On Thursday, Dr. Ann McKee, the Boston University neuropathologist who has diagnosed chronic traumatic encephalopathy (CTE) in dozens of deceased NFL players, gave a slide presentation that left physicians in the audience gasping.
McKee showed that Aaron Hernandez, the former New England Patriots tight end, who was convicted of murder in 2015 and committed suicide in prison in April of this year, had levels of CTE — a degenerative brain disease associated with repeated impacts to the head — never seen in someone younger than 46 years old.
Hernandez was 27 when he died. Images of his brain left no doubt that he had a significant buildup of tau proteins (named after the Greek letter) that destroy brain tissue in the frontal lobe — the area of the brain that moderates behavior, judgment and decision making — and the hippocampus, which controls memory.
The NFL, the unquestioned king of American sports about a decade ago, is facing all sorts of problems this season. Ratings are down 5.5% through the first nine weeks of 2017, according to Nielsen.
President Trump has regularly chided the league for refusing to punish athletes who, in an effort to raise awareness of social injustices, choose not to stand during the national anthem. Some fans are boycotting the league because of the anthem controversy. Papa John’s, the pizza chain, is blaming the NFL’s failure to quell the anthem issue for lagging sales of its pies. Colin Kaepernick has meanwhile filed a collusion grievance against the league; Kaepernick, the ex-San Francisco 49ers quarterback who started the protest movement last year, remains unemployed while teams sign quarterbacks with far inferior performance metrics.
Then there’s the dizzying Ezekiel Elliott case, which has wormed its way through the court system, stealing even more attention from the games on the field. In August, the NFL suspended Elliott for six games due to an alleged domestic violence incident. Elliott has appealed the decision in court and has been able to stay on the field during the litigation; on Thursday, however, the U.S. Court of Appeals for the Second Circuit terminated a temporary stay on the suspension.
Elliott will now sit out at least the next four games: he’ll return to court on Dec. 1. Cowboys owner Jerry Jones, aggrieved by Goodell’s punishment of his star running back, has reportedly threatened to sue the NFL over Goodell’s contract. He’s claiming that members of the NFL’s compensation committee misled owners about the number of votes needed to approve an extension for Goodell. (Jones was once one of Goodell’s biggest supporters. But Goodell wasn’t benching a marquee Cowboy in those days.)
As if the off-field activity wasn’t painful enough for the NFL, the on-field product hasn’t been all that compelling. Injuries have wiped out the seasons of a bevy of superstars, like New York Giants wide receiver Odell Beckham Jr., Houston Texans defensive end J.J. Watt, and Deshaun Watson, the Houston rookie quarterback who was tearing up the league before he tore a knee ligament in practice on Nov. 2. Aaron Rodgers broke his collarbone in October; he could return this season.
To be sure, some of these woes and squabbles largely serve as sideshows. But the Hernandez case can do much more damage to the NFL long-term. Football is now a public health issue; safety remains an existential threat to the game. Hernandez wasn’t some grizzled veteran offensive lineman who pounded heads on every play from scrimmage. He spent only three years in the NFL.
In her presentation, McKee offered one crucial caveat. She said she couldn’t “connect the dots” between Hernandez’s severe diagnosis and his violent behavior. She said Hernandez also had a genetic marker associated with brain diseases. Still, the results raised alarms. “We can’t take the pathology and explain the behavior,” McKee said. “But we can say collectively, in our collective experience, that individuals with CTE, and CTE of this severity, have difficulty with impulse control, decision-making, inhibition of impulses for aggression, emotional volatility, rage behaviors.”
The question on the minds of so many parents across the country — would you let your son play football? — just got much more difficult to answer. Or maybe not. Maybe now it’s a harder no.
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Write to Sean Gregory at sean.gregory@time.com