Story highlights
- Dr. Elizabeth Nabel is the NFL's first chief health and medical adviser
- Nabel has already recommended more research on concussions and mental health
- She hopes to make football a safer game to play for athletes of all ages
(CNN)For years, pro football players and their families have been trying to warn us about the devastating effects of suffering repeated concussions. They've reported memory problems, outbursts of aggression, even suicidal and homicidal tendencies.
Only recently have the rest of us started to listen, as black and white data begins to paint a clearer picture of the concussion crisis in football.
In April, a federal judge gave final approval to a class-action lawsuit settlement between the NFL and thousands of former players who accused the NFL of hiding the dangers of concussions.
No doubt at least in part because of the flood of criticism the NFL received over its handling of the issue, the league in February announced it was appointing its first chief health and medical adviser. Dr. Elizabeth Nabel, president of Brigham and Women's Hospital in Boston and a professor at Harvard Medical School, is tasked with overseeing the league's medical strategy in advancing player safety.
Nabel's credentials are impeccable.
For years, she served as director of the National Heart, Lung and Blood Institute, under the prevue of the National Institutes of Health. During her tenure, she played an integral role in launching the Heart Truth campaign, perhaps better known as the "red dress" campaign. The initiative, which remains one of the country's most visible health awareness programs, aims to educate women about heart disease and to encourage them to take action to improve their heart health.
But Nabel is a cardiologist, not a neurologist, neurosurgeon or even a neuroscientist. That has led many to wonder: Even though her career accomplishments are impressive by just about anyone's standards, is she the right person for this particular job?
Explain it to me: Concussions 02:38
"I've had a lifelong interest in health and wellness ... and also I'm someone who loves sports," Nabel told CNN's Dr. Sanjay Gupta in her first sit-down interview in her new role. "I believe in the power of physical activity, and joining the NFL as a strategic adviser was just one opportunity -- or one avenue -- for me to really apply those interests in health and wellness ... to professional sports."
'The NFL has a responsibility'
The following is a condensed version of Gupta and Nabel's conversation at The Brigham in Boston on July 16:
Gupta: A lot of people will be on your team, but did you think it was important to have a head or neck or spine person in this job?
Nabel: The commissioner was interested in having someone to stand back and look at the health and safety issues broadly, so that certainly includes head, neck and spine. That includes medical and cardiovascular, youth football, advisory committees, etc.
So I think the commissioner was interested in someone that had a firm understanding of medical research and sees the full spectrum of medical care on a day-to-day basis.
Gupta: Do you have specific goals outlined for yourself? You've been in the job for about six months. What do you think the next six months are going to look like?
Photos: Athletes and CTE
Photos: Athletes and CTE
Former pro football player Kevin Turner, shown here during a 1998 NFL game, had the most advanced stage of CTE when he died in March at the age of 46. Dr. Ann McKee of Boston University and the Concussion Legacy Foundation said that Turner's CTE brought on amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease.
CTE stands for chronic traumatic encephalopathy, a neurodegenerative disease associated with repeated head trauma. Scientists believe repeated head trauma can cause CTE, a progressive degenerative disease of the brain. Symptoms include depression, aggression and disorientation, but scientists can definitively diagnose it only after death.
CTE stands for chronic traumatic encephalopathy, a neurodegenerative disease associated with repeated head trauma. Scientists believe repeated head trauma can cause CTE, a progressive degenerative disease of the brain. Symptoms include depression, aggression and disorientation, but scientists can definitively diagnose it only after death.
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Photos: Athletes and CTE
BMX star Dave Mirra, who was found dead of a self-inflicted gunshot in February, was found to have CTE.
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Charles "Bubba" Smith, a former football player and actor who died in 2011, was also diagnosed with CTE. Smith played for the Baltimore Colts, the Oakland Raiders and the Houston Oilers.
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Former Minnesota Vikings linebacker Fred McNeill died in November 2015 due to complications from ALS. However, an autopsy confirmed that he suffered from CTE. What makes McNeill's case even more remarkable, though, is that he was potentially the first to be diagnosed while alive. Doctors used an experimental new technology to examine his brain.
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Oakland Raiders quarterback Ken Stabler, a former NFL MVP who died in July 2015, suffered from CTE, researchers at Boston University said.
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Kansas City Chiefs linebacker Jovan Belcher shot and killed his girlfriend before killing himself in December 2012. Pathology reports show he probably had CTE.
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Hall of Fame offensive lineman Mike Webster was the first former NFL player to be diagnosed with CTE. After his retirement, Webster suffered from amnesia, dementia, depression, and bone and muscle pain.
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The death of 36-year-old Pittsburgh Steelers offensive lineman Justin Strzelczyk put the link between football and CTE in the national spotlight. Strzelczyk was killed in a 2004 car crash crash after a 40-mile high-speed chase with police in New York.
