Many times, I employ the disclaimer that I am not an attorney when I discuss legal matters. Today, I want to be clear that I am also not a physician. The topic is the shooting last week at NFL HQs in NYC; the working hypothesis for investigators here is that the perpetrator wanted to get into NFL HQs to do some shooting there but instead got on the wrong elevator to the upper floors. According to police, the shooter – – now dead himself – – had a “history of mental illness” and that he had a note on his person indicating he had a beef with the NFL because he suffered from CTE.
In that simple paragraph above, there are triggers for several vocal segments of society spring-loaded to push their narratives:
- We have to do more to treat people with mental health issues,
- We need to have stricter gun laws
- CTE is caused by football and CTE is awful, ergo, football is awful.
Yes, we do need to do more in terms of therapy for folks who are mentally ill. There were fewer of those sorts of folks out and about in society when it was legal to commit adults to “mental institutions” prior to their being convicted of crimes; if I recall correctly, that practice was ruled out by the courts in the 1960s or 1970s. Mental health issues are much more difficult to diagnose without the cooperation of the “patient”; it is not like chicken pox where the “patient” presents with red spots all over his/her body. And, sadly, lots of mentally ill people do not present themselves to competent medical professionals.
I am ambivalent about the idea of “stricter gun laws”. The ineffectiveness of the current gun laws in terms of keeping the weapons out of the hands of mentally ill people makes me wonder if such a goal is achievable. At the same time, anything that might separate guns and people who are mentally ill would be a good thing for society. Frankly, I think the main issue here is that the two sides of the “gun ownership issue” are so dug into their positions that meaningful compromise has become extinct.
It is the third narrative above that really bothers me, however. CTE – Chronic Traumatic Encephalopathy – is a brain condition where there are “abnormal protein deposits” found in the brains of dead people who suffered “repeated brain trauma” while alive. CTE is even more difficult to diagnose than “run of the mill mental illness” because as of today, the only way to know if a person had CTE is to wait for him/her to be dead and the brain of the corpse to be analyzed. My amateur reading about CTE says that there is debate within the medical community of experts about the causal relationship between “repeated trauma” and a diagnosis of CTE.
Please do not take my uncertainty about CTE and causality as a way to accuse me of fostering some sort of conspiracy theory wherein the NFL – – in conjunction with the Trilateral Commission and the Illuminati of course – – are keeping a lid on understanding here because CTE serves a nefarious purpose on their parts. However, CTE is a convenient excuse for erratic behavior since the only way to deny its existence would be for the shooter in this case to be rendered “unalive” so that his brain can be excised and examined. I certainly do not know if the shooter had CTE – – and I suspect that he did not know that he had CTE but in whatever erratic construct of the universe existed in his mind, CTE was his preferred excuse.
Now let me go waaay out on a limb and talk about CTE and four other “neurodegenerative conditions” that are more well understood:
- ALS: It presents with pronounced motor symptoms and few psychiatric symptoms. It can be detected by brain imaging but can only be confirmed post mortem.
- Alzheimer’s: It presents with mild motor impairments and few psychiatric symptoms. It too can be detected with brain imaging in living patients.
- Huntington’s: It presents with definite motor symptoms and usually depression. Importantly, this is a genetic condition that can makes the condition diagnostic in living beings.
- Parkinson’s: It presents with definite motor symptoms, but psychiatric involvement is rare. It can be conclusively diagnosed in living beings.
We are not in medical school here; so, what’s the point of all this? These “other” neurodegenerative conditions” can be diagnosed in living persons; CTE cannot as of now. So, I think it is important not to get out ahead of science-based understanding of what CTE is; what it is not; and what causes it to happen.
CTE is a medical term for a condition that had a street definition long before anyone thought of describing something as “neurodegenerative”. When I was a kid, people referred to some retired boxers as being “punch drunk”. Their words were slurred; they moved less fluidly than other people their age; they might have memory issues or flights of fancy. Common folks who had never studied medicine chalked that up to “too many blows to the head”. Lyndon Johnson once said he thought Gerald Ford had played too much football without a helmet; LBJ did not mean that as a diagnosis or as a compliment.
CTE is a real condition – – but it may not be nearly as widespread as one might think because there may be sample bias in the brains donated for pathological analysis. That is why I am not one to jump on the bandwagon of CTE, being endemic to the population of anyone who ever played football – – or soccer for that matter. Let science march on …
I do wish, however, that there was a magic wand somewhere that someone would wave about and magically keep guns out of the hands of mentally ill people. So, let it be written and so, let it be done…
Finally, let me close with this adage:
“Don’t let your mind make your body believe that it must bear the burden of your mind’s worries.”
`But don’t get me wrong, I love sports………