They Played Football as Children. Now Their Families Mourn
S ince DuQuan Myers died six years ago, he’s come back in ways that are mysterious and magical and hard to explain.
自从六年前杜泉·迈尔斯去世后，他以一种神秘、神奇、难以解释的方式回来了。
It started the day of his funeral, when the doves that were released over his coffin refused to fly home, perching instead in the oak tree just above his grave as if witnessing a visitation.
从他的葬礼那天开始，在他的棺材上方放飞的鸽子拒绝飞回家，而是栖息在他坟墓上方的橡树上，仿佛目睹了一次拜访。
Then there was that drive to El Paso, Texas, when — not once but twice — the windshield wipers started swiping just as the satellite radio cut out midsong, switching to the tune Myers’ sister Natasha had been listening to at the exact moment when her mom called with the news that her brother was gone.
然后，在开车前往德克萨斯州埃尔帕索的路上，不止一次，而是两次，挡风玻璃雨刷器开始刮擦，卫星广播突然中断了歌曲，切换到迈尔斯姐姐娜塔莎一直在听的曲调，而她妈妈打电话告诉她哥哥去世的消息时，她一直在听。
There was the way Myers’ nephew — the one who was just a baby when Myers died — would sometimes point into an empty corner of a room and say “uncle.” There were the Pokémon cards that Myers had loved as a child but hadn’t played with in years turning up one by one in unexpected and impossible places, like the middle of a clean kitchen floor.
迈尔斯的侄子——迈尔斯去世时还是个婴儿——有时会指着房间的一个空角落说“叔叔”。迈尔斯小时候很喜欢但多年来没有玩过的神奇宝贝卡片一张一张地出现在意想不到和不可能的地方，比如干净的厨房地板的中间。
There were the nights when Myers’ mother, Letitia Wilbourn, would feel him, actually feel him, resting his head upon her shoulder, even though no one was there.
有些夜晚，迈尔斯的母亲利蒂西亚·威尔伯恩（Letitia Wilbourn）会感觉到他，真的感觉到他，把他的头靠在她的肩膀上，尽管那里没有人。
But, of course, that’s not right.
但是，当然，这是不对的。
There was someone there.
那里有人。
He was there.
他就在那儿。
She knew it.
她知道。
Such is the logic of grief.
这就是悲伤的逻辑。
Tragedy rips the grieving out of the storyline of their own life, denies them any sense of what the past meant or the future will hold.
悲剧将悲伤从他们自己生活的故事情节中剥离出来，使他们无法理解过去意味着什么或未来会发生什么。
Wilbourn remembers few details from her son’s funeral, but she does remember the doves.
威尔伯恩几乎不记得儿子葬礼上的细节，但她确实记得那些鸽子。
“That lady said, ‘These birds have never done this.
“那位女士说，‘这些鸟从来没有这样做过。
Never,’” she tells me, sitting on a small sofa in the darkened living room of her modest house in the suburbs of Fort Worth, surrounded by pictures and mementos from her son’s short life: an infant footprint from the hospital where he was born, a class project he wrote about wanting to own a whale, a photo of him posing in his Little League uniform with a shy smile.
从来没有。”她告诉我，她坐在沃思堡郊区她简朴的房子里昏暗的客厅里的一张小沙发上，周围摆满了她儿子短暂一生的照片和纪念品：他出生的医院里的婴儿脚印，他写的一个关于想要拥有一条鲸鱼的课堂作业，一张他穿着少年棒球联盟制服带着害羞微笑的照片。
“The lady was like, ‘Was he a very gentle spirit?’”
“那位女士说，‘他是一个非常温柔的人吗？’”
DuQuan Myers was a gentle spirit.
杜全·迈尔斯是一个性格温和的人。
His family called him the “animal whisperer,” the kid who loved to roam the farmland that still abutted their Echo Heights neighborhood and who would bring home all kinds of creatures he’d “rescued” — dogs, cats, turtles, frogs, lizards, toads, even once a snake that Wilbourn found, to her horror, in a candy jar.
他的家人称他为“动物语者”，这个孩子喜欢在仍毗邻回声高地社区的农田里漫步，他会把他“拯救”的各种动物带回家——狗、猫、乌龟、青蛙、蜥蜴、蟾蜍，甚至有一次威尔伯恩在糖果罐里发现的一条让她惊恐的蛇。
When his three older sisters squabbled, Myers was the one who always could diffuse the situation, the baby brother whose humor and charisma and cheerfulness were impossible to resist.
当他的三个姐姐吵架时，迈尔斯总是能化解矛盾，这个小弟弟的幽默、魅力和开朗让人无法抗拒。
It fit no known narrative that Myers would hurt any living thing, himself included.
迈尔斯会伤害任何生物，包括他自己，这与任何已知的说法都不相符。
And yet on the evening of Feb.
然而在二月的晚上。
17, 2017, Wilbourn had been driving home from her job as a cop for the Tarrant County Sheriff’s Office when she received a phone call.
2017 年 12 月 17 日，威尔伯恩在塔兰特县警长办公室当警察，开车回家时接到了一个电话。
On the other end, she could hear the keening sobs of the young woman Myers had dated off and on for years.
在另一端，她能听到迈尔斯断断续续约会多年的年轻女子的尖锐抽泣声。
“She said, ‘Quan’s dead,’” Wilbourn explains.
“她说，‘泉死了，’”威尔伯恩解释道。
“I was like, ‘What?’ She said, ‘DuQuan’s dead.’” Home alone in his apartment near Texas State, 26 years old and only months away from getting a degree in criminal justice, Myers had shot himself in the head.
“我当时想，‘什么？’她说，‘杜泉死了。’”26 岁的迈尔斯独自在家中，在德克萨斯州附近的公寓里，距离获得刑事司法学位只有几个月的时间，他开枪自杀了。
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Without thinking, wild with grief, Wilbourn turned her car toward San Marcos and drove 77 miles in 30 blind minutes before a friend called and persuaded her to pull over and turn around.
威尔伯恩不假思索地悲痛欲绝，把车转向圣马科斯，在 30 分钟的盲目驾驶时间内行驶了 77 英里，随后一位朋友打电话劝她靠边停车掉头。
Myers was gone.
迈尔斯走了。
There was nothing to be done that night, which Wilbourn spent at home, alone, her phone switched off so nothing could puncture the cocoon of mourning and confusion.
那天晚上，威尔伯恩无所事事，独自在家度过，她的手机关机，这样就没有什么可以刺破悲伤和混乱的茧。
She’d spoken to Myers earlier that day, just before he’d begun his shift at FedEx.
那天早些时候，就在迈尔斯开始在联邦快递上班之前，她和迈尔斯谈过话。
He’d seemed fine, his normal self.
他看起来很好，很正常。
But had she missed something?
但她是不是错过了什么？
She knew he had a gun, but he lived in Texas; everyone has one.
她知道他有枪，但他住在德克萨斯州；每个人都有一个。
She’d only discussed suicide with him once before, back when Chris Benoit, a wrestler Myers admired, hanged himself.
她之前只和他讨论过一次自杀问题，当时迈尔斯崇拜的摔跤手克里斯·贝努瓦上吊自杀了。
Myers had said, “Oh, I’d never commit suicide.
迈尔斯曾说过：“哦，我永远不会自杀。
I love me way too much for that.” Then he’d grinned at her with that way he had.
我太爱我自己了。”然后他就用那样的方式对她微笑。
“Look at how pretty I am.” Now, her beautiful boy was gone.
“你看我多漂亮。”现在，她美丽的男孩已经走了。
In the car the next day, on the way to San Marcos to begin the procedural processes of death — closing up Myers’ apartment, identifying his body, speaking to investigators who had no doubt that the gunshot wound was self-inflicted — Wilbourn was on a call with the medical examiner when, out of nowhere, she heard herself asking if they could save Myers’ brain, if they could have it studied.
第二天，在前往圣马科斯的车上，在开始死亡程序的路上——关闭迈尔斯的公寓，辨认他的尸体，与调查人员交谈，他们确信枪伤是他自己造成的——威尔伯恩正在与法医通话，突然，她听到自己在问是否可以拯救迈尔斯的大脑，是否可以对其进行研究。
“I just knew that the suicide didn’t make sense, because he wasn’t suicidal,” she says, her voice measured, her Texas accent melodic.
“我只知道自杀没有意义，因为他并没有自杀倾向，”她说道，她的声音很沉稳，德克萨斯口音很优美。
“I was just praying for answers, and when the phone rang, that’s what came out.
“我只是祈祷得到答案，当电话响起时，结果就是这样。
I wasn’t thinking that anything was wrong with his brain or anything like that, I just knew something wasn’t right.
我并不认为他的大脑有什么问题或类似的事情，我只是知道有些事情不对劲。
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There was also, perhaps, a subconscious concern.
也许还有一种潜意识的担忧。
Myers had played football for seven years, from sixth grade through his senior year of high school.
迈尔斯从六年级到高中四年级，已经踢了七年橄榄球。
In the time since he’d stopped playing, Wilbourn had learned about chronic traumatic encephalopathy — the degenerative brain disease that had plagued NFL greats like Mike Webster, Andre Waters, and Dave Duerson (who shot himself in the heart specifically so that his brain would be intact when studied).
自从退役后，威尔伯恩了解了慢性创伤性脑病——这种退行性脑病困扰着迈克·韦伯斯特、安德烈·沃特斯和戴夫·杜尔森等 NFL 巨星（他特意向自己的心脏开枪，以便在研究时他的大脑完好无损）。
Like many people, she’d been alarmed by the reports of these famously tough athletes whose very toughness had been their undoing.
和许多人一样，她对这些以坚强着称的运动员的报道感到震惊，正是他们的坚强导致了他们的失败。
Then again, she didn’t actually think Myers fit the CTE profile: He had not played football past high school; he’d never had a concussion that she knew of; he was nothing like Aaron Hernandez or Junior Seau, men who’d grown angry and addled and violent before dying angry and addled and violent deaths.
话又说回来，她实际上并不认为迈尔斯符合 CTE 的标准：他高中毕业后就没有踢过橄榄球；他没有踢过足球。据她所知，他从未患过脑震荡；他一点也不像亚伦·埃尔南德斯（Aaron Hernandez）或朱尼奥·肖（Junior Seau），他们在愤怒、疯狂和暴力的死亡之前变得愤怒、疯狂和暴力。
So it was a surprise, she says, when “the first thing out of my mouth was ‘Can we donate his brain to Boston University?’” She looks down at the photos surrounding her.
