[MUSIC] Welcome back. We want to welcome Chris Nowinski, joining us today to speak about the Sports Legacy Institute. Welcome, Chris. Thanks for being with us. >> Well thanks for having me, Peter. >> It's a pleasure. We want to go all the way back to the beginning, Chris. Please help us understand, how your personal experience led to your creation, along with Dr. Bob Cantu, of the Sports Legacy Institute? >> Sure, I never really thought I'd end up in the concussion world. But I was an athlete my whole life. Never actually had a diagnosed concussion. I ended up playing football at Harvard University and was fine, then I decided to join the WWE. And I had a great time playing fun character that everyone remembers, Chris Harvard. But got kicked in the head in 2003 gave me a severe concussion. I was in the ring. Forgot what was happening, I forgot where we were, forgot who was supposed to win the match. It was fake as you know. And the problem was I didn't appreciate that I really had a concussion that was a big deal, so I lied to the athletic trainer afterwords and said I was fine and then I lied for five weeks. And kept wrestling through a terrible headache, memory problems, nausea and I got so bad I had to quit. And that gave me post concussion syndrome that lasted five years. But for the first few weeks and months I was trying to get back into wrestling, and I was lucky to meet Dr. Robert Cantu, who helped me appreciate the fact that this wasn't my first concussion. I've been getting concussions my entire career. But because I didn't know any better, I was playing through them and that made them much worse. And this was the cumulative product of all those hits and all those concussions. And it blew me away that I was at that point a 24 year old, college educated athlete. And I had no idea even what a concussion was. Or the idea that you can arrest them. Or that there might be long term consequences. And so at that point I kind of committed myself to trying to change the status quo, because when you actually read the literature. and even the old literature. We all knew we should not be putting athletes back into the game with concussions. We know there were long term consequences, but we weren't talking about it. So my goal was to bring that message to the sports community, so that we changed how we handle the injury. And then SLI, Sports Legacy Institute, came about not because of that movement on concussions, but actually it it kind of shifted a little bit into the study chronic traumatic encephalopathy. The disease that we used to call Punch Drunk. because we thought it was only in boxers, but now we know it's in football players, soccer players, rugby athletes military veterans. Anybody who's been exposed to repetitive, or severe brain trauma, is a risk for this. And I started actually helping get the brains of athletes when they passed away, because the only way to diagnose this disease is looking at the brain post mortem. And I was lucky to be injured at a time where competitive ball was starting the first runner up players. I said, you know what, I'm going to get more brains, here we are. Seven years later we have a brain bank of 215 brains of former athletes and veterans, that have shown the world that this is a real disease and it is out there in the community and we need to change things. >> Chris, great answer and thanks for saying. Can you just start, begin at the beginning again. Post-concussion syndrome in your case just to personalize I know it's tough to go back through it and you still have some symptoms from it, but what was it like and how did Dr. Cantu help you realize, I need to do something about this? Well post-concussion syndrome was rough. And I was lucky to find Dr. Cantu. So, the idea is that some percentage of athletes, or anyone who gets concussion, doesn't bounce back like most people do. And they have longer, long term symptoms. And for me, it was probably compounded by the fact that I kept hitting my head, and working out after my concussion. But for five years I had headaches about half of my waking hours. My entire sleep system got destroyed, and so I developed REM behavior disorder, which means that I was acting out my dreams. I wasn't paralyzed like you should be when you're dreaming. So I injured myself, I woke up and running around the house and chasing shadows. It was a rut, that was for three years. I'd be heavily medicated every night, so I'd be sedated so I wouldn't hurt myself. I had depression issues. I had short term memory problems, that lasted for a year and a half. I became very much socially isolated, withdrawn, and a miserable person to be around. And there wasn't a pill I could take to make it go away. I just, with time, some of the symptoms went away. But I'm still not, we're 11 years later and I'm not back to where I was, I actually kind of cheat and still take a stimulant, a cognitive stimulant to help me both fight the headaches and be a little more focused so I can be productive. >> And what you've accomplished is nothing short of amazing. I'm so proud to be a member of your board. But now for our audience, help us understand what CTE really is, such as a layperson can understand it and explain it, and why it's really only diagnosable post-mortem? >> So CTE, Chronic Traumatic Encephalopathy, is a degenerative disease that's sort of in the world of Alzheimer's disease or Parkinson's disease but it's unique. And the idea is that trauma, for a reason that's still really not known, can injure your brain in a way that sparks a process that continues after the so called injury is recovered. And so when we see in athletes, when we look at the brains, as in teenagers and people in their 20s, you see these tiny spots where the structure of the cell has started to fall apart, and continues to fall apart. And then as you age, it just spreads throughout your brain, destroying your brain control memory or emotion. Essentially, it's like your brain rotting. Analogies could be, when you bruise an apple, the bruise will spread throughout the apple. Or there's other ones that I'm blanking on right now, but it's basically the structure of the cell just starts falling apart. >> And you know, you've been kind enough to introduce me to people like Teddy Johnson. What happens when you keep playing, and then we want to go to the unfortunate, the Dave Duerson's of the world. And their anger management issues that attend on that, or Junior Seau, does it lead to the ultimate sort of depression? >> Yeah, so it's interesting, the disease we're learning, we're just starting learning about it, because it was really never formally studied and in 2008 when we partnered with Boston University, we created the first CTE center in the world, it just didn't exist. And the idea is that, especially in