The Super Bowl: The Brain on Football

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Alyssa Hurst:

You're listening to RadioEd

Nicole Militello:

University of Denver podcast.

Lorne Fultonberg:

We're your hosts, Lorne Fultonberg.

Alyssa Hurst:

Alyssa Hurst,

Nicole Militello:

And I'm Nicole Militello. In today's episode, we're talking about one of the biggest sporting events of the year, the Super Bowl. While some people are looking forward to the commercials, others watch for the love of the game. But when Kim Gorgens watches the Super Bowl, she notices something else. The hard hits and the lasting impact they could have on these athletes. Gorgens is a clinical psychology professor who researches brain injuries. She stopped by the studio to talk about the risks that come with playing football and why this conversation doesn't just apply to sports. Thanks so much for joining us.

Kim Gorgens:

Nicole. Thanks for having me.

Nicole Militello:

I'm curious what it's like from your perspective as someone who is a traumatic brain injury expert. What goes through your mind when you watch the Super Bowl.

Kim Gorgens:

Ah, to watch the pageantry and the brutality of it all? Well, I think like everybody, I'm struck by the remarkable athleticism. The difference in my perspective I think is that I have a lot of relationships with retired NFL players, some of whom have one, two or three Super Bowl rings and their story is very different. It's not the glamor of a highly publicized sporting event with billions of dollars in advertising. Their experience is most often being scared and depressed and to have a third knee replacement on the way and to feel scared about the runway they're looking at for the rest of their lives.

Nicole Militello:

Do you think that they're really aware of what they're getting themselves into when they joined the NFL, when it comes to brain injuries and things like that?

Kim Gorgens:

It's such a great question and this is really where the field is right now that we don't know enough about how to predict who will have these relatively low frequency but terrible outcomes. So that might be dementing disease for example, or even the more likely consequences like pituitary gland changes and changes to the hippocampus in the brain, for example. Those are much more common and there are behavioral problems associated with that. But it's not dementing disease like we've talked about. So we don't know how to tell players how to be safe other than don't get your head knocked around. And we don't know how to identify the people who are most likely to end up in that circumstance.

Nicole Militello:

Okay. So with the research that we have now, do you think that there needs to be a bigger emphasis on educating or do you think that there's already a good job of doing that out there?

Kim Gorgens:

The NFL, to their credit, does a fairly great job of protecting their athletes. They're really smart about preseason and game season policies. For example, just this year there was a report that their preseason practice concussion rate went up 44% from last year. And so it's being debated right now in their collective bargaining agreement whether they should get rid of contact in next year's preseason practices.

Nicole Militello:

Contact all together?

Kim Gorgens:

All together.

Nicole Militello:

Interesting.

Kim Gorgens:

So the NFL responds really quickly. They may have been forced to do that. Their hand may have been forced. But they are very protective of their players. The real beef with the NFL has been that for players after retirement, which is right in the longterm we're going to have more health complaints, chronic illnesses that that's when the NFL really turns their back on them. That's a complaint that players have.

Nicole Militello:

Do you think that there is a safe way to play a high impact sports like football, maybe with different helmet technology or equipment?

Kim Gorgens:

It's so funny because there's really a gold rush in the equipment space to develop a safer helmet and in the coaching and athletic space to design a safer way to play. So there's a few really interesting pieces of data to this point. So one is that we've developed a whole slew of new helmet technologies and mouth guard technologies and some of them actually increase the risk for injury. So one that was really notable was, and you may have seen this in youth sports for a while, it was a set of padding that was worn on the outside of the helmet and they found this increases neck strain exponentially relative to regular helmets, which makes a lot of sense because the surface area is much bigger. And then when they did research with fluid filled bladders inside of professional helmets, they found that the severity of concussions was much greater. So for each step that we take towards figuring out the biomechanics of injury and how to better protect players, we take some unintended step backwards where we make things accidentally worse.

Nicole Militello:

Right. We were just reading an article in the New York Times about Stanford has a team trying to come up with a helmet that can reduce concussions.

Kim Gorgens:

Right.

Nicole Militello:

I think they were using the fluid filled helmet as well.

Kim Gorgens:

Right. So there's like fluid-filled bladders, air filled, there's internal/external mouth guards, neck protection. It really is like a gold rush to find a really viable technology so that players would have the peace of mind of knowing that to the degree possible their protective equipment is doing its job.

