Wednesday, December 14, 2011

Painkillers for N.F.L. Players? Not So Fast -

The former professional football player is confused. It is difficult for him to pinpoint, after the pads have come off for good, the precise cause of his aching body and his aching soul. He knows that the game did it. But what part of the game? Was it the physical violence? The psychological warfare? The realization that his life peaked in his 20s? The drugs he took to stay on the field? Whatever the cause, there is always the pain. The pain is constant in football and as a result it is constantly being manipulated.

Last week a group of 12 former National Football League players filed a class-action lawsuit against the league, claiming that the N.F.L. and its teams failed to warn players of the side effects of the drug Toradol, widely administered to players before games to numb pain. The lawsuit contends that the use of the drug masked injuries like concussions and thus further endangered the athletes.

When I played for the Denver Broncos, from 2003 to 2008, Toradol was a popular pregame injection. The night before we took the field, 10 to 20 of us would go into a designated room and stand in line to receive our shots. I don't remember what, if any, specific injury I was nursing on any particular occasion. I do remember that my body was perpetually feeling bad, as were those of my teammates. Our training staff knew this and would encourage us to get a shot. We were told it would make us feel better. So we lined up for the needle.

When I got to the front of the line, I was told that the shot was known to cause internal bleeding in a very small percentage of patients but otherwise was safe. This disclaimer was given with needle in hand and a line of men waiting behind me. There was no hesitation, no trepidation, no point at which I felt that taking Toradol was a risk. I trusted our team doctors. They wouldn't suggest a drug if it was dangerous.

The big risk, in my mind, was not being at my best the next day. The big risk was not taking the shot, playing poorly and being viewed by the staff as unwilling to do what it took to help the team win. The big risk was losing my job.

The N.F.L. is a machine. The operators of the machine pull its levers more frantically every season, pushing it past its breaking point. So the league has stockpiled interchangeable spare parts. The broken ones are seamlessly replaced and the machine keeps rolling. The old pieces are discarded and left to rust in a scrap heap.

This harsh reality is softened by human relationships. Football players spend every day with the members of their team's medical staff. They learn to trust them. The athletic trainers nurse the players back to health when they are injured. The team doctors perform their operations. Friendships are formed and bonds are created. But underneath it all hums the machine.

Athletic trainers are paid to keep the machine humming. The long-term health of the individual player is not their first concern; the health of the team is. The faster a trainer gets his players back on the field, the more likely he'll be to keep his job. Trainers are under pressure to do this by masking a player's pain with drugs and designing a hasty rehabilitation schedule, even if it inevitably trades one injury for the next.

The player rarely if ever has a say in the treatment process. When he is injured, the athletic trainers and team doctors take the necessary X-rays and M.R.I.'s and decide on the course of action among themselves. Only afterward do they tell the player what injury they have found and how they will treat it. If the player seeks a second opinion, which he is technically allowed to do, it is taken as an affront to the medical staff, and he will be treated in the training room like a turncoat. The medical staff issues its reports to the head coach, and is often beholden to him, which is another reason that players don't challenge their diagnoses or treatments.

The player is not told how to access his medical records or whether he even has a right to them. The folder of my medical records was as thick as a dictionary and I never had access to it. Even after I filed a workers' compensation lawsuit against the Broncos a year ago that later included a request for that folder, I still don't have it. The team hasn't released it to me.

If the N.F.L. is serious about protecting its players, it should appoint a league-wide medical body, unaffiliated with any specific team, to oversee players' health. Such an institution would be able to provide care to the athlete without the interests of his team distorting treatment.

Until then, teams will continue to convince players that their bodies and brains are ready for professional football, even when they are not. The injured body needs coaxing. It needs to be stroked, rubbed, heated, stretched and lied to. There are coaches, owners, trainers, fans and a host of media people counting on the players, after all, ready to question their manhood if they decide that the pain is too much to bear.

But the next game, the game that right now feels so important, will pass. In a couple of weeks, few will ever speak of it again. And then it's on to the next one. And the machine will keep humming.

Nate Jackson is working on a book about life in the N.F.L.