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From The New York Times, I'm Michael Wilborrow. This is The Daily. They started playing football as young as six years old. They died in their teens and 20s with CTE. Today, my colleague John Branch, on the growing body of evidence that a disease many believed was reserved for professional athletes is also afflicting young amateurs. It's Tuesday, December 19th.

John.

We wanted to talk to you because you have spent many years trying to understand what's been happening to the brains of athletes who play contact sports. You have been talking to researchers who study those brains, and those researchers recently told you about a major new discovery. So tell us about that.

Yeah. So what we're talking about, and we're talking about brain damage in contact sports athletes, is CTE, which stands for Chronic Traumatic Encephalopathy. And what this is, it's the brain disease, progressive brain disease caused by concussions and hits to the head. And for the most part, CTE has been connected with, at least in terms of the public perception, aging football players, Hall of Fame style football players, Ken Stabler, the Earlurl Morals, people like Junior Sayau, there are now 300 and some former NFL players who have been posthumously diagnosed with CTE. But what's new now is that for the first time, these researchers have gathered this a growing subset of young brains of young people, people under the age of 30, into a profound study. And it shows things that we knew or suspected, but it puts it in very stark terms. Young athletes, even teenagers as young as 17 years old, are getting CTE and feeling the effects of it.

Wow.

And these researchers at Boston University have found cases of CTE in more than 60 brains of young athletes who have died. Some of them were really advanced cases.

Which is genuinely startling. That would seem to completely change how we think about the very idea of CTE.

Yeah. I think where this changes the mindset for us is this is afflicting people who are just in high school, who are maybe just in college, who had no aspirations to go to the pros. These are people who starting from a really young age, suffer the same kinds of symptoms that we've seen in the pro players, things like memory loss and impulse control, insomnia. They're having troubles with substance abuse and severe depression, and sometimes ultimately even suicide.

And once, John, you absorb this new research and the implications of it, what do you do with all that?

We wanted to go talk to some of these families whose children had been part of this data group. These are families who have watched their child decline for reasons they couldn't explain. And they now have information that tells them a little bit more about what might have been behind those confusing years, all those signs that they couldn't make sense of. And we wanted to understand how they processed that new information, knowing now what that answer might be.

And which of those families stands out to you?

Well, there are several. All right, well, thank you both. But I would say that the family of Hunter Foraker. Let's start chronologically. Tell me about- His parents, Bill and Kim Foraker, still really stick with me.

In 1992, Hunter was born in May.

Why the name Hunter?

Bill came up with that name. Bill, can you tell us why?

It was a Colorado-y, and as it turned out, it was perfect for him.

Hunter was a kid who grew up in Colorado. And when I went to visit his parents, they really reminished about how great his childhood was.

We lived in the mountains. We had a chocolate lab named Hershey, and we hiked every day.

We striped. How much he loved the outdoors.

Fishing, hunting, skiing.

How much time they spent skiing and hiking and doing things up in the mountains.

Hunter was definitely a Colorado boy. Yeah. His parents.

Described him as quiet, but also very mature, never a troublemaker. And when he was seven years old, he began to play tackle football. The name.

Of the team was Cougars and Bill was the coach.

Yeah. Go, Hotdog!

Go, go, go!

His father, Bill, thought the best thing to do would be to coach my own child, to teach him the game, to teach him how to play it safely.

I was concerned if he was going to play a contact sport like football that I was there to supervise.

And so he coached his son all the way until his son got up to high school.

He was lights out. He excelled. I mean, at levels that they'd never seen before in a kid that young in high school.

He becomes a star at Molen High School, which is one of the big powerhouse football programs in Denver. And sometime in his mid teens-Was.

It during his sophomore summer?

Yeah. Hunter sustained a concussion, a pretty serious concussion.

I never knew during the scrimage. I knew he was acting a little different, but nothing alarming.

He was woozy afterward, seemed to have shaken it off the way a lot of kids do. But on the way home that day-.

He started to vomit.

-he threw up in the car. The forakers then took him to the hospital and then to his pediatrician.

His pediatrician looked him over and he said, Hunter, you're a big kid. You're tough. You got your bell run. Go get them. You're going to be an all-American. In other words.

Go back.

