The Hollow Man

As the top pick for the 1968 49ers, Sacramento’s Forrest Blue was a giant in the game. But after a career of impressive stats, the one that counted most was the one nobody wanted to discuss—the concussions he sustained on his path to glory.

A penny for the Old Guy …
We are the hollow men
We are the stuffed men
Leaning together
Headpiece filled with straw …
Those who have crossed
With direct eyes, to death’s other Kingdom
Remember us—if at all—not as lost
Violent souls, but only
As the hollow men
The stuffed men
From T.S. Eliot’s poem “The Hollow Men”

IIt’s a bright Sunday morning in early October, and Brittney and Brandi Blue, daughters of 1970s NFL standout Forrest Blue, are sitting in a West Sacramento coffee shop, sharing memories of their father, who passed away on July 16, 2011 at the age of 65 in an assisted living facility in Carmichael, after years of struggling with depression, memory loss, disorientation, hallucinations, and, in the end, full-blown dementia.

Much to the consternation of the stone-faced regulars quietly nursing their steaming mugs, the place is cluttered with parents and rowdy kids who, from their dress, appear to be either going to or returning from church. By contrast, the Blue sisters exhibit a very different energy—brittle exhaustion masked by wan smiles, and the weary resignation that only comes with prolonged bereavement.

Forty-Niner fans more familiar with the dynasty that Bill Walsh built with Joe Montana, Ronnie Lott and Jerry Rice in the 1980s might draw a blank when they hear the name Forrest Blue. But those with stouter memories know that Blue, whom The New York Times called “one of the NFL’s best centers [of his time]” days after his death, was far more than just a footnote in the franchise’s history books. Selected in the first round of the 1968 draft by the 49ers (15th overall), Blue would become a four-time Pro Bowl center and part of an almost impenetrable offensive line that protected veteran quarterback John Brodie and helped the club dominate the NFC West for years.

Like their father, who, in the prime of his athletic career, clocked in at an imposing 6 foot 5 inches and 260 pounds, both Blue’s daughters stand tall. Brandi, a former teacher who now works for the Department of Personnel Administration, has light brown hair streaked blond like her father, who wore it stylishly shaggy in the ’70s to accompany his bushy mustache. Brittney, a broad-shouldered triathlete who works at Pride Industries in Roseville, a nonprofit that employs and provides job assistance for people with disabilities, has darker hair, although the resemblance to her father is instantly recognizable in her proud, even features.

Neither Brittney, 39, nor Brandi, 41, can claim strong memories of their father on the field during his 11-year career with the NFL, which included seven years for the San Francisco 49ers and then four years with the Baltimore Colts. They say they were simply too young to recall anything about those hard-hitting days when he sacrificed his body for the love of the game, once taking a blow to the face so severe that it crushed his ocular bone.

Instead, the memories of their father’s heyday feel like yellowed Polaroids stuck in the frame of a vanity mirror in a child’s bedroom. One of Brandi’s strongest recollections is sitting in her dad’s lap as he drove around in a golf cart shaped like a 49ers helmet. Brittney’s most potent memory is a cheer her father taught her to say that incorporated his 49ers jersey number: “75, 75, yay, daddy!”

They tell other tales about their dad from that era: riding horses, playing softball and soccer in the yard, going to Duran Duran concerts. There were extended gaps when he was away at training camp, “but when he was [home], he was always involved in our lives and just fun,” Brittney says. “He was like that until he ended playing football. And then his personality started to change.”

Those changes are difficult for the Blue sisters to discuss; the depression that first became pronounced in the 1980s, when the man who loved to be the center of attention became strangely silent and reclusive; the ensuing years after their parents’ divorce, when contact with their once-attentive father became limited and then almost nonexistent, as he threw himself into a circle of new, good-time friends, questionable business endeavors and thrill-seeking hobbies like skydiving; and then the final years, after a divorce from his third wife, when his daughters took him in and cared for him full-time because his nightmares had worked their way into the daylight hours, and he became increasingly disorganized, disoriented and confused.

Their father, they say, ultimately became the arsonist of his own reality, his declining mental state evident first in violent dreams that morphed into horrible hallucinations. Once, while sleeping, he annihilated a bed, believing he was being attacked by it. He later became convinced that miniature people wearing tiny breathing apparatuses were living and working in the walls of his home. He talked frequently about an 8-foot African-American man who was following him. He was sure that a Kleenex box was a bugging device, and he would demand that everyone speak in whispers.

It’s the same tragic transformation that families of many other former NFL players have seen: a slow but steady shift in behavior that starts with memory loss and moodiness, and can lead to paranoia, increased risk-taking, violent outbursts, poor impulse control, a propensity for substance abuse, and, ultimately, if they don’t self-destruct in some other manner, complete cognitive breakdown after years of a hollowed-out existence.

In the weeks after his death, Forrest Blue’s Wikipedia page listed his cause of death as “chronic traumatic encephalopathy,” or CTE, a degenerative neurological disorder similar to Alzheimer’s. First identified in “punch-drunk” boxers back in the 1920s, CTE is believed to be caused by repeated blows to the head—essentially, multiple concussions, when the brain slams against the inside of the skull. In some people, the repeated injuries, which can also include asymptomatic subconcussive hits, can cause the start of progressive brain disease that slowly spreads over years, causing deterioration typically seen in much older patients. But CTE’s connection to athletes playing other contact sports has been a relatively recent discovery.

And the issue of CTE isn’t limited exclusively to the NFL. All major professional sports with the potential for head injury—football, boxing, hockey, basketball, baseball, soccer, and even the fast-growing mixed martial arts—are currently examining the issue of concussions and player safety. This new awareness, which is spreading down to college, high school and youth athletes alike, has the potential to completely change the way we look at seemingly safe activities such as heading a soccer ball.

The idea of CTE was not new to the Blue sisters. It had been discussed before, as had other diseases, even though Forrest had no history of mental illness in his family. For years, they had been talking to doctors, trying to figure out what was going on with their father. They had met with reputable general practitioners, neurologists and psychologists, and explored the possibility of Parkinson’s, Alzheimer’s, Lewy Body Dementia, as well as B-12 vitamin deficiencies, but no one had been able to give them a definitive answer.

“It’s really hard to pinpoint,” Brandi says.

