• Wilkes Barre, Pennsylvania. Bobby McBride, twenty years old, dies from injuries received in a college football game in mid-November.
• Bakersfield, California. John Vaughn, sixteen years old, dies from head injuries received while tackling in a sandlot football game in mid-December.
The above data are inconclusive, because I gathered them at random. A more responsible summary appeared in 1971 in the Encyclopedia of Sport Sciences and Medicine, whose editors reported that in the period of 1931–65 a total of 642 fatalities occurred which could be attributed specifically to football. Of these, 348 were high school players, 54 were college players, 72 were professionals and semi-professionals, plus one official who was struck fatally while refereeing.
In the most complete study yet made, the National Collegiate Athletic Association (NCAA) reported that in the period 1931–73 (excluding 1942, when no study was made) a total of 795 fatalities occurred which were attributable directly to football, plus another 384 relating indirectly. (The boy made it home, collapsed, but did not die till four days later.) The average per year was 28, proving that my figures were too high.
In the fall of 1974 one of the television networks carried a show relating to football injuries in high school, and made the documented statement that out of 100 boys who play the game in high school, 86 could expect to sustain at least one injury, and I reflected on what would happen in this country if high school physics had a record of killing 28 students every year and maiming in some degree 86 percent of all enrollees.
I think it obvious that physics would be eliminated as a subject, and within a very short time, for such a cost would be deemed excessive. But there is no cry to end football, nor will there be, because every society decides what it is willing to pay for its entertainment, and if football injuries and deaths do not markedly exceed the present rate, they will not be considered excessive.
Football has been so enshrined as a spectator sport, both in college and professionally, that it would be impossible for revisionists to alter it without protests of an almost revolutionary character. As long as the deadly violence does not accelerate, football is in no danger of discipline from without, and it is my own sad guess that deaths could triple or quadruple without causing much outcry. Football is the American form of violence, and whereas Spanish bullfighting is pretty despicable—one practitioner killed about every four years—and Mexican cockfighting abominable—no men ever killed—our violent sport is neither, because we have given it our moral sanction.
Steps to police the sport from within are being taken. Constant preaching by coaches has warned everyone within the ranks that dehydration on a hot field in August and September can cause death, and this particular cause of tragedy has diminished. Also, concerned specialists like Dr. Nicholas have worked imaginatively to provide equipment that remains protective to the wearer but causes less damage to the opponent. The rules committee has also done salutary work in outlawing tackling that involves grabbing the face mask, a tactic that used to snap necks. (Football is not our most lethal sport. Scuba diving, with relatively few participants, kills about 120 each year. Swimming, with enormous participation, accounts for about 600, but this figure includes accidents to people who were not intentionally in the water.)
But while football coaches strive to diminish the number of deaths, the general public appears to want an ever-rougher game. Newspapers extol a linebacker as ‘a real animal,’ and patrons exhort him to ‘tear the quarterback’s head off.’ When a linebacker delivers a bone-crushing tackle, women throughout the stands scream, ‘Way to hit, baby. Way to hit!’ And recently when an NFL team acquired a tackle from the Canadian League, the players coach said of him admiringly, ‘They’re getting a real gorilla.’
I would therefore expect the game to become rougher, with the rules committee endeavoring vainly to stem the carnage. Rough football is salable. It attracts the loyalties of wealthy older men who never played it themselves, and it seems destined to run its present course for at least another fifty years.
This is no new phenomenon. In 1905 in the relatively few colleges that played the game, 18 students were killed, but apologists pointed out that the manly sport killed at a rate of less than one in 50,000 players, and only one in 7,000 broke a limb. Another argued that ‘the game does not profess to be a gentle, tame affair like a church social or an afternoon tea. I am sure a much greater harm, even loss of life, results from overstudy or dissipation.’ And a speaker at the Harvard Club of Boston that year stated his belief that ‘even death on the playground was cheap if it educated boys in the characteristics that had made the Anglo-Saxon race pre-eminent in history.’ (Quoted in the Yale Alumni Magazine of November 1974. I would undertake to find in Oklahoma, Nebraska or Ohio many adherents of the game ready to advance similar arguments today.)