To the football field. Go back to the football field. And that's exactly what Hunter does. He becomes the captain of the football team his junior and senior year. That football team goes on to win a state title, and Hunter is an all-state player. But off the field, there were some challenges. Some of them felt like normal high school stuff to the Four Acres, and some of them didn't, especially in hindsight.

There.

Were some signs of him getting a bit of a temper. He began to drink a little bit, and a lot of kids do. How big of a concern is it? He was also having nightmares.

In high school, he had horrible nightmares. I asked him to please explain to me these nightmares. And he said, They are so effing bad. I cannot begin to tell you what they are.

And so he started getting some therapy, and they thought he was okay. He was doing well in school. He's playing well in football. But Hunter was not the type of person who thought he would ever go professional.

I think football to Hunter meant a way to a higher education.

A lot of these kids might dream of the NFL. That was not really his dream. His dream was actually for the best education possible. And so he saw football as potentially a useful tool to get him into a better school. And he fell in love with Dartmouth. And sure enough, that's where he went because Dartmouth in New Hampshire reminded him a lot of Colorado with the mountains and the outdoor activities.

And what happens to Hunter once he gets to Dartmouth?

Yeah. So he plays on the JB team his freshman year and does very well. And then during training campus sophomore year, he has another serious concussion.

It took him about a week and a half to really fully recover. He was foggy. He would report serious headaches.

He was really uncomfortable with the way concussions were handled.

Hunter told his parents he had seen some of his other teammates with concussions and saw how they hurried back despite having symptoms.

Then I remember having a conversation with him that it scared him to death that he's witnessed other football players on his team that have had concussions and he knows it, and they would just go right back in.

And he said, You know what? This is not for me. This is not really the reason why I'm here. I'm here to get an education. And he quit football.

So he understood these hits he had been taking as accumulating to something that he no longer wanted to be a part of.

That's right.

And what happens once he walks away?

Well, he continues there at Dartmouth, focuses on his studies, and actually graduates with a double major in environmental science and anthropology. And he stays at Dartmouth to work for the Alumni Relations Department. From Bill and Kim's perspective, he seemed to be doing okay. But there were some worrying signs. Some of the issues that they had seen in previous years from him seemed to be intensifying. He seemed to be drinking more and more. His nightmares seem to be getting worse. He started to talk a little bit about loneliness and depression, which they accounted to the fact that he was still at Dartmouth while most of his friends from the undergraduate years had moved on. And then they get a call.

And he said, Mom and dad, I'm so sorry. I really effed up. And we were like, What did you do? Because this kid was never in trouble. And he goes, Well, I drank too much. I ended up at Hitchcock.

Hunter was at Dartmouth Hitchcock Hospital.

And they told him he was an alcoholic. That's where he first got labeled.

So he spent a year or.

So- Rehab, detox, rehab, and detox. Rehab, detox.

-in and out of rehab, in and out of detox.

It was just the circle.

Drinking became a bigger and bigger problem.

I know the nightmares were horrible, and he was just trying to survive. I think that... I think that was part of the reason he was binge drinking was to get those thoughts out of his mind to clear those thoughts.

What do.

His parents think is happening at this point? How are they making sense of what are they going through?

Well, it's impossible, right? Because they're trying to make sense of small clues, phone calls and notes, things they hear. He's not living with them, so it's hard for them to know. At one point, Hunter told him that he had been diagnosed as bipolar and with depression and anxiety, and he had been given medications.

His weight had dropped by at least 50 pounds. He was just skinny, no muscle tone, unshaven, unkept. Those were alarming signs to us that something was wrong with him. But at the time, we were still hearing from the professionals that he is an alcoholic, and this must just be what happens to one's body.

And then they got a call one day, one winter, when they had not heard from him for a few days. And he was supposedly on a ski trip in Colorado and found out that Hunter had attempted suicide.

He had tried to drink himself to death. His intoxication level was the highest they had ever found a person to be, and they could not believe that he was still alive.

At that point, Hunter goes back into rehab and into counseling. But after a few weeks, he seems to be better. Things seem to be clicking for him.

He had cleaned up. He was freshly shaved. He had a nice haircut. He had on new clothes that fit him nicely. We thought, Oh, he's sober. He's on the right track. He put weight back on him. Yeah, he's turned a corner.

Just to point out how this went back and forth, and just as soon as you think things are getting really dark, now you start to see the light and you start thinking maybe he's moving forward. Maybe this is a positive step here. He actually got a job, a good job in Dallas. And so Kim and the couple's daughter helped move Hunter into an apartment in Dallas.

He seemed so happy. The old Hunter, he was just the old Hunter. And we were thrilled for him.

And they left there and went back home thinking, Hunter is in a really good place. Whatever all that was, he seems to have worked his way through it.

But.

A few days later, he stopped answering texts.

Thursday, we tried to get a hold of him. No answer. Couldn't reach him. Friday, we called him, Hey, let's FaceTime, let's Skype. Text him. No answer.

Over the course of a weekend.

By Sunday, I was frantic. Monday morning, over the top.

They couldn't get a hold of him and finally called the police to do a wellness check.

Finally, hours later. We get a call. We get a call back.

That was it.

That was it.

They found that Hunter had shot himself, that he had taken his own life.

The worst news you ever want to hear. The worst news you ever want to hear, you've lost your child.

So after the police find Hunter, the local coroner goes to the apartment and notices all the football helmets that Hunter has and calls the family and says, Have you considered donating your son's brain for research? The coroner obviously understands there's a connection between football and brain disease. The Foraker family, who had not considered this, turned around at that moment and said, Yeah, we're desperate for answers. We want to know what happened to Hunter. If this helps us understand it, then by all means, let's donate his brain. Hunter's brain ends up in Massachusetts at the same brain bank that has examined the brains of all these famous football players, hundreds and hundreds and hundreds of brains. The researchers then call Kim and Bill and say, Your son had stage two CTE out of a four-stage scale. Severe case of CTE, especially for somebody that age.

And then we started asking questions, of course. What exactly does that mean? What are the symptoms? Then she started telling us. Then it just came together and it was like that was Hunter. That's exactly his actions, his change in his lifestyle, his everything. It just started coming together.

In some ways, they were relieved. They had an answer for what had happened to their son. All these inexplicable things that he had been going through the last few years now suddenly made sense. They could be explained in some way. But it also struck him with a hard piece of guilt because they're the ones who put him into football.

How could we have let our child get harmed to that point? How could we have ever have let Hunter in a sport that damaged his brain to a point that gave him stage two CTE? I mean, that is something an NFL player has.

I feel a tremendous amount of guilt because I was there coaching the whole time.

Ill be right back.

I'm Elyce Hugh.

And I'm Josh Klein. And we're the hosts of Built for Change, a podcast from Accenture.

On Built for Change, we're talking to business leaders from every corner of the world that are harnessing change to reinvent the.

Future of their business. We're discussing ideas like the importance of ethical AI or how productivity soars when companies truly listen to what their.

Employees value. These are insights that leaders need.

To know to stay ahead. So subscribe to Built for Change wherever you get your podcasts.

John, I want to better understand the research at the heart of this reporting that you have been doing. And you mentioned it briefly at the beginning of our conversation, the work of these researchers at Boston University who've been studying the brains of people like Hunter Foraker. So take us more deeply inside of that research and into its specific findings.

Yeah. So this study is focused on brains of young athletes under the age of 30. Since 2008, between 2008 and 2022, they collected 152 of them. What they have to do is to take them into a lab and they literally slice them into really thin sheaths and put them underneath a microscope. What they're looking for is the buildup of what they call tau proteins. What Tau proteins do basically is tangle the neurons in the brains, not unlike what we see with older people who have dementia or Alzheimer's. So the researchers take a look at slices of the brains from the 152 samples that they have of people under 30 years old, and they find CTE in 63 of those brains. A little bit more than 40 % of them had CTE.

That's a lot.

Yeah. It sounds like a staggering number, I think, surprised even the researchers. Now, we have to be clear that this is a biased sample. People are donating these brains because they are looking for answers. So it's in no way to suggest that 40 % of kids who play football or anything else are going to have CTE. But yeah, more than 40 % of the brains that they had had CTE. Among those are athletes who are as young as 17 years old, 18-year-olds with very severe cases of CTE, as we've had as many of these NFL football players and Hall of Famers that we've been talking about. And it crosses a lot of sports. We typically associate this with football, and that's where most of these brains came from, were the families of football players. But there were other sports as well, hockey, me, soccer, boxers, an equestrian athlete, rugby. These are all contact sports that are now seeing increasing numbers of people with CTE, including young people with CTE.