However, while the circumstance and his symptoms certainly sounded in line with those ascribed to CTE, Wikipedia’s determination was premature. The disease can only be diagnosed posthumously by examining brain tissue on a cellular level.

Nevertheless, CTE was certainly on Forrest’s mind before he passed away. He had kept folders with article clippings about the long-term effects of repeated head trauma on football players, and it had been his wish that his brain be examined for it after his death.

How many concussions might Forrest have sustained in his career? No one can say with any certainty.  He knew he had taken a few “dings,” as they called it back in the day, collisions with rhinoceros-sized defensive linemen that had rung his bell, made him see stars, black out temporarily and forget what had happened in the play. However, as was the smash-mouth culture of the era, he shrugged it off like his teammates and returned to action, fearful like every other player of losing his spot if he was injured. “No one makes the club from the tub,” the old saying goes.

So on that October morning, Forrest’s brain, which had been removed from his body back in July, packed in plastic bags filled with ice and sent East with a medical courier service, was resting thousands of miles away at the Bedford VA hospital in Massachusetts, which works with the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine, ready for examination, along with the brains of several other recently deceased professional athletes, including Hall of Famers Joe “The Jet” Perry and John Henry Johnson, from the 49ers famed “Million Dollar Backfield,” whose numbers have been commemorated on SF helmets this season.

Meanwhile, his daughters, still clearly grieving their loss, and weary from years of constant care, worry and heartache, would have to wait until January to receive the results of the CTE analysis.

At the time, they said they hoped that it would provide a bit of closure, and possibly “aid science with one more case to look at,” as Brittney explains, ultimately helping athletes of other sports as well as their families.

But there was also a more personal question to be answered. The Blue sisters had felt emotionally abandoned by their father, but CTE gave their experience a different perspective. The mystery they hoped to solve was whether it was his hurtful choices or a disease that had robbed them of so many good years with their dad.

• • • • • • • •

OOn Feb. 5, some 110 million people around the globe will tune in to watch two well-trained and highly motivated armies go head-to-head in a violent pursuit of glory and fortune in Super Bowl XLVI at Lucas Oil Stadium in Indianapolis, Indiana.

If all goes as expected, it will be an unforgettable exercise of shock and awe, modern-day gladiating at its finest, an afternoon when fleet-footed, monster-sized men will regale audiences with acrobatic catches of sublimely launched spirals, zigzagging jailhouse breaks, and, of course, teeth-rattling blocks and tackles that will send flailing bodies helicoptering into temporary flight. It’s that violent voyeurism, that thrill of well-choreographed mayhem, that scratches a primal itch for physical dominance and has made football America’s biggest sport and the Super Bowl the most watched television event in U.S. history.

The current NFL season has offered a multitude of compelling backstories to heighten the drama on the field: the unlikely ascent of Denver Broncos quarterback Tim Tebow, the man with the unconventional arm mechanics who, at least for a time, seemed to have a direct line to God himself; the Green Bay Packers’ run at a perfect record, led by Chico-native Aaron Rodgers, which was ruined in late December; or the 49ers first playoff berth since 2002, thanks largely to a dominating defense and a power running game under first-year coach Jim Harbaugh.

But when sports historians look back at this season, it’s likely that they will view it primarily as one of the most pivotal chapters in the ongoing narrative about the health issues and human costs of the sport; the season that brain injuries in football went from a hot-button issue to center stage in mainstream consciousness.

To wit: Concerns about concussions are now so deeply ingrained in American popular culture that they’re even appearing in video games. For example, players who get their brains rattled in Madden NFL 12, which was released in August, are immediately sidelined for the duration of the game with announcers Gus Johnson and Cris Collinsworth explaining why they were pulled. Previous versions of Madden had allowed athletes with concussions to keep playing.

“Concussions are such a big thing, it has to be a big thing in the video game,” Madden, who serves on a newly created NFL advisory panel for player safety with former 49er Ronnie Lott, has said. “ I think the osmosis is if you get a concussion, that’s a serious thing and you shouldn’t play.”

Even in its earliest incarnations, football has always been a blood sport. Back in 1905, then-President Theodore Roosevelt threatened to outlaw the game after 18 college players died in a single season from injuries sustained on the field. In that era of eye gouges and face punches, Roosevelt called coaches from Yale, Harvard and Princeton to the White House for rule changes that included moving a first down from five to 10 yards, as well as allowing the forward pass, which subsequently made the game more open and far less brutal.

There are many observers who wish old TR were still around to step in and regulate what is increasingly being viewed as an epidemic.

The NFL has rarely enjoyed a good reputation for caring for the broken bodies of its former players. But now it has their heads to worry about as well, and in 2011, the issue of concussions and football reached critical mass with several high-profile stories involving CTE.

In February, after years of blurred vision, memory loss, depression and dementia, after his marriage failed and his food services business collapsed, former Chicago Bear Dave Duerson shot himself in the chest, rather than the head, so that his brain could be studied by the Boston University doctors, a point he made clear in his suicide note. In May, BU announced that Duerson, who was 50, did in fact suffer from a “moderately advanced” case of CTE. The disease has currently been identified in around two dozen former NFL players by Boston University and other institutions.

And then, in July, just 10 days before Forrest Blue’s death, ex-Baltimore Colt John Mackey passed away. The former All-Pro tight end, known best for catching a tipped pass from Johnny Unitas that helped the Colts beat the Dallas Cowboys in Super Bowl V, had been diagnosed with frontal lobe dementia in 2001. His wife Sylvia had compelled the NFL to create what’s known as the “88 Plan,” named for Mackey’s jersey number, which provides $88,000 a year for families of ex-NFL players with dementia who require care in an assisted living facility.

Sylvia Mackey has since stated that she’s convinced her husband suffered from CTE, and his brain has been sent to Boston University for study. However, more names would soon be added to the confirmed CTE list, players both young and old, from football and other sports as well: 49ers Joe Perry and John Henry Johnson; Buffalo Bills legend Cookie Gilchrist; and hockey enforcer Derek Boogaard, who played for the New York Rangers and died at age 28 from an accidental drug overdose.

For years, the NFL either minimized or refused to acknowledge any connection between football head trauma and long-term cognitive decline despite the emergence of scientific evidence and player testimony to the contrary, which started in 2002 and was regularly making national headlines by 2007. In fact, even as of just a few years ago, both the league and the players’ union were still critical of the notion that a player’s mental impairment could be caused by football.

