In the fall of 1893, Joseph Reeves got some bad news. A midshipman at the United States Naval Academy, he also played for the school’s football team, busting wedges and butting heads as an undersized lineman whose nicknames—“billy goat” and “bull”—aptly described his on-field style.
But all those hits had taken a toll. Prior to Navy’s contest against Army, a school physician familiar with Reeves’ history of head injuries and knockouts warned him that the next blow he received could cause “instant insanity,” or even death. Similarly, academy superintendent Robert L. Phythian told Reeves that he couldn’t in good conscience allow him to participate in the game.
Reeves was undeterred. Soliciting help from an Annapolis shoemaker, he took to the field against Army wearing a padded, mushroom-shaped moleskin cap—possibly the first-ever football helmet. The Midshipmen won the game, Reeves went on to become an influential admiral, and the two schools continue to play football against each other. Yet as Army and Navy prepare to meet in Philadelphia this weekend—their annual showdown now doubles as college football’s regular season finale—the same vexing question that once faced Reeves increasingly hangs over both institutions. Given the inherent brain injury risks, does it make sense for America’s military academies to sponsor tackle football?
By now, you are familiar with the practical and moral case against the game. Schools have two fundamental missions: nurture young minds, and ensure student safety. Football runs counter to both, largely because participants endure multiple hits to their heads as a matter of course—and while helmets are good for preventing catastrophic skull fractures, they don’t do much to keep the brain from being jostled. Repetitive head trauma has been linked to a wide spectrum of acute and chronic damage, from concussions to white- and gray- matter abnormalities to neurodegenerative diseases such as chronic traumatic encephalopathy (CTE), which Boston University researchers have found in the brains of 48 of 53 former college football players they’ve examined posthumously.
Of course, this all applies to Alabama and Harvard just as much as it does to Army and Navy. But for the service academies, Air Force included, the trouble with football runs deeper. Civilian institutions are sending their graduates off to work on Wall Street and for Snapchat; the academies are sending theirs to fight in America’s ongoing wars.
The signature wounds of those conflicts, as it happens, are traumatic brain injuries. The Department of Defense and the Defense and Veteran’s Brain Injury Center estimate that 22 percent of all combat casualties from Iraq and Afghanistan are the result of brain injuries, often caused by blast exposure from weapons like improvised explosive devices.
As is the case with football-induced brain trauma, there’s a good deal of scientific uncertainty about the underlying mechanisms of its blast-induced counterpart—as well as how those injuries manifest as clinical symptoms that can span a gamut from chronic headaches and ringing in the ears to mood disorders and suicidal ideation. Is a soldier who can’t sleep and has trouble remember things suffering from post-concussion syndrome? The early stages of a serious neurological disease? Post-traumatic stress disorder? A combination of all or some of the above? Some of this debate isn’t new: the term “shell shock” entered the medical lexicon during World War I, only to be subsequently dismissed by doctors who wrote off veterans’ debilitating symptoms as the result of emotional and psychological frailty.
Blasts are hardly the only source of brain injuries for soldiers, who suffer head hits and other insults in a variety of ways—one researcher I recently spoke with described examining a veteran with cognitive impairment who had made hundreds of jumps as a paratrooper instructor and never been diagnosed with a concussion, but said he had “his bell rung” every time he landed. Scientists have amassed sufficient evidence to prove that none of this is good, and studies have linked brain injuries in veterans to potentially premature brain aging, lower levels of glucose metabolism in the cerebellum, vision and hearing problems, and greater risk of epilepsy and Alzheimer’s disease. Another researcher who works with veterans—and who declined to comment on the record about an ongoing study—recently told me that a significant percentage of patients have hormonal deficiencies consistent with damage to the pituitary gland, a pea-sized structure that rests at the base of the brain.
Then there’s CTE. In 2012, researchers from Boston University and elsewhere found the disease in the brains of four veterans—three who had survived single or multiple combat explosions, and one who had a history of concussions from football and vehicle accidents. In the same study, the researchers conducted an experiment on mice to test the hypothesis that blasts could trigger CTE’s signature pathology, toxic tangles of a misshapen protein called tau in specific areas of the brain:
For the animal part of the study, [researchers] developed a 27-foot-long “shock tube” to simulate explosions. At one end of the aluminum tube the researchers attached a device that uses compressed nitrogen to explode a Mylar membrane, generating force equal to the explosion of a 120-millimeter mortar round. At the other end, they tied down mice, allowing their heads to move freely.
The researchers found that shock waves from the blast moving at more than 1,000 miles per hour had no perceptible effect on brain tissue. But the subsequent blast wind, traveling at 330 m.p.h., shook the skull violently in what the researchers called “bobblehead effect.”
When the scientists examined specially stained tissue from the mouse brains under microscopes just two weeks later, they found the telltale signs of C.T.E.
The scientists also found that mice exposed to blasts showed short-term memory loss and declines in learning capacity just a few weeks later.