因此，她说，当“我嘴里说的第一句话是‘我们可以把他的大脑捐给波士顿大学吗？’”时，她低头看着周围的照片，这让她感到很惊讶。
“I think that was just a God thing.”
“我认为这只是上帝的事。”
IT HAS BEEN ALMOST two decades since Pittsburgh Steelers Hall of Famer Mike Webster become the first NFL player to be diagnosed with CTE, after a heart attack at age 50 put an end to misery so intense that Webster — by then sleeping in his car because he couldn’t remember where he lived — would shoot himself with a taser gun until he mercifully blacked out.
匹兹堡钢人队名人堂成员迈克·韦伯斯特 (Mike Webster) 成为第一个被诊断患有 CTE 的 NFL 球员已经快二十年了，他在 50 岁时心脏病发作，结束了如此强烈的痛苦，韦伯斯特当时睡在车里，因为他不记得自己住在哪里，他会用泰瑟枪开枪自杀，直到他仁慈地昏过去。
Even then, CTE wasn’t exactly a new discovery: A medical report from 1928 described boxers with “punch-drunk syndrome,” later classified as dementia pugilistica.
即便如此，CTE 并不是一个新发现：1928 年的一份医学报告描述拳击手患有“拳击醉综合症”，后来被归类为拳击手痴呆症。
The first known use of the term “chronic traumatic encephalopathy” occurred in a neurology paper written in 1949.
“慢性创伤性脑病”一词的首次使用出现在 1949 年撰写的一篇神经学论文中。
But Webster’s 2005 diagnosis was a watershed moment, implicating the most popular sport in America, one grafted into the guts and glory of the American psyche — and one that millions of American kids were suiting up to play every season.
但韦伯斯特 2005 年的诊断是一个分水岭，它牵涉到美国最受欢迎的运动，这项运动深深植根于美国人的内心和荣耀之中，而且每个赛季都有数以百万计的美国孩子愿意参加这项运动。
So documentaries were made.
于是就拍了纪录片。
Brain banks were established.
脑库成立。
Funding flowed.
资金流入。
And as more and more brains of dead athletes were submitted for study, it became clear that, while CTE was a progressive disease, it was not the sole province of aging NFL players.
随着越来越多死去运动员的大脑被提交进行研究，人们清楚地认识到，虽然 CTE 是一种进行性疾病，但它并不是老年 NFL 球员的唯一领域。
It could show up in the brains of people in their teens and twenties, people who’d never played past the age of 18.
它可能会出现在 18 岁以上从未玩过游戏的十几岁和二十几岁的人的大脑中。
Even in CTE’s earliest stages — and for reasons scientists are still exploring — its effects could be grave.
即使在 CTE 的最早阶段——出于科学家仍在探索的原因——它的影响也可能是严重的。
“We’re north of 1,300 brains, and while the overwhelming majority are from people who are older, we certainly have hundreds of brains of people in that younger age group,” says Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy, chair of neurosurgery at Emerson Hospital, and the nation’s leading authority on concussions.
创伤性脑病研究中心联席主任、艾默生医院神经外科主任、美国脑震荡领域权威权威罗伯特·坎图 (Robert Cantu) 博士表示：“我们的大脑有 1,300 个以上，虽然绝大多数来自老年人，但我们当然也有数百个年轻群体的大脑。”
“CTE hasn’t directly killed anybody in their teens, twenties, thirties, forties, but we have a lot of people with CTE that have died at those ages.
“CTE 并没有直接杀死任何十几岁、二十岁、三十几岁、四十岁的人，但我们有很多患有 CTE 的人在这些年龄段死亡。
Almost all of them have died by suicide.”
几乎所有的人都自杀身亡。”
It is well-established that suffering even just one concussion is a risk factor for developing mental-health issues.
众所周知，即使只是一次脑震荡也是出现心理健康问题的一个危险因素。
The year after Myers’ death, the Journal of the American Medical Association published a study that found that a person’s risk of dying by suicide doubled after being diagnosed with a concussion.
迈尔斯去世后的第二年，《美国医学会杂志》发表了一项研究，发现一个人在被诊断患有脑震荡后自杀死亡的风险会增加一倍。
A 2021 study in the Journal of Neurotrauma followed patients for 180 days and found “significantly increased rates of depression, anxiety, or suicidal ideation following concussion” in those under 26 years of age.
《神经创伤杂志》(Journal of Neurotrauma) 2021 年的一项研究对患者进行了 180 天的跟踪研究，发现 26 岁以下的患者“脑震荡后抑郁、焦虑或自杀意念的发生率显着增加”。
Another study , from 2022 and published in American Journal of Physical Medicine & Rehabilitation, found that 48 percent of all concussion patients were later diagnosed with depression, anxiety, panic disorder, post-traumatic stress disorder, bipolar disorder, or schizophrenia in the three years that they were tracked, and that “all of the mental illnesses this study chose to evaluate were present in a higher proportion of patients after a concussion than the general population.”
另一项自 2022 年发表在《美国物理医学与康复杂志》上的研究发现，48% 的脑震荡患者在跟踪的三年内后来被诊断出患有抑郁症、焦虑症、恐慌症、创伤后应激障碍、双相情感障碍或精神分裂症，并且“本研究选择评估的所有精神疾病在脑震荡后患者中的比例高于一般人群。”
But CTE isn’t just about diagnosed concussions, most of which go on to heal with no obvious, lasting effects.
但 CTE 不仅仅是诊断出的脑震荡，大多数脑震荡会自行痊愈，但不会产生明显、持久的影响。
It’s about repeated, seemingly benign assaults to brain tissue, little “dings” that could occur dozens of times in a single game and that a player may not even clock but that nonetheless cause damage at the cellular level — microscopically torn blood vessels, disconnected neurons, jumbled tau proteins (the building blocks of the fibers that carry nutrients and messages from cell to cell).
这是对脑组织的重复的、看似良性的攻击，在一场游戏中可能会出现数十次的小“叮当声”，玩家甚至可能不计时，但仍然会造成细胞水平的损害——显微镜下的血管撕裂、神经元断开、混乱的 tau 蛋白（在细胞之间携带营养和信息的纤维的组成部分）。
Given time, the brain can usually repair this damage — except when players don’t even know there’s been damage, and so don’t grant themselves time to recover.
只要有时间，大脑通常可以修复这种损伤——除非玩家甚至不知道已经发生了损伤，因此不给自己时间恢复。
In that case, injuries can compound until the brain is overwhelmed, until — unable to reconfigure themselves — the tau proteins essentially rot, creating toxic lesions that spread deeper into the brain and even sometimes into the brain stem.
在这种情况下，损伤可能会加剧，直到大脑不堪重负，直到无法重新配置自己的 tau 蛋白基本上腐烂，产生有毒损伤，扩散到大脑更深处，有时甚至扩散到脑干。
This past June, the largest CTE study to date confirmed that the best predictor of future brain disease was not the number of diagnosed concussions a player had sustained but rather the cumulative force of all hits to the head throughout their career.
今年 6 月，迄今为止最大规模的 CTE 研究证实，未来脑部疾病的最佳预测因素不是球员遭受的诊断脑震荡的数量，而是整个职业生涯中所有头部撞击的累积力量。
In other words, a lot of little impacts could be as damaging as a smattering of major ones.
换句话说，许多小的影响可能与少数重大影响一样具有破坏性。
This means that when kids across America suit up this fall to square off on the gridiron, every hit will matter, every “ding” and every bell rung will count toward an unspecified number past which the brain might be permanently impaired.
这意味着，今年秋天，当美国各地的孩子们穿上衣服在烤架上摆好姿势时，每一次击球都至关重要，每一次“叮”声和每一次铃声都将计入一个未指定的数字，超过这个数字，大脑可能会受到永久性损伤。
It means that no amount of concussion protocols can definitively stave off disaster, that some level of danger is lurking in every play.
这意味着再多的脑震荡治疗方案也无法彻底避免灾难，每场比赛都潜伏着某种程度的危险。
It means that America’s greatest game is hurting our children in insidious and incalculable ways, and that addressing the issue might mean fundamentally changing the way we teach a game that has become fundamental to America’s sense of self.
这意味着美国最伟大的游戏正在以阴险和不可估量的方式伤害我们的孩子，而解决这个问题可能意味着从根本上改变我们教授游戏的方式，而这款游戏已经成为美国自我意识的基础。
“It’s a really profound problem to confront, especially for a sport that’s been at the center of so much of our community and cultural life, as youth football is and has been,” says Kathleen Bachynski, a professor of public health at Muhlenberg College and author of No Game for Boys to Play: The History of Youth Football and the Origins of a Public Health Crisis .
“这是一个需要面对的非常深刻的问题，特别是对于一项一直是我们社区和文化生活中心的运动来说，就像青少年足球一样，”穆伦伯格学院公共卫生教授、《男孩没有比赛可玩：青少年足球的历史和公共卫生危机的起源》一书的作者凯瑟琳·巴钦斯基（Kathleen Bachynski）说。
Bachynski’s research details a long history of medical objections that have done little to intercept the sport’s cultural dominance.
巴钦斯基的研究详细介绍了医学上的反对意见的悠久历史，这些反对意见对阻止这项运动的文化主导地位几乎没有起到任何作用。
In the 1890s, The Chicago Tribune announced that football would “physically ruin thousands of young men.” In the early 1900s, the brutality of Ivy League games led them to be described as “boy-killing, education-prostituting, gladiatorial sport” (even Teddy Roosevelt intervened, leading to the limitation of certain plays).
1890 年代，《芝加哥论坛报》宣称足球将“毁掉成千上万年轻人的身体”。 1900年代初，常春藤联盟比赛的残酷性导致其被描述为“杀害男孩、教育卖淫、角斗运动”（甚至泰迪·罗斯福也介入，导致某些比赛受到限制）。
And throughout the 20th century, doctors continued to sound the alarm in publications like the Journal of the American Medical Association (“Football is no game for boys to play”), the Journal of School Health (“More concussions occur in football than is generally realized”), and the American Journal of Public Health (“[Children are] encouraged to addle their own brains with repeated concussions in such sports as football and boxing”).
整个20世纪，医生们不断在《美国医学会杂志》（“足球不是男孩玩的游戏”）、《学校健康杂志》（“足球运动中发生的脑震荡比人们普遍意识到的要多”）和《美国公共卫生杂志》（“鼓励儿童在足球和拳击等运动中反复脑震荡”）等出版物上敲响警钟。
Meanwhile, as boxing declined in popularity, football’s reach only grew.