I would permit my son to play football in high school or college, even though I am aware of the dangers. This game has become so much a part of the American psyche, and it confers so much charisma on its participants, that I would not deny my son the right to take part, but I would not encourage him to do so.
I feel the same way about adolescents and motorcars. I am much impressed by the influence the automotive engine has on American life, and I would want my son to participate in its mystique, even though he might get into serious trouble with his car, or more likely, mine. But I would not allow him to own a motorcycle while he lived with me, and I would hope that he would not want one afterward, because the risk of injury is too great. I lived in Great Britain when the great motorcycle craze hit there, and one girl after another was swept off her pillion seat and under the wheels of oncoming trucks.
All sports, even croquet, involve risk. (I have known people in Hollywood suffering from some rather nasty mallet wounds not acquired by accident.) The prudent situation is that one risks a minimum of injury in order to gain a maximum advantage to one’s health. I have always been willing to take sizable risks because my enjoyment of sports has been so rewarding. But there are limits, and if those who make the rules for sports do not maintain a cautious respect for those limits, I would hope that society would step in and perform that function for them.
In 1905 it was President Theodore Roosevelt who saved football by insisting from the White House that it be debrutalized. As so often happens, his demand for reform led to the improvement of the game: the forward pass was legitimatized. Of the new game Roosevelt said admiringly, ‘I disbelieve in seeing Harvard or any other college turn out mollycoddles instead of vigorous men. In any republic, courage is a prime necessity for the average citizen if he is to be a good citizen. Athletics are good, especially in their rougher forms, because they tend to develop such courage.’
For older people the danger from sports can be very real. For a man of forty-five who has been sedentary for the preceding two decades to engage suddenly in violent sport is suicidal. However, the vigorous program which I have been recommending can be followed by men in their seventies, provided they have continued active through the middle years of their lives.
I would not recommend to anyone recovering from a heart attack that he follow my strenuous tennis regimen, nor would I want someone fifty years old and in apparent good health to go out and play a quick thirty-six holes of golf on a hilly course if he had laid off all exercise for the past twenty years.
But even being a spectator at a thrilling game involves dangers, as Harvard University discovered when many of its elderly alumni suffered heart attacks at football games. Two cardiac units had to be installed at opposite sides of the stands, and were put to good use. (When a western friend heard of this he said, ‘My God! A man who would drop dead at a Harvard-Yale game, he shouldn’t even be allowed to watch Oklahoma-Nebraska on television!’)
The strongest counterattack against physical exercise for older people to appear in recent years is contained in the medical best seller Type A Behavior and Your Heart, by Drs. Meyer Friedman and Ray H. Rosenman. The authors mount a frontal assault on exerci
se for anyone past thirty-five, and if any sedentary leader has been heckled by his wife or his friends to ‘get up, get out, and do something,’ this book will give him encouragement to persist in his lethargy.
Approximately 200,000 American men who had never experienced a single symptom of coronary heart disease died suddenly least year. From our own studies of scores of these cases, we have learned two facts. First, even if these men had no symptoms of heart disease before death, in each case postmortem studies revealed coronary artery disease of sufficient severity that a treadmill electrocardiogram may very well have shown its presence. Second, more than a third of these men died during or a few minutes after indulging in strenuous activity. In many cases, moreover, the men had been exercising strenuously, regularly, and for years prior to their demise.