Nicole Militello:

Right. And we've also discussed the conversation about whether it's just a giant concussion or two that could affect the player versus getting multiple hits over the course of their time playing football.

Kim Gorgens:

Right.

Nicole Militello:

What do you think about that?

Kim Gorgens:

This is probably the most important point of this whole conversation today, that there really is no research to suggest that one or two isolated concussions has any relationship with longterm poor outcomes. There is a relationship between even a single really big injury and longterm disease. And the other area of real concern is the accumulation of what we call sub-concussive blows. And these are in the area of 25g impact, which is like getting punched in the face, but it's a much lower g-force impact than a traditional helmet to helmet hit. The accumulation of those kinds of blows is stunning. And I can share these two pieces of data from high school and then from college. So this research embeds what are called accelerometers in helmets. So these measure force of impact, direction of travel, the biomechanics of the impact itself. So a research that looked at football players, so this was in a single season, measured an average g-force of impact, this is not a concussive impact, this is just an average force impact over the...

Nicole Militello:

Okay. Just regular tackles?

Kim Gorgens:

Totally.

Nicole Militello:

Okay.

Kim Gorgens:

Exactly. Over the course of the whole season was 25g so that was the absolute average. You can imagine that there were much higher than that and some much lower. What's even more interesting though is that the average number of 25g impacts was 774. And in that research one player reported 3,725g plus impacts in a single season. The same research looking at college players finds a slightly lower g-force of impact about 20 to 22, but double that many impacts in a season. So in that research it was 1,444. the accumulation of that many blows over the number of seasons that let's say a professional athlete will have played. This is someone who started, let's say it's football, they started playing sandlot football and Pee Wee and then they were in youth sports and chassis at the high school level. And then there were in NCAA. They have, in some cases, 20 to 30 years of the accumulation of these kinds of impacts. So we're talking about, in some cases, hundreds of thousands of blows. And that chronic inflammation is more likely related to these negative longterm outcomes.

Nicole Militello:

Wow. So like you said, this conversation is super important, not only for professional athletes, but especially for youth sports.

Kim Gorgens:

That's right.

Nicole Militello:

And kids as young as five and six are playing football.

Kim Gorgens:

Right.

Nicole Militello:

As a brain injury researcher, would you let your kid play youth football?

Kim Gorgens:

This was such a big deal at our house too. I did a Ted Talk in 2010 when my son was much younger and the image from that Ted Talk was him wrapped in bubble wrap. And it was as much a Ted Talk about neurotic parenting as it was about youth sports injury.

Nicole Militello:

Your Twitter handle is @bubblewrapbrain.

Kim Gorgens:

It's @bubblewrapbrain. That's right! So I've so thoughtful about his brain and how to manage risk. There's 99% of the risk we're exposed to is outside of our control, so I feel more responsible for that 1%. I tried to steer him towards sports that minimized exposure to the kinds of rotational force injuries. So things like full contact football and full contact hockey for example. So I pushed him towards Ultimate Frisbee where of course the benefits of running around and team membership and cohesion and the spirit of play and gamesmanship were all there, but the risk for injury was much lower than it is for some of those traditionally contact rotational injury sports like football, rugby, hockey, soccer in some cases too.

Nicole Militello:

Okay. Do you think that there's a specific age where it's okay to start playing tackle football?

Kim Gorgens:

Well, in the research....there's a debate in the research, but I find the research on contact sports before age 12 being more associated with longer term poor outcomes to be pretty compelling. The argument is that if you poll among all of these retired athletes who have poor outcomes, so let's say they have dementing disease or any physiological problem related to the accumulation of their probably sub-concussive injuries, but some brain injury. When you poll them, the folks who started playing much earlier than 12 are overrepresented in that group relative to the rest of the 99% of players who don't have these poor longterm outcomes. So we don't know that that's a causal link and there's an equally strong debate about training kids to play contact sports when they're much younger so they grow up in a safer style of play and they reduce their risk for injury in the longterm.

Kim Gorgens:

The problem with younger kids though with contact sports is that the size discrepancies are so huge. So you see that with the g-force of impact being greater for high school relative to college, and that's even greater for junior high where some kids have hit puberty and are giants relative to their pre pubescent peers who are playing on the same team.

Nicole Militello:

Right. I feel now concussions are so common in sports that people don't actually take it that seriously.

