Burden of Proof

00:00:15
Speaker 1: Pushkin.

00:00:19
Speaker 2: Before we begin, a warning this episode contains material that may be upsetting to some listeners.

00:00:27
Speaker 1: What was tell me a little bit about what Owen was like.

00:00:30
Speaker 3: When Owen was born, he was screaming and his neck veins were out, and the doctor said, this is a Viking. And I think that's kind of the way he lived a lot, you know, that kind of passion, So that's the way he lived.

00:00:53
Speaker 2: The man speaking is Tom Thomas. He's sitting with his wife, Kathy Brewerly.

00:00:58
Speaker 1: She's English.

00:00:59
Speaker 2: Both she and Tom are United Church pastors. They met when they were missionaries in Zambia. They have a son named Morgan, and we're all at Morgan's house just outside of Allentown, Pennsylvania, a bungalow in a tidy subdivision. There are two little children running around at a big friendly dog being big and friendly. Everyone has gathered to talk about Owen, the Viking, the son and brother. Who isn't there. My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. This episode is about Owen Thomas, a young man I never had the chance to meet, about what happened to him, and why we shouldn't forget about it. I went to see Owen's family on a cold winter evening.

00:02:04
Speaker 4: We knew that he was kind of feeling down, feeling depressed in the last well, what would you say, last month or so.

00:02:16
Speaker 5: I didn't know that, well, I didn't know he was depressed.

00:02:19
Speaker 6: I knew he was stressed.

00:02:20
Speaker 4: He was stressed. He was stressed. School, fine classes.

00:02:25
Speaker 2: Owen went full out all the time at everything. His older brother Morgan, says he couldn't keep up.

00:02:31
Speaker 5: Yeah, so we were sort of like opposites.

00:02:33
Speaker 6: I was real good at giving like eighty seventy five percent, and he was not everything. But just like for example, school schooling, he would not take anything less than a plus, a a minus.

00:02:45
Speaker 3: He was pissed as.

00:02:47
Speaker 4: But now we don't know if he was having difficulty remembering things because we never even asked We never asked him that, we never we never even thought that there might be anything cognitive. We just thought this was a somebody who's a tight, a person who's kind of like demanding so much of himself.

00:03:06
Speaker 6: In retrospect, I guess when things like this happened in retrospect, you can always try to look back and say, oh, I should have seen this, I should have seen that.

00:03:17
Speaker 4: But the Sunday night he called, he really sounded depressed. Then he really did.

00:03:24
Speaker 2: And you know, now you.

00:03:25
Speaker 4: Look back, we should have just gotten the car gone right down.

00:03:29
Speaker 1: What did he talk about in that last car.

00:03:32
Speaker 4: Well, it was it'd be my birthday, so he was his wishing me happy birthday. Anna. What did you talk to you about, Tom? He said, I'm failing everything.

00:03:41
Speaker 1: That's what I say.

00:03:43
Speaker 2: When I said at the beginning that we shouldn't forget about Owen Thomas, I'm talking about this, that we shouldn't forget that. He went from clarity and purpose to failing everything. In twenty thirteen, I was invited to give a lecture at the University of Pennsylvania Welcome.

00:04:09
Speaker 7: It is my great pleasure on behalf of Penn's four hundred and fifty Benjamin Franklin scholars to welcome you to the twenty thirteen Benjamin Franklin Lectureship.