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Evidence of CTE was found in the brain of football player Lew Carpenter after his death in 2010 at the age of 78.
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Pro Football Hall of Famer Louis Creekmur, who played for the Detroit Lions from 1950 to 1959, suffered decades of cognitive decline before his death.
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Linebacker John Grimsley of the Houston Oilers died of an accidental gunshot wound to the chest in 2008. Analysis of his brain tissue confirmed damage to the neurofibrillary tangles that had begun to affect his behavior and memory.
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Photos: Athletes and CTE
Chris Henry played five seasons for the Cincinnati Bengals before dying at the age of 26. He died after falling from the bed of a moving pickup during a fight with his fiancée. His young age prompted concern over how quickly athletes start to suffer from CTE.
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Offensive lineman Terry Long of the Pittsburgh Steelers committed suicide by drinking antifreeze. Although the antifreeze caused swelling of the brain, football-related brain injuries were a contributing factor to his death.
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Pro Football Hall of Famer John Mackey suffered from dementia for years before dying at the age of 69.
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Ollie Matson, who played 14 NFL seasons starting in the 1950s, suffered from dementia until his death in 2011.
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Andre Waters spent most of his 12 seasons with the Philadelphia Eagles before his suicide at age 44.
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Tom McHale of the Tampa Bay Buccaneers, right, died in 2008 of an apparent drug overdose at the age of 45.
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Junior Seau took his own life in 2012 at the age of 43. The question of CTE came up immediately after his death; scientists at the National Institutes of Health confirmed the diagnosis in January 2013.
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Pro wrestler Chris Benoit was found dead at his suburban Atlanta home along with his wife, Nancy, and son in an apparent murder-suicide. Testing found that the damage to his brain was similar to that of an elderly Alzheimer's patient.
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Reggie Fleming, who played for six NHL teams, was the first hockey player to be diagnosed with CTE.
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Hockey player Bob Probert was found to have CTE after dying of heart failure at the age of 45.
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Ryan Freel became the first Major League Baseball player to be diagnosed with CTE nearly a year after he committed suicide at age 36.
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Nabel: I joined the league in February and spent the first three months learning. After the first 100 days, I gave three recommendations to the commissioner, and those recommendations were to continue to fund medical research, looking particularly at the acute and chronic effects of brain injuries.
The second recommendation was to better understand the mental health issues in current and former players and understand how that relates to physical health.
And third, communication. I'm a sports fan. I'm a mom. I had no idea what was going on within the NFL and the tremendous work that's going on for the past four to five years. My other recommendation to the commissioner was to get out there and tell that story, so the public has a much better understanding of what the league is doing to improve health and make the game safer.
Gupta: When you look at this position, a few years down the road, do you think the impact of your job -- what you do here -- is going to be purely with the NFL, or is it going to be with other parts of our society, too?
Nabel: Because of the prominent role that the NFL has in our society, I think that the NFL has a responsibility -- one could say an obligation -- to really focus on player health and game safety. And by doing so, it would have a watershed effect on football, reaching into the NCAA and down into youth football. But I think the watershed effect extends to all sports and will affect men and women, so I think that's a good thing.
Gupta: For parents who may be saying, "I'm not sure if I should let my kids play football. I'm not sure how safe it is. I'm hearing a lot of bad things." Is Dr. Nabel going to reassure me? What is your position, and how safe is the game of football, as things stand now?
Nabel: I'm going to say, Dr. Nabel is going to focus on improving the health of the players and making the game as safe as possible. Dr. Nabel is going to focus on understanding what are the benefits and what are the risks and what are the questions that you as a parent should ask.
I'm a mom and have a son who played eighth-grade football. If I had young children today, I would be asking: Is the team that my son is going to play on connected to USA Football? Is there a certified athletic trainer on the sideline? Have the coaches, parents, the players and the trainer been educated around sports injury -- particularly head injury and concussion? What does my pediatrician think?
I would ask those series of questions, then weigh the pros and cons and make a judgment accordingly.
Gupta: If you have those precautions in place -- a trainer on the field, specific education for the trainers and coaches -- all that's in place. Do you think it's OK to play football then?
Nabel: I'll tell you what. Any contact sport is going to have a risk of injury. We see that, for example, in women's soccer.
I think what's critical is knowing how to play the game right, knowing how to play the game safely. If you understand the best way to tackle, if you've got good equipment in place and you know how to recognize injuries, then you're going to know how to play the game as safely as possible. And if you're really driven to play the game, then I would feel comfortable.
'My eyes are always out there'
Nabel says she already attends "a lot" of games and will continue to do so.
"I might have watched the game from purely an entertainment perspective in the past, but now I clearly watch the game from a safety perspective," she said. "My eyes are always out there watching the players, looking for potentially harm or injuries."
When asked to choose her favorite team, Nabel didn't hesitate in naming the New England Patriots. After all, she does live and work in Boston.