与此同时，随着拳击运动的受欢迎程度下降，足球的影响力却不断扩大。
Youth leagues began mushrooming in the Sixties.
青年联盟在六十年代开始蓬勃发展。
Kids as young as five suited up.
年仅五岁的孩子们都穿上了衣服。
“It’s really hard for us, societally, to confront something that we thought was great might not have been so great,” says Bachynski of this cultural expansion.
“在社会上，我们真的很难面对那些我们认为伟大的东西可能并不那么伟大，”巴钦斯基谈到这种文化扩张时说道。
“But there are some health risks that we have decided even a fully-informed parent can’t allow their kid to [take].
“但是，我们已经决定，即使是完全知情的父母也不能让他们的孩子[承担]一些健康风险。
If you understand all the risks and harms of cigarettes, you cannot let your 12-year-old smoke a cigarette — that’s not something you can choose as a parent.
如果你了解香烟的所有风险和危害，你就不能让你 12 岁的孩子吸烟——这不是你作为父母可以选择的事情。
And we have to decide: ‘Do repeated head impacts fall in that category?’”
我们必须决定：‘重复的头部撞击是否属于这一类？’”
For football’s defenders, the answer is no. “I love this sport.
对于足球后卫来说，答案是否定的。 “我喜欢这项运动。
I think it’s America’s greatest sport,” says Dr. Julian Bailes, a former team physician for the Pittsburgh Steelers, a neurological consultant to the NFL Players Association, and the head of the medical advisory committee for Pop Warner, the country’s largest youth-football league.
我认为这是美国最伟大的运动，”匹兹堡钢人队前队医、NFL 球员协会神经学顾问、美国最大青少年橄榄球联盟 Pop Warner 医疗咨询委员会主席朱利安·拜尔斯 (Julian Bailes) 博士说道。
Bailes knew Mike Webster personally and, having helped identify the clinical evidence of Webster’s CTE (he’s played by Alec Baldwin in the movie Concussion ), is considered to be a pioneer in the field.
拜尔斯认识迈克·韦伯斯特，并帮助确定了韦伯斯特 CTE 的临床证据（他在电影《脑震荡》中由亚历克·鲍德温饰演），被认为是该领域的先驱。
He certainly acknowledges the cumulative nature of the risk when it comes to head impacts and CTE, but argues that the threshold for developing the disease would be unlikely to be met just by playing a few years of youth football.
他当然承认头部撞击和 CTE 风险的累积性，但他认为，仅仅踢几年青少年足球不太可能达到患上这种疾病的门槛。
“I’m not pro-head injury or pro-concussion, but there’s no conclusive evidence that if you play youth football it’s going to lead to long-term brain damage,” he tells me.
“我不支持头部受伤或脑震荡，但没有确凿的证据表明，如果你参加青少年足球比赛，会导致长期的脑损伤，”他告诉我。
“The risk occurs as [players] get into high school and college, and they are big and strong and fast and have 600 to a thousand hits a season.
“当[球员]进入高中和大学时，风险就会出现，他们身材高大、强壮、速度快，每个赛季有 600 到 1000 次安打。
So in my opinion, it’s a misdirected argument.
所以在我看来，这是一个错误的论点。
There’s probably 100 kids who get killed on bicycles every year.
每年大约有 100 个孩子死于自行车事故。
There’s no kids dying playing Pop Warner football.”
没有孩子在踢波普·华纳橄榄球时死去。”
But science continues to raise red flags about the sport.
但科学继续对这项运动发出危险信号。
A 2016 study published in Radiology found that playing just one season of youth football caused measurable changes in the white matter of children’s brains as well as diminished brain function, even in players who had not displayed signs of having a concussion.
2016 年《放射学》上发表的一项研究发现，仅踢一个赛季的青少年足球就会导致儿童大脑白质发生可测量的变化以及大脑功能下降，即使对于没有表现出脑震荡迹象的球员也是如此。
Another , from 2018, showed that both years of football play and the age at which an athlete started affected the volume of the thalamus, the egg-shaped structure in the center of the brain that relays information from the body and has been associated with cognition and mood.
2018 年的另一项研究表明，参加足球比赛的年数和运动员开始的年龄都会影响丘脑的体积，丘脑是大脑中心的蛋形结构，负责传递来自身体的信息，与认知和情绪有关。
“Tau is the sexy thing to talk about, so that’s what people talk about,” says Cantu of the changes to the brain that can occur from repetitive brain injury.
“Tau 蛋白是一个很性感的话题，所以这就是人们谈论的话题，”坎图在谈到重复性脑损伤可能导致的大脑变化时说道。
“They think, ‘You got CTE.
“他们想，‘你得了 CTE。
That’s bad.’ Well, you can be very bad off without CTE, just from all those hits.”
这太糟糕了。’嗯，如果没有 CTE，光是受到这些打击，你的生活就会变得非常糟糕。”
According to Dr. Ann McKee, a neuropathologist and director of the CTE Center at Boston University — where she heads up the largest brain bank in the country — patients diagnosed with CTE almost always show other signs of brain damage, but those same injuries can still be present without the pathology of a progressive disease.
神经病理学家兼波士顿大学 CTE 中心主任安·麦基 (Ann McKee) 博士表示，她领导着美国最大的脑库，被诊断患有 CTE 的患者几乎总是表现出其他脑损伤迹象，但这些相同的损伤仍然可能存在，但没有进展性疾病的病理学表现。
“There are a lot of other changes that can cause very disabling symptoms, and they don’t have to rise to the level of CTE,” she says.
“还有很多其他变化可能会导致非常严重的症状，而且它们不一定会达到 CTE 的水平，”她说。
“We’re seeing changes in brain architecture, shrinkage of the brain, damage to brain structures, inflammation, evidence of vascular disease — meaning the tiny blood vessels of the brain are probably injured and leaky.”
“我们看到大脑结构发生变化、大脑萎缩、大脑结构受损、炎症、血管疾病的证据——这意味着大脑的微小血管可能受伤和渗漏。”
All of these changes have the potential to affect cognition and mental health.
所有这些变化都有可能影响认知和心理健康。
And even if the effect is difficult to quantify, with more than 2 million kids playing tackle football every year, certain researchers question whether it has led to an epidemic of children whose potential is diminished, whose cognition might have been a little higher, whose chances of developing depression or dying by suicide might have been a little lower if they had never played a sport in which they had repeatedly sustained injury to their brains.
即使影响难以量化，每年有超过 200 万儿童参加橄榄球比赛，某些研究人员质疑，这是否会导致儿童流行，如果他们从未参加过一项让大脑反复受到损伤的运动，他们的潜力可能会下降，他们的认知可能会更高一些，他们患抑郁症或自杀死亡的机会可能会更低一些。
“The novel mental-health-disorder research is actually becoming quite strong,” says Chris Nowinski, a former Harvard football player and professional wrestler who went on to co-found the Concussion Legacy Foundation and get a Ph.D. in behavioral neuroscience after a concussion he suffered in the ring in 2003 kicked off a sleep disorder, a behavior disorder, and a throbbing headache that didn’t let up for years.
“新型心理健康障碍研究实际上正在变得相当强大，”前哈佛橄榄球运动员和职业摔跤手克里斯·诺文斯基 (Chris Nowinski) 说，他后来共同创立了脑震荡遗产基金会并获得了博士学位。 2003年，他在拳击场上遭受脑震荡，之后他获得了行为神经科学博士学位，导致了睡眠障碍、行为障碍和多年没有缓解的搏动性头痛。
Now considered the public face of CTE awareness — he’s the guy Newsweek called after Hernandez died by suicide in prison, and the person families typically contact if they want to donate the brain of a loved one suspected of having CTE — Nowinski not only believes that the connection between repetitive, low-level head impacts and mental illness is strong enough that developing a mood disorder could prove to be a risk factor for developing CTE, but he also believes that the connection is strong enough to be worrisome in its own right.
现在，诺文斯基被认为是 CTE 意识的公众代表——埃尔南德斯在狱中自杀身亡后，《新闻周刊》给他打电话，如果家人想要捐献疑似患有 CTE 的亲人的大脑，诺温斯基通常会联系他。诺温斯基不仅认为，重复性、低强度的头部撞击与精神疾病之间的联系足够紧密，以至于出现情绪障碍可能被证明是发生 CTE 的一个风险因素，而且他还认为，这种联系本身就足以令人担忧。
A study published in the Journal of Neurotrauma the month before DuQuan Myers’ death found that cumulative head impacts, with or without diagnosed concussions, increased the risk of depression, apathy, and behavioral dysregulation.
杜泉·迈尔斯去世前一个月发表在《神经创伤杂志》上的一项研究发现，无论是否患有脑震荡，累积的头部撞击都会增加抑郁、冷漠和行为失调的风险。
A study published just a few months after his death found that participants with CTE showed accumulations of tau lesions specifically “in brain regions that have been associated with …
在他去世几个月后发表的一项研究发现，患有 CTE 的参与者表现出 tau 损伤的积累，特别是“在与……相关的大脑区域”。
impulsivity, depressive symptoms, anxiety, and explosivity.” Other studies have found football players to have higher rates of depression than the population at large.
冲动、抑郁症状、焦虑和爆发力。”其他研究发现，足球运动员的抑郁症发病率高于一般人群。
“Essentially,” says Nowinski, “we’re taking kids who have never had an anxiety or depression or self-harm issue, and they’re getting it because of damage to their brain.”
“从本质上讲，”诺温斯基说，“我们正在招募那些从未有过焦虑、抑郁或自残问题的孩子，他们之所以会出现这种情况，是因为他们的大脑受到了损害。”
A MATTER OF HOURS after a bullet entered DuQuan Myers’ brain, the local medical examiner in Lockhart, Texas, carefully, gingerly, removed it and submerged it in a formaldehyde solution.
一颗子弹进入杜泉·迈尔斯的大脑几个小时后，德克萨斯州洛克哈特的当地法医小心翼翼地将其取出，并将其浸入甲醛溶液中。
She then placed the container into a styrofoam box bound for Boston.
然后，她将容器放入泡沫塑料箱中，运往波士顿。
Once the brain arrived at McKee’s lab at the Boston University CTE Center, it was photographed and dissected.
当大脑到达波士顿大学 CTE 中心的 McKee 实验室后，它被拍照并解剖。
Half was snap-frozen and stored in perpetuity in a negative-80-degree freezer.
一半被速冻并永久保存在零下 80 度的冰箱中。
The other half, the half that would be used to make the diagnosis, was put back in formaldehyde.
另一半，即用于诊断的一半，被放回甲醛中。
Then the waiting game began.
