Daniel Te’o-Nesheim, who played four seasons in the N.F.L., was found dead at age 30 and later diagnosed with C.T.E. He left behind a paper trail of his struggles dealing with the injuries caused by playing the game he loved.

Daniel Te’o-Nesheim played parts of three seasons with the Tampa Bay Buccaneers. He died at the age of 30.

Daniel Te’o-Nesheim played parts of three seasons with the Tampa Bay Buccaneers. He died at the age of 30. Stacy Revere/Getty Images

As Daniel Te’o-Nesheim’s sister picked through his belongings after he died last year, she came across a plastic container filled with several pages from a journal he kept during his days as an N.F.L. defensive lineman — a scrawled catalog of his seemingly endless injuries and attempted treatments.

The entries are a sad coda to a life cut tragically short.

A standout at the University of Washington who played four years with the Philadelphia Eagles and Tampa Bay Buccaneers until 2013, Te’o-Nesheim was 30 when he was found dead in a friend’s house last October with a mix of alcohol and painkillers in his body. Neuroscientists later found chronic traumatic encephalopathy — the degenerative disease linked to repeated blows to the head — in his brain.

Te’o-Nesheim, who grew up in the Seattle area and in Hawaii, is not the youngest former N.F.L. player to be found with C.T.E., which can only be diagnosed posthumously. Nor did he have the most severe version of the disease, which has been found in hundreds of athletes and veterans.

But Te’o-Nesheim left a trail of documents, letters, text messages, photographs and voice messages that provides a vivid and heartbreaking, though incomplete, picture of a football player who in his last years began to display C.T.E.’s now familiar symptoms — including paranoia, disorientation, memory lapses and angry outbursts.

A page from Te’o-Nesheim's journal of injuries and treatments.

In his final years, Te’o-Nesheim’s deteriorating behavior concerned his family and friends, who knew him as easygoing, giving and sincere. He changed, they said, after he made it to Tampa, where he became more distant, depressed and distrustful, according to medical reports and interviews with more than a dozen friends, family and doctors.

[Parents are debating whether to let their young children play tackle football.]

As in other cases involving C.T.E., they blamed his hectic schedule during his playing days, or trouble adjusting to life after he was released by the Buccaneers in 2013. In reality, he was grappling with a host of orthopedic injuries, the effects of roughly 100 concussions (including 10 that left him unconscious), the drugs he took to cope with the pain, and a disease that can transform someone’s personality.

“Some symptoms are more visible, but never in my mind did I feel it was a worry to address,” said Marie Aiona, Te’o-Nesheim’s sister. “The combination can be life-threatening if not treated correctly. Once it progresses, it will ultimately change the person.”

1987

Family, Football and Food

Te’o-Nesheim in American Samoa, in a photo provided by Marie Aiona, Te’o-Nesheim’s sister.

Te’o-Nesheim was born in Pago Pago, American Samoa, in 1987, but his family moved to the Seattle area when he was 3 to be with his father’s mother. In the Samoan tradition, he was surrounded by aunts, uncles, cousins and grandparents. As a child, he played baseball, basketball, soccer, karate and, starting at 11, tackle football.

A year later, in 1999, his father died of an aneurysm. For Daniel it was a life-altering event, spurring him to pursue every day and every activity like they were his last.

The following summer, Te’o-Nesheim moved to the Big Island in Hawaii to board at the Hawaii Preparatory Academy, a private school. He excelled at baseball, football, basketball and the shot put, working out and playing until exhaustion.

“Football was his life,” said Max Unger, a center on the New Orleans Saints who was a year ahead of Daniel at the school, and a close friend.

The moment he stepped off the field, though, he was instantly smiling and relaxed, said Scott Oshiro, the athletic trainer at the school in those years.

Growing into an adult, he ate insatiably, plowing through several meals in the cafeteria before burning off the calories in the gym and on the field. He was rarely seen without shorts, T-shirts and flip flops.

At the University of Washington, he was an ebullient presence even though the Huskies were a dismal 14-35 in his four years on the team, including an 0-12 campaign in 2008. At 6 feet 3 inches tall, and 263 pounds, Te’o-Nesheim was not the largest defensive lineman. But he practiced to the point of collapse, forcing trainers to make sure he was hydrated on hot days.

