“A human being will get concussed at sixty G's. A common head-to-head contact on a football field? One hundred G's. God did not intend for us to play football.” —”Concussion” (movie, 2015)

Actor Will Smith, as Dr. Bennett Omalu, had the theatrical liberty to postulate that repetitive helmeted/head impacts on the football field caused Mike Webster, Justin Strzelczky, Andre Waters and Dave Duerson to take their lives; he charged that they took their lives after they became emotionally unstable because they suffered from chronic ­traumatic encephalopathy (CTE). That theatrical assertion was first chronicled and scientifically postulated by Omalu in a published paper in 2010, when he introduced the notion that suicidality was a clinical feature of CTE. Two years later, in 2012, six former NFL players committed suicide all by self-inflicted gunshot wounds.

Who were Owen Thomas (University of Pennsylvania college player, died at age 21), Zac Easter (high school player died at age 24), Kosta Karageorge (Ohio State player, died at 22) and Michael Keck (high school player died at 25)? Each of these young men played football and committed suicide and was diagnosed with some degree of CTE upon autopsy.

Causation

Over the past seven years, several researchers have published works defining CTE (upon autopsy) as a progressive neurodegeneration associated with repetitive head trauma, which can be staged both ­pathologically and clinically in association with a host of behavioral, mood and cognitive impairments. These scientists have taken the brains of more than 100 deceased former football players and correlated the pathological stages of CTE with the living history of each patient. This study has led to the emergence of four distinct clinical stages of CTE related to the “living ­behavior” of each former player. In correlating the topographically predictable pathological patterns of CTE brain disease into four clinical stages, the following have emerged: