Kathryn Fox comes to Murderati

Kathryn Fox is an Aussie crime fiction author (based in Sydney), who I’ve had the pleasure of meeting at a couple of crime conventions here in Australia. Kathryn’s first book, Malicious Intent, was a huge success both here in Australia (she won the 2005 Davitt Award for crime fiction) and overseas (it toppled The Da Vinci Code to become the no. 1 crime book on Amazon in the UK and Germany). Since then she’s released another four books — Without Consent, Skin and Bone, Blood Born and Death Mask.  

Like certain other female crime writers you may know (e.g. Tess Gerritsen, Kathy Reichs) Kathryn also comes from a medical background and uses this knowledge in her crime fiction. 

Today, Kathryn’s draws on her medical background to talk about chronic traumatic encephalopathy (CTE). Her post is a powerful one, and she will be in and out to check on your comments. 

A multibillion dollar industry. Corruption, disturbing public behaviour by key players. A series of suicides and violent deaths, leads to questions. Each autopsy reveals a horrifying discovery. There are calls for the industry to stop the carnage… 

It sounds like the plot for a thriller. Only this isn’t fiction. It’s currently taking place in two separate spheres at once, in real life. And it’s something I feel passionate about. 

The first industry involves sport. NFL, Ice Hockey, Rugby Union, Rugby League (in the UK and Australia) and Australian Rules. No prizes for guessing where the last one is played. The one thing these games all have in common is physical contact, and lots of it. Crowds love a bit of biff, thump and robust exchanges. But at what cost?  

For years now, high profile players have been the focus of media attention for all the wrong reasons. Not a season goes by without more scandalous headlines about players involved in sexual assault, domestic violence, alcohol and drug abuse, off-field violence and betting controversies. Boys will be boys, we’re told and it’s mostly harmless fun. Harmless of course, except for the victims, families and consequences for players themselves. 

With a life expectancy of 50 yrs for NFL players, it’s easy to assume that retirement, high food intake and reduced exercise are the causes. But a number of premature deaths and suicides in former NFL players and even a player who stopped after high school, shocked the medical community.  Each was found to have the unusual finding of CTE (chronic traumatic encephalopathy). 

What is CTE? It’s permanent and ongoing damage to the brain that was previously only ever seen in boxers after a career of blows to the brain. MRI and other medical investigations aren’t able to pick it up. Sadly, it’s only diagnosable post mortem.

CTE predominantly affects the front parts of the brain, or frontal and temporal lobes, which are responsible for decision-making, impulse control, mood, memory, amongst other things. Damage to these areas can result in depression, increased aggression, sexual inappropriateness, impaired judgement, addictive behaviours like gambling, drug and alcohol abuse. Does any of this sound familiar when you think about the football and ice hockey scandals? 

It did to me three years ago, when I began writing Death Mask. Please don’t think for a moment that I’m taking credit for the surge in information or subsequent outcry about CTE, or the decision by many former players to sue the NFL, but the headlines kept on coming and a fictional novel on the topic attracted more than the crime readers.

The chief executive officer of a professional team contacted me after reading the novel, and asked me to help educate players and team management about the dangers of CTE. He felt that the book had really captured the culture and mentality of team behaviour. It was a huge compliment, and vindicated a ‘slight’ obsession for research, but the lines between fiction and reality had begun to blur. 

As Death Mask was released in Australia, we coincidentally had a number of severe concussions during games and there was ample footage of players stumbling around the field before collapsing. 

It’s unusual for a fiction author to make it to the sports pages and sports segments of TV news shows. My sports fanatic father was so proud! (Above, Kathryn is interviewed with NFL player Colin Scotts.

Some commentators argued that I was just trying to bubble wrap children and that concussions were just a part of robust gladiatorial competition. As a doctor, and parent, I am in no way against sport, but any sport that causes brain damage and premature death deserves some review. It is, afterall, sport. Thankfully, public awareness has increased the pressure on sports doctors and administrators to take action and reassess the risks. 

Now, medical science is discovering that CTE doesn’t actually require severe concussions. It may be caused by recurrent, minor blows to the head and is especially damaging to developing brains. Helmets don’t necessarily protect the head and are heavy enough to cause some major damage. 

At the beginning of the blog, I mentioned two spheres involving multibillion dollar industries and strange autopsy findings. 

The second industry is, not surprisingly, war. Tragically, there has been an epidemic of suicides and social problems experienced by veterans of Iraq and Afghanistan. A newly published medical article reports that over a dozen veterans have been found to have CTE at autopsy. A 27 yr old diagnosed with post-traumatic stress disorder was the first recorded victim.

In no other wars have troops been exposed to, and survived, so many explosions.  