“They knew he would go until his muscles didn’t work,” said Randy Hart, his position coach for three seasons.

A two-time captain, Te’o-Nesheim arrived early in the morning to study video and treated younger players to meals of Hawaiian barbecue, even though he was not flush with cash.

Te’o-Nesheim, 2, and his sister Marie, 5, in Samoa. Te’o-Nesheim was born in American Samoa in 1987, but his family moved to the Seattle area when he was 3 years old. Te’o-Nesheim at a little league game in Bothell, Washington. Te’o-Nesheim at Hawaii Preparatory Academy, where he excelled at baseball, football, basketball and the shot put. back fwd

He was accommodating to children and the news media, though there could be long pauses during interviews as he thought carefully about his words. “He was awkward in a charming way,” said Jeff Bechthold, who directs athletic media relations at the University of Washington.

On the day of the N.F.L. Draft, he went with Unger and two college coaches to Beth’s, a diner in Seattle. Everyone ordered 12-egg omelets served on pizza trays. Te’o-Nesheim finished his food, and half of Unger’s plate.

During the draft, he was with his mother, but was too nervous to watch television, and too full from his meal. When the Eagles called after choosing him in the third round, he thought someone was playing a prank on him.

“I was just lying down and looking at the ceiling,” Te’o-Nesheim told reporters when asked where he was when he got that call.

2010

A Painful Transition to the Pros

Te’o-Nesheim was a two-time captain of the football team at the University of Washington. Otto Greule Jr/Getty Images

Philadelphia proved a tough adjustment. The weather was a big change for someone who lived in T-shirts. His teammates had their own families, and his new coaches were not the father figures he knew in high school and college.

He put down few roots, renting an apartment a mile away from the Eagles’ training facility and a car on days he needed one.

“He was always saying he was concerned about being on the bubble,” said Oshiro, who kept in touch with Te’o-Nesheim.

The players were faster and larger, too, and the injuries piled up. At his agent’s suggestion, Te’o-Nesheim kept a journal of his ailments in case he needed to file for disability benefits. Eventually those notes would be found by his sister.

One page revealed a sore shoulder at the end of his first minicamp, less than a month after being drafted. Te’o-Nesheim underwent an M.R.I. and learned a week later he had a slight tear in his labrum and fluid in his AC joint, where the collarbone meets the shoulder blade.

During training camp, he wrote that lifting weights was painful. He received Indocin, an anti-inflammatory drug. Despite treatment, his shoulder did not improve. He was promised a cortisone shot after the last preseason game several weeks away.

After the first preseason game, he complained of ankle soreness. Doctors had cleaned out bone chips from his ankle twice the previous week. After the second preseason game, he learned he had bone spurs in his ankle. Injuries kept him out of all but six games that regular season.

In January of 2011, Te’o-Nesheim had surgery on his right ankle. According to another page in his journal, written on N.F.L. stationery, he was told to wear a boot for two weeks. He had surgery on his shoulder a month later.

In training camp during the summer he passed a physical but was waived at the end of the preseason and joined the Eagles’ practice squad the next day. In late November, the Tampa Bay Buccaneers signed him.

2012

N.F.L. Success, but Early Signs of Trouble

Ripped pages from Te’o-Nesheim's journal were found in a plastic container after his death. back fwd

Te’o-Nesheim hit his stride in Tampa. He appeared in every game in the 2012 and 2013 seasons, registering four sacks, including one of Seattle Seahawks quarterback Russell Wilson.

He was also reunited with Mason Foster, a college teammate who entered the N.F.L. in 2011. They ate together often, at restaurants that Te’o-Nesheim would pick, or at Foster’s apartment, where they would cook Spam and rice — a Hawaiian staple — and Samoan dishes. They watched the television show “Man v. Food.” Foster said Te’o-Nesheim demolished a 48-ounce steak at a steakhouse.

“His name’s still on the wall,” Foster said. “Family, football and food, that’s all he cared about.”