00:04:19
Speaker 2: The talk was at a big auditorium at the Penn Museum. I had been assigned a theme proof. That's obviously a big topic. So I thought that this afternoon I would start by asking a relatively simple question which is what level of proof do we need about the harmfulness of some activity before we act? I decided to tell the story of a man named Frederick Hoffman, a remarkable man born in eighteen sixty five in Germany immigrated to the United States. Hoffmann rose to the position of senior statistician at the Prudential Insurance Company. At the time, that was a hugely important job. This was in the years before Social Security or Medicare. Private insurers were the safety net, and because they had to figure out what to charge for life insurance premiums, they had to closely monitor the health of Americans. And that was Hoffman's job. He set out and he would cover the entire country and he would go and visit towns and cities and villages all across this land. And he would interview doctors and hospitals and funeral directors, and he would visit all the major employers, and he would go to the cemeteries and he would talk to people, and he would walk around the town and he would try and get a sense of what people are dying of. Hoffman was one of the first people to sound the alarm about smoking. He was one of the first to describe the terrible health conditions on Indian reservations, But perhaps his most important work concerned what was known at the time as miners asthma. I give a fair number of talks, and one of the things that you can usually tell is if you've lost your audience. And I remember that day pen thinking that I had no idea twenty minutes in I began to panic a little because I'm going on and on about Hoffman, about coal mining, about how big a deal coal was the turn of the century, About how much dust the process of coal mining created, About how coal miners would have coughing fits and spit up this black, inky substance, and they would cough more and more of it the more they mined in the more time they spent in the coal mines. That was absolutely beyond question. The audience is incredibly quiet, and I couldn't figure out if that was because they found the subject as fascinating as I did, or if they were thinking what on earth. The thing that no one could agree on was was that whether that was dangerous? Did it harm the health of someone to inhale all of this dust from coal mining miners? Asthma wasn't bothering the medical community and the mining companies. They said, look, miners have lower rates of tuberculosis than everyone else. TB is a respiratory disease, so maybe cole dust is protective in some way. Another argument was if miners were coughing up dust particles, then their lungs were functioning as they should. So for years and years and years, nobody paid particular attention to the problem of col dust because they had all of these arguments that they used to convince themselves that it wasn't a health risk. And then along comes Frederick Hoffman. Prudential ensured a lot of miners, and if they're dying young, then that was a real problem for Prudential. So Hoffman investigated and in nineteen eighteen he publishes this famous report was called Mortality from Respiratory Diseases in the Dusty Trades, and it comes out. It was published by the Bureau of Labor Statistics by the government federal government in nineteen eighteen. Hoffman was methodical. First, he looked at the government statistics on tiberulosis. He found no evidence miners had lower rates of TB. Then he looked at asthma death rates. They were five times higher for coal miners than for other working men. Hoffmann looked at census data who was still working after the age of forty five. For farmers at the time, almost a third were still working. For miners it was a fifth. If mining was so healthy, why were all the miners disappearing from their profession. So he adds all this up, but he says, look, I don't buy it. I think that this miners asthma's thing is something that we should be concerned about. So here we have the senior statistician from one of the most powerful and important institutions in the country publishing a report on the health of workers in one of the most important and critical industries in the country and saying there's a problem. So what do you think happens? Nothing happens, nothing think whatsoever? And why does nothing happen? Because all kinds of people stood up and read Hoffman's report and said, you've got no proof. Let's give the students at pen credit for their patients. Because this part of my talk went on for a very long time, but I was trying to answer the question at the core of proof, At what point do you act? People argued after Hoffmann published his report that we still didn't know quite enough, that he had a lot of suggestive evidence but not definitive evidence. And that was true, But it was also irrelevant because if you wait until the evidence is perfect and complete, you'll never act. It was not until the nineteen seventies that people suddenly realized that tens of thousands of miners were dying horrible deaths, vastly prematurely because of the dust they inhaled while working.

00:10:14
Speaker 1: In the minds.

00:10:18
Speaker 2: Now, I think we can all agree that that is a appalling story, right, that should never have happened. We should have acted on this in nineteen eighteen. Instead, we acted on this in nineteen seventy five. We look around the room and we say to ourselves, we would never do that, would we We're much too educated and sophisticated and empathetic to ever look at the suffering of someone else and say, oh, we're not going to act until we have proof. But we do do that. All of us do that. Everyone in this room is doing that even as we speak. Now, what am I talking about? I'm talking about football. Owen Thomas, the Redheaded Viking, was a football player. So is his father Tom.

00:11:24
Speaker 3: It was the nineteen sixties. Yeah, so I was a full back, which in the backfield. If you know anything about American football.

00:11:32
Speaker 2: Owen's grandfather played for Millersville University. His older brother, Morgan, played offensive tackle for East Stroudsburg University.

00:11:41
Speaker 1: And then Owen played.

00:11:42
Speaker 3: So I guess we're kind of a football family.

00:11:44
Speaker 1: Yeah.

00:11:46
Speaker 2: On the dining table right in front of me are Owen's helmets from middle school and high school and college, all scratched and battered, lined up in a row.

00:11:56
Speaker 6: It's hard for alignment to be a star, you know, like you running back, quarterback, those are really the stars. But he was definitely a feared player from all angles and people knew who he was, so he was definitely one of the one of the stars.

00:12:09
Speaker 3: He couldn't wait for the season to begin. You know, most most of the football players say, oh, I just I don't want to The.

00:12:17
Speaker 4: First day of practice was would just be like like running, putting on a uniform and running.

00:12:22
Speaker 3: For him said I just can't wait to hit somebody. I just want to hit something.

00:12:25
Speaker 4: And that was that's his own team, that's his own team.

00:12:28
Speaker 2: That when it came time for college, Owen Thomas went to the University of Pennsylvania.

