On the day he took his own life, Austin Trenum ate cheesecake.

He was 17. He loved cheesecake. He loved the Beastie Boys, too, and

SpongeBob Squarepants and the silly fauxhawk haircut he spent months

cultivating and two minutes shaving off because, well, that’s what

teenagers do. He loved his little Geo Metro convertible, neon yellow and

as macho as a golf cart, a gift from his grandfather, the two driving all

the way from Texas to Austin’s home in Nokesville, Virginia, a close-knit

community of 1,354 in Prince William County.

Austin loved his parents, Gil and Michelle, and his younger

brothers, Cody and Walker. He loved his girlfriend, Lauren. He loved

cheering for the girls’ volleyball team at Brentsville District High

School, smearing his chest with paint and screaming his lungs out

alongside his lacrosse teammates; loved sneaking out of his chemistry

class to sing “Bohemian Rhapsody” with his friend Carmen in the band room;

loved fishing and paintball, roller coasters and blasting “Sweet Caroline”

with the top down.

Austin’s brain showed he had a multifocal axonal injury, which can disrupt normal impulse control. Scientists are struggling to understand the connection between concussions and suicide. Photograph courtesy of the Trenum family.

He especially loved football. Loved watching the Dallas

Cowboys. Loved playing for the Brentsville varsity team—fullback and

linebacker—taking hits and delivering them, seldom leaving the field,

eating two Hostess cherry pies before every game. He was a handsome kid,

green-eyed like his mother, six feet tall and 190 pounds, growing stronger

and more confident all the time. Under the Friday-night lights, in his

beat-up helmet and shoulder pads, you could see the man Gilbert Allen

Austin Trenum III was becoming.

• • •

It was Sunday, September 26, 2010. Michelle Trenum woke up

around 8 am. Gil was out of town, returning that afternoon from a weekend

drill with his Navy Reserve unit in New Jersey. Walker, ten, their

youngest, was on the living-room couch, hiding under a blanket. He jumped

up when Michelle walked in. Boo!

“Austin’s awake,” Walker said. “He’s in the basement playing a

video game.”

That’s odd, Michelle thought. Austin never got up early on

Sundays. Not voluntarily.

Michelle made her sons breakfast. Austin drove his other

brother, Cody, 15, to a lacrosse game and cheered from the sidelines. He

took more pride in his siblings than himself; he was that kind of brother.

On the way home, he teased Cody. “You did good,” Austin said, before

delivering the punch line. “You surprised me!”

Back at the house, Austin ate lunch. And cheesecake. While

Austin surfed the Internet, he and Michelle talked about Adam James, a

Texas Tech football player who had allegedly been locked in a dark

electrical closet by the school’s head coach, Mike Leach, after suffering

a concussion. The story, which ultimately ignited a media firestorm and

led to Leach’s firing, began when the injured James showed up to practice

in sunglasses and street clothes; Austin joked with his mother that he

should do the same, just to see how his high-school coach, Dean Reedy,

would react.

Austin then turned serious, balancing on one foot to mimic a

neurological test.

“Am I going to be out all week?” he said. “I don’t want to be

out all week. Do you think I’ll be out two weeks?”

“You’ll just have to see,” Michelle said.

During a football game the previous Friday night, Austin had

sustained a concussion. Brain trauma had been in the news. There were

reports of retired NFL players suffering from depression and dementia

linked to their hard-hitting careers. There were congressional hearings,

some of them dealing with high-school football. In the coming months, the

sport would be engulfed in a full-blown health crisis. Austin’s parents

were mostly unaware of the controversy. They had both grown up in Texas,

where football was king, where getting your bell rung was just a part of

the game. Almost a badge of honor.

• • •

Gil and Michelle had been in the Brentsville High bleachers on

Friday night, chatting with friends, a full moon overhead. Neither of them

saw the hit, but Gil spotted their son standing with his helmet off,

touching his index finger to his nose at the direction of team trainer

Richard Scavongelli. Just like last season. Good grief.

On the sideline, Austin was dazed, slurring his words. During

the drive to the emergency room, he was alert enough to call Lauren, his

girlfriend. By the time he was standing in line at Prince William

Hospital, shirtless and sweaty, he seemed fine. He cracked jokes, flirted

with the nurses who brought him a sandwich and a soda. He begged a doctor

to let him leave, asked if Lauren could come back to the examination

room.

A nurse asked if he wanted Tylenol.

“The last time you got a concussion, you got a headache,”

Michelle said. “Are you sure you don’t want it?”

“Mom, I’m fine,” Austin said. “I don’t have a headache. Except

for my normal football headache. I get them after every game.”

The medical staff gave Gil and Michelle a sheet of

instructions: Watch for vomiting and clear fluid coming out of Austin’s

nose, signs of a more severe brain injury. Limit their son to “quiet

activities” for the next 24 hours. Wake him from sleep every few hours to

check for evidence of intracranial bleeding, such as confusion and extreme

drowsiness.

Heading home, the Trenums stopped at the Chuck Wagon, a

restaurant around the corner from their house, where the Brentsville High

players gathered after games. Austin’s teammates recounted his sideline

exchange with Scavongelli.

Scavongelli: “Do you know where you are?”

Austin: “Yeah. This is my field!”

Scavongelli: “No. Do you know what school you are

at?”

Austin: “Yeah. My school!”

Scavongelli: “Do you know who you’re playing

against?”

Austin: “No.”

Photographs courtesy of the Trenum family.

This is my field! Everyone laughed. They laughed at the way

Austin had gotten emotional on the field, too, cussing out one of his

buddies, something he never, ever did.

On Saturday morning, Austin attended football film study; that

afternoon, he went fishing; in the evening, he took Lauren to a Sugarland

concert, a belated celebration of her birthday. They sat on the Jiffy Lube

Live lawn, taking pictures under the stars. When Austin got home, he

texted Lauren good night. The next day, he was sitting in his family’s

dining room doing homework, texting her again about meeting up two hours

later to watch a Redskins game.

Austin was a good student, ranking in the top 6 percent of his

class. He planned to study chemical engineering in college and was

deciding between Virginia Tech and James Madison. The former had a better

football team; the latter, he deduced during a campus visit, had

better-looking girls. As Austin studied for his Cold War history class,

Michelle went online to check his academic progress. There was a problem.

He hadn’t turned in two papers. Michelle was upset and lectured him about

slacking off.

Gil came home around 2:30 pm. Michelle gave her husband a kiss

and cut him a slice of cheesecake. She told him about Austin’s schoolwork.

Austin looked irritated—almost angry. That was out of character. Michelle

saw his jaw clench. His mouth moved. She was stunned. Did he just call

me a name? Austin stared straight ahead.

“If you don’t finish your work,” she said, “you can’t see

Lauren tonight.”

Gil and Michelle went outside. Cody and Walker were on the

living-room couch, watching a football game. At some point, Austin went

upstairs.

“I don’t know what’s wrong with Austin,” Michelle said. “He

shouldn’t disrespect me like that.”

“He’s a teenager,” Gil said. “I’ll go talk to him.”

Gil went inside. He passed the kitchen table, where his

cheesecake sat untouched. He walked up the stairs, the same stairs where

Austin would ambush Walker when he came home from school, peppering him

with foam darts from a toy gun. The door to Austin’s room was

open.

Michelle Trenum heard her husband scream.

• • •

On her way to the hospital, Patti McKay made a deal with God.

Not Austin. Please. Take me instead. The boy was like a second

son. Every summer, the McKay and Trenum families vacationed together at a

lake in Maine, where the kids would play King of the Dock—wrestling for

control of a wooden swimming platform, tossing one another in the water,

Austin always making sure the younger children won their

share.

When her cell phone rang, Patti was in her sister’s garden,

kneeling in the dirt. It was Cody, panicked. Austin wasn’t breathing. Gil

was trying to resuscitate him. An ambulance was on the way. What should

they do?

Keep performing CPR, Patti said.

A cardiology nurse, Patti suspected a subdural hematoma. A

brain bleed. Which was odd. She had just seen Austin, about 90 minutes

earlier, pulling up in her driveway—the top down on his little yellow

convertible, Cody in the passenger seat.

Austin had been grinning. He had a gift with him, a Snickers

cheesecake.

“Here, Ms. McKay,” he said. “Look what we brought for

you.”

“How are you feeling?”

“Okay.”

“No, really—how are you feeling?”

“I’m fine. My headache is almost gone.”

Patti had been at the game on Friday night, standing with

Austin in the Brentsville High parking lot, holding his arm to help him

balance. But today his gait was normal, his hands weren’t shaking. She

called the emergency room, professional instincts taking over. You’re

getting a boy who had a concussion two days ago. You need a neurosurgeon.

If you don’t have one, have a helicopter ready to evacuate. Arriving

at Prince William Hospital, she didn’t see a helicopter. She saw Rob

Place, the Trenums’ next-door neighbor.

Austin hanged himself, Place said.

• • •

Nothing made sense. Not suicide. Not Austin. Not the boy who

went deer hunting in West Virginia with his father and crafted elaborate

zombie-apocalypse defense plans with Walker. Not the young man who always

said “Yes, sir” and “No, ma’am” and was adored by his friends’ parents.

Not the charmed kid who never got mad on the lacrosse field, who’d scored

a goal six seconds into his first high-school game.

“If someone came to me and asked me to rank, 1 to 25, the kids

on the team most likely to have problems and the kids who were the most

stable, Austin was number one on the stable end of the list,” says Carl

Kielbasa, Austin and Cody’s former high-school lacrosse coach. “His

maturity level was extremely high. Never experimenting with drugs and

alcohol. Almost fatherly to his brothers. Had a wonderful sense of humor.

He was a great teammate, very attentive and aware, very patient and kind.

A big-time leader on the team and in school—he could hang out with the

kids who were partyers and be in an honor-society meeting the next day.

Everyone loved him.”

Austin was taken to Inova Fairfax Hospital, where he died at 2

am on Monday. The entire community was stunned. The boy was beloved.

Football was beloved. In the Nokesville area, plans were underway to build

a new $850,000 youth-football complex; elementary-school students were let

out early on Friday afternoons, the better to high-five Brentsville High

players as they made their march down the town’s main road.

How could this have happened?

The Trenums went home. Later that day, their phone rang. Laura

O’Neal answered. She was Austin’s godmother, one of Michelle’s best

friends. She’d been there for Austin’s first birthday, eating

cowboy-themed cake; there when he got his first lacrosse stick, which he

carried everywhere, like a scepter. Now she would plan his

funeral.

There was a man on the line, Chris Nowinski, a former Harvard

football player, calling on behalf of scientists at Boston

University.

They wanted Austin’s brain.

Austin’s room remains as it was. Sometimes his mother, Michelle, lies in his bed just to feel his blanket. Photograph by Melissa Golden.

The human brain is a wondrous thing. It enables us to throw a

football, allows us to breathe, think, and love. In its neurons and glial

cells, synapses and neurotransmitters, it is essentially who we

are.

And who we are is fragile.

Gerard Gioia opens his laptop. On the screen is a video

depicting a brain inside a skull. The brain, he explains, is a spongy mass

of tissue. Surrounded by fluid, it moves independent of the skull, just

slightly, the arrangement providing a protective measure of shock

absorption.

“And this,” he says, “is why the helmet will never be the

simple answer to this injury.”

Helmets prevent skull fractures but not concussions. Gioia

clicks a button. The head rocks back and forth. The brain smashes against

the inside of the skull. The screen flashes like a strobe light, a

comic-book pow! Such is the basic dynamic of a concussion, an

injury that occurs in football with alarming regularity: According to the

American Association of Neurological Surgeons, 4 percent to 20 percent of

high-school and college players will suffer one during a single season.

That’s likely a low estimate—some experts believe as many as eight of ten

concussions go undiagnosed.

“When the head or the body takes force, the brain moves,”

explains Gioia, head of Pediatric Neuropsychology at Children’s National

Medical Center and an expert on youth and adolescent sports concussions.

“It has a certain threshold, beyond which it stretches and

strains.”

Gioia loves football—played it himself in high school and

college. He wants to make the sport safer. Three weeks after Austin’s

death, he met with Gil and Michelle in his Rockville office, where a New

York Giants-themed street sign hangs on the wall. Michelle brought a

picture frame containing three photos of Austin, including one of him

joyfully painting his face before a volleyball game the week before his

death.

“Look at this boy,” she said, fighting tears. “Look at these

pictures. He wasn’t depressed.”

Shock giving way to despair, the Trenums wracked their brains.

Was there something we missed? They talked to Austin’s friends,

checked his text messages, read the journal he kept for English class:

I heard my favorite Sublime song. Today was good. I forgot to wear my

Hawaiian shirt. Bummer.

No angst. No suicide note. No sign that anything was wrong.

Nothing. The concussion, they figured—it had to be the concussion. But

how? Didn’t they go to the ER, keep Austin from strenuous activity, do

everything right? Scavongelli, the Brentsville High trainer, had

immediately pulled Austin from the game, protecting him from second-impact

syndrome, a rare but horrific condition in which athletes suffer a second

concussion while recovering from a previous one, causing rapid,

catastrophic brain swelling that ends in severe disability or

death.

After a concussion during his junior year, Austin was held out

of football practice for a week. A medical-hotline operator advised

Michelle to watch for signs of depression. She told Austin. He

laughed.

Oh, please, Mom.

“Why?” says Michelle. “Why did he do this? We must have said

that seven million times.”

• • •

A concussion is not a bruise. It’s a disruption of the

intricate system of electrochemical signals that constitute normal brain

function. Contrary to widespread belief, concussions don’t always coincide

with loss of consciousness. Symptoms include headaches, sensitivity to

light, confusion, lack of focus, irritability, and loss of interest in

favorite activities.

With rest and a gradual return to regular activity, most

athletes who suffer a single concussion experience no permanent ill

effects. Some, however, suffer post-concussion syndrome, in which symptoms

persist for months or years, in rare cases permanently. Having one

concussion may increase the risk of another. Multiple concussions are

associated with an increased risk of post-concussion syndrome as well as

depression and memory loss.

Think of your brain as a computer, Gioia says. The tissue is

the hardware, and the electrochemical signals are the software.

Concussions can scramble both, disrupting healthy equilibrium. Moreover,

they leave the brain drained of energy, like a cell phone with a bad

battery.

The best treatment? Rest—lots of it. Waking a sleeping

concussion patient every few hours to check for brain bleeding has long

been conventional medical wisdom, Gioia says, but actually is not a good

idea: You should check on them, but not disrupt their sleep. “The

essential aspect is allowing the cells to rebalance themselves.

Overworking the brain interferes with that recovery. And it’s not just

avoiding additional blows to the head. You can’t be out running. You need

good sleep. You have to manage school, any activity that involves a lot of

thinking.”

• • •

For 21/2 hours, Gioia and the Trenums talked, going over

Austin’s final weekend. As they connected the dots, two things became

clear: Football had injured his brain, which subsequently was overworked.

Texting. Video games. Driving. Studying. Staying up late. Normal teenage

activities. All of them too much.

Looking back over the weekend, they saw warning signs, subtle

indicators that something was amiss. Austin had trouble sleeping on Sunday

morning. He got lost on the way to Cody’s lacrosse game, even though the

directions consisted of a single right turn. He forgot what month it was

while fishing with his friend Carmen. He had “football

headaches.”

When Austin was concussed a few plays before halftime during a

football game his junior year, his teammates were the first to notice. In

the locker room, he couldn’t figure out how to work his chin strap and

began to bawl. Similarly, his final concussion left him cursing out his

best friend, Ryan Hall, for an on-field prank meant to make Austin

laugh.

Gioia showed the Trenums a diagram of the brain. He pointed out

the frontal lobes, about one-third of the total brain mass, the portion

just behind the forehead, where so much football contact takes place.

These gelatinous hunks of meat, he told them, are our executive control

centers. They allow us to reason, to choose right from wrong, to override

impulses, to connect current actions to future consequences.

In teenagers, the frontal lobes are still developing; in

everyone, they require a great amount of energy to function properly.

Damage or disrupt them, stretch them like Silly Putty, and concentration

suffers. Memory gets spotty. The systems governing emotion and reason are

thrown out of whack. You might forget how to work a chin strap; you might

consider that unbearably tragic. Nothing makes sense.

Austin’s parents believe that their son may have suffered as

many as four concussions during three years of playing football. Did those

injuries lead him to take his life? Gioia can’t say. There’s no direct

causation. The brain remains mysterious.

“My thought to the Trenums was that Austin’s brain wasn’t

functioning properly,” he says. “It was drained in terms of overall

energy, unusual emotional response was one of his manifestations, and the

argument about academics hit at that time. Bam! Those emotions go off, and

now the decision-making is not working properly, either.”

Meeting with the Trenums, Gioia was more succinct. He told them

Austin’s case was a perfect storm.

Photographs courtesy of the Trenum family.

On the first snap of Brentsville’s first football game without

Austin, the school’s quarterback mimed a handoff to his absent fullback,

then took a knee. He pointed to the night sky, where cheerleaders with the

number 43 painted on their cheeks had released the same number of

balloons. The whole school wore white. Cody and Walker wore jerseys

bearing their brother’s number, 43, and watched from the sideline. At the

end of the game, a Brentsville player carried Walker off the field on his

shoulders.

Football went on. The Trenums understood. Gil, 46, had grown up

in Ohio and Texas, states where the sport is practically a religion;

Michelle, 48, was raised an hour and a half from Odessa, Texas, the

real-life setting of Friday Night Lights. She remembers pep

rallies and rabid boosters, caravans of cars with shoe-polish-painted

windows, what seemed like entire towns turning out for high-school games.

Gil and Michelle attended Texas Tech, where Austin went to summer football

camp. They loved the sport. So did Cody, a member of the Brentsville High

JV squad, and Walker, who played on a youth team.