The injuries continued. According to his notes, Te’o-Nesheim damaged his finger, injured his neck, suffered chronic headaches and continued to struggle with ankle and shoulder pain. He rarely spoke to his family about the physical toll, but there were signs of drug use. In his journal, he wrote that he had trouble sleeping and a team doctor prescribed Ativan, a sedative. Doctors also prescribed painkillers like Tramadol, Percocet and Vicodin.

He remained rootless. He booked rooms at extended-stay hotels.

Friends and family said he became paranoid and more distant. He did not reply to emails for months, then he would call from random phone numbers and not sound like himself. “It was scary and we tried to reach out, but could not get him to open up,” Marie, his sister, said.

After the season, Tampa Bay did not renew his contract.

2013

A Life Unraveling

Te’o-Nesheim sacking Christian Ponder of the Minnesota Vikings in October 2012. He registered four sacks that season. Hannah Foslien/Getty Images Jim Mone/Associated Press Te'o-Nesheim appeared in every game in the 2012-’13 season. Brian Blanco/Associated Press back fwd

Te’o-Nesheim searched for a next step after the N.F.L. Foster said his friend was ready to move on. Indeed, Te’o-Nesheim looked into applying to graduate school so he could coach at the college level.

Without football, though, Te’o-Nesheim’s life in Tampa was untethered. Depression set in. He was ashamed of failing to make it in the N.F.L., according to family and friends. His paranoia deepened. He insisted he was being followed and thought maids were going through his trash, so he moved hotels. He complained that someone was using his credit card, only to realize that he had made the purchases but had forgotten.

He insisted someone was “inside” his computers, so he destroyed his laptop and bought a new one, then did it again, and again. During this time, he spoke to his aunt, Faimafili Monaghan, known as “Fili.” They chatted about technology because she handles I.T. for a police department in Maine, where she lives.

In May 2014, Daniel left a voice message in which, in a faraway voice, he asked Monaghan to call him. Concerned, she called the police in Tampa to ask if they would check up on her nephew. Monaghan sent a text to her sister, Daniel’s mother, with an update, telling her that Daniel had thanked his aunt for sending the officer to check on him.

Te’o-Nesheim’s former agent, Eric Kaufman, said his client told him he was “lost without football,” yet he canceled a trip to Buffalo to workout with the Bills. Te’o-Nesheim changed his cellphone number. Hotels evicted him for not paying. When hotel workers entered his unit, they said it looked like a tornado had blown through.

“Without a doubt in my mind, all of these were early signs of C.T.E.,” Kaufman said.

2015

A Hawaiian Homecoming

Te’o-Nesheim returned to Hawaii Prep to coach football in 2015. Patrick O'Leary/Hawaii Preparatory Academy

Te’o-Nesheim returned to Hawaii in the summer of 2015 a changed man — for worse and for better. He was forgetful, overwhelmed, mentally and physically disorganized and dismissive, his sister said. He played down the pain in his knees, shoulders and back, and the constant headaches and the Tylenol he took daily. His clinical summary, a neuropsychiatric profile composed by a Boston University researcher, Dr. Jesse Mez, from interviews with family members and medical record review, said that he drank three to five times a week, “frequently excessively.”

When his sister, Marie, shared her concerns about her brother’s health, he pushed back. “Daniel was very adamant that he knew his body and he was an adult who could make his own decisions,” she said.

There were questions why an N.F.L. player, presumably wealthy, would return home to the small town of Waimea. He lived with his mother for a while, and regretted spending all his N.F.L. money and never buying a house.

Still, the paranoia he exhibited in Tampa had subsided, and he was excited to return to his alma mater, Hawaii Preparatory Academy, to coach track and field and football. Without a car, he would sometimes sleep on the floor in the locker room and eat breakfast in the dining room so he would be on time for practice in the morning.

Despite his erratic behavior, Te’o-Nesheim was a favorite son and made head football coach in 2017. He moved on campus to be a dorm adviser. The team finished 2-7, but photos from that season show him cheering on his players on the sideline much like he was one of them.

