nowinski]

No. No. So I had dabbled in theater.

[Interviewer (Dan)]

Here we go.

[Bachelor Clues]

Yeah.

[Chris Nowinski]

So I was in west side Story in high school as Diesel 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.

[Interviewer (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.

[Interviewer (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.

[Interviewer (Dan)]

So that's not what you were aiming for?

[Chris Nowinski]

No.

[Interviewer (Dan)]

What were you aiming for?

[Chris Nowinski]

I had no idea. That's why I went into pro wrestling.

[Interviewer (Dan)]

Tell me how that happened.

[Chris Nowinski]

Yeah, so, 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. I didn't sign with wcw right away is I needed shoulder surgery with a six month recovery.

[Pace Case]

Oh.

[Chris Nowinski]

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 they. 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.

[Interviewer (Dan)]

Forgive me, I know that name sounds a little bit familiar to me, but who is Killer Kowalski?

[ACAST Announcer]

The Killer.

[Chris Nowinski]

The Killer Killer was 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 was just the nicest vegetarian you've ever met named Killer. So, yeah, so 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.

[Interviewer (Dan)]

13 wrestlers in a house looking for a WWF contract on TV.

[Chris Nowinski]

The last one standing gets a three year contract with WWE. And this was back in. 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.

[Interviewer (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 wanna, yeah, you wanna know if a guy went to Harvard, 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 gonna be the underdog, you're gonna be the bad guy. Then I learned the show, started editing me as the bad guy.

[Interviewer (Dan)]

Oh.

[Chris Nowinski]

And it gave me this nice boost into that future career. Because people actually thought I was a horrible person.

[Interviewer (Dan)]

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.

[Interviewer (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.

[Interviewer (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. My, the.

[Interviewer (Dan)]

I love the idea of this Chris Harvard.

[Pace Case]

Yeah.

[Chris Nowinski]

I mean, it was such great creative freedom.

[Interviewer (Dan)]

Yeah.

[Chris Nowinski]

To just say and do whatever you want and just, you know, get a microphone and insult people.

[Interviewer (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.

[Interviewer (Dan)]

So now you're achieving another American dream being on TV.

[Chris Nowinski]

Yeah.

[Interviewer (Dan)]

Were you excited about that part of it?

[Chris Nowinski]

Well, yeah. When I made debuted on Monday Night Raw in June 2003, it was very cool. 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. Was great.

[Interviewer (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.

[Interviewer (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 damage to the point that it never quite recovered. And I couldn't actually perform the job because I couldn't remember matches and I couldn't get my heart rate up without feeling sick. So I retired from post concussion syndrome.

[Interviewer (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.

[Interviewer (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.

[AT&T Business Wireless Representative]

Right.

[Chris Nowinski]

And then I had a really, just massive headache that wouldn't go away.

[Pace Case]

Yeah.

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[Pace Case]

Hi, I'm Pace Case.

[Bachelor Clues]

And I'm Bachelor Clues.

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[Interviewer (Dan)]

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?

[Shopify Advertiser]

I'm good.

[Interviewer (Dan)]

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 was CTE later. Oh, I was a kid. I was six or seven.

[Chris Nowinski]

You're not going to get CD from that.

[Interviewer (Dan)]

Oh, good. Okay, well, don't tell me how you know that yet. Okay, so you. So you have this concussion. 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.

[Interviewer (Dan)]

I forgot John Cena was a real WWE guy.

[Chris Nowinski]

And B, I know, I know he's 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're trying to send me doctors, put Humpty Dumpty back together again. The eighth doctor I see is Dr. Robert Cantu, who, as 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. 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. 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've tried 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 crisis. Like we're just not acknowledging this invisible injury because it's invisible and no one's talking about it.

[Pace Case]

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 were 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.

[Pace Case]

Yeah.

[Chris Nowinski]

And I got a $4,000 advance because no one wants to read a book like this. $21,000 worth of liability insurance for my ACC 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.

[Interviewer (Dan)]

Well, I've seen your story on TV about the book. I mean, 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 change 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 as somebody who was hitting the head 10,000 times at this point, I knew that your brain can't tell whether it's a football helmet or a fist that's punching in the head. Your brain's going to feel the same thing. So two NFL players have been studied. I interviewed the doctor who 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 and 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.

[AT&T Business Wireless Representative]

And.

[Chris Nowinski]

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. So I did that.

[Interviewer (Dan)]

How was that call?

[Chris Nowinski]

It was. I had a. 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.

[Interviewer (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. So when you die from unknown causes, they will keep tissue and blood.

[Interviewer (Dan)]

Okay.

[Chris Nowinski]

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.

[Interviewer (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 in 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.

[Interviewer (Dan)]

Oh, wow.

[Chris Nowinski]

And 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, we're the New York Times. How do we not know about this?

[Interviewer (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 head.

[Interviewer (Dan)]

Yeah.

[Chris Nowinski]

For a long time. 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.

[Interviewer (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's 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.

[Interviewer (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.

[Interviewer (Dan)]

Are these what we would call plaques?

[Chris Nowinski]

They're not the plaques, okay?

[AT&T Business Wireless Representative]

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 harder to deal with because it's inside the cells.

[Interviewer (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 injuries. 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 would describe 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 CTE is. So at that point we can look back and go, yeah, we were right, but it was speculative back then.

[Interviewer (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.