However, in 2009, a study released by the University of Michigan, and commissioned by the NFL, reported that Alzheimer’s or similar diseases were diagnosed in former players vastly more often than in the national population; 19 times higher than the normal rate for men aged 30 through 49.

That study, as well as increased scrutiny from the media, prompted Congress to take a stand, and it was largely a shameful experience for the league. At one hearing, Representative Linda Sanchez, a Democrat from California, compared the NFL to the tobacco industry, saying its refusal to admit a link between concussions and brain damage was akin to the denials that smoking causes lung cancer. The NFL’s top two doctors—Ira Casson and David Viano—later resigned.

The hearings helped turn both the league and the players’ association from skeptics to energetic proselytizers about the dangers of concussions and football. They also fomented many significant rule changes on how, when and where players can be hit to increase player safety, as well as the new return-to-play guideline dubbed “one and done,” requiring players who show any signs of concussions to be removed from a game or practice and barred from returning the same day (studies have shown that if the brain is not given adequate healing time, much lighter blows can cause the brain to become concussed in the future). Players also need clearance from both team doctors and independent neurological consultants before they’re back on the field.

“We have taken numerous steps over many years to address player health and safety,” the NFL’s chief spokesman Greg Aiello says. “This has included a wide range of initiatives relating to the prevention and treatment of concussions and the funding of research on that issue. We have brought tremendous awareness to this injury and have advocated for the passage of [legislation] in states to better protect young athletes.”

The league has also introduced better testing to diagnose in-game concussions, and has donated $1 million to Boston University’s Center for the Study of Traumatic Encephalopathy for unrestricted research, encouraging players and their families to cooperate with the university’s studies. In addition, the NFL put posters with explicit warnings about concussions in stadium locker rooms, and even sponsored televised public service announcements.

Last February, NFL commissioner Roger Goodell was back in front of Congress, this time urging legislators from around the country to pass youth concussion laws.

The issue even made its way into contract negotiations this summer, where, for the first time, the medical director of the NFL Players Association, Dr. Thom Mayer, had a seat at the bargaining table. As a result, the new league contract limits the amount of practice contact drills a coach can use with his players, lessening the exposure to potential repetitive head trauma, and has been heralded as the most significant non-financial piece of the new labor agreement.

“I don’t think [CTE] is an emerging disease,” Mayer says. “It’s an emerging recognition of what was there before.”

Even with—or perhaps because of—the increased awareness, statistics indicate that concussions in professional football continue to rise. Those who track these numbers, including the well-respected Concussion Blog, state that by the end of the regular season, this year’s brain injury numbers surpassed last year’s 171 to 159. Meanwhile, the U.S. Centers for Disease Control and Prevention estimates that as many as 3.8 million sports-and-recreation-related concussions occur annually.

All of this has resulted in a scrutiny of the league’s policies never before seen in the history of the sport. Perhaps the starkest illustration of this came on Dec. 8, when Browns quarterback Colt McCoy was put down by an illegal helmet-to-helmet hit from Pittsburgh Steeler James Harrison and sustained a concussion. The Browns staff failed to give McCoy a concussion test and sent him back into the game after two plays. As a result, the NFL has told the league’s 32 teams that, effective immediately, an independently certified athletics trainer will be on hand at every game to monitor and manage all concussion-related injuries.

The NFLPA has said it may still file a grievance against the Browns. When asked why the players’ association is doing all of this now, especially after years of not taking up the cause, Mayer cites a growing awareness about concussions, clear commitment from the union’s new leadership in this area and a desire by the players’ association to make sure the time between talk on the issue and action to protect players is as short as possible. He paraphrases part of the T.S. Eliot poem “The Hollow Men.”

“Between the idea and the act falls the shadow,” he says. “The idea is this is a violent sport and we are trying to make that shadow as brief as we can, and get even more aggressive about protecting the players’ interests.”

• • • • • • • •

AAnne Blue, Brittney and Brandi’s mother, sits in the kitchen of her South Land Park home, with her current husband, Scott Harvey, wandering in and out. They’ve just returned from their lake home in Alabama, and the remains of their trip are scattered around. Anne’s curly hair is cropped above her shoulders, framing delicate features. She radiates a mix of grace, wisdom and confidence that can only be labeled as Southern charm.

Speaking of Forrest Blue, whose last name she kept for professional reasons (she is an artist with studio space in midtown now, but had an active political career that included becoming the first mayor of Loomis), is both easy and difficult for her. Easy because they maintained a close and caring relationship despite divorce, one that even included Scott becoming friends with Forrest. Hard because, as the details of Forrest’s medical condition continue to unfold, she is seeing their shared history with new insights that fundamentally change the narrative of a painful past.

The story of how Forrest and Anne came together is such cliché that a Hollywood screenwriter would be embarrassed to write it.  Anne was a cheerleader, classically pretty and vivacious. He was a football star, handsome, polite and the biggest guy on the field. They were both at Auburn University in Alabama in the mid-’60s, where football ruled the temperate autumn nights. Before home games, boosters and students lined the main drag for the “Tiger Walk,” when the team, clad in their orange and navy uniforms with stars on the shoulders, marched like young gods into the stadium while fans whooped the “war eagle” battle cry.

Anne saw Forrest around campus and in the stadium. He was hard to miss, towering above the other players in his No. 50 jersey. Despite knowing who the other was, they had little direct contact until just before Forrest’s senior year—Anne already had a beau at the University of Alabama and Forrest wasn’t the type to pursue someone else’s girl. But soon after that relationship dissolved, he called one of Anne’s friends to see if Anne would be interested in a date.

“He said that he had his eye on me for a while,” she recalls. “And that was it.”

Anne wasn’t ready to be back in another relationship, but she was impressed by Forrest’s personality as she got to know him. “It took me awhile to realize what a special person he was,” she says. “He was bright and smart, he was handsome, he was athletic. He was just the whole package.”

With his sandy blond hair cut respectably short and parted to the side, Forrest was the image of the all-American athlete, a “gentle giant,” she says. Forrest had started playing sports when he was 6 years old, and by his teenage years, he excelled at baseball, basketball and football, a true triple threat.

