Bob Fitzsimmons, senior partner at the Wheeling-based Fitzsimmons Law Firm, has been active in researching brain trauma, especially involving professional and amateur athletics.
Together with renowned doctors Dr. Julian Bailes and Dr. Bennet Omalu, Fitzsimmons founded the Brain Injury Research Institute (BIRI). The three individuals, together with Dr. Jenn Hammers, serve as co-directors of the institute, whose purpose is to study and examine the effects of head trauma and concussions, specifically including chronic traumatic encephalopathy.
CTE is a permanent and progressive disease that can be caused as a result of concussions and head trauma, and has been an all-too-common term in professional football circles lately.
BIRI has autopsied the brains of more than 40 individuals, including former NFL players, WWE wrestlers, professional boxers, college and high school football players and military veterans.
It's fair to say that BIRI's research and studies have played an instrumental role in encouraging the NFL and other contact sports associations to properly diagnose, manage and treat concussions.
"A lot of the research that's been done has included a lot of football players; that's just the nature of the ones that have volunteered to be tested," said Fitzsimmons. "But through the Brain Injury Research Institute, we've also studied hockey players, soccer players — anybody that would be exposed to contact. It's clearly not limited to the NFL. But the media attention has pretty much concentrated on football, and professional football players in particular.
"Concussions aren't exclusive to a particular sport. It's a national concern."
Webster's legacy is help for others
The NFL has begun emphasizing concussion prevention, on the field and off the field.
But it was the injuries and eventual death of former Pittsburgh Steelers center Mike Webster that brought brain injuries in the NFL to the national spotlight.
"The whole thing kind of kicked off in 1998," Fitzsimmons recalled. "I represented (Pro Football) Hall of Famer Mike Webster. We filed a disability claim against the NFL, alleging that Mike had experienced repeated concussions, sub-concussive blows and the result of that was that he was permanently disabled."
Fitzsimmons said, the pension board made a decision in 1998 that Webster was totally disabled as a result of football related trauma, meaning the concussions and sub-concussive blows he experienced during his 17-year NFL career.
"They made the finding on the NFL pension board as early as 1998, recognizing that concussions and sub-concussions contribute to total disability, he said. "That was the first allegation, the first finding, and was pretty much the beginning."
In 2002, Webster died, and Omalu, a pathologist from Pittsburgh, asked for permission to autopsy Webster's brain.
"The family gave permission through me to the doctor," said Fitzsimmons. "He did staining on a brain that otherwise appeared normal.
"Dr. Omalu determined that there were large amounts of Tau protein, which is protein that is left after a cell is destroyed. It's left as a deposit in the brain."
It was a breakthrough discovery.
"That was the first discovery, scientifically, that we had alleged, and the NFL had agreed to, that there is permanent damage in the brain that is caused by concussions and sub-concussive blows," Fitzsimmons said.
As a result, the term chronic traumatic encephalopathy, or CTE, was coined in relation to football brain injuries, and became forever tied to the NFL.
A league springs into action
The National Football League has 32 teams, with about 1,600 active players and thousands of former players.
It became clear that the sport known for its highlight reel hits had to react.
"The NFL put together its own concussion group that disputed the findings of Dr. Omalu," said Fitzsimmons. "They refuted it for years and years. So we formed a research company too. We wanted to find more answers."
It was then that, with Bailes and Omalu, Fitzsimmons founded the Brain Injury Research Institute, which is now located at NorthShore University Hospitals in Chicago. It originated in Boston, and then worked through West Virginia University, until Bailes moved to Chicago two years ago.
Bailes is "the best neurosurgeon in the country," according to Fitzsimmons, adding that Bailes was voted the best last year and given an award at Stanford.
More information and more research have led to more awareness, Fitzsimmons said.
"The research has created awareness with the public that didn't exist before, as to the significant damage that multiple, repeated concussions can cause," Fitzsimmons said.
Lately, there have been additional significant findings.
"In November of 2012, UCLA tested five football players with a product called FDDNP," Fitzsimmons said. "It's put into a liquid and injected into the body. It goes into the brain and attaches to and identifies Tau protein. Prior to that time, the only way that CTE could be diagnosed was in a dead individual. Although this is in the early research stage still, it's very promising and appears to provide the same insights in a living individual as a dead individual in an autopsy.
"It's a pilot study, only five players were tested," Fitzsimmons added. "But they've tested four other players recently — Tony Dorsett, Leonard Marshall, Joe DeLamielleure and Mark Duper. Those findings were also conducive to CTE. Once again, it's still under an investigory research license and the medical community has not had the ability to fully weigh in yet. But we're expecting a paper with those results to come out hopefully in the next 60 to 90 days."
Not just athletes
The research being done on brain injuries will serve not only football players, but any one that has experienced concussions.
"As we go through life, a lot of people suffer significant problems due to brain damage," Fitzsimmons said. "They suffer memory loss, aggressive behavior, depression and even more severe cases — like suicidal ideology, or actual suicide. It can be a devastating condition. There's a great deal of science being done, looking for ways to diagnose it."
But it takes time, he added, and is an evolving science.
"A lot of people are jumping into the arena to test and treat CTE," Fitzsimmons said. "There are some great things on the horizon that people are trying to do. It's good stuff.
"Hopefully we can all work toward eliminating the downside of this disease, with knowledge and prevention."
Because of his work in research, Fitzsimmons had a decision to make.
It was one he gladly made, because of the impact BIRI can have.
"I have represented other players, but I stayed out of the NFL litigation because it would disqualify me from continuing to participate in the research that our group does," he explained. "I don't do the actual research, since I'm a lawyer, but I hang out with the doctors that do and provide whatever assistance I can from a legal standpoint.
"Everything we've done in the research is voluntary work. I spend about 10 hours a week relating to concussions and things related to it, which advances the science.
"That's a great feeling."