Changing a Culture Against Its Will

An op-ed piece in The New York Times today chastised the NFL medical professionals for acting as if the evidence that concussions and repeated blows to the head can cause long-term brain injury were new. The piece cites research published in the Journal of the American Medical Association in 1928 that came to that very conclusion, from a study of former boxers who had been rendered, as the saying goes, "punch drunk."

How is it, says Deborah Blum, the piece's author, that we are still discussing this problem as new and perhaps unproven, 80 years after the fact?

It's simple. As Upton Sinclair said, "It is difficult to get a man to understand something when his salary depends on his not understanding it."

The NFL, and football in general, has not developed its warrior culture of clashing helmets, hand-to-hand combat, and hard-hitting sacks and tackles in a vacuum. Or even against the wishes of not only its coaches and owners, but the people who come to the coliseum to watch the gladiators grapple. As the Super Bowl looms this weekend, the crowds that gather to watch will be hoping more for battle than ballet. Without the bloodshed, of course, and with some really poetic passes and fakes, speed in motion, brilliant strategy, and breathtaking feats of impossibility in the fray. But battle, nonetheless.

There is money and excitement in the combat, so seeing the medical evidence that the action is not entirely without bloodshed or casualties is a really inconvenient truth. But the culture of football is also so closely linked with its fierce contact element that changing its approach to that element is not a simple switch.

Can a sport's culture change? Given that football players already wear far more padding than they used to, the easy answer is "yes." At least to some degree. And sportscasters are now making an effort not to glorify getting "jacked up" or the sounds of clashing helmets. Nobody gets a sense that they like it; it's just that sportscasters and networks recognize the fact that, somehow, a tide has turned.

But the truth remains that changing any culture is a slow and difficult process--especially in sports where participants get a certain amount of pride in the fact that it's not entirely safe.

Take, for example, the sports of flying and SCUBA diving. Both activities started out as necessarily "macho" endeavors, because the technology for each was pretty rudimentary, and the environments in which they operated were naturally hostile. An article in California Medicine in 1970 (23 years after Jacques Cousteau and Emile Gagnan invented the first regulator and open-circuit breathing system) estimated that SCUBA diving was approximately 96 times more dangerous than driving a car.

I don't have the exact statistics on early flying fatalities, but they were staggeringly high. A fighter pilot's average life expectancy in World War I was something in the order of three weeks. And in Ernest Gann's classic book Fate is the Hunter, he devotes five full pages to a double-column list of early airline pilots who died on the job, just flying the line. And that was after engines and materials had progressed considerably from the days of the barnstormer.

But those early risks meant that those who took on those risks took a lot of pride in survival. The swaggering barnstormers knew they were defying death, as did the diving pioneers of Jacques Cousteau's early era. And so a kind of "macho" culture evolved; one where risk-taking was at least tacitly admired.

Today, the culture associated with SCUBA diving is markedly different. Those who dismiss safety or regulations are not held up as heroes, but as idiots, and there's a much greater focus on safety practices like having a dive buddy, decompression stops, and strict adherence to dive times and depths. Recreational SCUBA diving still has some risk (each year, somewhere around 100 people still die out millions of divers, worldwide), but its safety record, and its culture, have shifted dramatically toward the safety end of the scale.

How did the SCUBA industry improve its safety record so dramatically? Throughout the 1960s and 1970s, a greater emphasis on training and technique was certainly was a piece of it. But improved equipment also meant that the sport could start attracting less physically fit and risk-tolerant people into its midst. And the greater number of clients that allowed meant more money for SCUBA industry operators. So there was an incentive to skew toward safety. There may have been other factors at play, as well. But at some point, a critical mass developed to turn the tide, and the sport developed a culture and reputation as something relatively "safe," with safety as a high priority for its promoters and participants.

Aviation, on the other hand, has remained a tougher nut to crack. It still requires a lot of training and investment of money to become a pilot, and airplanes are far more expensive to buy, and far more complex to maintain, than SCUBA equipment. So despite all the manufacturers' efforts to market the idea of "an airplane in every garage," the pilot population, unlike the SCUBA population, has not grown significantly in the past three decades. As a result, the old guard who pride themselves on their bravery remain a larger percentage of the pilot population. And there is less internal pressure for the culture to change.

Given that football is not about to start attracting less physically fit individuals, and that the NFL is not about to become a recreational family sport, what is perhaps surprising is not that it's taken this long for the tide to start turning with regard to the injuries its players sustain, but that it's even beginning to turn now.

What caused the shift? The fact that football, unlike flying or diving, is a spectator sport. So even if we're not playing on the teams, we--the ticket-buying, bet-placing, television-watching public--influence its culture. And over the past year, enough evidence and stories emerged, with enough publicity, in enough places, that even if we wanted to believe otherwise, it became difficult to avoid the truth. Images of former hero athletes no longer able to conduct their daily lives, or even fill out a form without help, began to tweak our collective conscience. It's hard not to have the realization lodge, somewhere inside, that this heartbreaking damage occurred, at least in part, because of our own selfish desire for entertainment.

If we didn't have those twinges of guilt, the impassioned arguments of people like Gay Culverhouse, the former president of the Tampa Bay Buccaneers who's become a leading advocate for disabled players, would not have had such an impact. Indeed, the NFL's initial resistance to the growing swell of publicity and medical reports this past fall arguing a link between on-the-job head injuries and neurological problems later in life felt very much like an unfortunate delayed reaction on the part of its managers. The public got over its reluctance to see the evidence before the industry did.

Football is still a contact sport, and its appeal will remain rooted in its conflict. So it's unlikely to become domesticated anytime soon. But quarterbacks now routinely wear rib protection. Helmets are larger. Change has already begun creeping in around the edges, if only to protect each team's assets. And we, the spectators, have adjusted. Just as collegiate ice hockey players today can't imagine a world in which face guards didn't exist, we will soon get used to players going off the field and not coming back in the game--and a culture that doesn't glorify the crash of helmets quite so gleefully.

The old guard might complain that the sport is losing its edge. But what we gain is an ability to enjoy the game with a little less guilt. We may still cringe at some of the more spectacular take-downs on the field. But at least our consciences won't have to cringe, as well.

Photo credit: Wikimedia Commons