If Sydney Seau Doesn't Speak Out Against the NFL, Someone Else Will

Sydney Seau says she won't speak out. Not against the sport she still loves. Now that she's allowed to talk when her father, Junior Seau, is inducted into the Pro Football Hall of Fame this weekend, she's expected to stay on script—lauding and remembering Junior's life, sparing the National Football League the embarrassment involved in discussing battered brains, corporate cover-ups, and his premature death.

Odds are, the league won't always be so lucky.

Three years ago, Junior committed suicide, shooting himself in the chest to preserve his brain. Pathologists subsequently diagnosed the 43-year-old former linebacker with chronic traumatic encephalopathy (CTE), a neurodegenerative disease linked to repetitive head trauma; meanwhile, his family filed an ongoing wrongful death suit against the league for denying and dissembling about football's long-term health risks. This came to a head last week, when the Hall of Fame said Sydney would not be permitted to speak at the induction ceremony—the better to save time—and then backtracked, announcing that a NFL Network correspondent would be allowed to ask Sydney questions during the unveiling of her father's bronze bust.

Many concluded that the NFL—the Hall's primary financial patron—was working to muzzle a potential threat. Lost amid the outrage? That there's more to come. More devastated families. More dead and damaged men. Sooner or later, one of them—or one of their survivors—will take a stand against the game at its annual summer self-celebration, no matter what the league does to hedge against it.

After all, Hall of Fame-caliber players—the ones like Junior Seau, who played the best and the longest—seem to be the most likely to suffer the worst kind of football-induced brain damage.

Let's do some simple math. In 2007, researchers in Boston began collecting and examining the brains of deceased players, looking for the telltale malformed microscopic protein tangles that indicate CTE, a condition characterized by mood, behavior, and cognition dysfunction. The same year, the NFL started funding the 88 Plan: a cash benefit paid to retirees diagnosed with dementia and other neurodegenerative diseases, and the league's first tacit admission that football can be bad for the brain.

Between 2007 and 2015, 31 members of the Hall of Fame who played at least one game in the NFL died. Six of them—19 percent—were diagnosed with CTE, according to reports from the Sports Legacy Institute, a Boston-based nonprofit that studies sports-related concussions and brain trauma. Another nine—29 percent—were diagnosed with dementia or Alzheimer's disease, according to their obituaries.

In other words: for every five Hall of Fame players to sit down at the same banquet table this weekend, one of them is likely to end up with CTE. If 10 Hall of Famers gather for a group photo—almost an in-game huddle—around half of them likely will develop a neurodegenerative disease of some kind.

By contrast, the best current (and possibly conservative) estimate of the CTE rate in the general NFL population is 3.7 percent, while the league itself estimates, in federal concussion class action lawsuit settlement documents, that nearly 30 percent of all players will eventually develop a serious neurocognitive disease or disorder.

A Hall of Fame player, then, may be around 60 percent more likely to develop a serious neurological ailment than his non-Canton peers, and roughly five times more likely to suffer from CTE specifically.

Some caveats: I am not an epidemiologist. This is not academic paper. The above numbers aren't ideal, in part because the NFL privately holds the best data. They don't include Parkinson's disease or amyotrophic lateral sclerosis (ALS), which also have been linked to head trauma andappear to afflict former NFL players at higher than average rates. My sample is small, and suffers from selection bias—since not every football player who died between 2007 and 2015 has had their brain examined for CTE, there could be a number of undiagnosed cases.

Moreover, the estimated CTE and neurodegenerative disease rates among all NFL players are just that: estimates. Any scientist working in this area will tell you—many have told me personally—that more and better research is needed to understand the true prevalence of the problem.

Still, the data is suggestive. Powerful. It jives with current scientific research on the connections between football and neurological disorders, brain damage, and getting hit in the head, a body of knowledge that has advanced significantly over the past half decade.

"To get to the Hall of Fame, you have to have a longer career, and there's no question we think length of career matters," said Chris Nowinski, executive director of the Sports Legacy Institute. With CTE risk, he added, "we think there's a dose response, like the curves you see with smoking and lung cancer—your total years smoking has more of an effect on risk than the cigarettes smoked per day."

Does football work like smoking, producing cumulative, compounding harm? For now, there's no way to say with absolute certainty. But it certainly looks possible.