Kim Gorgens:

Right. Exactly. And for younger athletes to feel the pressure to get back to the game. That we really incentivize them to discount their symptoms. And when you look at the data, the rate at which athletes describe themselves as being symptom-free versus the length of time where any one of these injury biomarkers that we're only just now beginning to track, there's no relationship between those two things. And especially for someone who sustains another injury not long after the first injury. That extends the injury from the recovery from the second injury. And in cases with younger kids could be potentially fatal. The stakes couldn't be higher and these are easy things. For social networks to rally around your friend who's had a concussion is probably part of what you do anyway. And here's the medical neuropsychological advice that says keep it up.

Nicole Militello:

Interesting. So the New York Times also did a piece looking at the popularity of football over the past decade. And one of the lines that stuck out is nationally high school participation in 11 man football has fallen more than 10% since 2009. We have seen football evolve over the past years with all the brain injury research. Do you think football is going anywhere?

Kim Gorgens:

Well, interestingly, the change of policies in professional football, so at the NFL level when they instituted the crown of helmet rule, that was 2013, they saw a dramatic reduction in the frequency of concussive injuries during a season. A few years earlier than that, youth sports developed this heads up style of play that sponsored coaches would teach their players, which is to not lead with their head and to be smart and no spearing. So interestingly, even as recently as last year, data suggests no change in the number of reported youth sport concussions related to training kids to play in a way that doesn't include their head. Those data I think are discouraging. When you think of could we even create a game that is safer to play? I'm not sure whether or not we can. The problem with the conversation though is what people hear is that this is about aerobic exercise and sports relative to a sedentary lifestyle, and it's really not. That we know that the benefits of exercise outweigh the risk for potential exposure to injury. But what we really want to do is give someone all of that benefit and reduce the risk as much as possible. So if we could get rid of it almost altogether, that would be great even for littler kids and they could learn how to tackle when they hit college.

Nicole Militello:

Right. And what do you think about the NFL's role in all of this when it comes to the research and how they share it?

Kim Gorgens:

The Head, Neck and Spine committee really famously was doing a lot of this research for a long time. And they've taken a lot of heat for withholding that from the players. And I think that there's an element of that that is probably true. What I hear from a lot of NFL players is they felt totally blindsided by this conversation. Like, "I was never told that this was a risk for me over the course of play." So there may be an element of withholding, maybe even just passive withholding. They have, in response to media pressure, really doubled down on committing to fully transparent research. So the NFL makes millions of dollars of grants available to academic researchers to drive the field forward. So they've responded by really harnessing of momentum among university folks and research labs to do better by the players.

Nicole Militello:

Even like with that football helmet challenge that they're opening up to the public to create a new helmet.

Kim Gorgens:

That's right. Yeah. And when you think about the difference between the NFL and youth sports, so the NFL has been doing helmet research since folks were wearing leather helmets in the 1910s and 20s. So they have this long hundred year history of doing helmet research and they only just this year started doing the same research on youth sport helmets. So it's like, "My God, did we just assume that kids were injured in the same way or that their brains performed in the same way that a 30 year old's professional athletes brain performs?" And it's for everything that we talk about really meeting to happen at the NFL level, the youth sport movement lags decades. In this case, we're talking about a hundred years behind. So we could do a lot better on that front too.

Nicole Militello:

Right. And you were even talking about the research here at DU when you're talking about classic symptoms of a concussion that they might not even be necessarily what you think they are.

Kim Gorgens:

That's right. That's right. So things like feeling dizzy, which again you might attribute to exertion or heat exertion, a really hard training workout. We also see a disorientation in the slightly longer terms. So let's say this is the one to 14 day window. You see mood change, cognitive change. So people have thinking difficulties. They may have concentration problems or lose math ability, for example. They have a hard time reading without getting headachy. Headaches shows up in almost a hundred percent of that population. And those symptoms in an uncomplicated concussion scenario resolve completely inside of, we usually tell people it's 14 days to 30 days. In some folks it takes a little bit longer, especially if they've pushed themselves way too hard in that early recovery stage, they can prolong their recovery. But most people are going to get relief from those symptoms in the shorter term.

Nicole Militello:

Right. So this research is out there, but now how do you get people to really care about it? A lot of football fans love tuning into their favorite team every Sunday watching.

Kim Gorgens:

Right.

Nicole Militello:

How do you get them to really understand the extent of these brain injuries?