00:12:37
Speaker 6: He was just kind of guy that on a on a bad day when they had to wake up at six seven o'clock in the morning to do a workout and everyone you know, had class and everything. He was the kind of guy that would get everybody motivated to complete the workout and then go on with your day.

00:12:53
Speaker 2: He was named captain of the football team. Seventy six out of the eighty players voted for him. Then, one day out of the blue, in the spring of his junior year, he hung himself in his apartment.

00:13:15
Speaker 4: Tom sent me a text message except I was listened to an a lecture, so saying call me. Well, there are all these messages, call me, call me, call me.

00:13:26
Speaker 2: They drove down to Philadelphia, they went to identify their son's body in the hospital, and in the car on the way back on this terrible, terrible day, they got a call from someone named Chris Newinski. Newinski is a former college football player with a PhD in neuroscience who runs the Concussion Legacy Foundation. He works with a group of researchers at Boston University. For more than a decade, they've been autopsyying the brains of people who have, in the course of their lives suffered repeated blows to the head, looking for something called chronic traumatic encephalopathy CTE. Getting hit in the head causes your brain to twist and bruise if you get hit enough times. That bruising causes the accumulation of a protein called TAO, and that tao slowly works its way through the brain like a poison. So far, Newinski's group has autopsied the brains of one hundred and eleven former NFL players. One hundred and ten had CTE. Seven of eight former Canadian Football League players had it, so did nine of fourteen semi pro players, forty eight of fifty three college players, three out of fourteen high school players. The symptoms of ct include difficulty thinking, impulsive behavior, depression, short term memory loss, difficulty planning, emotional instability, and suicidal thoughts and behavior. It's not pleasant. One of the first pro players diagnosed with CTE was Mike Webster. He was a Hall of Fame center with the Pittsburgh Steelers. He died at fifty. In his house, his family found page after page of scrippled notes written by Webster to document his mental state. Like this, deep confusing, twisting, fishing line, tangled up mess of confusing things go.

00:15:41
Speaker 1: On all the time?

00:15:43
Speaker 2: Or Junior Seou and Dave Durson, two of the great football players of their generation, both shot themselves in the chest at the ages of forty three and fifty Why in the chest to make sure their brains were intact for autopsy to make the pathologists job easier? Now our case like this absolute proof of a connection between CTE and football players getting hit in the head. No. The research group at Boston University has just published a study which looked at players who had started playing tackle football before the age of twelve. I'm quoting youth exposure to tackle football may reduce resiliency to late life neuropathology may reduce Remember they're working from a non representative sample autopsies conducted on players whose families believe something was wrong. Proof would be if you identified two thousand people, half of whom played football and half of whom do not, followed them over the course of their lives and compared the autopsies of their brains at death. Did the football players have on average more the protein TAO in their brain tissue than the non football players. The problem is that the average American male life expectancy is seventy five years. If we start that study now, we'll have definitive proof somewhere around the turn of the next century. The much much harder question is what you do in the interim, And the answer is that you do what Chris Nowinski of the Concussion Foundation does. You plug away. You call people up at the height of their grief and ask them for brain tissue before the body of their loved one is buried or cremated. You call up people like Owen Thomas's parents.

00:17:42
Speaker 4: This is a day when it was like poured and poured and poured with rain the whole day, and so we were going back. It was must have been about like ten o'clock at night, right driving at the turnpike, and suddenly this I get this phone call from this person whose name I can hardly understand.

00:18:03
Speaker 2: The Thomases were too stunned to say no.

00:18:06
Speaker 4: But he still had to do quite a lot of work because he had to then call the undertaker and get the undertaker to get the brain matter which had been just like dumped in a bag by the medical examiner. Yeah, he has something to answer from. Well, the medical examiner did an autopsy. Right, So this was a football player who had committed suicide and he didn't he didn't make any attempt to preserve the brain matter, which now I look back on it and I think, how crazy is that that that the brain matter was just like all mixed up with all the rest of the bits and pieces and just thrown in a bag.

00:18:55
Speaker 2: Owen Thomas died in April. The following September, his parents got a second call. Owen had CTE and suddenly it all made sense. Why they're focused, joyful, high spirited son had suddenly called and said, I'm failing at everything.

00:19:15
Speaker 1: How did that news change you?

00:19:17
Speaker 5: We?

00:19:17
Speaker 1: What was the impact on hearing that? You said? You were relieved in some sense.

00:19:22
Speaker 3: That there was a contributing factor, that it wasn't just depression, that there was a cause that you could medical cause that you could maybe say that contributed to him.

00:19:35
Speaker 4: Well, it gave us a hold on He gave us a purpose.