Back to football. Many scientists suspect that brain trauma can be cumulative and compounding—that is, the more blasts or head hits you endure, the higher your risk of injury and disease. Various studies of contact sport athletes suggest as much; in Boston University’s studies, former NFLers have a higher rate of CTE than players who stopped in college, who in turn have a higher rate than former high school players; another recent Boston University study found that athletes who started playing tackle football before age 12 doubled their risk of developing behavioral problems and tripled their chances of suffering depression later in life.
For now, there’s no formula demonstrating that X number of hits, blasts, or years playing football increases brain damage risk by Y percent. Much more research is needed, and the science of head trauma is in many ways only recently out of its infancy. That said, we already know enough to ask a difficult question of the service academies: if their goal is producing sound-minded soldiers—and protecting those soldiers as much as possible while likely putting them into harm’s way—then why expose them to thousands of unnecessary hits to the head simply for the sake of a sport that’s wholly unessential to military preparedness and national security?
As is the case at other schools, football is a source of communal entertainment, pride, and goodwill for the academies. In 2015, the local economic impact of the Army-Navy game was predicted to be as high $30 million; ratings for the contest were the highest in 15 years. “It delivers an incredible show for the entire country every year,” a Philadelphia sports official recently told the Baltimore Sun. The sport also serves as a military recruiting tool: last year, the Defense Department lifted the “David Robinson Rule”—a minimum two-year postgrad active duty requirement for academy athletes—in order to allow them to play professional sports immediately, provided they serve for eight to 10 years in the reserves. Why the change, which allowed Navy quarterback and Heisman candidate Keenan Reynolds to play in the NFL preseason for the Baltimore Ravens? Public relations. “The value that we get far outweighs the active duty service commitment,” then-Secretary of the Navy Ray Mabus told Sports Illustrated.
With football in particular, there’s a longstanding and sentimental sense that the game’s inherent violence helps prepare players for actual combat—or, as Gen. Douglas MacArthur once put it, “on the fields of friendly strife are sown the seeds that on other days, on other fields will bear the fruits of victory.” Could the academies ever conclude otherwise? In the short term, it seems unlikely. Critics inside and outside the military have argued that football compromises admission standards, detracts from the core mission of preparing officers for active duty, and costs too much money. And still football goes on.
Two years ago, Navy running back Will McKamey collapsed during practice and later died of brain swelling and a brain bleed; the 19-year-old had suffered a similar injury in high school. Football continued. That same year, the New York Times reported that full-contact boxing classes—which are required for first-year students at all three academies—produced nearly 200 documented concussions over a three-year period, leading some parents and policymakers to question the practice, which military leaders long have believed teaches courage and perseverance. “No brain trauma is good brain trauma — even if there are not diagnosable concussions, there can still be lasting damage,” Boston University’s Robert Cantu, a concussion and CTE expert, told the Times. “Maybe you could justify it if there is some crucial life-saving skill that can’t be taught in any other way. But short of that, it’s absolutely stupid.” Last year, West Point made boxing mandatory for first-year female cadets, too.
So far, so stupid. But it’s easy to imagine a future in which increased medical and scientific knowledge about the links between head trauma and brain harm—the steady drip of small studies all pointing in the same dismal direction; the ability to image CTE in living people—might change the academies’ contact-sport calculus. After all, they have to worry about combat readiness. “Executive function and multitasking are important,” one researcher told me. “This kind of ability to think is difference between life and death. [A solider] needs to make split-second, complex decisions—deploy this weapon at this moment at this time, decisions that could impact their mission at national and international levels… When you damage those parts of your brain, it’s very well known what happens to your ability to think. People make really crazy decisions. Do we want that? Do we want to damage our best assets? These are serious questions.”
Most schools can hide behind a NCAA concussion settlement that doesn’t cover medical care. They can duck paying worker’s comp to injured players thanks to the made-up, quasi-legal term “student-athlete.” But through the VA, the military is on the hook for soldiers’ long-term medical costs. And brain injuries are expensive. If the academies conclude that football’s brain risks can’t be mitigated—if the price can be deferred, but not denied—then the sport’s place at Army, Navy, and Air Force will become increasingly untenable, both as a matter of good conscience and as an upside marketing play with unjustifiable physical and financial downside. The Army-Navy game is a time-honored tradition. So were horse-mounted cavalry.
In early 1894, just months after Bull Reeves’s final college contest, Secretary of War Daniel S. Lamont and Secretary of the Navy Hillary A. Herbert agreed to cancel Army-Navy. The rivalry, they agreed, was a “bad influence,” an overheated, out-of-control affair that had nearly provoked an actual shooting duel between an admiral and a brigadier general. Five years later, the game was reinstated; like Reeves, Army and Navy decided to strap on their helmets and roll the dice. Football’s allure was simply too strong, and has been ever since. The question is, for how much longer?