I grew up in Alabama, so my love for football may have been inevitable. Though I never played the game (my small high school was one of the few in the state not to field a team), the sport has occupied a prominent place in my life.

As an undergraduate, I spent many a Saturday afternoon keeping stats in the Yale Bowl press box. My history senior essay focused on the role of football in the racial desegregation of Southern high schools. Yale’s come-from-behind 9–7 triumph in The Game in 1998 was one of the highlights of my bright college years. In my adult life, both Alabama and Yale football have been major avenues through which I’ve stayed connected to old friends and made new ones.

This weekend, I will join thousands of other Yalies in Boston to cheer on Tyler Varga and company as they vie for the Ivy title against the Crimson.

But I will do so with growing ambivalence. Not about the outcome of The Game — I badly want us to beat Harvard. Rather, I have started to question whether we should be playing or watching the game at all.

Over the last several years, evidence about the long-term neuropsychiatric consequences of football-related head injuries has been mounting. Former Harvard linebacker Chris Nowinski was one of the first players to speak publicly about his experience with concussions and has dedicated his career to better understanding the risks of football-related head injuries. Numerous other ex-players have since acknowledged significant mood and cognitive problems, and a few have committed suicide. Autopsies of former NFL players have demonstrated evidence of chronic traumatic encephalopathy — a pattern of brain degeneration that has been linked to repetitive concussive and even subconcussive blows to the head. The NFL is close to finalizing a $765 million concussion settlement with former players, protecting the league from further litigation but acknowledging that the game has severe inherent risks.

For those of us who love the game, the sport’s danger is an inconvenient truth. Football may very well build character among the boys and men who play. The sport can certainly enliven school and civic spirit and bring communities together for a common cause. And there’s no doubt the game can be hugely profitable for several universities and professional teams. As a fan, I derive great pleasure, and occasional anguish, from football. Yet at what cost does my entertainment come?

As a psychiatrist, I am all too familiar with the devastating effects that mental disorders can have on the lives of patients and their families. In my field, we have had some success in treating depression but have limited ability to stop or reverse dementia. Rarely are we able to prevent the development of mental disorders in the first place. But it now seems evident that by reducing repetitive head injuries, we could prevent certain movement, mood and cognitive disorders and perhaps even suicides. And we could limit such head injuries by eliminating football, or at least football as we know it.

It may be that there is no such thing as safe football. But searching for ways to make football safer rather than eliminating it entirely is practical; the sport is so enmeshed in our culture that it seems difficult to believe it will ever disappear. I acknowledge that it’s also personally convenient, a way to resolve my cognitive dissonance about the sport. I can watch football without feeling guilty about it.

Yale is ideally positioned to pioneer radical change in the sport. This is a campus that could embrace a serious discussion about whether an institution of higher learning like ours should be sanctioning an activity that is putting students’ future mental health in jeopardy. Unlike places like Alabama or Ohio State, whose identity and bottom line seem inextricably linked to the pigskin status quo, Yale could have a similar existence even without a varsity football team. And Yale could almost certainly tolerate a version of football that looks quite different than the one we know.

Yale and its Ivy League peers could take immediate steps to advance our understanding of football-related brain injury and improve player safety. These institutions have the financial and scientific resources to invest in research on head injuries and the development of enhanced diagnostic algorithms and superior player equipment. Because the Ivies don’t compete for a national football title — and therefore are less subject to concerns about competitive disadvantage with non-conference foes — the schools could mutually agree to new rules that focus on player safety: player weight restrictions, practice limits, cognitive screenings or eligibility decisions by an objective third party, the elimination of certain high-risk plays like kickoff returns and increased penalties for certain dangerous plays are just some of the ideas we could implement.

Yale is the place where Walter Camp fathered American football over 130 years ago. And it is a place where football should now be reimagined.

Matthew Goldenberg is an assistant professor of psychiatry at the Yale School of Medicine. Contact him at matthew.goldenberg@yale.edu.