Something you just said seems a little hard to wrap your head around, which is that there are cases where these young athletes have CTE that is as serious as professional athletes, which is very counterint, even a young athlete who plays football for a long time. That doesn't evoke the hits that I think of when I think of professional football. So how do the researchers come to understand that?

Yeah. This is all part of the nasty trick of trying to figure out what CTE is and who gets it and why. The researchers don't know why somebody is more apt to get it, why somebody is more apt to get more severe cases of CTE. Michael, you and I could have the same career. You and I could play football through our youth and into the pros for 20 years. I may have a severe of CTE. You show no signs whatsoever. And part of the difficulty of this is that this does not just involve concussions that we see on TV every Sunday where somebody is maybe knocked out and carted off the field. Cte is the product of subconcussive hits as well. And subconcussive hits are those hits that maybe don't even register to the person who's absorbing them, certainly not to anybody else who's watching. If you think about in the NFL or in football, the offensive line men and defensive line men are banging heads every single play. Cte, they believe, is basically the accumulation of the total force that you're taking. That force can be in several big hits, or it can be thousands of little ones.

And so what you're talking about with kids is when you're putting them into football at the ages of six or seven, those hits add up.

So according to this theory about subconcussive hits, in the case of someone like Hunter, what ultimately mattered to his CTE might not have been those two big concussions. He suffered one at high school, one in college, it may have been ultimately countless smaller hits he took over his career that he didn't even notice all the way back to when he was in Bowie football.

That's exactly right. I mean, his family knows of two big concussions. They don't know if Hunter had a lot of other ones he never owned up to. They don't know if he had a lot of ones that maybe he thought were just minor hits that he felt and maybe made him feel weird for a day or two. And they certainly don't know how many thousands and thousands or whatever the total might be, hits he took in every single practice from the age of seven through the first year or second year at Dartmouth in college. But that's 10 or 12 years or more of football and being hit in the head a lot of times.

Well, given that reality, what do these researchers say about the overall safety of any version.

Of.

Youth contact sport, especially football, but really any of the sports that we've been talking about here?

Yeah. The researchers say essentially don't do it.

Are they that explicit?

Yeah. They believe that, look, in this country, we're not going to stop the hits in the NFL. And at this point, we're probably not going to stop them in college. And maybe even in high school and some of these communities that worship taco football. But one thing they believe we can do is to stop letting kids from the ages of five or six or seven or eight hit themselves in the head, often tell at least they're in high school. So their recommendation is anybody under, say, the age of 14 or anybody before they get to high school should not be playing tackle football. If it really truly is an issue of number of years of exposure to hits, we know most people are not going to go play in college. Very few people are ever going to play in the pros. So how much CTE could we eliminate by just eliminating them tackling when they're young?

In other words, limit the exposure to the four years of high school for most people, which is a lot of years potentially of brain damage, but it's fewer than if a kid starts when they're five or six.

That's exactly right.

I'm curious, are these recommendations, are they focused just on football or do they extend to other youth contact sports?

There are now other sports that are certainly more aware of concussions and even subconcussive hits. An example might be soccer, where a lot of the youth leagues now are banning heading of the soccer ball because soccer players now have been shown to have CTE. Well, they're not hitting each other like football players on every play. Where they're getting a lot of their hits are from just of hitting the ball. And that's a subconcussive hit. And now we know there might actually be a long term ramifications to that.

Right. John, you had mentioned that Hunter's parents, when they learned of his diagnosis of CTE, looked back at his time as a player with a lot of guilt. How have the parents of the other young athletes in this study who were also diagnosed with CTE handle that news? And what did they tell you about how they now think about football and what their kids were doing?

Yeah, there are certainly a lot of families that are on board with the idea that young kids should not play football, at least to a certain age, and they regret what they had their kids do. But not everybody. In fact, we talked to a couple of families who are still deeply involved in football. One of them who lost their son, the father is the head football coach at University of Maryland. He believes football does so many good things for kids that even though his own son had CTE, he is is still involved at the highest level of the game. The 18-year-old who had stage two, his parents say if they had to do it over again, he would still play football.

That's going to be hard for some listeners to wrap their heads around. The idea that a parent whose kid is diagnosed with CTE posthumously doesn't regret them playing football and doesn't want to discourage anybody else from playing football.