The son of an Army captain, Forrest moved from his hometown of Marfa, Texas to Tampa, Florida, as a teenager when his father retired. There, he attended Chamberlain High School, known for turning out professional athletes (among his schoolmates were future major league baseball star Steve Garvey and a young Lauren Hutton, whom he dated). While playing for the Chamberlain Chiefs, he was named All-City, All-State, All-Southern, and All-Western Conference offensive tackle. Under then-coach John Adcock, Forrest, then a sophomore, helped the team win the Class AA state championship in 1961 in an undefeated season.

“Forrest had a lot of natural ability. He was a great football player, but he also was a great basketball and baseball player,’’ Adcock told The Tampa Tribune years later. “You could always count on him to give a supreme effort. He was a role model, a leader and a pleasure to coach.’’

That on-field success never went to his head, though. Classmates recall him as kind and unassuming, bagging groceries at the local U-Save after school and wearing weights on his ankles as he walked through the halls in an effort to up his speed on the turf. He was also smart, making the National Honor Society for his academic prowess.

Moving up to college ball didn’t seem to change who Forrest was. He backed off of basketball and baseball (though he hit over .400 for the Auburn team his freshman year) to focus on the pigskin, shifting from defensive tackle to offensive, but he kept up with his studies, majoring in economics and math. Anne recalls that Forrest was quick with numbers. “Something that I would certainly have to sit down and take my time to multiply out, he could do in his head,” she says.

The two were soon a steady couple. Forrest was named an All-American center his senior year and also served as team captain, and it became clear that he had a professional sports career ahead of him—although he also earned admission into law school. In the 1968 draft, San Francisco scooped him up, offering a $17,000 salary with a $2,500 signing bonus (part of which he used to pay for Anne’s tuition to finish her degree).

“Things were different then. People didn’t live together,” says Anne, who was several semesters behind Forrest in school. “So we decided to get married when he got drafted.”

The newlyweds relocated to the Bay Area. Forrest, with his trademark energy and determination, quickly began to make his mark on his new team. Faced with his imposing and unusual size for the time, teammates dubbed him “Big Tree,” which was shortened to the nickname that stuck—“Tree.”

Forrest’s size made him an unlikely choice for an offensive center. Back then, the position was commonly manned by a quick, short and squat player who was lower to the ground. The average man in his spot was 5 inches shorter and 40 pounds lighter.

But Forrest Blue was instrumental in changing the role of the offensive center for the entire game. He had a rare mix of being big, strong—and fast. He could not only take the defensive tackle by himself—who up until then had been one of the largest and toughest men on the field, often requiring two offensive linemen to stop—he was nimble enough to tackle in tight quarters and fast enough to run down players.

“He was the first big man to play the position like a small man,” explains New York Times football writer Andy Barall. “He had small-man skills in a big body. And it was an advantage to the 49ers when they had a man over him because he could handle a big nose tackle by himself. No one could do that. Because he was so big, the guards next to him could be free to do other things. He was a forerunner for what we see today.”

Forrest’s quick mind helped him to evaluate the other team’s lineup and make calls for his own line based on what he saw. “He was a very intelligent guy,” recalls Len Rohde, another member of the 49ers offensive line at the time who still lives in the Bay Area. “He was always on the ball.”

Defensive linebacker Skip Vanderbundt, who was the 49ers next draft pick after Forrest, roomed with him when the team traveled and lived in the same apartment complex as Forrest and Anne. “Forrest, whatever he decided he was going to do, he would learn everything he could about it, study it, and try to improve on it,” he says. “That’s just the nature of the guy, the reason he was a success as a football player.”

But the flip side of constantly striving for the best is that nothing is ever good enough. Vanderbundt, who is 65 and lives in Arden Park, also remembers Forrest as someone who was hard to please.

“He was never happy,” Vanderbundt recalls. “I’ve never been around a guy who didn’t like the food in the restaurant or the beds that we were sleeping in on the road or the fact that the buses were late to come pick us up. I used to laugh at him and make fun of him and finally he kind of realized that he was being that way.”

Forrest also had a mischievous streak that gave him a reputation as a practical joker who “was balls to the wall,” says Vanderbundt, who was often his partner in crime. “He didn’t get into anything that he didn’t do full blast.”

Vanderbundt remembers how they tormented veteran defensive cornerback Jimmy Johnson, who was “deathly afraid of snakes.” While traveling for an away game, the two roommates went to a fish and tackle shop and bought a bag of giant rubber worms, eight inches long. “We snuck into his room and put them in his drawers. We put them in his helmet. We put them in his playbook,” he says. “And you would hear a yelp in the dark, in the film room, because he’d open his book and one would fall on his lap.”

But as he had at Auburn, Forrest managed to stay grounded despite being under the bright lights of pro ball with its “glamour and fun,” says Anne. Forrest continued to be the thoughtful, kind person that she had fallen in love with, even as he grew into his new role as a team leader. She cites the example that the two of them would walk through the hippie mayhem of Golden Gate Park, Forrest often clad in fashionable plaid polyester suits sewn by Anne (he was too big to fit into off-the-rack clothes, but liked to be stylish), to make weekly visits to the veterans’ hospital near Haight-Ashbury. Forrest liked to visit and play cards with the soldiers who had returned from Vietnam with injuries.

“He was very passionate about our doing that,” she says.

• • • • • • • •

BBy 1970, the 49ers had built an offensive line that would become legendary. Forrest was joined by Rohde and Cas Banaszek as tackles, and guards Woody Peoples and Randy Beisler. They formed an unstoppable front. That year, they made history by allowing quarterback John Brodie to be sacked only eight times. The team also took its first of three consecutive NFC Western Division titles, losing twice to the Dallas Cowboys in the championship games.

“That was really the rebirth of 49er football,” New York Times’ Barall says. “The offensive line came together really quickly.”

Forrest earned his way into the Pro Bowls, being named first team All-Pro in both 1971 and 1972. Playing as the long snapper on punts (a common practice for offensive centers in the day), he also did the unimaginable—running the ball in for a touchdown after a 25-yard fumble return against the New England Patriots. “That’s so rare,” says Anne of Forrest’s moment in the end zone. “That was huge because a center never scores. That was really exciting for him.”

Equally as exciting was the young family he and Anne had begun, with Brandi and Brittney coming in quick succession two years apart. “He loved the girls,” says Anne. “He was a very, very loving, hands-on father.”