University of Tulsa scientists studying college football players have found that the longer an athlete has played football, the more their hippocampus—a seahorse-shaped area deep inside the brain that plays an important role in emotional control and memory formation—appears to shrink. (Hippocampus shrinkage is hallmark of Alzheimer's disease and also characteristic of CTE.) An ongoing Cleveland Clinic study of nearly 400 active and retired boxers and mixed martial arts fighters has found that higher exposure to head trauma—as a result of career length and intensity—correlates with lower brain volume and reduced performance on cognitive testing.

Last month, a Harvard University study reported that traumatic brain injuries result in production of a misfolded protein, called cis P-tau, that kills neurons, spreads through the brain, and leads to CTE. After a single, isolated concussion, elevated levels of the protein appear to dissipate. But after repeated concussions—the kind, researchers said, "that might occur in contact sports"—cis P-tau production was "robust and consistent," similar to what scientists see after military blast injuries.

Back to Hall of Famers. They play football longer. Harder. Through repeated concussions and subconcussive hits to the head. An old NFL saw holds that "you can't make the club in the tub." Likewise, you don't end up in Canton by sidelining yourself every time a hit leaves you woozy or seeing stars.

Seau played 20 years in the league. Reportedly, the hard-hitting linebacker never suffered a diagnosed concussion; odds are, he suffered dozens, amid thousands of other blows to the head. The hits add up. They added up for Mike Webster, a deceased Hall of Fame center who played in the NFL generation preceding Seau and became patient zero for CTE. They've added up for Tony Dorsett, a living Hall of Fame running back who has been diagnosed with signs of the same disease.

The hits figure to add up for Seau's contemporaries, too—men who often started tackle football during elementary school; played longer college and professional campaigns with less rest and more year-round hitting; missed fewer games and seasons due to better orthopedic surgery and increased use of painkilling drugs; and generally received a larger dose of football directly into their beat-up helmets.

Rebecca Carpenter Mayer is the daughter of Lew Carpenter, a former NFL player and longtime coach who was posthumously diagnosed with CTE. She's making a documentary, Requiem for a Running Back, about her family's painful firsthand experience.

When I shared my rough Hall of Fame numbers with her, she wasn't surprised.

"I know some Hall of Famers who are alive and have problems, but haven't gone or aren't going public," Mayer said. "I'm not a scientist, so I'm not claiming I've conducted a longitudinal study with ten thousand controls over a 30-year period. But from my observations and informal data gathering, the numbers are much, much higher."

Will someone speak out at Canton? It seems inevitable. Especially as the NFL continues to downplay the problem, whistling past the dementia ward. League commissioner Roger Goodell refuses to acknowledge the link between brain injuries and football, while his wife claims that "kids are more likely to get injured riding their bike on the way to (football) practice than at practice." A NFL-affiliated doctor appears on the NFL Network and insists that CTE concerns are "over-exaggerated," and publishes a junk science paper concluding the same. League lawyers insist that the pending concussion settlement can't cover or compensate any new cases of CTE because the condition currently can only be diagnosed after death, can't be definitely linked to football, and may or may not be a real thing, anyway.

Imagine you're related to a Hall of Fame inductee. You're proud of your husband. Want to celebrate your father. But you're also heartbroken. You've experienced mood swings, erratic behavior, inexplicable craziness. You know that football took away the man you loved—slowly first, and then all at once. How much more can you swallow—how many Joe Maroons can you listen to—before you snap? Before you give the league a piece of your mind, no matter who's holding a microphone or what kind of softball questions they ask?

For that matter, what happens when you're left with a stack of medical bills, and the settlement has left you high and dry? Do you still bite your tongue? What happens when researchers develop a CTE test for living people—something that is well on its way—and future Canton inductees who definitely know they have the disease are giving their own speeches?

Eventually, the ceremonial cone of silence will come undone, for the same reason Seau's family is suing the NFL—because keeping quiet is unsustainable. Because the damage already has been done. Earlier this year, Hall of Fame president David Baker announced plans for an ambitious, $1.3 billion expansion that would transform the museum into "the Disney of Pro Football." Included in his vision? An assisted living center for former players in need. It's a kind gesture. It's also a necessary one, a grim acknowledgment of the terrible truth. Junior Seau is just the beginning.