Kim Gorgens:

Well, here's what is an interesting backstory. So this has been really a latent conversation I would say among neuropsychologist and team psychologists and athletic trainers who've seen this, I'll call it the seedy underbelly. This is retired players who have these really devastating physical health outcomes. And that didn't get a whole lot of press for a long time. Interestingly, a group of NFL wives got really scrappy and started to do a little bit more higher profile complaining about that. And there's a double edged sword there and I do a lot of work with NFL wives now to walk the line between catastrophizing and drawing too much attention to the plight of their husbands and really genuinely drawing attention to something that is remiss in the management of players and player health. So they're trying to walk that line. They were the first to really draw attention to this issue. Because when you just talk about football and the risk for injury in the abstract, it really doesn't land, especially when it's part of everyone's Monday night and Sunday afternoon tradition and they've grown up rooting for their local college football team. And we have a way that this is part of, the fabric of our culture. So talking about injuries in that sport can be really abstract until you start to hear from your favorite players. And we've seen that over the last 10 years where players are identifying themselves as having these problems. And you've seen some younger players who are very publicly leaving the sport because of their fear of injuries. When they hit three or four injuries and they think "I may have exhausted all of my freebies." So I credit the NFL wives for really driving that momentum to draw attention in just the right way that would hook the public's interest and not oversell it and cast blame. I will say that NFL wives feel a lot of pressure. So what they're really conscious about doing is to not be so shaming about the NFL. They credit their lifestyles and their husband's careers, in this case, to the NFL. And it is really hard for them to feel at the same time they want to have a larger conversation about, "Hey, my husband forgets where he parked the car and he's 37 years old." Or "My husband can't drive. He forgot how to drive and he's 44 years old." There's a way that... There's much less support for them. So the tension between wanting some attention and resources versus not wanting to condemn the NFL altogether has been really tough.

Nicole Militello:

It's probably such a change of lifestyle too for them. Being in the NFL and having all of this support and then when they retire, maybe they have a traumatic brain injury and suddenly that support's not there anymore.

Kim Gorgens:

That's right. And it really is all of the things that happen after a player retires. So we know on the biomarker side that they have much lower levels of a hormone called BDNF, which promotes brain growth. So they have lower levels of that hormone. They may or may not have increased levels of these misfolded proteins that predispose folks to dementing disease. But they also develop substance abuse problems related to chronic pain and they have tremendous muscular skeletal complaints. So it's the adjustment with depression. From being on the Super Bowl field to checking someone out at Home Depot. That's a pretty precipitous decline in terms of your imagined status. So it's likely these poor outcomes or some combination of all of those things. It's mental illness and depression and mood and stress and pain and other substance use. It's really, for the athletes that I've had the pleasure of working with, it's been really tragic to see the fall.

Nicole Militello:

And I think a lot of people don't know about that. You don't hear about that.

Kim Gorgens:

That's right. And again, the people who would draw attention to it, so the athletes won't themselves. I do a lot of consultation with retired athletes who get in touch because they're scared. They will have forgotten their keys other way out the door on one morning and immediately they're thinking because it's part of the national dialogue "Okay, well this is it. I guess this is the start of my dementing disease pathway." And so I'm able to do a lot of reassurance. But over time, their risks are different than the general population and really unique to them. And so their wives who have a front row seat and really bear the brunt of the caregiving, owe a lot to the NFL and want to, at the same time, hold them responsible for what are longer term management and chronic health and behavioral problems that require a lot greater intensity of resources than the NFL provides.

Nicole Militello:

So I also wanted to talk to you about some other research involving traumatic brain injuries that I think a lot of people might not know about. And you actually did an entire Ted talk on this and that's the connection between traumatic brain injuries in the criminal justice system.

Kim Gorgens:

Right.

Nicole Militello:

So you start right away and you share the statistic that really jumped out to me that up to 80% of people in the criminal justice system have a TBI.

Kim Gorgens:

That's right.

Nicole Militello:

And that's compared to just the 5% of the general public.

Kim Gorgens:

That's right.

Nicole Militello:

So can you just tell us more about this link and what's behind it?

