Tuesday, December 29, 2015

Pathologist as Movie Star: Concussion (2015)

Rare when a movie stars a pathologist.   

Concussion (2015) tells the story of recent controversies and publications in sports concussion-related encephalopathy through the perspective of Bennet Omalu, a neuropathologist who devoted considerable energies to the definition of chronic traumatic encephalopathy (CTE).
There are two major books on the recent policy and politics of CTE in the NFL, League of Denial (book Amazon, 2013; PBS Frontline, 2013) and Concussion by Jeanne Marie Laskas, November 2015.   The first book, League of Denial, takes a broad-based, investigative journalist's approach. In contrast, the book Concussion views the story as seen through the biography of Omalu, beginning with his childhood in Africa.

See Concussion on IMDB, here; Rotten Tomatoes, here; Wikipedia, here.  For an essay by an NFL player after seeing the film, Darrelle Revis,  here.  For a deatiled Slate article by columnist Daniel Engber, here.

The neuropathologist featured in the movie is Omalu, played by Will Smith, with a secondary role for Steve DeKosky, Chair of Neurology at Pittsburgh, played by Eddie Marsan.  (The books discuss other prominent neuropathology experts like Ann McKee of BU and Peter Davies of Einstein.)

In his early cases, Omalu described CTE as a condition seen in players who had had multiple concusions, with marked behaviorial decompensation.   Autopsy, often after suicide, showed little brain atrophy but severe tauopathy and an absence of plaques.   Much remains to be learned about when CTE occurs, its prevalence, and when head trauma contributes instead to the heightened risk of a more conventional Alzheimer pathology.

Pathologists on film are uncommon.   There is a 1939 German film, Robert Koch, which features Koch's work as a bacteriologist and has a major role for Rudolf Virchow (here).  I don't believe it was ever released in the US on VHS or DVD.   Looking for more, I ran across references to a 2001 autobiography by a surgical pathologist, "The Language of Cells" by Spencer Nadler (here).    If we extent to books, not movies, there is a joint biography of a husband-wife pair of mid century neuropathologists, "Cecile and Oskar Vogt: Visionaries of Modern Neuroscience," by Igor Klatzo (2002, here).