Q&A with Bennet Omalu, M.D.

The subject of the movie 'Concussion' on brain health and why he can’t watch football.

For months of the year, every Sunday afternoon, football has our national attention. For America, it’s a deeply-engrained cultural tradition, a ritual and pastime. 

But for forensic pathologist Bennet Omalu, M.D., M.P.H., it’s a dark and dangerous reminder of the progressive and degenerative brain disease that—one day in 2002—he discovered in the brain of Pittsburgh Steelers center Mike Webster. The condition is called Chronic Traumatic Encephalopathy (CTE); Omalu went on to identify it in others, uncovering the fact that CTE affects athletes who’ve suffered from repetitive head trauma.

His story comes to light on Christmas Day in Concussion, a Hollywood recreation of the Nigerian-born doctor’s career path (and struggle to get his research the attention it deserved from sports institutions like the NFL), in which he's played by Will Smith.

And the movie comes at a time when brain health has its biggest stage. After all, research out just this year identified the hallmark proteins of Alzheimer’s disease in the brains of 20-year-olds. Films like Still Alice leave us to ponder the implications of dementia. And in addition to football, studies suggest concussions are commonplace in sports like soccer and ice hockey as well. Remarkably, pro players are opting out of their careers due to these dangers. 

Recently, Q touched base with Omalu. Below, he describes his hopes for the sports world; how average athletes can protect and strengthen their brains; and what he wants people to know, now that the world is finally listening.

Q: In layman's terms, happens to the brain with CTE?
Omalu: With every blunt force impact to your head while playing high-impact contact sports, there are microscopic injuries to the blood vessels, nerve cells, and nerve fibers in your brain. Abnormal proteins are expressed and later absorbed by the brain. When these blows are repetitive—at some point in time, which we do not know yet—the brain loses its ability to absorb these proteins and more abnormal proteins are formed, which strangle and kill the brain cells. You begin to suffer symptoms of dementia and motor disorders like loss of intelligence, memory, and judgment; mood disorders and major depression; loss of inhibition; drug abuse; alcoholism; rampant fluctuations in mood; exaggerated reactions to the daily stresses of life; increasing religiosity and sexual improprieties; violent tendencies and criminal behavior; and movement disorders. Once the brain is damaged, the damage is permanent, irreversible, and progressive.

Q: What implications do you hope the movie Concussion will have for sports?
Omalu: The movie will educate us so that when we make the decision to play, it will be an informed decision, knowing fully well the risks involved. Also, we need to consider an ‘age of consent’ for playing high-impact contact sports for our children, just like we have done for smoking, alcohol, joining the military, voting, and even sex. We should no longer intentionally expose our children to the harmful effects of repetitive head impacts. 

Q: Do you have a hard time watching football yourself?
Omalu: Yes. I have tried to watch football, but in every play, when I see the repeated head impacts, I visualize what is going on in the brains of the players. I develop goose bumps and my heart starts pumping faster and stronger. I just cannot get myself to watch it, unfortunately.

Q: The average athlete may not be playing tackle football, but brain health proves to be an important and timely issue. Why?
Omalu: The brain is the single most valuable organ in our bodies that defines who we are as human beings. Unfortunately, it is the most vulnerable and sensitive organ in the human body, too. 

Q: Are there brain health precautions every athlete should take?
Omalu: Prevention is the best cure. Stay away from any activity that will expose your head to repeated blows or repeated acceleration-deceleration of the brain, no matter how seemingly innocuous. Mitigate your risk. Engage in sports with less impact and less contact. Engage in brain-friendly activities like meditation; practice your faith; read as much as you can; eat healthy; drink less alcohol; do not smoke; take omega fatty acid derivatives and multivitamins. You must also see your primary care physician every six months. Hypertension and hyperlipidemia are very prevalent diseases, especially when you are above 40. If you do not see a physician regularly, there is no way you can diagnose these diseases early. The same applies to diabetes mellitus. When you are treated, you will significantly reduce your risk of developing brain diseases.

Q: Do you exercise?
Omalu: I go to the gym as frequently as I can. My favorite workout is riding the stationary bike while watching a movie on my iPhone—small steps at a time. I am not in the best of shape, but I am working on it. In the past six months, I lost 23 pounds—I was over 200 pounds. I want to get down to my ideal weight of about 170 pounds. I am now 185, so I have to lose some more.

Q: You have pushed and pushed the conversation about CTE and brain health. People are finally listening. What is the most important part of the conversation?
Omalu: 
We should stop intentionally exposing our children—the most precious of our gifts of life and the most vulnerable in our society—to the harmful effects of repetitive head impacts, knowing what we know now. Barack Obama and many retired football players have said that they would not let their sons play football if they had one. I will not let my son play. It is not just about football, it is about other high-impact contact sports like boxing, mixed martial arts, and ice hockey. For other lower impact contact sports like soccer and lacrosse, we have to keep the head out of the game.