Kim Gorgens:

It's such a great question as to what's behind it. So the link is that you see a dramatic over representation of traumatic brain injury history in people who are in the criminal justice system. So in our research, for example, we're looking at probationers and we're looking at inmates. So county jail inmates. Other research has looked at federal prison inmates, Department of Corrections, they looked at parolees for example. So we have just two categories. We find that that rates statewide in Colorado for adults is 54% and it gets as high from setting to setting as 97%. so the data suggest that there is a relationship between criminal justice, the risk for criminal justice involvement and the injury. What's important though, a quick little sidebar is one of my favorite research studies looked at the frequency of brain injury sustained in jail and it just was for anyone who's nerdy about research, they so appreciate this. This was a study in New York City that added head injury to the electronic health record of the New York City Correctional System and their control group was the neighboring community emergency rooms. And they found that while incarcerated, the rate of sustaining a brain injury in the New York City Correctional System was 50 times higher than it was for the neighboring emergency rooms. So I don't want to make this conversation complete without nodding to how dangerous a setting that is for inmates and for correctional officers just the same. So in terms of what's the link there, because what we do find is that per report, most people's injuries predate their criminal involvement. You see a really characteristic cluster of deficits after, let's say, a frontal lobe brain injury, which is most common. And you see this when people go over the handlebars or get punched in the face or aren't wearing a seatbelt in a car, for example. The really common cluster of deficits includes a disinhibition or being really impulsive, poor judgment, poor anger management, irritability, a failure to forecast consequences. So you can start to see where someone who maybe has less social support or less robust family support would be at risk for getting themselves into a lot of trouble. What we found is that these folks don't get themselves into a lot of trouble with high wattage violent crimes. These are folks who are getting picked up for drinking and driving or for drug possession. And then they get stuck in criminal justice. So they have much longer periods of incarceration relative to their peers. And it's not because their crimes were more serious, it's because they've been in there multiple times. So there's a way that the deficits, associated with traumatic brain injury, create a vulnerability to law enforcement problems, in the same way that it does with developing a substance abuse problem and mental illness and risk for suicide, that you see this really troubling circular relationship between the injury substance abuse, people who are abusing substances are more likely to sustain a brain injury. People after brain injury are more likely to develop a substance abuse. So you see this cycle that becomes really vicious for the folks who are stuck in that system.

Nicole Militello:

And you also shared that the numbers are a little bit different specifically for women.

Kim Gorgens:

Right.

Nicole Militello:

So what more can you tell us about that?

Kim Gorgens:

Well, this is a conversation that no one is having. And there's a part of this conversation that is community dwelling women. So this is specifically looking at women who've been exposed to interpersonal violence and those data, our colleague here on campus Anne DePrince has really pioneered some of those data. Her data just overall suggests that one in seven women has been exposed to interpersonal violence, but more stunningly when you poll them, when they hit either an emergency room or a shelter, 90% of them have a history of traumatic brain injury. So in a community dwelling sample, you see this risk for traumatic brain injury history, and in particular, this pattern of repeated injuries. So in that Ted Talk from 2018 I described these women as looking just like retired NFL players. They have the same kinds of chronic health complaints, but there's no media attention for them. So this is such an important platform to talk about. In our research, we're looking at those women who are incarcerated and on probation. And what we find is 97% of them have a history of traumatic brain injuries. So there's something uniquely vulnerable about some women and their rate of sustaining violence related multiple traumatic brain injuries is much higher relative to their male peers who are incarcerated. And those kinds of injuries are associated with even poorer outcomes. So we're trying to design wraparound programming that might better address the unique vulnerabilities of that population.

Nicole Militello:

So going along with this conversation, a new study just came out and researchers found that a majority of people who experience homelessness may have suffered a traumatic brain injury. So this goes right along with the criminal justice system conversation. We're talking about domestic violence. These are huge societal problems. Why do you think that we're starting to learn about all of this right now?

Kim Gorgens:

I loved this study. So this was a Canadian research study that was reported in the Guardian last month. And in that research. They looked at US, Australia, Canada, Japan, South Korea, and the UK. So they combined all of those data and found that the rate of traumatic brain injury history among people who are homeless was 53%. So way exaggerated relative to the general population, which for all brain injuries is about 8.5%. For moderate and severe injuries is probably closer to three or 4%. So we here at the University of Denver with the Burnes Center for Housing and Homelessness just launched a study last year to look at this same phenomena. So to look at the over representation of traumatic brain injury among people who are homeless. More importantly, the question that the Guardian article begs, which we're hoping to address, is what is the relationship between the brain injury and homelessness? So is there a causal link between having a brain injury and ending up homeless? Or what we also know is true is that being homeless creates a vulnerability to interpersonal violence. That is not the case when you live in a home or you have the psychosocial protective variables. So do most of these folks sustain their brain injury while they're homeless? And nobody really knows that. So we're going to look at those data across the state of Colorado in urban and rural centers interviewing literally every homeless member of four communities across Colorado. We're rolling that out in January this year.