As the Trenums grieved, friends and neighbors brought them

food, mowed and reseeded their lawn, even repainted their front door. The

family watched football. Tuesday nights. Thursday nights. All weekend

long. College and pro. Tackle after tackle, hit after hit. “I don’t know

why,” Gil says. “We just did. It was a distraction, something you had to

focus on.”

Gil and Michelle kept in touch with Gioia. They had donated

Austin’s brain to the Boston University scientists, who were studying the

effects of concussions and head trauma. The Trenums came to a frightening

realization: Like so many others around the country, the Prince William

County school system wasn’t doing enough to address athletic concussions.

What happened to Austin could have happened to anyone.

Six months before Austin’s death, Virginia had passed a law

requiring schools to educate students and parents about concussions and to

remove students suspected of sustaining the injury from the field of play

until cleared by a medical professional. In Fairfax County, education

meant watching a ten-minute online video; in Loudoun County, it meant

signing a two-page form. Prince William’s policy was still being written,

not scheduled to take effect until 2012.

A member of the Prince William County school board, Gil wanted

something quicker and better. A policy with teeth. He lobbied

administrators. He had Gioia make a presentation to the board, got input

from Nowinski, the former Harvard football player now with the Boston

University program. Spurred by his son’s death, Gil was

relentless.

Prince William’s new concussion policy went into effect in the

summer of 2011, mandating stricter return-to-play guidelines and more

thorough education for school athletic trainers. Students trying out for

sports are now required to attend an hourlong concussion seminar with at

least one parent.

“I have families contacting me all the time, telling me they

can’t thank Gil enough,” says Kendra Kielbasa, an advocate for

youth-concussion care and the wife of Austin’s former lacrosse coach.

Working with Gil to draw up a policy that stresses post-concussion

cognitive rest—the kind Austin didn’t know enough to get—Kendra had drawn

on her own experience. Her son, Connor, was concussed after being dropped

on his head during a seventh-grade wrestling match. Emergency-room doctors

checked Connor for a brain bleed and cleared him to return to school the

next day. Three weeks later, with his grades plummeting and his emotions

off kilter, he asked his mother if he could lie down.

“Sure,” Kendra said. “Why don’t you go to your

room?”

Connor looked around the living room. “I don’t know where it

is,” he said. “Can you take me?”

“The hardest part is that people don’t understand—your child

looks like he is fine, but he’s not,” Kendra says. “People have to

understand that it’s not just a bad headache for a day or two. And it’s

not enough to do [concussion education] in the high schools. We have to

bring it to the middle and elementary schools.”

Would more education have saved Austin’s life? The Trenums

think so.

Last fall, Cody played in a lacrosse tournament in

Williamsburg. Michelle was in the stands. A boy from another team was hit

hard and concussed. As his parents pulled him off the field, a woman

approached. She said she was a nurse. Michelle could overhear their

conversation. The boy was dazed, struggling to remember

things.

“Well, he’s not passed out,” said the nurse. “That’s a good

sign.”

Actually, Michelle thought, episodic amnesia is more of an

indicator of serious problems than passing out is.

The nurse continued to offer medical advice, much of it dated.

Michelle began to panic. As soon as the nurse left, she ran over to the

parents. “Take your son to a doctor,” she implored. “A neurologist. Get

him some rest. Keep a close eye on him.”

The parents asked, “Are you a doctor?”

“No,” Michelle said. “But my son died last year after a

concussion.”

“That scared them,” she says. “And all I could think was ‘At

least your son will live.’ ”

• • •

The brains come here, to a red-brick building in suburban

Boston. Each is weighed, photographed, and examined for signs of trauma

and disease, then carefully sliced in half. One half goes to the upstairs

laboratory, where scientists create tissue samples ten microns thin,

chemically stained and mounted on slides for microscopic inspection. The

other half is placed in a closet-size, stainless-steel freezer, preserved

for future study.

“There are more freezers,” says Victor Alvarez, a researcher at

the lab. “We’re always looking for more space.”

Football has a problem. The sport kills too many players. Some

slowly, some all at once. The evidence is in the freezers and in the

stacks of slides cluttering the office of Ann McKee, a neuropathologist

and codirector of the Boston University Center for the Study of Traumatic

Encephalopathy.

Each brain tells a story: former Pittsburgh Steelers lineman

Justin Strzelczyk, dead at age 36 after leading police on a high-speed

chase that began with hallucinations and ended in a fireball; former

college-football player Mike Borich, dead at 42 from a drug overdose;

former Philadelphia Eagles safety Andre Waters, dead at 44 from shooting

himself; former NFL safety Dave Duerson, dead at 50 from shooting himself

in the chest—specifically in the chest—after scrawling a note to

his family asking that his brain be donated to science.