00:19:42
Speaker 2: Not an answer, because there's still too much unknown for that a purpose. Now what am I talking about? I'm talking about football. What do we know about football? We know about football approximately what Frederick Kaufman knew about old dust in nineteen eighteen. So there I was in the Harrison Auditorium at the University of Pennsylvania. It was twenty thirteen. Owen Thomas had been dead for three years. There were students in the room who had known him, who remembered him. So I told the story of how he was found hanging in his apartment, and I asked them, is that enough proof for you? Is the death of someone you went to school with who was the captain of your football team enough evidence to walk away from the game? I sometimes think about that moment. When I met Bob's Library at New York University, I do a lot of my research there. The library has a massive, multi story atrium at its center, and a few years ago a student jumped over one of the railings overlooking the atrium, and immediately, immediately, and at great expense, the university put up high plexiglass screens in front of every railing. Then a few years after that, a student found a way to wriggle over the plexiglass and jump to his death. So the university installed an even more expensive and elaborate and fool proof metal screen that was impossible to get around or over. Two suicides, and they spent millions of dollars. Why because the job of a university is to watch out for the welfare of the students under its care. And NYU didn't need any more evidence to act.

00:21:58
Speaker 8: Two thousand and nine lits in a crowd by coming together in order to overcome the adversity the plans stake in the field. In November, here.

00:22:09
Speaker 2: Is what Penn did in response to the suicide of Owen Thomas and the results of his brain autopsy. They honored him with forty seconds of silence before the season opener the next fall against Lafayette. Owen's jersey had been number forty. His teammates wore decals on their helmets with the number forty on.

00:22:29
Speaker 8: Them, blinking hand in hand parallel to the sideline, standing for a forty second moment of silence and tribute to their former teammate Owen Thomas, who pass away on Monday Aprilty twenty six this past off season.

00:22:47
Speaker 2: And here is the statement the university issued upon hearing that Owen Thomas had been diagnosed with CTE. I read it to the audience when I was at Penn in twenty thirteen. While we will never know the cause of Owen Thomas's depression and subsequent suicide. We are aware of and deeply concerned about the medical issues now being raised about football head injury, and will continue to work with the Ivy League and the medical community in addressing these issues. Owen's untimely death was a terrible tragedy, and we continued to grieve for his loss. Where to start. Let's start with the statement we will never know the cause of Owen Thomas's depression and subsequent suicide. Are you kidding me? What is there more to know? A healthy young man with no previous history of depression hangs himself in his apartment and when they do an autopsy on his brain, they find he has the beginnings of a debilitating neurological disorder caused by taking too many hits on the football field. And then the statement we are aware and deeply concerned about the medical issues being raised about football head injuries. We are so aware and deeply concerned about the medical issues being raised about football head injuries that three years after Owen Thomas's death, Penn continues to play football. In my book, that does not count as concern. That is moral indifference, not long ago. I went to see Albegnoli. He's the head football coach at Glumbia University. Before that he was at Penn. He was Owen Thomas's coach, and he reminded me I'd left someone out. Owen Thomas wasn't the only one.

00:24:42
Speaker 5: Oh, we had two. We had Kyle Ambrosey too. They're both traumatic. But Kyle's was unbelievable because.

00:24:50
Speaker 7: That happened right in mid season, So it happened after he scored two touchdowns or we'd beat Buck now fifty one or something.

00:24:59
Speaker 2: Kyle Ambrosi star running back on the Penn football team and a student at the Wharton School of Business, just like Owen Thomas. He shot himself at his mother's house in October two thousand and five. There wasn't an autopsy on Kyle Ambrosie's brain in two thousand and five. CTE just wasn't on people's radar in the same way that it is now, So we'll never know whether he suffered from the disease the way we know with Owen Thomas. We don't have proof, but what happened to Kyle Ambrogie sounds very much like what happened to Owen Thomas. All his life, a young man plays a sport that involves repeated blows to his brain, until suddenly he fell apart in a way that looks an awful lot, like the way people fall apart after they've had repeated blows to their brain.

00:26:00
Speaker 9: You know, there is even physical changes, like his eye color got lighter, and you can just see that he was fighting demons and he couldn't explain them.

00:26:10
Speaker 2: That's Kyle Ambrogie's brother Greg.

00:26:14
Speaker 9: I asked him, and he, you know, would try to explain them, and he just would run out of words. He would open his mouth and nothing would come out, and I would just look at him and I didn't.

00:26:24
Speaker 10: Yeah, the only thing he said to me is, Mommy, it's so dark.

00:26:27
Speaker 5: It's scary.

00:26:28
Speaker 10: And it was very frightening to him because he was always used to being in control, and this isn't out of control, feeling.