What are these severe or strenuous exercises which we are cautioning every American past thirty-five years of age to avoid as if they were a plague? First on our blacklist is jogging. This miserable postcollegiate athletic travesty has already killed at least scores, possibly hundreds, of Americans. Jogging is a form of exercise in which man transforms himself into a machine. Chug-chug-chugging along, looking neither to the right nor left, panting, the ‘man machine’ chugs along. And what is ‘its’ goal? To see if ‘it’ can chug-chug faster today than yesterday. And what is ‘its’ only joy? The soothing miraculous feeling of relief when the chug-chugging is finished. If ever an exercise was custom-made for the attack-prone person, jogging is that exercise. Yes, some of our best friends are joggers!
Competitive handball, tennis singles, and squash rank next to Jogging in potential lethality for the middle-aged American who plays these games—whether once a month or every day—without first having had his heart checked at least by the treadmill-electrocardiographic test (which, incidentally, is certainly not foolproof). And fully as dangerous as any of these violent sports may be speed ice-skating and playing touch football or basketball with your teenaged sons, particularly after even a moderate-sized meal.
Friedman and Rosenman do recognize that moderate exercise can make a contribution to general well-being:
Of course, you might be temped to ask why we bother to recommend even moderate exercise in view of our doubt about its efficacy in prevening coronary artery disease, and our belief in the evident danger of violent exercise. We would reply that man has always felt better physically and psychologically after indulging in bodily exercise … By moderate physical activity, we mean any form of exercise whose execution does not cause panting, excessive acceleration of your heartbeat (that is, above 120 beats per minute), or leave you unduly fatigued. Walking on the flat, up very gentle hills, up one flight of steps or down as many flights of steps as you wish, swimming (noncompetitive), golfing, bicycling, tennis (but only doubles, and preferably mixed doubles), fishing, hunting (but not deer hunting at high altitudes or wading after fallen ducks), skeet shooting, horseshoe playing, croquet, billiards, and so forth, are the forms of exercise we recommend.
Anyone defending sports must sooner or later confront the popular belief that ‘men who play vigorous sports in college die prematurely.’ One rumor states that ‘the men who rowed in the Harvard crew in 1922 all died in their forties.’ Just the other night a leading educator asked me, ‘Is it true that Big Ten football players and distance runners rarely live beyond their fifties?’
Three substantial and trustworthy studies have explored this question. In 1928 Louis I. Dublin, the widely known health statistician, reported in Harper’s magazine on a study of 4,976 graduates of Harvard, Yale, Cornell and seven other colleges. He compared men who had won letters in sports with the standard life-expectancy figures contained in actuarial tables. He found that athletes enjoyed a 4.5 percent longevity edge over expected deaths. But as soon as these favorable figures were published, critics pointed out that Dublin was comparing college graduates, a favored lot, with run-of-the-mill citizens who had not had the advantage of wealth, superior family circumstances and above-average health services. ‘Of course the college men would live longer whether they were athletes or not,’ the critics argued. ‘The real test would be college athletes versus college non-athletes.’
Dublin recognized the validity of this criticism; indeed, he had anticipated it, and in 1932 issued a more sophisticated analysis. He had gone back and studied 38,269 graduates of eight eastern colleges during the years 1870 to 1905. He compared men who had won letters in major sports with men who had been primarily scholars. The non-athletes lived 2.17 years longer than the athletes, and that remains the definitive study, although why the athletes tended to die earlier has been the subject of much subsequent discussion.
In 1956 Henry J. Montoye compared 628 varsity athletes at Michigan State University with 563 classmates who did not win letters. The athletes tended to die two years earlier than the non-athletes, age sixty-two versus sixty-four, but the numbers of participants covered by the study were not large enough to be statistically significant. Five years later Montoye updated his study and found that the seventy-seven new deaths that had occurred in that interval confirmed the earlier results. The athletes died two years earlier.
In 1970 Anthony Polednak and Albert Damon, of Harvard University, published in Human Biology an article entitled ‘College Athletics, Longevity and Cause of Death’ in which they not only provided an excellent review of all previous studies but also reported the results of an intensive study of 2,631 who attended Harvard between the years 1800–1912. The men were divided into three groups: major athletes (baseball, football, crew, etc.); minor athletes (fencing, golf, swimming, etc.); non-athletes (no record of having participated in formal intercollegiate sports).