Inside, though, there was turmoil. He experienced blackouts. Friends and family members said he had trouble planning, concentrating and multitasking. He did not file his 2013 taxes until the summer of 2016. He promised to attend his friend’s wedding, then said he forgot to book a ticket.

“He would talk and would make you feel sore just listening to him,” said Kaluka Maiava, another Hawaiian N.F.L. veteran who befriended Daniel during his last two years. “Just seeing him, he looked like he never slept, exhausted all the time. He’d be up all night in the dark staring at the walls dealing with the stuff in his head.”

Friends noticed that he appeared depressed. Te’o-Nesheim cried when he told his players they had to forfeit their last game of the season because they did not have enough players. When the season ended, his funk deepened.

2017

Trying to Get Help From the N.F.L.

The N.F.L. initially denied Te’o-Nesheim’s request for “line of duty” benefits.

What friends and colleagues didn’t know is that Te’o-Nesheim had reached out for help. Earlier in 2017, he contacted Sam Katz, a lawyer at ATHLAW, a firm in Beverly Hills that helps former players obtain disability benefits.

After gathering Te’o-Nesheim’s medical records, Katz filed an application in July 2017 for “line of duty” benefits given to players whose injuries are a direct result of football. Administrators with the benefits plan scheduled an appointment with an approved orthopedist, Dr. Saenz, in San Antonio for October 2.

According to Katz, the doctor told Te’o-Nesheim that he had one of the worst cases of degenerative arthritis in his ankles that he had ever seen. He also found damaged knees and shoulders, pinched nerves in his neck, and a tendon tear in his biceps.

After the appointment, Te’o-Nesheim turned to Katz, who had accompanied him, and asked him how to donate his brain.

“He looked at me and said, ‘I want you to take care of my family if anything happens,’” Katz recalled.

Several weeks later, on Oct. 27, Te’o-Nesheim and his coaches hosted a team banquet. Te’o-Nesheim posed for pictures with his players, giving the shaka, or “hang loose” hand sign.

On Oct. 29, Te’o-Nesheim went to a friend’s house, where they drank vodka, talked and mowed the lawn. That evening, Te’o-Nesheim went to sleep in one of the bedrooms. He was found face down and unresponsive 12 hours later. He was pronounced dead of an overdose.

The next day, the disability plan sent a letter to Katz: Te’o-Nesheim’s application was denied because, they said, his injuries were not severe and numerous enough.

2018

A Diagnosis of C.T.E.

A shrine for Te’o-Nesheim in November 2017, the day after a memorial gathering for him at a friend’s house on the Big Island of Hawaii. Angel Yandall

After Te’o-Nesheim’s death, Katz appealed the decision so Te’o-Nesheim’s family could receive his retroactive benefits. On May 25, the disability plan sent a letter to Katz notifying him that the application had been approved, a rare case of benefits being awarded posthumously. His family received $17,500.

“He could have used some of that line-of-duty money to get some care,” Katz said. “He never got the shot.”

Brian McCarthy, a spokesman for the N.F.L. said a range of benefits and resources are offered to support medical, emotional and financial challenges, and ensure long-term health and well-being.

“What we want every player, active or former, suffering from issues like Daniel's - or otherwise - to know is this: the care and support you need is available. No one should suffer alone,” McCarthy said.

Te’o-Nesheim’s family donated his brain to the Boston University C.T.E. Center, where Ann McKee, the director and a neuropathologist, found no overt signs of damage, which is not unusual in a patient so young. But on the microscopic level, she found many lesions in the frontal lobe linked to C.T.E.

A normal brain is shown on the left. Te’o-Nesheim’s brain, shown in microscopic photographs, had C.T.E. lesions in multiple areas. Ann McKee, MD, VA Boston Healthcare System/Boston University School of Medicine

“It’s always surprising and disturbing to see so many lesions in a guy who was just 30,” McKee said.

Studies show the early onset of Te’o-Nesheim’s C.T.E.-related symptoms — the paranoia, depression and dementia — happens more frequently in players who start tackle football before the age of 12. Te’o-Nesheim began playing tackle football at 11. When adding his years of youth, high school, college and pro ball together, he played half his life.