00:26:35
Speaker 2: Kyle's mother, Donna, listening to the Ambrosies was like listening to the Thomases. Someone you know becomes someone you don't know right in front of your eyes, and they haven't done anything. They haven't been in a terrible accident or overdosed on drugs or squandered their life away. They've just played a game, played it well.

00:26:59
Speaker 10: And if you're always, like I said, the internally driven, you know, never had to say, Kyle, do your homework, go practice, go whatever. He always had it done ahead of time. That was him. This is what he wanted to do. So if you're used to being in control and your mind is you're having thoughts that you don't have control over, it's very scary.

00:27:29
Speaker 2: Had anything you've done as a coach prepared you for I mean that's a really tough position to be.

00:27:34
Speaker 5: No, no, no, nothing you can do.

00:27:37
Speaker 2: What did you say to your players.

00:27:40
Speaker 5: Basically we're here for you. Yeah.

00:27:42
Speaker 11: I mean, you know, anytime you get that kind of trauma, to deal with it, because again, it kind of brings you back to Okay, what's really important and what isn't important. You know, you've been so much premium on Okay, you gotta win this game, you gotta win that game. You're trying to win a title, and yet when it comes to human life that's rather trivial.

00:28:06
Speaker 2: I'm assuming the full team went to the funerals in both cases. That must have been unbelievable.

00:28:14
Speaker 7: It's it's very sad because again, it's hard to explain. Not that it's any easier to lose somebody in a car accident, but you can explain it. Or someone who suffers from terminal cancer. It's just as traumatic, but you can explain it. When you're a teammate of a kid who commits suicide, you're you know, could I have Why didn't I see this?

00:28:37
Speaker 5: Could I have done something? Why? You know? I think you always question yourself, what could I have done that? Maybe in some other ways of death you kind of accept.

00:28:52
Speaker 2: I've thought a lot about that talk. I gave it penn. I'm not sure I won them over. The students listen politely, and at the end ask thoughtful and skeptical questions. I talked about the costs of football. Why didn't when they talk about the benefits? They asked, doesn't everything come with a risk? Shouldn't people be free to make their own choices. A student who was on the football team stood up and said, I wouldn't be here if it wasn't for football. When I met with coach Bagnoli, he talked about rule changes, how they are now much more vigilant about concussions, how they don't tackle in practice like they used to how he doesn't believe that little kids should play tackle football. I got the sense that a lot of students were thinking about those things too. Maybe we can just manage this problem, reduce the risk to some more acceptable level. After the speech, as I walked to the post event reception, one of the big deans at PENN looked at me and shook his head. He said, we're not stopping football. Of course not, and it won't stop at least not until the third suicide, or maybe the fourth suicide or the fifth, at which point the students in Alumnia Pen will finally say that's an awfully high price to pay for a game. Al Begnoley brought up one more.

00:30:26
Speaker 11: Name that's unfortunately becoming more and more prevalent than I just saw, the kid from in Washington State whose brother actually was here.

00:30:35
Speaker 2: The name of the kid from Washington State was Tyler Helensky. He was supposed to be the twenty nineteen starting quarterback for the Washington State Cougars. A few days before my interview with Begnolly, Helensky borrowed a teammate's rifle and shot himself in the head. A bright, outgoing kid with a big smile, no motive. It's unfortunately becoming more and more prevalent. But I guess we don't have enough proof. Well, it's your classmates who are dying, right, it's your classmates who are putting their lives at risk by playing this game. I think all of you has to think about has to consider boycotting football games at PEN. And I think you have to convince your friends to boycott football games at PEN. And I think you have to pick it outside football games a PEN. And I think you have to go to the administrators of this university and you have to ask them why is a world class institution, one of the finest universities of higher learning in this planet exposing its own students to the risk of injury and death. And if they ask for proof, tell them you don't need proof. Sometimes proof is just another word for letting people suffer.

00:32:01
Speaker 5: Thank you.

00:32:19
Speaker 2: Revisionist History is a Panoply production. The senior producer is Mia Lobel, with Jacob Smith and Camille Baptista. Our editor is Julia Barton. Flon Williams is our engineer. Fact checking by Beth Johnson, Original music by Luis Gara. Special thanks to Andy Bauers and Jacob Weisberg.

00:32:40
Speaker 1: I'm Malcolm Glavo.

00:32:53
Speaker 2: Suicide is a difficult topic. It can be hard for people to talk about suicide or get help if they're in danger, but there are resources available people want to help. The National Suicide Prevention Hotline is one excellent resource. It's free, confidential, and available twenty four hours a day. The number in the US is one eight hundred two seven three, eight two five five one eight hundred two seven three Talk