然后等待的游戏开始了。
Inside the skull of a living human, the brain is almost the consistency of jello, a miraculous mush of electrical charges.
在活人的头骨内，大脑几乎是果冻的稠度，是一种神奇的电荷糊状物。
It took months for the formaldehyde to seep all the way in, hardening Myers’ brain to a consistency that would allow it to be cut into eighth-of-an-inch slivers.
甲醛花了几个月的时间才完全渗透进去，使迈尔斯的大脑硬化到可以被切成八分之一英寸的碎片的程度。
Those slivers were then further dissected into hundreds of 10-micron slices, almost impossibly thin ribbons of neural matter that were stained and put into slides for McKee or one of her team to analyze under a microscope.
然后，这些碎片被进一步解剖成数百个 10 微米的切片，这些切片是几乎不可能的神经物质薄带，经过染色后放入载玻片中，供 McKee 或她的团队之一在显微镜下进行分析。
Meanwhile, clinicians were rounding up medical records to determine Myers’ medical past, his history of head impacts, and what symptoms he may have had.
与此同时，临床医生正在收集医疗记录，以确定迈尔斯的病史、头部撞击史以及他可能出现的症状。
Both teams worked blindly: Neither would communicate about Myers’ case until the clinicians had finished their research and the pathologists had made their determination.
两个团队都盲目地工作：在临床医生完成研究并且病理学家做出决定之前，双方都不会就迈尔斯的病例进行交流。
In the spring of 2018, Letitia Wilbourn received a notification that McKee and her colleagues had come to a conclusion in her son’s case.
2018 年春天，利蒂西亚·威尔伯恩 (Letitia Wilbourn) 收到通知，称麦基和她的同事已就她儿子的案件得出结论。
Not knowing what she expected or even what she wanted to hear, she arranged to take the call by herself, over her lunch break.
她不知道自己在期待什么，甚至不知道自己想听什么，所以她安排在午休时间独自接听电话。
“I didn’t want to be home alone,” she says.
“我不想一个人在家，”她说。
“I was carrying so much guilt with his suicide, thinking, ‘Did I miss something?
“我对他的自杀感到非常内疚，心想，‘我是不是错过了什么？
Did I do something?
我做了什么吗？
What caused it?’ I had so much guilt.”
是什么造成的？’我非常内疚。”
On the call, McKee gently shared the diagnosis: Myers had had stage 1 CTE, characterized by one to three microscopic lesions.
在电话中，麦基温和地分享了诊断结果：迈尔斯患有 1 期 CTE，其特征是一到三个微小病变。
At this level, the lesions would have affected such a small percentage of Myers’ brain that they may not have accounted for any changes in mood or behavior.
在这个水平上，病变只影响了迈尔斯大脑的一小部分，以至于它们可能无法解释情绪或行为的任何变化。
But they would certainly have been proof of brain trauma that had been unable to fully heal.
但它们肯定是无法完全治愈的脑损伤的证据。
In fact, his brain also showed arteriolosclerosis (the thickening of small blood vessels), neuroinflammation, and loss of fibers in the white matter, Wilbourn was told.
事实上，威尔伯恩被告知，他的大脑还出现了动脉硬化（小血管增厚）、神经炎症和白质纤维损失的情况。
“Then they explained that there was nothing that I could have done to prevent what happened,” she says.
“然后他们解释说，我无法采取任何措施来阻止发生这样的事情，”她说。
“They told me that there was no way for me to have known.
“他们告诉我，我不可能知道。
It was an instant release.
这是一个即时的释放。
I actually had the best day I’d had since he’d died.
事实上，我度过了他去世以来最美好的一天。
And then came the guilt of having put him in football to begin with.”
然后就是因为一开始就让他进入足球界而感到内疚。”
As gentle as he’d been off the field, Myers had been formidable on it, starting as both an offensive and defensive lineman despite his small size — only five feet five and 140 pounds by the end of high school.
尽管迈尔斯在场外很温和，但他在球场上却表现得很强大，尽管他身材娇小——高中结束时只有五英尺五英寸、体重 140 磅，但他一开始既是进攻型前锋，又是防守型前锋。
“He loved to tackle people, that’s for sure,” Wilbourn tells me.
“他喜欢对付别人，这是肯定的，”威尔伯恩告诉我。
She thought of all those times when he had taken a brutal hit and she’d caught her breath, wondering if she should go down to the field and check on him but stopping herself with the reminder that parents weren’t supposed to do that.
她想起了他遭受残酷打击的那些日子，她屏住了呼吸，想知道是否应该去田野里看看他，但她又提醒自己父母不应该这样做，从而阻止了自己。
She thought of that time he’d broken his leg during practice and been rushed to the hospital, how she’d thought that fractured fibula and tibia were the worst injuries of his life.
她想起那次他在训练中摔断了腿，被送往医院，她以为腓骨和胫骨骨折是他一生中最严重的伤。
She thought of the terrible headaches he’d have after practices, how she’d chalked them up to allergies.
她想到了他在训练后会出现的严重头痛，她是如何将其归咎于过敏的。
She remembered how in high school he’d complained about his vision and suddenly needed glasses when no one else in the family ever had.
她记得在高中时，他曾抱怨自己的视力不佳，突然需要戴眼镜，而家里其他人都没有戴过眼镜。
Now, on the phone with McKee, these things took on new meaning, the past reorganizing itself in her mind.
现在，在与麦基的电话中，这些事情有了新的含义，过去的事情在她的脑海中重新组织起来。
She’d been clear with the clinicians at Boston University: Myers’ life was not without sadness.
她向波士顿大学的临床医生明确表示：迈尔斯的生活并非没有悲伤。
He and his girlfriend had recently broken up, though that wasn’t unusual: They’d broken up and gotten back together more times than Wilbourn could count.
他和他的女朋友最近分手了，但这并不罕见：他们分手又复合的次数多得威尔伯恩都数不过来。
His cousin had just passed away, shot by an ex in an act of passion.
他的表弟刚刚去世，被前男友射杀。
Like the rest of the extended family, Myers had been shocked and devastated, but seemingly not any more than anyone else.
和大家庭的其他成员一样，迈尔斯也感到震惊和震惊，但似乎并不比其他人更震惊。
On the call with Boston University, these events were referred to as “triggers,” not relevant to the official diagnosis, but certainly not irrelevant to what transpired.
在与波士顿大学的电话会议中，这些事件被称为“触发因素”，与官方诊断无关，但肯定与所发生的事情无关。
“Often there’s a very impulsive component to these suicides,” McKee tells me when discussing Myers’ case this past spring.
“这些自杀通常都有非常冲动的成分，”麦基去年春天在讨论迈尔斯的案件时告诉我。
“People with an injured brain have a lower ability to control their impulses.
“大脑受伤的人控制冲动的能力较低。
They can be fine one minute and then all of a sudden just pull the trigger or whatever they decide to do.
他们可能前一分钟还好好的，然后突然扣动扳机或者做任何他们决定做的事情。
Their judgment is off.
他们的判断是错误的。
There’s a situation where something doesn’t go well or they become depressed, and they don’t have the checks and balances that a person who didn’t have an injured brain [would have].
在某些情况下，事情进展不顺利或者他们变得沮丧，并且他们没有大脑没有受伤的人所拥有的制衡能力。
We all get depressed at some point, we all feel lousy, but the injured brain just can’t stop it.
我们都会在某个时候感到沮丧，感觉很糟糕，但受伤的大脑无法阻止它。
They can’t pull themselves back.”
他们无法把自己拉回来。”
For McKee’s team, Wilbourn’s grief has become a familiar refrain.
对于麦基的团队来说，威尔伯恩的悲伤已经成为一种熟悉的说法。
“That’s really common, in my experience, to have just a random, totally impulsive act that just blindsides the family,” McKee says.
麦基说：“根据我的经验，这种随机、完全冲动的行为确实很常见，只会让家人措手不及。”
“That’s not uncommon with these suicides.”
“这在这些自杀事件中并不罕见。”
Then again, she also has encountered plenty of cases in which the suicide is not unexpected.
不过，她也遇到过很多自杀并不意外的案例。
It’s the end that some families have been expecting, warding off, fighting back for a long, long time.
这是一些家庭长期以来一直期待、抵制、反抗的结局。
AROUND THE TIME of his freshman year of college, Michael Bartlett — the person he was, the person he’d always been — started to disappear.
在大学一年级左右，迈克尔·巴特利特（Michael Bartlett）——他曾经的那个人，他一直以来的那个人——开始消失。
It happened gradually, so slowly that at first it didn’t seem like much of anything at all, maybe just a bumpy transition into adulthood.
它是逐渐发生的，如此缓慢，以至于一开始看起来根本没什么大不了的，也许只是进入成年期的坎坷过渡。
Still, his parents, Larry and Susan, grew concerned: Michael had always been friendly and easygoing, with a smile so big it seemed to hijack his entire, handsome face.
尽管如此，他的父母拉里和苏珊还是开始担心起来：迈克尔一直很友好、随和，笑容如此灿烂，似乎占据了他整张英俊的脸。
On the football field, he’d been the sort of solid kid others looked up to.
在足球场上，他是其他人尊敬的那种坚强的孩子。
Now, he seemed to frustrate more easily; now, he seemed a little aloof.
现在，他似乎更容易灰心丧气了。现在，他显得有些冷漠。
A year or so into these changes, Larry and Susan took him for academic testing, hoping to figure out why their smart, quizzical son — the one who’d read philosophy as a child — was struggling so much with college.
这些变化发生一年左右后，拉里和苏珊带他参加了学业测试，希望弄清楚为什么他们聪明、好奇的儿子——小时候就读过哲学的儿子——在上大学时如此挣扎。
The results surprised them: They were told that Michael had a very high IQ but very low cognitive function.
结果让他们感到惊讶：他们被告知迈克尔的智商非常高，但认知功能非常低。
“She said it was like having a 400 horsepower engine in a car with no wheels,” Susan says of the report.
“她说这就像在一辆没有轮子的汽车上安装了 400 马力的发动机，”苏珊谈到这份报告时说道。
“And we’re like, ‘What does that mean?’”
“我们会想，‘这是什么意思？’”
What it ultimately meant was a decade of misery for her family, a decade of Michael’s brain seeming to turn on him.
这最终意味着她的家人将经历十年的痛苦，这十年迈克尔的大脑似乎对他不利。
He tried cognitive therapy.
他尝试了认知疗法。
He tried antidepressants.
他尝试过抗抑郁药。
He tried taking medication for ADD.