Austin Trenum, dead at 17.

Concussion Care After taking a forceful blow, athletes experiencing any of the following signs or symptoms should be removed from play and examined by a health-care professional trained in concussion evaluation. The rule of thumb? When in doubt, sit players out. Observable Signs Don’t Miss Another Big Story—Get Our Weekend Newsletter Our most popular stories of the week, sent every Saturday. Or, see all of our newsletters. By signing up, you agree to our terms • Dazed or stunned appearance. • Confusion about the game, player’s position, score, or opponent. • Inability to remember instructions. • Vacant stare or glassy eyes. • Clumsy movements. • Answering questions slowly. • Loss of consciousness, even brief. • Mood, behavior, or personality changes. • Inability to recall events before or after the blow. • Any seizure. Self-Reported Symptoms • Headache or pressure in head. • Nausea or vomiting. • Balance problems or dizziness. • Ringing in ears. • Double or blurry vision; seeing stars or flashing lights. • Sensitivity to light or noise. • Feeling sluggish, hazy, foggy, or groggy. • Problems with concentration, thinking, or memory. • Depression, sadness, irritability, or anxiety. • Change in sleep pattern or trouble falling asleep. After a concussion, athletes need physical and mental rest—no television, video games, music, reading, computer use, school attendance, or homework. Sleep is essential. A return to regular activities should take place slowly after all signs and symptoms have resolved, under the supervision of a neurologist or other medical professional. Current medical guidelines call for a graduated series of monitored steps, in the following order, with each successive step allowed only if no concussion signs or symptoms manifest themselves: 1. Total rest. 2. Return to school half days. 3. Full return to school. 4. Light exercise (walking, stationary cycling). 5. Non-contact-sport activities and training (running, throwing). 6. Drills without body contact; light weight training. 7. Drills with body contact; heavy weight training. 8. Game play. Sources: Centers for Disease Control and Prevention, 3rd International Conference on Concussion in Sport, Ontario Neurotrauma Foundation, TheConcussionBlog.com.

Last summer, Gil and Michelle came to McKee’s office. They

looked at slides of Austin’s brain. Through the microscope, they saw

axons, the long, slender fibers that connect nerve cells and conduct

electricity in the brain. In a healthy person, axons run together like

fiber-optic cable, straight and smooth. Austin’s were twisted, bulbous,

broken. In scientific language, it was a multifocal axonal injury; in

layman’s terms, the equivalent of frayed automobile wiring. Turn on the

radio and the windshield wipers might move; turn off the lights and the

whole car might shut down.

Michelle choked up. This, she thought, is my baby. This is what

ended his life.

Austin’s case isn’t unique, McKee says. There have been other

sudden, inexplicable suicides following concussions—some in the military,

some among high-school football players. Scientists are struggling to

understand the connection. But something is happening. Something

terrible.

“It’s the same pattern,” McKee says. “They have disordered

thinking and electrical impulses in the brain. They have a minor

irritation. And they just want to end it. It’s like having a fly in your

room and deciding to blow up your house.”

• • •

A decade ago, McKee wasn’t studying dead football players.

Nobody was. That changed when Bennet Omalu, a forensic pathologist and

neuropathologist, examined the brains of former Steelers linemen Mike

Webster in 2002 and Terry Long in 2005. Both had suffered slow, puzzling

descents into erratic behavior and madness, with Long ultimately killing

himself by drinking antifreeze and Webster dying of heart failure after an

extended period of living in his truck in which he sometimes shot himself

with a Taser gun in order to sleep and other times sniffed ammonia to stay

awake.

Omalu found that each had suffered from chronic traumatic

encephalopathy (CTE), a progressive neurodegenerative disease similar to

Alzheimer’s and linked to the absorption of repeated blows to the head, a

condition previously associated with prizefighters—in layman’s terms,

“punch drunkenness.”

Evidence suggests that CTE is caused not only by concussions

but also by subconcussive trauma. Little hits—the ones inherent in

football that occur on every snap, like the 1,000 to 1,500 hits to the

head that Boston University researchers estimate the average high-school

lineman takes each season, some at forces equivalent to or greater than a

25-mile-an-hour car crash.

CTE has been found in a number of deceased football players,

including Strzelczyk, Creekmur, Borich, Waters, Duerson, and Chris Henry,

a former NFL receiver never diagnosed with a concussion. Early stages of

the disease also were discovered in the brain of Owen Thomas, a

21-year-old University of Pennsylvania football captain who hanged

himself, and in Nathan Stiles, a 17-year-old high-school player from

Kansas who collapsed during a game and died of a rebleed of a brain injury

suffered in a previous game.