Current thinking is that the number of blasts from bombs or grenades have a catastrophic impact on these young brains, and may be responsible for the high rate of suicides in veterans. A helmet might protect from the head from shrapnel, but can’t do anything about the brain rattling around inside the skull. 

If CTE is occurring in people this young, the worst is yet to come. Degeneration continues to occur with age. 

These people have served their countries and may end up paying for the rest of their lives, and with shortened and debilitated lives. More importantly, there is NO treatment. We all owe it to troops to prevent CTE and protect those who have already returned from active service. The potential health problem for the US, UK and Australia, amongst other nations, is enormous. 

Now, if a journalist dares ask me if I want to bubble-wrap troops and stop all wars, I can unequivocally say yes.  

8 thoughts on “Kathryn Fox comes to Murderati

  1. Karen in Ohio

    More stuff I don't understand, regarding a short-term gain or pleasure with serious long-term consequences. It's a mystery to me why anyone would tolerate this, either the players or the spectators. I guess because so much money is thrown into it, via not just player salaries, but vast stadium holdings, and many other related industries: souvenirs, food and drink, advertising, etc. But at what cost.

    When my youngest daughter lived in Sydney we went to an Aussie Rules footie game at the Olympic stadium. It seemed way less traumatic to me, I must say, than an American football game. If players are experiencing such injuries from a game with so much lower levels of trauma, what kind of brutality is our own NFL undergoing?

  2. JJ

    Our city just lost a wonderful man to suicide at the age of 43. He played 20 hard years in the NFL and many years before that in high school and college. We'll never know what kind of pain he was in to choose to go so soon but my thoughts turned immediately to CTE, no longer only theory but a real disease. His family is now trying to decide whether to donate his brain to research, a horrible decision for any family to make, but how necessary if we're to find ways to stop this damage. Junior Seau, #55, R.I.P.

    Thanks for the thoughtful post, Kathryn. I look forward to reading your book.

  3. lil Gluckstern

    Very interesting, with interesting consequences. will we ever stop this? Unlikely. Should they change rules and equipment-yes. I will seek out your books.

  4. Alexandra Sokoloff

    Hey, Kathryn, thanks so much for being here and for this thought-provoking post! I'm going to take a sociological POV – I've got to think that jock and military culture also contribute to the violence and aggression and damage to the players/soldiers AND the people around them that you're talking about. But I'm sure that repeat instances of concussion are a huge part of the problem, too.

    Really fascinating.

  5. Tom

    Kathryn, thanks for your well-researched and qualified analysis. We'll go looking for your books.

    War and its surrogate, full contact sports; now that we know the truth, it remains to be seen whether those in power will care enough to change anything.

    My esteemed spouse is the daughter of a surgeon and an anaesthetist. She's been pointing out the consequences of saving lives in the Mideast battlefields for years, now, in agreement with your assessment. The butcher's bill will come due in installments for decades.

    Alex, all the more reason to make dance more a part of the Olympics, right?

  6. Kathryn

    JJ, I read about Junior Seau, it's so sad for his family.

    And Alex, I agree that there is a testosterone fuelled culture, that appears in most male team sports, tribes and gangs. Australian Rules may not look bad, but there are lots of elbows and knees to heads as they go for balls.

    As for dancing at the Olympics? Absolutely! I'd vote for a special section just for tap:)

  7. PD Martin

    Thanks, Kathryn, for being our guest today! I really enjoyed reading the post … I was the lucky one with the first look putting it up ๐Ÿ™‚

    It's fascinating stuff. As you mention, we all 'know' that many boxers suffer long-term consequences to their brains but it's scary to discover this is also the case for sports people and armed forces personnel. I never knew about the shortened life expectancy for NFL players.

    I'm not a fan of contact sports (yes, even Aussie Rules, even though I am from Melbourne!!!) but they're just so popular it's hard to imagine the rules changing so dramatically as to almost completely prevent concussion or blows to the head. It also makes me glad I have a little girl and not a boy.

    And Tom – so true about the bill coming in decades to come.

    Phillipa

  8. Reine

    Kathryn, I'm sorry to be so late. This is a terrific post. I recently read that even soccer causes CTE from repeated minor head trauma. I have bi-temporal and rt-frontal seizures that cause damage with each, so I have a little sense of what it might be like. I don't know if trauma caused it initially, but much of what is described in your post says it well. I am grateful that I'm still hanging in there, but I had the best of help from a Brigham & Women's neurologist, a professor, turned colleague, now friend, who helped me live with it and try to preempt the effects of as many bad events that are bound to happen, and to deal well with the others. Until a regenerative process is discovered and implemented, I think there is much that can be done in medicine in this area. Physically restorative options, direct to the brain, aren't available yet, but there is still much to do with the mind while learning to take care of the brain.

    Yes. Down with war. Most definitely.

    Tell me, though, is ice dancing okay, do you think? I love to watch the pairs.

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