Success on the field came with a cost, though. Like every player at the time, Forrest was expected to play through pain. Veterans warned rookies not to complain or seek medical treatment for injuries or else risk being dropped from the roster. From 1969 to 1974, Forrest didn’t miss a single game. But he routinely took hits. “On the offensive line, literally every play you’re blocking somebody, so as a result of that you’re getting contact on your head every play,” former teammate Rohde explains.

Vanderbundt says players used to laugh about concussions. “That’s when head slaps and helmet-to-helmet [hits] were legal,” he explains. “You’d get dinged. You’d get one once or twice a season really bad. And you’d remember them, that you got up or couldn’t get up and staggered off the field the wrong way.”

Trainers would check for concussions by holding up two fingers and asking how many fingers the player saw. “But they always held up two fingers,” says Anne. And so most of the time, players went right back in despite their head injuries.

Dan Bunz, who won two Super Bowls with the 49ers in 1982 and 1985 and is currently a physical education instructor at Sutter Middle School in Sacramento, knew Forrest from around town, and says playing through concussions was just the way it was done.

“I was knocked out once and played the whole first half,” recalls Bunz, now 56, of a time he got hit during opening kickoff in a game in New York. “I can’t remember anything about the game. I felt terrible. I mean, I didn’t even know what state I was in. And then I went back and watched the film and I was pretty good. It was like I was on remote control.” The next day, he says, coaches told him to get out to practice. “There wasn’t any, ‘Take a day off.’ It was like, ‘Just get back out there.’ ”

• • • • • • • •

FFor the Blue family, the late ’70s and early ’80s brought change. Forrest’s last season with the 49ers was in 1974, when he was traded to the Colts. Unsure how long he would be with that team, he and Anne decided to keep the family part-time in Los Altos Hills, traveling between the two locations. Neck, shoulder and back injuries were making it increasingly hard to stay competitive, leading him to retire from the sport in 1978.

That same year, the family moved up to Sacramento from the Bay Area. Forrest, “had a friend who did contracting, so we moved up here so he could get into contracting with him,” Brandi says.

Forrest entertained offers to go into sports broadcasting, but instead decided to start Forrest Blue Properties Inc., a commercial construction business, which developed shopping centers, motels and other buildings. He even built their custom home in Rocklin. “He loved construction because it was physical,” Brittney says. “He could have just run the business, but he liked to do the actual physical labor because he liked the feeling of using his body.”

But the changes that haunt Anne are the ones she didn’t understand at the time. Forrest’s personality began to shift. Once extremely conservative and careful with their finances, he began to put money into “things that didn’t make sense,” she says, buying into businesses such as Laundromats.

Around that time, he also began to distance himself from the friends he had made with Anne to hang out with a group of younger, more superficial people, Anne says. Most alarmingly, the outgoing and social man she had known became periodically depressed and withdrawn, even shunning his two daughters.

“Literally, you would come in with your friends and be like ‘Hi, Dad,’ and he would just ignore you—no acknowledgment that you were even there,” Brandi says.

“A lot of his personality just changed,” Anne says. “It was very hard on me, especially after seeing what it was doing to the girls. They didn’t know what was going on. This was their dad that they danced with, played with, rolled on the floor with, and all of a sudden, he’s just not paying any attention to them, and so they didn’t know how to handle that. The girls were devastated.”

Anne attributed the problems to the ending of Forrest’s football career and the transition into “civilian life” out of the limelight. But now, having learned more about the potential effects of concussions, she believes the changes she saw in that period were likely the beginnings of Forrest’s mental illness. “It makes me sick to my stomach when I say that because I didn’t know that that was what was happening. I had no idea that things like that would happen. But it’s all hindsight,” she says.

The unexplainable changes in Forrest made life with him progressively more difficult. Anne was deeply involved in politics, and had become the first mayor of the newly established town of Loomis in 1984. They began to move in separate crowds. Increasingly unhappy with his removed reticence, she spent a year and a half in counseling. “I was befuddled with the changes in personality and what was happening,” she says. Anne moved out of the house that Forrest had built for the family, and in 1986, they divorced.

After Brandi graduated from Del Oro High School and Brittney from Loretto, Forrest continued to fade out of their lives. “To go from the kind of father who was so supportive to one who doesn’t bother to call, that’s two different personalities, that’s two different men,” says Anne. “At the time, I thought he was just trying to recapture his youth or something. And I thought, ‘You know, this is not working.’ But now, I think it’s much deeper than that. I think he lost some capacity.”

• • • • • • • •

BBrittney Blue is running her fingers along the contours of her dad’s scuffed 49ers helmet. It’s late fall, and the garage door of her West Sacramento home is rolled up, revealing boxes, many of them packed with her father’s possessions. A large plastic tub sitting on a metal shelf holds several helmets from his past teams, but it’s the protection gear from his tenure in San Francisco that grabs her attention.

She peers inside the Riddell helmet, and points to the primitive cushioning inside the hard orb: double rows of foam rectangles cased in yellowed plastic line the interior. “You look at it now and it’s so obvious that it’s inadequate,” she says.

Helmets have come a long way in the past few decades, now sporting high-tech suspension systems and even sensors to monitor the severity of hits. While helmet technology has improved, it hasn’t limited concussions. “It gives a false sense of security,” Brittney says, echoing the sentiment of sports experts, who say that while helmets can protect the outside of the head, there is only so much they can do to mitigate momentum when the brain bangs the inside of the skull so hard that it can’t be cushioned by the cerebrospinal fluid.

“The sport has gotten rougher and rougher and the hits are harder and guys are bigger and heavier,” she says.

For years, there had been a division of labor with the Blue sisters when caring for their father. Brandi has a home in Rocklin, where Forrest was living back in the beginning of his decline, and so she was on point with the day-to-day duties of his care. In West Sacramento, Brittney handled the logistics of his care, finding doctors and filing the paperwork for the NFL’s 88 Plan, which later paid for his stay at an assisted living facility in Carmichael when he was no longer able to care for himself.

A closet in the house stores even more artifacts: decades and decades of photos, black and white and color, promotional and personal; a carton of VHS tapes featuring highlights from seasons past; reams of paperwork, including a signed agreement between Forrest and the Baltimore Colts in 1978 detailing a raise in his annual salary from $71,500 to $78,650; advertising materials for a local company called Toby Toys, featuring Forrest sitting on a giant rocking horse dressed in his 49ers uniform, a broad and welcoming smile on his handsome face, betraying none of the pain that he would face later in life.