他尝试服用治疗ADD的药物。
When none of that helped, he self-medicated with alcohol.
当这些都没有帮助时，他就用酒精自我治疗。
He dropped out of college, moving home to his parents’ house in La Mesa, California, isolating himself in his room, fully aware that not just his future but something even more intangible was slipping away.
他从大学退学，搬回到父母位于加利福尼亚州拉米萨的家，将自己隔离在自己的房间里，他充分意识到，不仅他的未来，还有一些更无形的东西正在消失。
“He knew there was something wrong with his brain,” says Susan.
“他知道他的大脑出了问题，”苏珊说。
“He kept saying, ‘There’s something wrong.
“他一直说，‘出了点问题。
This is my best tool.
这是我最好的工具。
I cannot lose my brain.
我不能失去我的大脑。
I can’t.’ He tried to figure out what was wrong: ‘Maybe I have this, maybe I have that.
我不能。”他试图找出问题所在：“也许我有这个，也许我有那个。
I don’t know what’s wrong.’” She doesn’t remember him ever mentioning CTE, though the thought may have occurred to him.
我不知道出了什么问题。’”她不记得他曾经提到过 CTE，尽管他可能也有过这个想法。
He’d started playing football when he was nine, coming home so beat up that Susan remembers thinking, “‘You’re not going back to that.’ That’s the stupidest thing I ever saw.” But he did go back.
他九岁的时候就开始踢足球了，回家时他很沮丧，苏珊记得他当时想：“‘你不会再回到那样的状态了。’这是我见过的最愚蠢的事情。”但他确实回去了。
By his early twenties, “he started to shut down a lot.
到了二十岁出头，“他开始变得封闭起来。
I knew we were in terrible trouble, because he would say things like, ‘If I can’t get my brain right, I can’t live.’”
我知道我们遇到了可怕的麻烦，因为他会说这样的话，‘如果我的大脑不能正常运转，我就无法生存。’”
Eventually, it became clear that he didn’t intend to.
最终，事实证明他并不是故意的。
He got a DUI.
他酒后驾车。
He tried to hang himself with a belt in his closet.
他试图用皮带在衣柜里上吊自杀。
When Michael was arrested for lunging at the gun of one of the cops who’d responded to a suicide call, Larry couldn’t help but realize that, mixed in with the hurt and sadness, he also felt a sense of reprieve.
当迈克尔因冲向一名接到自杀电话的警察的枪而被捕时，拉里情不自禁地意识到，在受伤和悲伤的同时，他也感到了一种缓刑的感觉。
“The thing is, he wasn’t gonna die in jail, wasn’t gonna commit suicide if he stayed there,” he says, his voice breaking.
“问题是，如果他留在那里，他不会死在监狱里，也不会自杀，”他声音沙哑地说。
Michael never had a girlfriend.
迈克尔从未有过女朋友。
He never had a job.
他从来没有工作。
Larry and Susan had no idea what to do.
拉里和苏珊不知道该怎么办。
There was no family history of mental illness, no indications of past trauma; there was only the constant vigil their life became, trying to keep their son alive.
没有精神疾病家族史，没有过去创伤的迹象；他们的生活只剩下不断的守夜，试图让他们的儿子活下去。
“We had problems leaving the house at all,” says Susan.
“我们根本无法离开家，”苏珊说。
“Because we were always afraid [of what we’d find] when we came home.”
“因为当我们回家时，我们总是害怕[我们会发现什么]。”
When it comes to mental illness, causation is difficult, if not impossible, to prove.
当谈到精神疾病时，即使不是不可能，也很难证明因果关系。
Many mental illnesses present in young adulthood — and their causes are certainly multifactorial.
许多精神疾病出现在成年早期，其原因肯定是多因素的。
But for a number of the scientists who study CTE and brain injury, the multifactorial nature of mental illness — the nature versus nurture of it — is exactly the point.
但对于许多研究 CTE 和脑损伤的科学家来说，精神疾病的多因素性质（先天因素与后天因素）正是重点。
No one can predict their genetic chance of developing a mental illness; no one can predict how those odds might change after hundreds or thousands of blows to the head.
没有人能够预测他们罹患精神疾病的遗传几率；没有人能够预测在头部遭受数百或数千次打击后，这些几率会发生怎样的变化。
“In the concussion clinic that I run, all of our clinicians doing intake evaluations ask, ‘Have you ever been diagnosed or worked up for ADD, ADHD, any learning disability, any mood disorder, anxiety, depression, panic attack?’” Cantu says.
“在我经营的脑震荡诊所中，所有进行摄入量评估的临床医生都会问，‘您是否曾被诊断出患有注意力缺陷多动症 (ADD)、注意力缺陷多动症 (ADHD)、任何学习障碍、任何情绪障碍、焦虑、抑郁、惊恐发作或接受治疗？’”坎图说。
“The reason that we do this is that whenever you have an underlying challenge to start with, brain injury will only aggravate it.”
“我们这样做的原因是，每当你面临潜在的挑战时，脑损伤只会加剧它。”
This is especially true while the brain is still developing.
当大脑仍在发育时尤其如此。
Though Michael Bartlett never played football past high school, he started at an age when the head is still relatively big compared with the body, and when the muscles of the neck have not been built up, meaning that even minor impacts can snap the head about.
尽管迈克尔·巴特利特高中毕业后从未踢过橄榄球，但他开始踢球的年龄与身体相比，头部仍然相对较大，而且颈部肌肉尚未发育成熟，这意味着即使是轻微的撞击也会使头部折断。
At nine, the brain is also less myelinated than it one day will be.
九岁时，大脑中的髓鞘也比一天中的髓鞘少。
“Myelin is the coating of nerve fibers,” Cantu explains.
“髓磷脂是神经纤维的涂层，”坎图解释道。
“It’s like the coating of a telephone wire.
“这就像电话线的涂层。
It not only improves transmission, but it also makes it a little harder to break, so the same degree of acceleration forces on youngsters’ brains can do more damage to the axons than they would do to an adult.”
它不仅改善了传输，而且还使其更难断裂，因此对青少年大脑的相同程度的加速力对轴突造成的损害比对成年人造成的损害更大。”
Most importantly, according to Cantu, Bartlett began playing just before a crucial stage of brain development that, he says, occurs between the ages of 10 and 12.
最重要的是，根据坎图的说法，巴特利特在大脑发育的关键阶段之前开始打球，他说这个阶段发生在 10 岁到 12 岁之间。
In these years, the circuitry is being honed — some connections between nerve cells drop out, and others are enhanced — creating the smoother neural pathways that not only allow for more efficient information processing but also dictate adult personality and intellect.
这些年来，神经回路正在被磨练——神经细胞之间的一些连接消失，而另一些连接则得到增强——创造出更平滑的神经通路，不仅可以实现更有效的信息处理，还决定了成年人的个性和智力。
“If you injure the brain during that period of time, you’re essentially causing your genetic endowment not to occur, but some aberration of it,” says Cantu.
坎图说：“如果你在这段时间内损伤了大脑，那么你本质上就会导致你的遗传禀赋不再发生，而是发生一些畸变。”
“And the aberration is not better.”
“而且像差也好不到哪儿去。”
Nor is it reversible.
它也不是可逆的。
A 2017 study on 214 former football players found that those who had started tackle football before the age of 12 were twice as likely to have “problems with behavioral regulation, apathy, and executive function” and three times more likely to have “clinically elevated depression scores,” even if they never played past high school.
2017 年对 214 名前橄榄球运动员进行的一项研究发现，那些在 12 岁之前开始接触橄榄球的人，出现“行为调节、冷漠和执行功能问题”的可能性是其他人的两倍，“临床上抑郁症评分升高”的可能性是其他人的三倍，即使他们高中毕业后从未参加过比赛。
Another study from the following year found that participants with CTE who’d started playing tackle football before 12 developed behavioral and mood symptoms 13 years earlier than those who started at 12 or later, a pattern that was also observed in participants without CTE.
第二年的另一项研究发现，12 岁之前开始踢橄榄球的患有 CTE 的参与者比 12 岁或更晚开始踢橄榄球的参与者早 13 年出现行为和情绪症状，在没有 CTE 的参与者中也观察到了这种模式。
(Bailes points out, however, that there are some studies that do not replicate these findings.) Younger age of first exposure to a collision sport — one in which contact doesn’t just randomly happen but is part of every play in the game — has been associated with structural alterations in the thalamus (even when adjusting for years of play) and in the corpus callosum , the bundle of nerves that connects the brain’s two hemispheres.
（然而，拜尔斯指出，有些研究并没有重复这些发现。）首次接触碰撞运动的年龄较小（碰撞运动不是随机发生的，而是比赛中每场比赛的一部分）与丘脑（即使根据多年的比赛进行调整）和胼胝体（连接大脑两个半球的神经束）的结构改变有关。
And while damage may not become apparent until early adulthood, when cognitive demands could outpace the brain’s diminished capabilities, or may even fly under the radar — how can one measure potential that’s lost?
虽然损害可能要到成年早期才会显现出来，但此时认知需求可能会超过大脑减弱的能力，甚至可能会被忽视——人们如何衡量失去的潜力呢？
— the bottom line, Cantu argues, is that “those who start young will have greater later-life chances to wind up with cognitive, behavioral, and mood issues — and if they get CTE, it’ll be worse.”
坎图认为，底线是“那些年轻时开始的人在晚年有更大的机会出现认知、行为和情绪问题——如果他们患有 CTE，情况会更糟。”
All of which could contribute to an explanation of what happened on July 11, 2019.
所有这些都有助于解释 2019 年 7 月 11 日发生的事情。
Just after his 29th birthday, Michael Bartlett drove to an overpass, pulled his car over, climbed up on the concrete wall, and jumped 85 feet to the pavement below.
迈克尔·巴特利特 (Michael Bartlett) 刚过完 29 岁生日，他开车来到一座立交桥，将车停在路边，爬上混凝土墙，然后跳下 85 英尺高的人行道。
Larry and Susan had been driving around La Mesa, frantically looking for him, when they saw the flashing red lights.
拉里和苏珊当时正在拉米萨周围开车，疯狂地寻找他，这时他们看到了闪烁的红灯。
“The police wouldn’t even let me see him,” Larry says.
“警察甚至不让我见他，”拉里说。
“All they would let me do is hug the body bag.
“他们只让我抱住裹尸袋。
I don’t even remember the next two days.
我什至不记得接下来的两天。
It was just like we were in a different world.
就像我们身处不同的世界一样。
And it’s been that way ever since.”