Nicole Militello:

Okay, so now that we're aware of this research, what's the next step? What can people do?

Kim Gorgens:

Well, I love that we can talk about this before we close. So what we know about the stigma for brain injury is that not only is there an emotional cost for the persons with brain injury, but there's a tangible cost and healthcare. So we know that healthcare professionals, for example, have greater bias against people with brain injuries relative to people whose limbs are injured. And we know that that translates into poorer care. So there's a tangible healthcare costs. And then there's the stigma that employers and friends and families might have, which lead to social isolation, unemployment unemployability for the person with the brain injury. So it goes beyond just the emotional reaction of not feeling seen in the community. This is an invisible disability. So it's unique in that way. What has worked in research to combat stigma has been A, education, so that's always been the standard. And I recommend the CDC Heads Up webpage that has great data, especially on mild injuries. And then the US Brain Injury Alliance, it's usbia.org, has great information about state by state resources and statistics, and they have all of the CDC data there. So the first step is education. How big a problem is this? How likely is this to crop up in my social circle or in my family? And for countless people out there, it already is in their family and it may be in their own history. And the second piece of that is to build a social network that includes someone who talks about their brain injury. To normalize the conversation and to be willing to be kind and be patient with someone as they're rehabbing, which can take years and years. As a rehab psychologist, we talk about rehabilitation being a lifelong process and capitalizing on the plasticity of the brain. We're not just going to recover function in that first six months. But to immerse yourself in that world and the willingness to have the conversation and be open to it and to meet someone where they're at is really immeasurable in terms of the social impact.

Nicole Militello:

Interesting. And I'm wondering too, the research out there on Alzheimer's about what can help people that have Alzheimer's improve their cognitive function.

Kim Gorgens:

Right.

Nicole Militello:

Does any of that overlap with things that we can do for people with traumatic brain injuries?

Kim Gorgens:

I love that. It's the exact same. And thank you for pointing it out. It really is the exact same constellation of recommendations. And it is so old school and I'm sure family medicine doctors who took horses and buggies to clients' homes were giving the same advice a hundred years ago that we're still giving, which is, it's partly nutrition, it's partly exercise, it's partly getting a good night's sleep and it's partly stress management. And all of these lifestyle factors combine in ways that are extraordinary from a physiological perspective. And I confessed to being the person who has always scorned at my nutritionist colleagues. And I would think like, "Well, how important can it be?" Like, "Okay, could you pass me the Doritos please." And now come to find out they were right all along. And it has everything to do with the physiology of the brain, especially after injury and especially in a circumstance where you have a vulnerable brain as would be true for a diseased brain.

Nicole Militello:

So last question for you. What are your big burning questions about brain injuries? What's the next thing that you want to research?

Kim Gorgens:

So I feel so lucky here at DU because we have really the world's most extraordinary researchers. And I have the luxury of working with them all the time and I know them to be so humble. They don't hog a lot of the limelight. But they're really changing the national stage. And on a global level, we have a lot of colleagues with appointments that global health institutes who are really changing the dialogue worldwide about brain injury and brain injury research. My real passion is, obviously, I've done a lot of work with prevention and injury prevention and I still do some consultation on research designed with helmet technology for example. So I think there is a great conversation to be had. We could do better at injury prevention. But my attention has traditionally been on this downstream model. So the folks who end up in criminal justice, because they burn through all of their family and friends. Or the women who end up homeless because they've been exposed to 20 years of interpersonal violence and hundreds of brain injuries in that context. And to the aging adults for whom we have very little resource available. So these are folks who may have demanding disease. So for example, Alzheimer's or Alzheimer's related dementias, when we talk about football, we're talking about chronic traumatic encephalopathy. There's almost nothing available to those folks. So I've really been drawn to addressing the vacuum of their treatment needs. And not only for them but for the caregivers too.

Nicole Militello:

Great. Well thank you so much for joining us.

Kim Gorgens:

Nicole, thank you for having me.

Nicole Militello:

To read more about Kim Gorgen's work or watch her Ted Talk, visit our show notes at du.edu/radioed. Be sure to subscribe and check back for new episodes every other Tuesday. Alyssa Hurst is our executive producer. Aaron Pendergast mixes our sound. James Swearingen, arranged our theme, and Tamara Chapman is our managing editor. I'm Nicole Militello, and this is RadioEd