Brittney explains that she first heard about the issue of CTE and football from a 2007 episode of HBO’s Real Sports. “Someone told me about the show so I went and watched it,” she says. “That’s what planted the seed.”

The show featured an unlikely spokesperson for CTE; Chicago native Chris Nowinski, a former defensive tackle at Harvard and professional wrestler for the World Wrestling Entertainment, who had his own health struggles with sports-related brain injury. While in the ring, Nowinski had accidently been kicked in the head in June 2003 by a wrestler named Bubba Ray Dudley in a stunt gone wrong.

Despite the ensuing memory loss and unrelenting headaches, Nowinski kept wrestling. But he knew something was wrong. “I went to a bunch of doctors to figure out why I was having so many problems,” he says. “I wasn’t getting any answers.”

The eighth doctor he visited was Boston University’s Robert Cantu, who had written the first return-to-play guidelines for sports and concussions back in 1986, a CTE pioneer who has been involved in some of the most groundbreaking research on the subject. “He opened my eyes to the fact that I’d had a lot more concussions than I realized,” Nowinski says. “I had never processed any previous blackout or any previous time that the sky had gone orange on me as a concussion.”

In his office that day, Dr. Cantu asked Nowinski how many concussions he’d had in his career. “I said zero,” Nowinski says. “He said, ‘How many times have you been hit in the head and blacked out or saw stars?’ He went through this list of symptoms. I could remember five immediately. That made about six concussions in the previous five years that I could remember at the time. I’d probably been suffering through them all along and I was just one of the guys who could play through it.”

Since then, Nowinski, who spoke about his experience in front of Congress during the 2009 and 2010 hearings, has gone from patient to advocate. Currently, he serves as co-director at Boston University’s Center for the Study of Traumatic Encephalopathy, while he finishes his PhD in behavioral neuroscience. He’s also president and co-founder of the Sports Legacy Institute, a nonprofit institute dedicated to solving the sports concussion crisis.

During initial interviews, Nowinski would not talk specifically about the Forrest Blue study; it was not yet complete and the center always speaks first with the family. However, he acknowledges the importance of former athletes donating their brains for research because there is so much that isn’t yet known about CTE. How common is it? Why do some people who take hits to the head get it and others don’t? How does it start? How can we diagnose it in living people? How can we treat and cure the disease?

“Between 1928 and 2008 there were only 48 cases [of CTE] studied in medical literature,” Nowinski says. “This is an incredibly limited study in a lot of ways. If you want to use a football analogy, we just caught the kickoff and we’re on our own 20.”

Currently, the BU CSTE has studied about 100 brains, Nowinski says. Of the 70 former athletes examined by Nowinski’s colleague Dr. Ann McKee, over 40 have shown evidence of CTE, including more than a dozen NFL players, as well as college and high school athletes. The disease is marked by the accumulation of a toxic protein called tau, signaling a different deterioration than Alzheimer’s, and has been found in a diverse range of people, including hockey players, professional wrestlers, a soccer player, a battered spouse and a circus clown.

“It appears that brain trauma, in some people, sparks a disease that starts as a small point in your brain,” he says. “The structures within your brain on a cell-by-cell level start to fall apart. It has the ability to spread, relatively slowly, but we believe it continues to spread for the rest of your life. At some point, it has attacked or impaired so many neurons that your behavior changes. You’ve lost enough cells in the parts of your brain that control specific things like memory or emotion, that you change. Almost always, for the worse.”

According to Nowinski’s co-director at BU CSTE, Dr. Robert Stern, a fairly recent focus of CTE study has been on the concept of subconcussive injuries, or blows to the head that cause a similar disruption of brain cell functioning but without symptoms. These are common in sports, Stern has said, singling out certain positions in football such as linemen, who receive contact on almost every play. Some studies have shown that a player can sustain as many as 1,000 to 1,500 of these a year. And other studies suggest the possibility that they can be caused in a less violent sport such as soccer by heading the ball.

In addition, the exposure of these hits can start much earlier in life than was previously thought, well before athletes make it to the professional level. “We think this is progressive because the young cases have focal, very small spots of tau deposition,” Nowinski says. “In the older cases, it’s much more increased.

“This is a very destructive disease in some people that impairs their lives,” Nowinski continues. “In sports, people are receiving this trauma voluntarily. It’s hard to say this isn’t life or death stakes.”

So what’s the solution? For football, pundits have offered up endless scenarios. Eliminate the three-point stance so players on the line can block with their hands instead of their helmets. Get rid of all tackles above the waist. Impose weight limits on players, who, according to some statistics, have grown 10 percent heavier since 1985. Some have even suggested removing pads and helmets entirely so players lose what many call a false sense of security and stop leading with their heads on tackles and runs and play more rugby style.

Or is it time to examine the very DNA of football, and decide if the game’s risks for debilitating injury are simply too high?

Some say that will never happen. The game is too popular, and, in an industry that generates $9 billion in revenue annually, there’s too much money at stake. Also, fans would have to admit the inherent hypocrisy of demanding hard-hitting action while still championing player safety.

But perhaps the biggest hurdle is the game’s competitive warrior culture, which elevates the ability to play through pain above almost any other virtue. Stories about former players like Jack Youngblood, the Hall of Fame Los Angeles Rams lineman who, in 1979, played with a magazine duct-taped around a broken leg, remain legend. It’s an attitude that persists. And even though multiple concussions ended the careers of high-profile players such as the 49ers’ Steve Young or the Dallas Cowboys’ Troy Aikman, head injuries are still willfully ignored by the very people who sustain them. In a recent poll conducted by the Associated Press, 23 of 44 NFL players interviewed said that if they sustained a concussion during a game they would try to conceal it rather than pull themselves out.

For his part, Nowinski says he wants to focus on educating players, from professional to Pop Warner and beyond, about concussions, care and the potential risks of long-term brain damage. He says that these changes will need to continue to come top down from the NFL—much like information about spine injuries, which has become commonplace with players knowing not to move people with hurt necks and backs—and they have.

Gov. Jerry Brown recently signed AB 25, a bill written by Assemblywoman Mary Hayashi and sponsored by the NFL, which requires all athletes under the age of 18 who are suspected of sustaining a head injury to get written consent from a licensed medical provider before returning to play. The bill, which just became law on Jan. 1, makes California one of the most progressive states in legislating concussion safety.