从那以后一直都是这样。”
These days, when Susan feels like she’s spiraling, she pulls out the report from Boston University, the one that diagnosed Michael with stage 1 CTE.
这些天，当苏珊感觉自己的病情不断恶化时，她拿出了波士顿大学的报告，该报告诊断迈克尔患有第一阶段 CTE。
“You know, when you’re in a bad place, it’s kind of helpful to see the medical answer,” she explains.
“你知道，当你处境不利时，看到医疗答案会很有帮助，”她解释道。
It doesn’t change what happened, of course, but it achieves something: It solves the mystery Michael had been so desperate to solve when he was alive.
当然，这并没有改变所发生的事情，但它取得了一些成果：它解开了迈克尔生前迫切想解开的谜团。
For that, the Bartletts are grateful.
对此，巴特利特夫妇深表感激。
“That’s where our son exists today, in Boston,” says Larry.
“这就是我们儿子今天生活的地方，波士顿，”拉里说。
“That’s his contribution to this horrible disease.
“这就是他对这种可怕疾病的贡献。
He contributed his brain.”
他贡献了自己的大脑。”
THE CHICAGO SPRING RECEPTION hosted by the Concussion Legacy Foundation is a cascade of grief amid canapes.
由脑震荡遗产基金会主办的芝加哥春季招待会在小吃中充满了悲伤。
One evening this past spring, in a lovely room of the University Club with sweeping views of downtown, family members of the deceased or desperate stand up one by one to share their plight.
今年春天的一个晚上，在大学俱乐部的一间可爱的房间里，可以将市中心的景色尽收眼底，死者或绝望的家属一一站起来，分享他们的困境。
There is the young son who speaks of his father’s decline, the dad who wants to honor his child’s memory, the teammate who wonders if his friend’s struggles await him also.
年幼的儿子讲述了父亲的衰落，父亲想要纪念孩子，队友想知道他的朋友是否也会面临同样的困境。
Toward the end of the impromptu speeches, Jan Callaghan falteringly makes her way to the center of the room.
即兴演讲快结束时，简·卡拉汉摇摇晃晃地走到房间中央。
Her son Barrett’s legacy story is on the CLF’s website, alongside a photo of the football helmet he’d worn in middle school, the one scarred with deep gashes and gouges.
她儿子巴雷特的传奇故事发布在 CLF 的网站上，旁边还有一张他在中学时戴过的橄榄球头盔的照片，头盔上有很深的伤口和凹痕。
She’d pointed them out the day before, standing over the helmet as it rested on the dining-room table of her house in the Orland Park neighborhood of Chicago.
前一天，她站在位于芝加哥奥兰公园附近的家中餐桌上的头盔旁边，指出了它们。
There was a time when those gouges were a source of pride.
曾经有一段时间，这些凿痕是一种自豪的源泉。
Now, Jan shudders at the thought.
现在，简一想到这个就浑身发抖。
For years, hers had been a football family, their lives arranged around the endless drills and practices, their weekends spent driving to and from games, their laundry hamper full of grass-stained uniforms.
多年来，她的家庭一直是一个足球家庭，他们的生活围绕着无休止的训练和练习，他们的周末开车往返于比赛，他们的洗衣篮里装满了沾满草的制服。
When he was seven, Barrett saw his brother Richie play and begged his parents to find a team for him.
七岁时，巴雷特看到他的兄弟里奇打球，并请求他的父母为他寻找一支球队。
Jan remembers getting a call from her husband during one of Barrett’s first games: “He said, ‘You’ve got to get up here.
简记得在巴雷特的第一场比赛中接到她丈夫的电话：“他说，‘你必须站起来。
You’re not going to believe this.’” As she approached the field, she searched out Barrett’s little red uniform with the number 3.
你不会相信这一点。’”当她走近球场时，她找到了巴雷特的红色小制服，上面印着 3 号。
“And my jaw dropped as I watched him go from one end of the field to the other with the football, never stopping.
“当我看着他带着足球从球场的一端跑到另一端，永不停息时，我的下巴都惊掉了。
As a young boy, he was a force.
作为一个小男孩，他就是一股力量。
When that football hit his hands, there was no stopping him.”
当足球击中他的手时，没有人能阻止他。”
As Barrett got older, it became clear that he’d never play professionally, but it was also clear that football would organize the rhythms of his life.
随着巴雷特年龄的增长，很明显他从未参加过职业比赛，但也很明显足球将安排他的生活节奏。
One of his sisters was a cheerleader.
他的一个姐妹是啦啦队长。
His dad, Rich, volunteered as a coach.
他的父亲里奇自愿担任教练。
“The slogan we had was ‘Don’t drop your bonnet,’” he says the day we meet, sitting at the kitchen table, his voice thick with sorrow.
“我们的口号是‘别把帽子掉下来’，”我们见面的那天，他坐在厨房的桌子旁说道，声音里充满了悲伤。
“‘Tackle the right way, into the chest with your face guard up.
“‘以正确的方式击球，将面罩向上打入胸部。
Don’t have your head down.’” Richie had heeded this warning.
不要低着头。’”里奇注意到了这个警告。
But Barrett was a different sort of player than his brother, one who made up for his small size with his tenacity.
但巴雷特是一位与他哥哥不同的球员，他用坚韧弥补了自己身材矮小的缺陷。
“He was a really tough player,” Jan says.
“他是一位非常强硬的球员，”简说。
“He did play with his head.”
“他确实用脑子玩。”
There were a lot of tough players on the South Side of Chicago, where the kids attended Catholic school and where football came second to God, if only just.
芝加哥南区有很多强硬的球员，孩子们在那里上天主教学校，足球仅次于上帝，如果只是这样的话。
“They call it the black-and-blue South Side Catholic,” says Rich.
“他们称之为黑蓝南区天主教徒，”里奇说。
“Because the kids are black and blue.” So it was hard to explain to football friends what was happening to Barrett in the final years of his life.
“因为孩子们脸色青一块紫一块的。”因此，很难向足球朋友们解释巴雷特在他生命的最后几年里发生了什么。
People thought he was lazy when he dropped out of college and moved back home, unfocused when he couldn’t hold down a job, losing the thread when he’d lash out aggressively for almost no reason.
当他从大学退学搬回家时，人们认为他很懒；当他无法保住一份工作时，人们认为他精神不集中；当他无缘无故地猛烈抨击时，人们认为他失去了线索。
People distanced themselves.
人们拉开了距离。
Jan would have to remind them, “This is Barrett we’re talking about.
简必须提醒他们，“我们正在谈论的是巴雷特。
You’ve known him forever.
你已经认识他一辈子了。
Do you think it was normal that he couldn’t finish school?” She saw how he couldn’t sleep, how embarrassed he was when he couldn’t take in simple information or remember simple tasks, how he saw his brother and sisters building lives and careers and families and felt desperately left behind.
你觉得他没能完成学业是正常的吗？”她看到他如何无法入睡，当他无法接受简单的信息或记住简单的任务时，他是多么尴尬，他如何看到他的兄弟姐妹建立生活、事业和家庭，并感到绝望地被抛在后面。
When he came down to the kitchen one summer afternoon and told Jan he thought he had CTE, she had already come to the same conclusion.
一个夏天的下午，当他来到厨房告诉简他认为自己患有慢性创伤性脑病时，她已经得出了同样的结论。
She assumed she’d go the rest of her life not knowing for sure.
她以为她的余生都会在不确定中度过。
But when state troopers knocked on her door at 4 a.m.
但当州警在凌晨 4 点敲响她的门时。
the morning of Sept.
九月的早上
26, 2021, and told her that Barrett had died in an accident, a head-on collision with a car going the wrong way on the highway, she had barely been able to even take in the news before she started making plans to have his brain donated.
2021 年 12 月 26 日，并告诉她巴雷特在一场事故中死亡，那是在高速公路上与一辆逆向行驶的汽车正面相撞，她几乎还没来得及接受这个消息，就开始计划捐献他的大脑。
As with smoking and lung cancer, there’s no known threshold for developing CTE and no way to know an individual player’s risk factors for being affected by it or other structural changes to the brain — no way to yet explain why some players are ravaged while others seemingly escape harm.
与吸烟和肺癌一样，目前还没有发生 CTE 的已知阈值，也无法知道单个玩家受 CTE 影响或大脑其他结构变化的风险因素 - 目前还无法解释为什么有些玩家受到蹂躏，而另一些玩家似乎逃脱了伤害。
On average, those who play a collision sport for less than five years have a very small chance of getting diagnosed with the disease, but the risk goes up after that; at 15 years of play, the risk has been estimated to be 10 times higher.
平均而言，参加碰撞运动少于五年的人被诊断出患有这种疾病的机会很小，但之后风险就会上升；打球 15 年时，风险估计会高出 10 倍。
The location of the damage probably matters, too; some parts of the brain are “silent” and harm to them could pass unnoticed, while others are crucial to cognition and regulation of mood.
损坏的位置可能也很重要；大脑的某些部分是“沉默的”，对它们的伤害可能会被忽视，而其他部分则对认知和情绪调节至关重要。
And some people may just take longer to heal, making them more susceptible to outrunning their cognitive reserve.
有些人可能需要更长的时间才能康复，这使他们更容易超出他们的认知储备。
“Probably in some cases, the brain’s regulatory systems are not very good — they are more fragile — so the brain cannot bring itself back to normality,” says Dr. Lea Grinberg, a neuropathologist who studies the early stages of neurodegenerative disease and whose 2018 study on Alzheimer’s found it to also be preceded by mood dysregulation.
研究神经退行性疾病早期阶段的神经病理学家 Lea Grinberg 博士说：“可能在某些情况下，大脑的调节系统不是很好——它们更脆弱——所以大脑无法恢复正常。”她 2018 年对阿尔茨海默氏症的研究发现，情绪失调也会出现这种情况。
Despite these unknowns, the diagnosis of stage 1 CTE has been enlightening, but further isolating for Barrett’s family.
尽管存在这些未知因素，1 期 CTE 的诊断仍然具有启发性，但也让巴雷特的家人进一步感到孤立。
“This woman whose husband took his life brought up this great point,” Jan tells me.
“这个丈夫自杀的女人提出了这个伟大的观点，”简告诉我。
“She said, ‘Everybody went on and on when he passed about what a hard, tough player he was and a great teammate.
“她说，‘当他谈到他是一位多么坚强的球员和一位伟大的队友时，每个人都在不停地谈论他。
And then when I told everybody that he had CTE?
然后当我告诉大家他患有 CTE 时？
Crickets.