[Interviewer (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. Yeah. I mean, when you talk to NFL players when they. When they retire, they'll tell you weekly their, you know, seeing double in their, 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. Are. Are broken. So basically, the point is that CT 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. 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.

[Interviewer (Dan)]

Wow.

[Chris Nowinski]

And. And those curves look a lot like smoking and lung cancer curves. Yeah, 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.

[Interviewer (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.

[Interviewer (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 CTE 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 accomplished that. So for a lot of people, you will see that 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. 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 to 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 the most common outcome. The more common outcomes are the later stage cognitive problems. Okay, but 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 knew for five years, who seemed fine until he killed his wife, seven 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.

[Interviewer (Dan)]

Right.

[Chris Nowinski]

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[Pace Case]

Hi, I'm Pace Case.

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[Interviewer (Dan)]

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 cte, 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, 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 wear off of this late twenties ex athlete 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.

[Interviewer (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 came down in the 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.

[Interviewer (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.

[Pace Case]

Uhhuh.

[Chris Nowinski]

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. And, and what's been hard is that along this way I mentioned I, 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 and the 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

[Interviewer (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 will 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 we're 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?

[Interviewer (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.

[Carl's Jr. Advertiser]

Wrong.

[Chris Nowinski]

And, and the problem is we' 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.

[Interviewer (Dan)]

Right, right. Because they're not affiliated with your school or the public school system or anything.

[Chris Nowinski]

So I don't know how we win that battle. Like, you know, we, we, you know, we've had certain wins here and there. You know, we got heading ban before age 11 in soccer, but we are creating more CT cases now than we ever have before because we have more

[Interviewer (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 1960s Pop Warner was not even a national organization.

[Shopify Advertiser]

Right.

[Chris Nowinski]

And so there are very few kids, people starting at 5 now we have tons of people starting at 5. And those people have a much greater risk of CT. 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.

[Interviewer (Dan)]

Oh my God.

[Chris Nowinski]

But it's not happening fast enough. So we think about someone like Junior Seow having bad CT. He had stage two CTE after, you know, 20 years in the NFL. He died in his mid-40s. And the disease progresses as you get older. We now have, you know, almost 10 college football players who died in their 20s with stage three CTE that are worse than say 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, you know, addiction, mental health, couldn't hold jobs, families, you know, 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.

[Interviewer (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. I know, right? Like you realize like that's, that'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 I, 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. 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?

[Interviewer (Dan)]

Not one?

[Bachelor Clues]

No.

[Interviewer (Dan)]

How do we find that person? How do we, what do I, we've

[Chris Nowinski]

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 yeah, you find your so gross.

[Interviewer (Dan)]

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 they're, most of them are in denial.

[Interviewer (Dan)]

Is it just toxic masculinity?

[Chris Nowinski]

No, no, no, no. I mean, you know, I, I, I wrestle with my four year old son every day but also with my six year old daughter, like, you know, there's. 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.

[Interviewer (Dan)]

Right.

[Chris Nowinski]

Your brain doesn't have, doesn't have pain, nerves.

[Interviewer (Dan)]

Right.

[Chris Nowinski]

So you literally can't know that you're damaging your brain until it's too late.

[Interviewer (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.

[Interviewer (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.

[Interviewer (Dan)]

Right?

[Chris Nowinski]

So I don't know.

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I.

[Chris Nowinski]

There's no easy answers here. I don't blame anyone for what they're doing. And they have also been fed misinformation. Their whole career, right? Their whole career they've been told, this is safe.

[Interviewer (Dan)]

Well, you're doing great work to try to fix that. I feel like the conclusion here is Bunny is evil. That end? No. Well, 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.

[Pace Case]

Oh, oh.

[Interviewer (Dan)]

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 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.

[Interviewer (Dan)]

Okay.

[Chris Nowinski]

It's a sign of 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.

[Interviewer (Dan)]

Okay?

[Chris Nowinski]

That quick shake back and forth, shaking

[Interviewer (Dan)]

the water out of there.

[Chris Nowinski]

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 400 young former athletes, showed him 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 SH 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.

[Interviewer (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.

[Interviewer (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?

[Interviewer (Dan)]

Yeah.

[Chris Nowinski]

No, I think. No, I mean, you know what you're doing. You know what you.

[Interviewer (Dan)]

What you need to make a good story.

[Chris Nowinski]

So I'm happy to. I appreciate you doing it, and I'm just 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.

[Interviewer (Dan)]

Yeah. Well, thank you for sharing your knowledge and coming on the show. I appreciate it.

[Chris Nowinski]

It was my pleasure.

[Interviewer (Dan)]

Take care, Chris.

[Chris Nowinski]

All right. Thanks.

[Interviewer (Dan)]

Okay, Bye.

[Jameela Jamil]

Bye.

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ACAST powers the world's best podcasts. Here's a show that we recommend.

[Jameela Jamil]

What if you laughed all through your commute? Or if you heard the funniest story while at the gym? Well, now you can. I'm Jameela Jamil, and guests on my new podcast, Wrong Turns share their most mortifying and hilarious disaster stories. I'm talking people like Mae Martin, Bob the Drag Queen, Katherine Ryan, Jake Johnson, Margaret Cho, Simon Pegg Penn Badgley, and so many more.

[Chris Nowinski]

More.

[Jameela Jamil]

So listen wherever you get your podcast. Wrong Terms where dignity goes to die.

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ACAST helps creators launch, grow and monetize their podcasts everywhere. Acast. Com.