Clinicians drew in a postmortem conference a full portrait of patient K-0623, based on a detailed questionnaire and research they had conducted into his life. They learned all about the deceased’s happy childhood, his early high school graduation, and his athletic prowess, including his stardom in an elite collegiate football program.
The neurologists, neuropsychologists, and psychiatrists also learned that the subject, known to them for now only by a number, had taken painkillers at one point, so he could keep up an all-too-brief NFL career.
But then the neuropathologist weighed in on her findings: K-0623, she told her colleagues — and the dead man’s family listening in via conference call — had unusual issues in his brain. His frontal lobe, as the Los Angeles Times reported, “had atrophied and the lateral ventricles were enlarged. The changes don’t usually appear until a person is 50, 60, or even 70 years old. Slides from the superior frontal cortex and inferior parietal region, magnified 40 times, revealed scores of brown specks — telltale … lesions. Other slides showed the same thing.”
And so did the family of the late Keith Ellison (shown leftt) get a definitive diagnosis that the troubled 31-year-old Los Angeles resident likely had “CTE, or chronic traumatic encephalopathy, the devastating neurodegenerative disease found in people who have suffered repeated head trauma but can be diagnosed only after death. Football players are its most prominent victims,” the newspaper reported.
Ellison was more than a run-of-the-mill ball player. He had become a star at the University of Southern California as a “hard-hitting defensive back, team captain, and fan favorite” on a top-ranked Trojan team. (USC, on social media, saluted Ellison on his death by Tweeting his 2006 hit for the Trojans on DeSean Jackson, a Cal wide receiver and now an NFL star, see above.) Ellison played for the San Diego Chargers for three years, and had one brother who was a Buffalo Bill, and another sibling who was a football star at Brigham Young University .
The newspaper story, however, details the head-injury risks that football players take on, as well as the pain and sorrow their families may suffer when trying to help one-time standout individuals if their damaged brains fail. Reporter Nathan Fenno also captures the sacrifice that loved ones have made, as others have, to assist medical scientists as they try to derail a debilitating and potentially lethal condition.
For the Ellisons, the pride and joy they took in Kevin’s stellar accomplishment dimmed over time and turned to dismay as his behavior grew ever more erratic. He lived near his mother. He slowly stopped driving, and hard a difficult time keeping jobs. As the newspaper reported:
“He had a headache that never really left. His neck hurt and he felt dizzy. He couldn’t sleep, heard voices, talked to the sky. Sometimes the old Kevin returned, his mother recalled. But she could tell when the darkness approached. His grin faded. His eyes wandered. He took long showers to escape, the sound drifting into the living room.”
Further, Fenno recounted:
“The family traced Ellison’s decline to the middle of 2012. After his NFL career faltered, he joined an Arena Football League team in Washington state. He had started drinking, something he avoided at USC, and took prescription painkillers. In his first game for the Spokane Shock in May 2012, he scored a touchdown. Five weeks later, Ellison ignited the bed in his apartment at the Big Trout Lodge with a marijuana-filled cigar. He jumped out a third-story window, later telling authorities God ordered him to start the fire and would prevent anyone from being hurt. Eventually transferred from jail to a psychiatric facility, Ellison was diagnosed with bipolar disorder and schizophrenia. ‘He would reset. He would falter. He would be hospitalized,’ Camille Ellison, his sister, said during his memorial service. ‘He would feel better. He would start a new job. He would have to quit. He couldn’t work long hours or drive because that required a considerable amount of concentration and his brain couldn’t handle it. Yet, oh, how his spirit wanted it.’”
Ellison eventually did something that took his loved one’s anxiety to exponential levels: Rather than accept psychiatric help and confinement, he bolted. And he disappeared.
A few days later, just before midnight, Fenno reported, “a man wandered onto the northbound lanes of the 5 Freeway in the San Fernando Valley. He waved his arms at passing vehicles. Minutes after a motorist called 911, a Chevrolet Astro minivan hit the man. Paramedics pronounced him dead at 11:36 p.m. He carried a bus pass and wore a USC sweatshirt. The Los Angeles County medical examiner-coroner identified Ellison through fingerprints.”
Researchers in Boston, at the Department of Veterans Affairs, at Boston University CTE Center, and at the Concussion Legacy Foundation, monitor news reports, following cases like Ellison’s. They reached out to the family quickly. The family did not hesitate. With they help of the Los Angeles coroner’s office, they donated Ellison’s brain for study.
It became part of the growing evidence on how serious the consequences can be for repeated head harms, notably the concussions and other brain blows that NFL players suffer. The Boston researchers say, sadly, they have contacted many families seeking organ donations to advance research and care of brain trauma. They’ve become, tragically, well known enough that more families reach out to them these days, then they call loved ones grieving ball players.
The data they have developed don’t bode well for players with repeated brain injury, as Fenno reported:
“[A] study published last year found CTE in the brains of 133 of 136 former pro football players, though the sample was drawn from donations — and families are more likely to donate the brains of loved ones who had experienced difficulties in life.”
Ellison’s diagnosis will add to what medical scientists know about CTE. It will help experts understand more about the brain injury interaction with mental illness, because, as the news article said, “The interplay between CTE and Ellison’s mental health issues wasn’t clear. CTE can be mistaken for bipolar disorder and schizophrenia — Ellison experienced both — or be found at the same time as both conditions.”
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by spinal cord and brain injuries, especially from repeated knocks to the head in athletics or, say, trauma related to car, truck, or motorcycle wrecks.
For some old-school fans, the speed and violence of on-field encounters — whether in football hits, hockey collisions, wrestling falls, or even soccer headers, or gymnastic tumbles — may provide a part of contests’ high thrills. But players, parents, coaches, and leagues have fast learned that head trauma, repeated and even slight, can take a heavy toll — athletics of all kinds are reckoning with this now, with play limits, rule and equipment changes, and more.
The Ellison family, no doubt, can testify to this. It was likely tough on them to watch a loved one’s decline, to make the difficult decision to allow his postmortem study, and to read the details of that process in Fenno’s article. Organ donation and participation in medical studies can be challenging in any circumstance. This family did a tragic service to others, and for them, Ellison himself, and others with CTE, we have much work to do.