Because their brains are still developing, children and

adolescents are particularly vulnerable to brain trauma. A recent Virginia

Tech study measuring head impacts among seven- and eight-year-old football

players found that some hits generated more than 80 g’s of force, equal to

the blows delivered in college football.

“I think that in ten years we’re going to look back at this and

say, ‘Whoa,’ ” says McKee, who has examined thousands of brains over 26

years. “The public only knows some of the evidence. It’s overwhelming. And

as it accumulates, it’s impossible to deny.”

• • •

Austin Trenum showed no signs of CTE, none of the telltale

clusters of dark brown spots on slides of stained pinkish brain

tissue.

The sport damaged his brain nonetheless.

At a 2009 congressional hearing, Ann McKee presented a summary

of her work, acknowledging that hundreds of thousands of former football

players seem perfectly healthy. She then asked: Do we expect that 100

percent of cigarette smokers will develop lung cancer? Do we expect 100

percent of children who play with matches or even chainsaws will get

hurt?

Representative Ted Poe, a Texas Republican, said that parents

and players already know football is dangerous. He said government

involvement would mean “the end of football as we know it” because the

sport would end up becoming “touch football.”

Such are the terms of an ongoing national debate over

football’s safety and long-term viability, an argument that has

intensified since the May suicide of popular former NFL linebacker Junior

Seau. Mismanaged concussions can cause permanent harm and death. But even

players who never have a concussion are at risk of developing CTE. How

much is too much?

McKee is no abolitionist. She grew up in Wisconsin rooting for

the Green Bay Packers. Her favorite player was Willie Wood, a DC native

now suffering from dementia. Her two older brothers played the game. She

doesn’t want to end football; she wants to save the sport from itself.

Three years ago, she ran into a group of players from her daughter’s high

school at a doughnut shop outside Boston.

“So,” McKee asked, “you guys know anything about

concussions?”

“Oh, yeah,” said one of the boys. “I’ve had five.”

“I’ve had seven,” said another.

“It was a badge of honor,” McKee recalls.

For years, McKee loved attending prep football games. Not

anymore, she says. You just don’t know what will happen.

The room remains as it was. A lacrosse helmet. An SAT prep

book. A half-empty pack of gum. All on a desk. Austin and his friends

mugging in a photo booth, young and happy and full of life, the snapshots

tacked to a mirror. Clothes are piled on the closet floor, the bed unmade.

Sometimes Michelle will come upstairs and lie down, just to feel her son’s

blanket.

Downstairs is a bathroom. When Austin was in the hospital,

doctors working to save his life, Michelle tried to make a deal with God:

I’ll rip out the bathroom, make it bigger. Austin can be a vegetable

and we’ll take care of him. Just let him live.

“But I knew,” she says, her voice trailing off.

The first months were the hardest. Gil, a senior engineer at

SAIC, went back to work. The boys were in school. Michelle, a stay-at-home

mom, would lie on the living-room couch—the family’s golden retriever,

Biscuit, at her feet—and sob. Before Austin’s death, she had been

outgoing, involved in the community, digging up local land-use records and

political-campaign contributions to lead a successful fight against a

planned rock quarry. Not anymore.

She withdrew, felt vulnerable, couldn’t be around people who

didn’t know Austin. She threw herself into spy novels, then science

fiction, sometimes reading for seven hours a day. She had once favored

Anne Tyler and Pat Conroy, selections from Oprah’s book club. “But I

couldn’t read those,” Michelle says. “Nothing with mothers and kids and

emotions.”

When children take their lives, parents blame themselves.

Michelle wondered why she’d gotten on Austin about his homework; Gil

wondered why he’d let him do homework in the first place. A grief

counselor told Michelle it would take a year for the guilt to pass. “Even

I have trouble sleeping sometimes,” says Patti McKay, the Trenums’ close

friend. “I think about what Gil and Michelle saw. I don’t know how they

sleep. I can’t imagine living with that.”

Michelle still watched football, but not in the same way. She

winced at every big hit, noticed that concussed players almost always fell

with their forearms extended away from their bodies, a reflex scientists

call “the fencing response.” She began investigating sports concussions

and teen suicide, spending hours online, reaching out to military and

academic experts.

Researchers at the Centers for Disease Control and Prevention

tracked suicides, but they didn’t correlate those deaths with recent brain

trauma, never mind athletic participation. Nor did anyone

else.