“Kids want to stay in the game, and believe they need to be tough and play through injuries,” Hayashi says. “But when it comes to concussions, this kind of enthusiasm can be life-threatening.”

According to the University of Pittsburgh’s Brain Trauma Research Center, more than 62,000 concussions are sustained each year in high school contact sports, and among college football players, 34 percent have had one concussion and 20 percent have endured multiple concussions. The likelihood of suffering a concussion while playing a contact sport is estimated to be as high as 19 percent per year of play, the center states. And it isn’t just male players who are being affected. According to the Centers for Disease Control and Prevention, girls’ soccer ranks just behind football in its list of sports with the most exposure to traumatic brain injuries.

“This isn’t really a professional discussion,” Nowinski says. “This is a public health discussion. What are we doing to our children’s brains? We create games that expose children to repetitive voluntary and severe brain trauma. We never paid attention to it and that has cost people their lives. It has cost people their intellectual capacity. It has cost people a lot.”

That growing awareness has rattled many former players, including Forrest’s old teammates and other past 49ers, breeding fear over the slow changes they see happening in their own lives.

“I’m worried,” says Bunz, who thinks he probably had “hundreds” of concussions.  “I don’t want to be like Forrest Blue. My family shouldn’t go through that.”

For Len Rohde, the apprehension has morphed into reality. Recently, the 73-year-old applied for long-term disability insurance through the NFL. During the application exams, he says he was diagnosed with minor cognitive impairment, but was subsequently denied coverage.

“I’ve definitely sensed that things aren’t coming up as quickly as I’d like or I can’t remember stuff,” says Rohde, his voice tight with emotion. “It affects your confidence. You’re not real sure when you think, ‘Well, this happened or that happened.’ You say, ‘Should I really count on that? That’s what I recall but I’m not real sure.’ The more times you find out you’re wrong on these things, the less confidence you have in your judgment.”

Rohde is arranging to donate his brain to the CTE researchers at Boston University so that it could “prevent some other person from incurring the same problem.” Currently, more than 500 athletes have promised their brain to the center, including current players such as Matt Birk of the Baltimore Ravens, as well as former players like Kyle Turley, who played for the Kansas City Chiefs. Rohde says he isn’t sure if football is the cause of his impairment, but he quips: “You usually don’t get it from teaching school.”

• • • • • • • •

FFor what it’s worth, neither Blue sister feels any animosity toward the NFL—or football for that matter—for what happened to their father, nor are they involved in any of the more than dozen pending lawsuits, brought by former players and their families, that accuse the NFL (and in some cases, helmet manufacturers) of concealing the risks of head injuries and not doing enough to protect players from head trauma.

They say Forrest had no regrets about his playing days. “My dad wouldn’t have changed a thing,” Brandi says. “Even if he had known the outcome. I think he would have taken the risk and done it anyway. That was his identity, 100 percent his identity, no matter what else he did.”

Brittney, like her mother Anne, remains an ardent supporter of Auburn football, where she went to school as well. Brandi says she’s never really enjoyed watching football, but would have let her teenage son Micah play if he had so desired. He went out for the football team his freshman year in high school, “but he didn’t like the coaching mentality, the screaming at you and that kind of stuff,” she says. “So he quit.” Instead, her son has found himself more interested in basketball and rugby.

One thing the sisters agree on is that 2006 will always stand out as the demarcation point, the year that their father returned to their lives. From the time he had married his third wife in 1994 until then, he had had been largely absent, traveling the globe to places like Australia and Honduras. He was still heavily involved in sports, working out twice a day, and spending countless hours mountain biking, scuba diving, skiing and skydiving, logging more than a thousand jumps.

“There is no other sport like this,” Forrest said to KCRA in the mid-’90s about skydiving. “There’s really no way to compare it. I mean, when you’re playing pro sports, you get an adrenaline high from some of the successful things that you do. This is a little different in that every time you get ready to jump out of an airplane you get an adrenaline rush just because you’re basically committing suicide and spending the next 70 seconds saving your life.”

But everything soon came crashing down for Forrest. According to Brandi, the questionable financial behavior Anne had first noticed at the end of their marriage had grown worse, and he made risky investments, often “with shady people who wanted to take advantage of him.” He invested in coffee shops, tanning beds and insulated backpacks for stadium concession workers. Money problems took a toll, as did a failed marriage that ended with another divorce and the loss of the spacious Mediterranean-style home that he had built himself near Penryn, a town close to Loomis.

In addition to memory loss, Forrest had been plagued for many years by what Brandi describes as “wild dreams,” something that she says that her dad had initially tried to downplay, as he did with his struggles with his work. “It was a big blow to his ego,” she says.

However, his mental problems were becoming harder and harder to conceal. When Forrest ended up moving in with Brandi and her son in their home in Rocklin, she finally saw what he was experiencing firsthand.

“He was staying in my bedroom and I was sleeping on my couch,” Brandi says. “And he would wake me up several times a night, yelling. I would go in there. One time, he thought he was trapped and was punching a wall. I have a four-poster bed and he broke one of the posts fighting it, thinking it was a person. I had an elliptical trainer in there. He knocked it through the wall. He did not know the difference between his dreams and what was real.

“He became very paranoid,” Brandi continues. “Before we moved him into the house, he thought people were spying on him. He wanted us to set up cameras.”

To hear about dementia is one thing—to live through it and see the mental collapse of a loved one is quite another. As Forrest’s derangement became more advanced, so did his hallucinations. An object in his hand would turn into a snake. He would see giant soldiers chopping cars on the freeway. The VCR was secretly taping him. He would arrange garbage on the ground in a circle, and then become convinced that the little people in the walls had done it. He would set up chairs and stay up all night, waiting to catch them in the act.

After six months of living with Brandi and her son, the sisters moved their father into a nearby apartment while they took him to see more doctors. They installed special nightlights that would come on instantly if he needed them to and made sure that “there wasn’t anything for him to hurt himself [with] or knock over or break,” Brandi says.