蟋蟀。
Nobody wants to talk about it.’” She looks down at her hands spread over the table.
没有人愿意谈论这件事。’”她低头看着摊在桌子上的双手。
“It’s like you’re on an island,” she continues.
“这就像你在一座岛上，”她继续说道。
“I don’t know if they just don’t believe it, or they don’t want their precious little football tarnished.” Or maybe, she considers, they just don’t want to have to face the possibility that the same fate could await their kid, which is a reservation she understands.
“我不知道他们是否只是不相信，或者他们不想让他们珍贵的小足球受到玷污。”也许，她认为，他们只是不想面对同样的命运等待着他们的孩子的可能性，这是她理解的保留意见。
Even Rich had trouble accepting Barrett’s diagnosis at first, though time and research have helped him come around.
就连里奇一开始也很难接受巴雷特的诊断，尽管时间和研究帮助他接受了这一点。
“There’s clearly more than a smoking gun here,” he says.
“这显然不仅仅是铁证，”他说。
“The gun’s been fired.” Jan nods in agreement: “You pay attention, or you don’t.”
“枪已经开了。”简点头同意：“要么你注意，要么你不注意。”
IN RECENT YEARS, plenty of people have paid attention.
近年来，引起了很多人的关注。
According to the Sports and Fitness Industry Association, participation in tackle football for kids ages six to 12 has declined almost 29 percent since 2016, the year the NFL first publicly (and belatedly) confirmed a link between football and CTE — which has now also been found in the brains of hockey, soccer, and rugby players, as well as wrestlers, mixed-martial artists, and the first woman, Australian rules footballer Heather Anderson, who died last year at the age of 28 by an apparent suicide.
根据体育和健身行业协会的数据，自 2016 年以来，6 至 12 岁儿童参与橄榄球运动的人数下降了近 29%，2016 年 NFL 首次公开（虽然姗姗来迟）证实了足球与 CTE 之间的联系——现在曲棍球、足球和橄榄球运动员、摔跤运动员、综合格斗艺术家以及首位女性澳大利亚橄榄球运动员希瑟·安德森 (Heather Anderson) 的大脑中也发现了这种联系，后者于去年去世，享年 12 岁。 28 明显自杀。
Meanwhile, every state in the nation has passed laws aimed at protecting children who get concussions playing sports, and helmets have undergone overhauls in pursuit of the perfect padding.
与此同时，美国每个州都通过了旨在保护因运动而遭受脑震荡的儿童的法律，并且头盔也进行了彻底改造，以追求完美的填充。
U.S.A.
美国
Football, which governs the amateur arm of the sport, has promoted “heads up” tackling and concussion training.
足球运动是业余运动的一部分，它提倡“单挑”抢断和脑震荡训练。
Pop Warner introduced concussion guidelines in 2010 (including the mandate that anyone suspected of having a concussion must be cleared by a medical professional), banned full-speed head-on blocking and tackling drills in 2012, limited full-contact practices to 25 percent of the time and banned kickoffs (the game’s most dangerous play) for athletes under the age of 11 in 2016, and got rid of the three-point stance (which lowers a player’s head) in its younger divisions in 2019.
波普·华纳 (Pop Warner) 在 2010 年推出了脑震荡指导方针（包括要求任何疑似患有脑震荡的人必须经过医疗专业人员的检查），在 2012 年禁止全速迎头拦截和铲球训练，将完全接触训练的时间限制在 25%，并在 2016 年禁止 11 岁以下运动员开球（这项运动中最危险的动作），并废除了三分站位（这会降低球员的头）在2019年的年轻部门。
(Changes have also been made to youth hockey and soccer.)
（青少年曲棍球和足球也发生了变化。）
Yet many brain scientists and public-health officials question whether some of these changes are having a demonstrable effect, or even an effect at all, when it comes to the most insidious forms of brain injury.
然而，许多脑科学家和公共卫生官员质疑，当涉及到最隐蔽的脑损伤形式时，其中一些变化是否产生了明显的影响，甚至根本没有影响。
Many states’ laws tend to deal with managing concussions after they happen, not preventing them.
许多州的法律倾向于在脑震荡发生后处理脑震荡，而不是预防脑震荡。
When it comes to helmets, improvements better protect the skull, but they do not stop the brain from ricocheting inside of it, slamming against bone, torquing the brain stem; in fact, the more padding a helmet has — and thus the heavier it is — the more of a weapon it ostensibly becomes.
就头盔而言，改进可以更好地保护头骨，但它们并不能阻止大脑在头盔内部弹跳、撞击骨骼、扭转脑干；事实上，头盔的填充物越多——因此它就越重——它表面上就越像一种武器。
A British Journal of Sports Medicine study from 2017 found that new protective equipment had no measurable effect on concussion prevention, much less on the prevention of non- or subconcussive blows.
英国运动医学杂志 2017 年的一项研究发现，新的防护装备对于预防脑震荡没有明显的效果，更不用说预防非脑震荡或亚脑震荡的打击了。
Leagues that use heads-up techniques have actually recorded slightly more concussions (though the increase was statistically insignificant).
使用单挑技术的联盟实际上记录的脑震荡略有增加（尽管增加的统计意义微不足道）。
According to Cantu and Nowinski, the only changes that demonstrably help are those that reduce contact overall, like the ones Pop Warner has implemented in the face of declining participation.
坎图和诺温斯基认为，唯一明显有帮助的改变是那些减少整体接触的改变，就像波普·华纳在参与度下降时实施的改变一样。
Yet such changes are only as good as their enforcement, and while volunteer coaches may mean well — and may no longer subscribe to the myth that their job is to turn grade-schoolers into gladiators — they may also take false comfort in pronouncements that attempt to undermine the connection between CTE and collision sports and that are sometimes made by organizations with a financial stake in keeping that connection blurry.
然而，这些改变的效果取决于它们的执行力，虽然志愿者教练可能是出于好意——并且可能不再相信他们的工作是将小学生变成角斗士的神话——但他们也可能会从试图破坏 CTE 和碰撞运动之间联系的声明中获得虚假的安慰，而这些声明有时是由拥有经济利益的组织发布的，目的是模糊这种联系。
The International Consensus Conference on Concussion in Sport, an entity responsible for issuing the guidance that informs sports protocols across the globe — and one led by a number of scientists with ties to sports organizations — has consistently published statements that treat the science as unsettled, providing legal cover to conference sponsors like FIFA and World Rugby should they be accused of covering up known risks.
国际体育脑震荡共识会议是一个负责发布指导全球体育协议的实体，由多位与体育组织有联系的科学家领导，该会议一直发表声明，认为科学问题尚未解决，为国际足联和世界橄榄球联合会等会议赞助商提供法律保护，以防它们被指控掩盖已知风险。
In 2016, Pop Warner settled a case brought by the mother of a former player who died by suicide at age 25 and was later found to have CTE, opening the door to other potential lawsuits.
2016 年，波普·华纳 (Pop Warner) 解决了一名前球员母亲提起的诉讼，该球员在 25 岁时自杀身亡，后来被发现患有 CTE，这为其他潜在诉讼打开了大门。
(“At Pop Warner, there is nothing more important than the safety of our players, and since 2010, we have led the way in making the game of youth football a safer and better experience than ever before,” the organization stated in response to the settlement.)
（“在 Pop Warner，没有什么比我们球员的安全更重要的了，自 2010 年以来，我们一直在努力让青少年足球比赛变得比以往任何时候都更安全、更好的体验，”该组织在回应和解协议时表示。）
For whatever reason, there are certainly scientists who tend to focus not on what’s known — that exposure to collision sports is the one constant in nearly all documented cases of CTE and that CTE is not the only negative neural outcome — but instead on what’s unknown.
不管出于什么原因，肯定有一些科学家倾向于不关注已知的事情——几乎所有有记录的 CTE 病例中，接触碰撞运动都是一个常数，而且 CTE 并不是唯一的负面神经结果——而是关注未知的事情。
“Nobody’s looking at chess players to see if they die by CTE,” says Dr. Michael Lewis, who specializes in preventive medicine and serves on the Pop Warner Youth Football Medical Advisory Board.
“没有人通过观察国际象棋棋手来判断他们是否死于 CTE，”专门研究预防医学并在 Pop Warner 青年足球医学咨询委员会任职的迈克尔·刘易斯 (Michael Lewis) 博士说。
While Lewis supports the changes Pop Warner has made, he also argues that they are solutions to a problem that may be overstated — or oversimplified by pointing a finger at collision sports.
虽然刘易斯支持波普·华纳所做的改变，但他也认为，这些改变是为了解决一个可能被夸大的问题，或者通过指责碰撞运动而过于简单化的问题。
“I mean, I kind of look at it as the climate-change thing.
“我的意思是，我将其视为气候变化问题。
Is the science settled on climate change?
科学已经解决了气候变化问题吗？
I don’t think so.
我不这么认为。
But what’s the downside of cutting back on carbons?
但减少碳排放有什么坏处呢？
[When it comes to] getting your head hit or whatever, there’s no downside to decreasing the exposures.
[当谈到]头部受到撞击或其他什么情况时，减少暴露没有什么坏处。
We kind of look at it as, ‘OK, the science is anywhere but settled, but let’s be conservative and let’s limit the amount of contact in practice.’ Let me just say, it’s not straightforward.
我们的看法是，“好吧，科学还没有定论，但我们要保守一点，限制实践中的接触量。”我只想说，这并不简单。
It’s the brain.
这是大脑。
It’s complicated.”
这很复杂。”
Such a stance puts one of the doctors advising the nation’s largest youth-football organization behind not just the NIH but even the NFL in acknowledging the connection between football and CTE.
这种立场使得一位为美国最大的青少年橄榄球组织提供咨询的医生不仅支持 NIH，甚至支持 NFL，承认橄榄球与 CTE 之间的联系。
But one need look no further than the American Academy of Pediatrics to see the sway football has had over science.
但只要看看美国儿科学会就可以看到橄榄球对科学的影响力。
In 1957, the academy advised against collision sports for children ages 12 and younger, concluding that “body-contact sports, particularly tackle football and boxing, are considered to have no place in programs for children [of this age].” Since that time, and even as an abundance of evidence of brain trauma has come to light, the academy’s stance has softened.
1957年，该学院建议不要为12岁及以下的儿童进行碰撞运动，并得出结论：“身体接触运动，特别是擒抱足球和拳击，被认为不适合[这个年龄段]儿童的项目。”从那时起，尽管有大量脑外伤的证据被曝光，但该学院的立场已经软化。
In 2015, the AAP — the same group that recommends against body-checking in hockey in players under the age of 15 due to concussion risk — released a policy statement that essentially sidestepped the issue when it comes to America’s most popular game.