Michelle befriended Dustin Fink, an Illinois-based athletic

trainer who runs a concussion blog. Fink’s anecdotal evidence suggested

that boys who played both linebacker and running back were at greater

brain-trauma risk. Michelle made a spreadsheet, one she still maintains,

logging every instance she could find of high-school and college football

players killing themselves: name, age, position played. She saw a pattern.

Linebacker. Running back. Linebacker. Running back. Just like

Austin.

• • •

Two football helmets rest on a table. One is black, matte and

battered, with an orange mouthpiece wedged in the facemask. The other is

reddish and gleaming, decorated with a skull and crossbones and a

breast-cancer-awareness sticker. Two gashes run down the

front.

The first helmet belonged to Austin. The second belongs to

Walker.

Michelle pushes them together. “This,” she says, “is how it

happens.”

It’s a Saturday, exactly one year after the weekend of Austin’s

death.

Cody finished the previous Brentsville High football season,

then quit. He didn’t say why. Walker continued to play for a youth squad,

fullback and linebacker, same as Austin. Gil and Michelle didn’t want to

overreact, give in to emotion, cocoon their son in bubble wrap. Besides,

Austin always took such pride in Walker. The boy loved to hit, so much so

that he bragged about it: Mommy, that kid is a baby. He cried, and I

didn’t even hit him that hard.

Walker wore a special chin strap, rigged with accelerometers

that measured the force of every blow he absorbed. If built-in software

deemed any hit powerful enough to cause a head injury, three green LED

lights on the chin strap would flash red. While Walker was making a

routine block, his head whipped sideways. Red lights. His coach pulled him

off the field. Two sideline nurses checked him out. Dizzy and frightened,

he cried.

“My head,” he said. “My head.”

The Trenums followed Gioia’s instructions. They made Walker

rest. They took him to a Sunday-night bonfire—a memorial for Austin—but

didn’t let him run around with his friends. On Monday morning, a

neurologist diagnosed Walker with a concussion. Sensitive to light and

sound, he was held out of football practice and gym class for a week. One

week after that, he was back on the field, Michelle looking

on.

“You’re so calm,” one of the other mothers said.

Michelle wasn’t. Watching football on TV was bad enough. This

was worse. Also, the chin strap. It was supposed to make things easier,

safer. But the lights kept turning red, once when Walker hadn’t even been

hit. Michelle made him sit out the entire game. Walker fumed, said he

wouldn’t wear the device again. Michelle sent the faulty chin strap back

to the manufacturer, got a replacement, then sent that one back, too. More

red lights. Was the problem a bad battery? Water leaking into the

electronics? Was the problem football?

Michelle wasn’t watching her son. She was watching the lights,

waiting for green to go red. She worried about punch-drunk football

players, the blows adding up over time—wondered if Walker’s concussion was

God’s version of a yellow flag. It was all too much.

Michelle Trenum kept coming back to the same

question.

“If you’re that worked up,” she says, “then what are you doing

letting your kid out there in the first place?

• • •

Losing a child, Michelle says, is like jumping from one train

onto another headed in the opposite direction. In an instant, you’re

barreling away from everything you once knew, farther and farther with

each second.

Brentsville High has a scholarship in Austin’s name. In their

living room, the Trenums keep a large photo of Austin, sweaty and beaming,

coming off a football field. On the ceiling above the kitchen table is a

spot with his fingerprints, smudged and faded, where he and his brothers

once liked to test how high they could jump. “I sometimes think we can

never repaint that,” Michelle says. There’s sadness in her eyes—green like

Austin’s—and pain.

“I love football,” Gil says. “I loved watching the kids play.

But it’s not the same anymore.”

Twelve years ago, Dallas Cowboys quarterback Troy Aikman

retired after suffering the tenth concussion of his Hall of Fame career,

the result of a vicious hit from Washington Redskins linebacker LaVar

Arrington. Aikman since has become a successful broadcaster, a man who

owes much to football. After the Super Bowl in February, however, he said

that the sport was “at a real crossroads. . . . If I had a ten-year-old

boy, I don’t know that I’d be real inclined to encourage him to go play

football in light of what we’re learning from head injuries.”

Michelle showed Walker the comment.

“I don’t think I want you to play football,” she

said.

He was upset—for a moment.

“Can I play another sport?”

Gil and Michelle are not against football. They don’t judge

others. But they’ve made their decision.

“As a mother,” Michelle says, “I’m a lot more relaxed watching

basketball.”

Patrick Hruby is a culture writer for the Washington Times and a contributor to ESPN.com and TheAtlantic.com, among others. You can contact him at patrickhruby.net.

This article appears in the August 2012 issue of The Washingtonian.