The conclusions were specific: 1) Non-athletes lived longer than athletes, but the difference was not statistically significant. 2) Minor athletes lived longer than major athletes or non-athletes, and here the difference was statistically significant. 3) The man with a stocky apelike build characteristic of most athletes (mesomorph) died markedly sooner than the tall, skinny man (ectomorph). The round, chubby man (endomorph) rated in between.
Polednak and Damon make many learned guesses as to causes. My own suspicion is that athletes tend to be of the body build that is most susceptible to early death, and that the cause of death is not athletics but the nature of the human being engaging in them.
The weakness of such studies is that they must deal with conditions that existed half a century ago. It could not be otherwise, for a study of longevity has no final validity until most of the participants are dead. (In the Harvard study, 90.9 percent had died.) I believe that athletes today have learned from experience to take better care of themselves and are living longer, but proof cannot be forthcoming until forty or fifty years from now.
There remains the problem of ‘athlete’s heart,’ which popular legend claimed was so enlarged as to limit the life of the strenuous athlete to fifty-five years or less. Research does not substantiate such belief. R. Ackermann of Germany photographed the heart shadows of athletes who had been under severe stress, and reported, as others have since, that in such conditions the normal heart actually retreats in size; it is the weakened or diseased heart which enlarges. Professor H. Herxheimer, also of Germany, studied nearly five hundred champion athletes and found that their heart could be indicated by the following index numbers—the higher the number the larger the heart:
HEART SIZE IN ELEVEN TYPES OF ATHLETES
From this and parallel studies I conclude that training for endurance enlarges the heart, whereas training for short bursts of intense effort does not. The case of weight lifters illustrates this principle: they develop large muscles without enlarging the heart significantly, hence their index remains low, even though they are capable of enormous bursts of sudden energy.
But even if the heart is somewhat enlarged, does this mean premature death? Vaughan Thomas, in his study on stamina, concluded that the slightly enlarged heart was an asset rather than a liability:
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p; In the old ignorant past it was commonly observed that those who had led a strenuous athletic existence tended to develop enlarged hearts similar to some chronic invalids. This led to warnings about the bad effects training had upon the heart. We now know that in such invalids their heart muscle has been developed in order to compensate for a weakness elsewhere, or to overcome the heavier resistance provided by hardened arteries and such like. Provided the heart itself is normally healthy, then such development through graduated training programmes does nothing but good to the heart. Recent discoveries concerning training effects on the heart have shown, in fact, that there is an increase in the number of blood vessels serving the heart, and an enlargement of the coronary arteries, thus increasing the possible blood flow to the heart muscle.
In addition, the capillaries interconnect in such a way as to provide alternative routes to almost any part of the muscle. Previously a blood clot which formed in any part of the hearts blood supply caused a large area of heart muscle to die. In a trained heart, however, the area of muscle affected would be very much smaller. Those fortunate individuals ‘suffering’ from athletic heart can feel great confidence in their ability to withstand cardiac stress.
Thomas, Vaughan, Science and Sport.
On balance, I conclude that sports, conducted reasonably, produce more health benefits to both young and old than they do dangers. However, I must admit that I know many men and women who live perfectly satisfactory lives without ever moving an unnecessary muscle. They stay alert; they achieve their allotted longevity; through television they appear to enjoy sports as much as anyone else; and they keep on performing their jobs with distinction. They are a minority, but they exist.
I would cite as prototype a gentleman in his sixties, tall and lean, who works hard at a demanding job. He commutes to the city, walks slowly from the railroad station to his office, eats sparingly at lunch and does not smoke. He never exercises, in the ordinary sense of this word, but he loves nature and lives in harmony with it. He rakes leaves occasionally, does some mild gardening, walks his dog, and moves indoors when anyone mentions tennis. He remains in better health than many of his more vigorous friends.