2015 年，AAP（由于存在脑震荡风险，建议不要对 15 岁以下曲棍球运动员进行身体检查的组织）发布了一份政策声明，在谈到美国最受欢迎的运动时，基本上回避了这个问题。
It conceded that eliminating youth tackle football would “likely lead to a decrease in the incidence of overall injuries, severe injuries, catastrophic injuries, and concussions,” but also argued that it would “lead to a fundamental change in the way the game is played.”
它承认消除青少年铲球足球“可能会导致整体伤害、严重伤害、灾难性伤害和脑震荡的发生率下降”，但也认为这将“导致比赛方式的根本改变”。
In light of this trade-off, the AAP, the agency tasked with advising parents and pediatricians about reasonable risk, essentially passed the responsibility for that determination on to them: “Participants in football must decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling.” (When approached about this policy, a representative from the AAP informed Rolling Stone that it was “currently undergoing an update.”)
鉴于这种权衡，美国儿科学会（AAP）这个负责就合理风险向家长和儿科医生提供建议的机构，基本上将做出这一决定的责任转嫁给了他们：“足球运动员必须决定，与适当铲球相关的娱乐益处是否超过了承受这些伤害的潜在健康风险。” （当就这项政策进行询问时，AAP 的一位代表告诉《滚石》杂志，该政策“目前正在更新。”）
Thus far, CTE can only be diagnosed postmortem, though this month, Bailes’ research team will begin stage three of an FDA trial to diagnose the disease in living people using PET scans and MRIs.
到目前为止，CTE 只能在死后诊断，不过本月，Bailes 的研究团队将开始 FDA 试验的第三阶段，使用 PET 扫描和 MRI 诊断活人的疾病。
This would be a significant breakthrough, not just enabling those with the disease to get early intervention but also allowing for the possibility of treatment.
这将是一个重大突破，不仅使患有这种疾病的人能够得到早期干预，而且还使治疗成为可能。
“There’s plenty of potential treatments,” says McKee.
“有很多潜在的治疗方法，”麦基说。
“But it’s hard to assess their efficacy without having a biomarker to follow to see if it’s getting better.
“但是，如果没有生物标志物来观察其疗效是否有所改善，就很难评估它们的疗效。
That’s part of the problem right now: We can’t diagnose it during life, so we can’t follow a treatment to see if it’s actually beneficial.
这就是现在问题的一部分：我们无法在一生中诊断它，因此我们无法遵循治疗来看看它是否真的有益。
But I think we’re going to get there.”
但我认为我们会到达那里。”
Until then — and in light of not just CTE but other potential cognitive and mental-health outcomes — many doctors and scientists argue that the best approach from a public-health perspective is to outlaw the collision part of collision sports, at least until children’s brains have passed the period of rapid development in their tween years.
在那之前，不仅考虑到 CTE，还考虑到其他潜在的认知和心理健康结果，许多医生和科学家认为，从公共卫生角度来看，最好的方法是禁止碰撞运动中的碰撞部分，至少在儿童大脑度过青少年时期的快速发育期之前是如此。
The Concussion Legacy Foundation’s “Stop Hitting Kids in the Head” campaign has encouraged parents to hold off on enrolling their kids in tackle football until they are 14.
脑震荡遗产基金会 (Concussion Legacy Foundation) 发起的“停止打孩子头部”活动鼓励家长推迟让孩子们在 14 岁之前参加橄榄球比赛。
Cantu has called on the surgeon general to ban tackle football for children under that age, pointing out that all of the health and social benefits of a team sport can be retained in less-violent versions of these games (in fact, the Manning brothers famously didn’t start playing tackle football until middle school).
坎图呼吁卫生局局长禁止该年龄段以下儿童使用铲球，并指出团队运动的所有健康和社会效益都可以保留在这些游戏的暴力程度较低的版本中（事实上，众所周知，曼宁兄弟直到中学才开始玩铲球）。
McKee goes even further, arguing that no one should play a collision sport until they reach the age of consent, until they are emotionally mature enough to weigh the risks themselves and physically mature enough to better withstand them.
麦基甚至更进一步，认为任何人都不应参加碰撞运动，直到他们达到同意的年龄，直到他们在情感上成熟到足以自己权衡风险，并且身体成熟到足以更好地承受风险。
That may sound extreme to football diehards, but not to McKee, who spends her days looking at damaged brains and speaking to the devastated families who donate them.
对于足球顽固分子来说，这可能听起来有些极端，但对于麦基来说却并非如此，她整天都在观察受损的大脑，并与捐赠大脑的悲痛家庭交谈。
“Part of the reason I can’t let this go is I know what it’s doing to people,” she tells me.
“我不能放手的部分原因是我知道它对人们造成的影响，”她告诉我。
“And I also know it’s preventable.”
“而且我也知道这是可以预防的。”
A TEXAS THUNDERSTORM is brewing, the air growing hot and thick with the smell of the coming rain, on the recent Saturday morning when Letitia Wilbourn visits her son’s grave.
不久前的周六早上，利蒂西亚·威尔伯恩 (Letitia Wilbourn) 前往儿子的坟墓时，一场德克萨斯州雷暴正在酝酿之中，空气中弥漫着即将下雨的气味，变得又热又浓。
Under the shade of the oak tree where the doves once perched, she rearranges the plastic flowers and carefully sweeps dust off the gravestone with a little brush she keeps in the car for that purpose.
在鸽子曾经栖息的橡树树荫下，她重新排列塑料花，并用她在车里放的小刷子小心地扫去墓碑上的灰尘。
Her daughter Natasha stands there and cries.
她的女儿娜塔莎站在那里哭泣。
Wilbourn tries to keep herself busy.
威尔伯恩试图让自己忙碌起来。
“I promised Quan I wouldn’t break,” she says, walking back to her car.
“我向 Quan 保证过我不会食言，”她一边说，一边走回自己的车上。
“I told him I will always try to smile when I’m discussing him.”
“我告诉他，当我谈论他时，我会一直努力微笑。”
Back home, Wilbourn sits on the floor of her living room, in view of Myers’ football trophies, surrounded by his photos, down the hall from the room where his clothes still hang in the closet.
回到家里，威尔伯恩坐在客厅的地板上，看着迈尔斯的足球奖杯，周围都是他的照片，穿过大厅，从房间里走过去，他的衣服还挂在衣柜里。
The extended family has gathered today, assorted cousins, aunts, uncles, and grandchildren passing through the room and in and out of the house, a tight-knit, boisterous group of which Wilbourn seems to be the calm and stoic center.
大家庭今天聚集在一起，各种各样的表兄弟姐妹、阿姨、叔叔和孙子们穿过房间，进出房子，一个紧密团结、热闹的团体，威尔伯恩似乎是其中平静和坚忍的中心。
Life goes on, certainly, even if, in some ways, it now revolves around the memory of death.
当然，生活仍在继续，即使在某些方面，它现在围绕着死亡的记忆。
“If Quan was still here right now, then he probably would be dealing with something mentally in his head,” Natasha offers haltingly.
“如果全现在还在这里，那么他可能会在脑子里处理一些精神上的事情，”娜塔莎结结巴巴地说道。
“Like, how would he be today?
“比如说，他今天会怎么样？
Would he be outside walking around with his shirt off?
他会脱掉衬衫在外面走来走去吗？
No shoes?
没有鞋子吗？
Where would he be?”
他会在哪里？
Wilbourn’s oldest child, Monique, nods.
威尔伯恩最大的孩子莫妮克点点头。
They all know the CTE narrative, the tragic way it unfolds.
他们都知道 CTE 的叙述及其悲剧性的展开方式。
“What would have been the progression?
“进展会怎样？
Would we have to have been looking for him out in the streets?”
我们一定要到街上去找他吗？”
“I don’t know if I would be happy seeing him here right now with dementia versus what happened,” Natasha says, beginning to cry again.
“我不知道现在看到他患有痴呆症和所发生的事情我是否会高兴，”娜塔莎说，又开始哭了。
Wilbourn reaches for her daughter’s hand.
威尔伯恩伸手握住女儿的手。
Still, she doesn’t break.
尽管如此，她并没有崩溃。
There are times when she does.
有时她会这样做。
Sometimes, she’ll be driving and pass a field with peewee players huddled together, their little helmets and bodies clashing under the Texas sun, and she won’t be able to look away.
有时，她会开车经过一片场地，小球员们挤在一起，他们的小头盔和身体在德克萨斯州的阳光下相互碰撞，她将无法将目光移开。
“I pull over and pray for every kid out there,” she tells me.
“我把车停在路边，为每个孩子祈祷，”她告诉我。
“I pray, and I cry.” When people ask about her son, she tells them about CTE.
“我祈祷，我哭泣。”当人们询问她儿子的情况时，她会告诉他们有关 CTE 的情况。
She implores parents to consider other sports.
她恳求家长考虑其他运动。
She wants her son’s death — her own suffering — to have some purpose, some meaning.
她希望她儿子的死——她自己的痛苦——有某种目的、某种意义。
But, she tells me, “this is Texas, and football is God to some people.”
但是，她告诉我，“这是德克萨斯州，足球对某些人来说就是上帝。”
As we’re talking, a 12-year-old boy walks into the room and sits silently on the sofa.
正在我们说话的时候，一个12岁的男孩走进房间，静静地坐在沙发上。
He’s Wilbourn’s nephew’s child.
他是威尔伯恩的侄子的孩子。
He started playing tackle football this past year, despite his family’s experience with CTE, despite Wilbourn’s admonishments, despite the fact that his father sits nervously on the sideline of each game, watching his son’s head and the movements of his body, looking for signs of disaster.
尽管他的家人有过CTE的经历，尽管威尔伯恩的警告，尽管他的父亲紧张地坐在每场比赛的场边，观察他儿子的头部和身体的动作，寻找灾难的迹象，但他从去年开始玩铲球足球。
This very afternoon, the boy is a witness to his family’s grief, yet it won’t stop him from playing this game of neural Russian roulette.
今天下午，这个男孩目睹了家人的悲痛，但这并不能阻止他玩这款神经俄罗斯轮盘赌游戏。
What can Wilbourn do?
威尔伯恩能做什么？
He isn’t her child.
他不是她的孩子。
All she can do is pray that maybe, just maybe, this is a game he’ll win.
她所能做的就是祈祷也许，只是也许，这是一场他会赢的比赛。