RICHMOND, Va. — It took four suicides to raise public awareness of how devastating head injuries can be in football.
It took brain injuries from countless improvised explosive devices in Iraq and Afghanistan to help turn what was called a "silent epidemic" into a very vocal one.
Since 2006, four former NFL players have committed suicide by shooting themselves: Andre Waters, Dave Duerson, Junior Seau and Ray Easterling, who killed himself in his Richmond home.
Studies of the brains of Easterling, Waters and Duerson showed damage from repeated blows to the head. The initial autopsy on Seau's brain did not list concussions or brain injury as a contributing cause of death. Samples of Seau's brain tissue have been sent to the National Institutes of Health for more advanced studies.
This month, the NFL gave a $30 million grant to the NIH for research on brain injuries and other medical issues related to athletics. This comes despite the NFL repeatedly seeking to have dismissed a class-action lawsuit that carries the name of Easterling and more than 3,800 other former players claiming the league knew about the serious side effects associated with concussions for years but never told players.
But this is a problem that goes far beyond football and sports. Head injuries and their long-term effects are a major issue for the U.S. military. But the two most common causes of head injuries are commonplace — falls in the home and accidents on the road.
According to Susan Connors, president and CEO of the Brain Injury Association of America, someone in the United States suffers a traumatic brain injury every 18.5 seconds.
"We used to call it the silent epidemic because no one was talking about it," Connors said. "You can't look at someone and tell he has a brain injury. Fewer and fewer who suffer these injuries have no physical disability. What they have is cognitive disability.
"Now, we're more likely to call this an invisible epidemic. You can't see it, but at least people are starting to hear about it.
"The only cure for a brain injury right now is prevention. In the meantime, the most effective treatment is rehabilitation. Someday, we will find a cure."
Dr. Gregory O'Shanick has been involved with head injury research and treatment since 1981. The Richmond neuropsychiatrist is acutely aware of the challenges of treating head injuries.
"It was not an issue that was in front of the public until (ABC television news correspondent) Bob Woodruff suffered such an injury, and we became aware of (improvised explosive devices) in Iraq and Afghanistan," said O'Shanick, medical director of the Center for
Neurorehabilitation Services and medical director emeritus of the Brain Injury Association of America.
"These injuries do not discriminate in terms of age, gender, race or economics. They do not require specific genetic loading. All that is required is being in the wrong place at the wrong time."
And that's more likely to be at home or in your car than on the football field.
"No. 1 is falls, an indication of our aging population. No. 2 is motor vehicle accidents," O'Shanick said.
"Motor vehicle accidents were No. 1, but tougher drunk driving laws and (seat belts and airbags) have lowered the numbers. For those ages 15-24, the primary causes are motor vehicle accidents and contact activities. And there is roughly a 2-to-1 male to female preponderance. For those ages 5 years and below, the No. 1 cause is abuse."