Yeah. I think for a lot of people, it seems simple, right? But it's complicated, and it's complicated for these families who are going through the worst thing that any of us could ever imagine. The tricky part of this is that CTE is... There's not a straight line between CTE and the ultimate death of your child. Some families will say, Look, I know CTE maybe had some factors in the decline of my child, but he was going through a lot. There were some other mental health issues. There were changes in his own life. I can't draw a straight line between what happened to him and CTE. Right. And so I wouldn't want to take away what gave my son so much joy that for all those years growing up, those are the best times in his life. And if I can't necessarily say that that's exactly why he's not here anymore, then why would I take that away?

There's something I think ultimately very sad about the way we got to this entire conversation, John, which is, as you said, you can't diagnose CTE when somebodys is alive. The only way we get here is because so many young people suffered so much that many of them took their own lives, donated their brains to these scientists in Boston. Therefore, it feels like the only way we're going to keep getting a deeper understanding of this is through the death of more and more young athletes.

Yeah. Unfortunately, the brain banks are going to grow with the brains of young athletes. I think it's just the fact that CTE is just mysterious enough and intangible enough that people are able to ignore it and think, You know what? It's probably not going to happen to my kid, and I'm not going to be the one that pulls him off the football field because of some fear that is probably unrealistic. But as we found out from these families, it is realistic. And there is a cultural awareness now that didn't use to exist, probably didn't exist 10 years ago, in that even kids today, and certainly families today, increasingly are aware of concussion issues and CTE. One of the families that we spent time with was the family of Wyatt Brownwell. He took his life at the age of 18 and had stage two CT, a very severe case of CTE, the worst that they have seen in somebody so young.

Hello. What this is? This is me explaining what's wrong with me.

But moments before he took his own life, he recorded a video in his car explaining his decision.

My head is pretty messed up and damaged.

To be sent to family and loved ones.

But the voices and demons in my head just started to take over everything I wanted to do because my life for the past four years has been living hell inside of my head.

And he says it's all because of football.

I took a lot of hits through football. A lot of hits through football. Took a lot of concussions. And a.

Lot of times I'm- And all the concussions that he took, including the ones that he never told anybody about.

Dad, I know you're capable of doing this, and I want you to do it.

His last request is to his father.

After my funeral, which will be an open casket, I want my brain donated to be studied. I feel like it'll be closure for me and it'll be closure for you guys to know that maybe Wyatt suffered from brain damage. Maybe that was the reason. So do that for yourself. I would like that to be done.

Basically, Wyatt was predicting his own CTE, and he was absolutely right. Well, John, thank.

You very much. We appreciate it.

Thank you.

We'll be right back.

I'm Aalyase Hugh.

And I'm Josh Klein. And we're the hosts of Built for Change, a podcast.

From Accenture. On Built for Change, we're talking to business leaders from every corner of the world that are harnessing change to reinvent the.

Future of their business. We're discussing ideas like the importance of ethical AI or how productivity soars when companies truly listen to what their.

Employees value. These are insights that leaders need.

To know to stay ahead. So subscribe to Built for Change wherever you get your podcasts.

Here's what else you need to know today. On Monday, Pope Francis gave priests permission to bless same sex couples. His boldest step yet to make the Roman Catholic Church more welcoming to LGBTQ Catholics. It was a major about phase for the church, which has long argued that any official approval of same sex couples amounted to blessing a sin. But the church stopped short of allowing priests to marry gay couples, which remains forbidden. And the governor of Texas, Republican Greg Abbott, has signed a law that permits Texas police to arrest migrants who illegally enter the state from Mexico, setting up a legal showdown with the federal government. Abbott said that such arrests are needed to allow Texas to reduce illegal crossings into the state, which exceeded 60,000 over the past year. But according to Democrats and immigration activists, it would violate the US Constitution, which gives the federal government, not states, the power to enforce immigration law. Today's episode was produced by Will Reed and Alex Stern, with help from Michael Simon Johnson. It was edited by MJ Davis-Linn, with from Rachel Quester. Contains original music by Marion Lasano, Dan Powell, and Sophie O'Landman, and was engineered by Chris Wood.

Our theme music is by Jim Runnberg and Ben Landfork of Wonderly. That's it for The Daily. I'm Michael Mubiro. See you tomorrow.

I'm Josh Klein.

And I'm.

Elyce Hugh. We host a podcast from Accenture called.

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