This summer, one of the National Football League’s most honored linebackers, Junior Seau, was inducted into the league’s Hall of Fame – posthumously. But only Seau’s family attended the induction: the retired player had killed him­self in 2012. Nine months later, the National Institutes of Health reported that he had a degenerative brain disease consistent with chronic traumatic encephalopathy (CTE), making him the most prominent player to be associated with the disease. This year’s induction brought renewed attention to the disease.

The Fall 2014 issue of Penn Medicine looked at concussion and the growing recognition of the danger of CTE among football players. Unlike traumatic brain injury, which can re­sult from one or two very hard hits to the head, CTE seems to emerge after countless smaller shocks. As H. Branch Coslett, M.D. 1977, a professor of neurology, pointed out, it is not yet clear why some people who have received blows to the head get CTE while others do not. The article also noted that the first positive diagnosis of CTE in a football player was published in 2005 by Bennet Omalu, M.D.

The NFL, whose annual revenues are now about $10 bil­lion, was slow to deal with CTE or concussions. In fact, when Omalu published his first article on his discovery in the journal Neurosurgery, the league demanded that it be retracted. For several years, its own doctors continually dismissed Omalu’s findings as seriously flawed and purely speculative. Now there are rumors that the NFL has again stirred itself, in response to a movie set to open on December 25: Concussion, starring Philadelphia’s own Will Smith as Dr. Omalu. Last month, The New York Times re­ported that the movie had been altered to avoid antago­nizing the NFL. The director of the new film, Peter Landes­man, disputed the report. “Anyone who sees the movie will know that it never once compromises the integrity and the power of the real story,” he said. The viewers, of course, will judge.

The cover story of this issue of Penn Medicine looks at another controver­sial topic, fracking. It has been hailed as a cure for the nation’s economic woes and assailed as a health hazard. Penn experts have been studying the effects of fracking in recent years. In 2014, Penn’s Cen­ter of Excellence in Environmental Toxicology (CEET) spon­sored a conference that brought together scientists, physi­cians, corporate representatives, and citizens to examine the matter. Earlier this year, members of CEET and re­searchers from Columbia University’s Mailman School of Public Health published a major study in PLOS One. It identified an association between fracking and increased hospitalization rates in counties where “unconventional gas and oil drilling,” as the study puts it, has taken place. 

The article argues that rigorous science is all the more necessary when tension is high and divisions are wide. Sci­ence will establish whether fracking is the cause of the vari­ous illnesses and other negatives effects. If the studies point to fracking, policy makers and industry leaders will likely be called upon to compensate inhabitants of the affected re­gions – and the findings could halt the entire drilling process until safer procedures can be developed and proven.  


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