But he would phone them at all hours, unable to make the TV, dishwasher or oven work. He constantly lost his keys, wallet and glasses. And his behavior became increasingly erratic when he would forget to take his medications. On one triple-digit summer day, he sat for hours in his truck in front of a local bike shop he frequented, believing he had lost his keys. He ended up suffering from dehydration and heatstroke. After the owners called 911 and the paramedics came, Forrest’s keys were found in the ignition.

They later moved him into a rental house owned by Anne, but his grip on reality continued to slip. “When he lived in that rental house, he was scared,” Brittney says. “He was battling [imaginary] people, he was alone, it was stressful for him. That’s when I think he started to realize that there was a lot more going on and [he was] willing to admit more to us.”

By 2009, they decided that he needed constant care from an assisted living facility. He took his medications more consistently and his condition improved, but he was very angry at his loss of independence. “At assisted living, he became mean [and] very aggressive,” Brandi says, explaining that he would lash out, yelling, “You’ve ruined my life. You’ve stuck me here.’ ”

But by April 2011, at only 65, the man who once towered over his competitors had become emaciated and was losing his ability to communicate. “He would start a sentence and then it would just drop off,” Brittney says. “He would say stuff that made sense and then he would say stuff that sounded a little like gibberish, words you couldn’t understand. And then he would get real quiet.”

In May, he could no longer bear his own weight and was wheelchair bound, largely unable to talk. He continued to decline until he passed away in July.

After his brain was removed and sent to the Bedford VA hospital, his body was cremated. “Brandi and I plan to spread his ashes all over the San Francisco Bay,” Brittney says, “because that’s where he spent all of his prime years, because the Niners were his glory years, [with] his friends and all that.”

• • • • • • • •

FFor the past few months, the Blue sisters have been processing their grief very differently. Both have experienced the resolute sadness of losing a parent—not once, but twice. However, while Brandi has been able to reflect on it as an event that strengthened her bond with her sister—“I think actually in the end it brought us closer together,” she says—for Brittney, the pain remains much more raw and complicated.

“When we started taking care of my dad, there were mixed emotions,” Brittney says. “ ‘Oh my God, this is great, I get to spend time with my dad. Oh my gosh, I have no idea who my dad is. Oh my gosh, I’m pissed. I haven’t seen him in 15 years and now he expects me to take care of him.’ And there was a level of expectation with my dad, and even that had to evolve [with] him understanding that he was lucky to have his daughters there. If we hadn’t been there or if we had said, ‘Screw you, you haven’t been around,’ he would have been out on the street.”

Both sides made bids of reconciliation in the final years, but by that time, as Brittney explains, “he was not the same person.”

“They both gave up their lives for a couple of years to take care of him,” says Anne. “They had anger and sadness because of [all]
the years that they felt they’d lost with him.”

Anne says that caring for him through the dementia allowed the girls their first understanding that perhaps there was more to the story than simply an absentee dad. “Watching him was to realize how he was not himself and what little control he had over the way he behaved and some of the things he did,” she says. “And I think in their minds it’s easier to understand and easier to accept. That doesn’t mean it doesn’t hurt. Still it hurts, but you understand it. I think it helps to take the sting away.”

That, says Anne, is what the family hopes the results from BU will bring: not a final resolution or cause of death, but clarity.

• • • • • • • •

This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but with a whimper
The last stanza of “The Hollow Men”

The news came in January. In a conference call with Anne, Brandi and Brittney, Boston University doctors reported that Forrest Blue did in fact suffer from CTE, as well as Lewy Body Dementia, another brain disease that’s associated with hallucinations. Having two brain diseases, or “mixed cases,” is not common, Nowinski says, but “happens in a minority of our older [aged] CTE cases.”

The findings did not come as a total surprise to the Blue family—“I would have been absolutely floored if CTE hadn’t been involved,” Brittney says—but the intensity of the emotional responses they’ve experienced, which have included sadness, guilt and even relief, weren’t as easy to anticipate.

“We all have different reactions,” Brandi says. “It was more closure for my mom and my sister. For me, I think I already had that. It’s what I expected. So it’s not really shocking. It’s more a [confirmation].”

“For me, the hardest thing about hearing all of it, and it really kills when I think about it, is that my dad suffered so badly,” Brittney says. “He didn’t just suffer from CTE, which is bad enough in itself and all the things that it does to completely change your life, but then he had Lewy Body that magnified it times a thousand.”

Brittney says that the BU doctors weren’t able to determine exactly when her father first developed disease, but their findings were consistent with chronology of events put forth by the family. Tau proteins, she says, were evident in “all the major places where CTE is found” and “there would have been no other way that he would have gotten it other than football.”

Both sisters say CTE has altered the way they think about Forrest as a father, and for Brittney, verification of the disease after having spent so many years wondering about its presence, adds a new layer to the grieving process.

“If I had understood what he had with CTE, then it would have explained his behavior better,” Brittney says, crying. “It would have made it easier to understand and I would have treated him differently. And so that hurt me, to figure that out. I know my mom feels the same. She feels so guilty. I feel guilty that all this time we were upset with him or disappointed in his behavior, when so much of that could have been and probably was the way his brain was changing.”

According to Nowinski, Blue is the 18th confirmed case of CTE out of the 19 brains of former NFL players that have been examined by the BU doctors, who are currently preparing a paper on their findings that will be released in the near future, adding more knowledge to the vital discussion about concussions in sports.

But perhaps the most profound observation about Forrest Blue’s life comes not from medical experts or scientists, but from the man who married his first wife.

In the kitchen of their home, gray November rain falling outside, Anne’s husband Scott Harvey, who had become friends with Forrest over the years—so much so that he even took him to a reunion of the 1975 Colts team in Indianapolis after Forrest was too sick to travel by himself—offers this: Remember that the true legacy of Forrest Blue isn’t just football or his contribution to the understanding of CTE; it’s Brandi and Brittney.

Remember, he says, that Forrest and Anne showed them enough “nurturing and unconditional love,” that it still filled their hearts despite the decades of emotional estrangement from their father. Remember that these women selflessly opened their homes and lives to Forrest when he had no place else to go, and that he helped to instill in them the courage to face whatever life brings with grace.

Harvey later follows a journalist outside. Remember, he adds, that the Blue sisters are good, strong women. And good women are grown in part by good fathers, even ones who are imperfect.

In other words, remember, in the end, that these terrible and unforgiving diseases may have hollowed out Forrest Blue’s life, but his daughters made his time in their shadow as bearable as possible.