football players, it always starts in the frontal lobe, and so the frontal lobe is very important for things like attention and concentration. Can be associated with headaches. But that's what you'll see in the first kind of ten years of the disease. But as it spreads, it starts to take more brain tissue in your frontal lobe, and as it spreads further it moves to an area of your brain called your medial temporal lobe. What you need to know there is that, that controls your ability to, to create short term memories. And also, has areas of the brain like the amygdala, which are very important for the fight or flight response, the emotional response and so the kind of CTE that we know, from reading the news from people maybe taking their lives or people becoming violent, angry, or abusive or bizarre. That is something you often see in mid-life when the medial temporal lobe gets involved and diseased and destroyed, and then by stage four it goes everywhere and those people get dementia. And they can't take care of themselves any more. So, mid-life it's memory. It's behavioral problems. Lot of impulse control issues. And then, by the end. You, you can't function. You have no memory and it's really, it's quite tragic, and the horrible thing about it is, it's really a slow moving disease. So often with Alzheimer's disease, from the moment you're diagnosed, to the time you die, is maybe seven to ten years. With CTE, we've seen people that start acting bizarrely or even get dementia and then they still live for 20 years, and in a lot of ways they bankrupt their family. And it can tear families apart. >> Mike Webster, being one of the most famous examples, and can you also mention how there's now a tie to Lou Gehrig's disease, apparently? SLI and BU have been able to make that connection, preliminarily. [CROSSTALK]. >> Yes, the Dr. N McKee was able to discover basically by looking at the brains of a lot of former NFL players and boxers who developed Lou Gehrig's disease what's called amyotrophic lateral sclerosis, which is a type of motor neuron disease, that affects the way your body's able to move the motor cortex and the spinal cord. She basically started looking at the brains of people like Wally Hilgenberg, who won four Superbowls for the Vikings. Eric Scoggins who played a little bit for the 49ers. They both developed ALS, but when you actually got to the brain and spinal cord, it didn't look like the normal types of ALS. >> Under microscope. It actually just looked most like CTE that had spread to the spinal chord areas, the motor cortex, and destroyed those places. So she basically proposed, a few years back, that this is a sub type of ALS that's caused by trauma. So it's really kind of CTE plus a little bit more and so what's been interesting is that now they've gone back and looked at old records and they've found that NFL players are four times more likely to die of motor neuron disease. Military veterans are about twice as likely to die of motor neuron disease and they think trauma might be that cause so that three out of four NFL players have got ALS. Three of them got if from trauma, one got it from a way that we still don't understand. >> Jumping to the player's association, the last collective bargaining agreement we learned, probably these kinds of safety issues, were job one for D Smith and his team. >> I think there's no question that it was it was great under D Smith's leadership that they started to prioritize the concussion issue. And so they actually put together their first ever, own committee of concussion experts. So for years the NFL Players Association sort of, they had a part time medical director. But a lot of the decisions were being made by the NFLs committee. And those of us who are history know that they were making strong calls, and the risks were on how athletes should play. So, by pulling together that expert committee they fought for a number of changes, that have lead to things like having an independent doctor on the sidelines, who can assess you for concussions. But also, limiting number of days of hitting to fewer than one day per week during the season. So again, we should be lowering the number of concussions and hopefully reducing the risk of CT down the road. >> We talk about the silver bullet Chris. Oh, isn't there some magic helmet out there, that could protect these players? Or a buzzer that goes off if there's a concussive hit? Is that part of the solution, or is that more of the problem? >> Well, helmets have played both roles as being part of the solution and part of the problem. Originally, when helmet, hard hit shell helmets were invented, and I never realized this when I was an athlete, and I used my head as a weapon. But the helmet was really there to keep your skull from fracturing, which used to kill a lot of athletes in football and really injured some college skull fractures in ice hockey. And that's why, in those two sports, we added helmets. Turns out, especially in the early designs, they didn't do very much of anything for concussions, because your brain is floating in fluid inside of your skull and it moves around independently of the skull. And actually the other problem was it covered up nerve cells on your scalp. So no one ever tells athletes, and they really should. You don't have pain nerves in your brain, so you can't feel your brain rattling around, stretching, tearing, bleeding. And so, that's why everyone was comfortable hitting each other in the head and hitting, getting hit in the head because they didn't feel classic pain. And when you cover up the nerves they didn't feel any pain, or bleed, or have any negative consequences that were they were able to observe. So now, there's a lot of money and investment going into trying to change how much to make them safer for the brain, but the reality is there's no such thing as a safe helmet that can prevent all concussions. And we're much better off focusing on not hitting athletes in the head at all, especially when they're young. And so one of our initiatives to the sports legacy is to our new hit count initiative, which is developed a pitch count for the brain. So the idea is we count, how many times a baseball player throws so they don't wear out their elbow, and we restrict it. If you throw 80 times, you're out of the game. Well, with hit count, we're going to use sensors and have a universal threshold that all the sensors use, just count how many times you're hit in the head. And then you'll be to compare team to team, sport to sport, player to player. And by counting them we'll be able to start to diminish those numbers, because so many of them are wasted by practice, and so many of them are caused by the rules of the game, that could be changed to make it much safer. So I'm excited about that future. [MUSIC]
