Concussion: Seeking the next Big Tobacco

by Saurabh Jha

ScreenHunter_1711 Feb. 22 10.22As a general rule, if you keep clobbering a body part it may, in the long run, get damaged. This is hardly rocket science. Soldiers marching long distances can get a stress fracture known as “March fracture.” The brain is no exception. Boxers can get “dementia pugilistica.” This is why we frown upon people who bang their heads against brick walls.

Footballers are at risk of brain damage, specifically a neurodegenerative disease known as chronic traumatic encephalopathy (CTE). CTE was described in a football player by forensic pathologist, Bennet Omalu, who performed an autopsy on Michael Webster, a former Pittsburgh Steeler. Webster died of a heart attack but had a rapid and mysterious cognitive decline. Webster’s brain appeared normal at first. When Omalu used a special technique, he found a protein, known as tau, in the brain.

Omalu’s discovery inspired the movie Concussion in which Will Smith plays the pathologist. The Fresh Prince plays convincingly a god-fearing, soft-spoken but brilliant physician, who is up against incredulous colleagues and the National Football League (NFL). The NFL clearly has a lot to lose from Omalu’s discovery. However, the director’s attempt to emulate The Insider, where big tobacco tailgates the scientist, fails at many levels.

This is not just because the NFL is not really Big Tobacco. The NFL is adept at playing to the gallery. Recently, it carried a pink logo to increase awareness of breast cancer. The NFL could have chosen prostate cancer. But solidarity with sisters is better PR than showing solidarity with brothers.

The reason why Concussion fails to ignite memories of Big Tobacco is that there is still a lot we don’t know about CTE, or the precise risks of banging one’s head. Some who play contact sports develop CTE, but many are unaffected. CTE has also been reported in people who haven’t had concussive injuries.

Omalu’s discovery has predictably touched our inner sanctum of social justice. Some want college football to be banned. Pitchforks have been raised full mast against the NFL. A narrative has developed in which the rich, greedy and unethical NFL conscripts young, hapless, unsuspecting men from poor families to inevitable brain damage. Righteous indignation is especially delicious when backed by science.

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How elite soccer illustrates an ancient paradox and a current problem

by Emrys Westacott

The market is efficient. The market knows best. This belief underlies much contemporary theory and practice, especially in the realm of government policy. It is has been used, for instance, to justify privatizing the railways and the post office in the UK, and it forms a central plank in the arguments of those who oppose a government run national health care system in the US. Imgres

The basic idea is simple enough. People express their preferences through their spending habits; they vote with their wallets. If DVDs replace video tapes, or if Amazon puts Borders Books out of business, that is just efficiency in action, with the market performing the function that natural selection performs in the course of evolution. And just as evolutionary biologists do not criticize environmental conditions (although they may sometimes put on another hat and seek to protect threatened species or habitats), so economists, insofar as they are trying to be scientific, will not criticize consumer preferences. About expressed preferences there is no disputing.

But of course, as engaged, concerned, interested, moralizing, and occasionally sanctimonious human beings, most of us do make value judgements about people's preferences. We do this in one of two ways.

1) We normatively judge the preferences themselves. E.g. we criticize people (including ourselves) for drinking too much, eating unhealthy foods, watching stupid TV shows, spending too much time playing video games, or engaging in conspicuous consumption. And we applaud people for learning new skills, cultivating their talents, supporting a local enterprise, or giving to charity.

2) We evaluate how well people's preferences, as expressed through their actions, will help them realize their ultimate goals. E.g. Teachers tell students that if they want to be professionally successful they should study more and party less. Psychologists tell us all that if we want to make ourselves happier we should spend less on ourselves and more on others.

Often, the first sort of evaluation is really a version of the second, but that needn't concern us here. It's the second kind that interests me.

We all often act on specific short-term preferences in a way that produces long-term consequences that are contrary in some ways to what we really desire. The paradox that by pursuing what we think we want we fail to attain what we really want was first explored by Plato in the Gorgias and the Republic.[1] I believe top-flight soccer offers an interesting and instructive illustration of this paradox.

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Football, Finance, and Surprises

As the New Orleans Saints lined up to kick off the second half of Super Bowl XLIV, CBS Sports color commentator and former Super Bowl MVP Phil Simms was explaining why the Saints should have deferred getting the ball after winning the pregame coin toss. Simms suggested that the Saints, 4½-point underdogs to the Indianapolis Colts, would be in a better position were they not giving the ball to future Hall of Fame quarterback Peyton Manning, who already enjoyed a four-point lead and had had 30 minutes to study the Saints’ defensive strategy. Simms had barely finished this thought when Saints’ place kicker Thomas Morstead surprised everyone – the 153.4 million television viewers, the 74,059 fans in attendance, and most importantly the Indianapolis Colts – with an onside kick. The ball went 15 yards, bounced off the facemask of an unprepared Colt, and was recovered by the Saints, who took possession of the ball and marched 58 yards down the field to score a touchdown and gain their first lead of the game, 13-10. The Saints would go on to win the championship in an upset, 31-17.

Although Saints quarterback Drew Brees played an outstanding game and the defense was able to hold a dangerous Indianapolis team to only 17 points, Head Coach Sean Payton received the bulk of the credit for the win, in large part because of his daring call to open the second half. Onside kicks are considered risky plays and usually appear only when a team is desperate, near the end of a game. In fact the Saints’ play, code named “Ambush,” was the first onside kick attempted before the fourth quarter in Super Bowl history. And this is precisely why it worked. The Colts were completely surprised by Payton’s aggressive play call. Football is awash in historical statistics, and these probabilities guide coaches’ risk assessments and game planning. On that basis, didn’t Indianapolis Head Coach Jim Caldwell have zero reason to prepare his team for an onside kick, since the probability of the Saints’ ambush was zero (0 onside kicks ÷ 43 Super Bowl second halves)? But if the ambush’s probability was zero, then how did it happen? The answer is that our common notion of probability – as a ratio of the frequency of a given event to the total number of events – is poorly suited to the psychology of decision making in advance of a one-time-only situation. And this problem is not confined to football. Indeed, the same misunderstanding of probability plagues mainstream economics, which is stuck in a mathematical rut best suited to modeling dice rolls.

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