He stood on the sidelines. The roar of the crowd had changed. Sounds were whirling, lodged in the background; in the foreground, a ringing resounded. He was a little dazed. He hadn’t shown any outward symptoms — the training staff could not have known — yet he knew: He had a concussion. But this was the Yale-Harvard game. This was the Ivy League Championship. And, in that moment, nothing mattered more than winning — not even his head.

This is the story of a Yale football player, who spoke to me on the condition of anonymity. But it’s also the story of a wider debate in professional football.

It’s no coincidence that the first dip in NFL TV ratings has coincided with reports of chronic traumatic encephalopathy, or CTE, resulting from football. The new challenges that these discoveries pose have yet to be solved. They may be unsolvable. Yet, in some ways, there is nothing new about this news. Sports have always been violent, particularly football. Concussions have always played a prominent role; nobody seriously thought you could avoid lasting brain damage after a long NFL career at middle linebacker.

And yet, the game is still played. And yet, the players, who know the realities of their sport far better than the fans do, continue to play. And yet, a Yale football player consciously hid his symptoms from the training staff because he concluded “Yes” when he asked himself, “Is playing worth it?”

Yale athletes are intelligent; without their sport, they could have gone to any number of great schools. In this sense, they did not need football. At Yale, they are not under contract; they are here to learn. They could cease playing and ride off into the extracurricular sunset. In this sense, they do not need their sport. And, when they graduate, their career will be just beginning; they will make money, support a family and live happy lives outside of athletics. In this sense, they will not need their sports.

For the vast majority of professional athletes, none of the above holds true. Retired NFL player Patrick Willis grew up in Bruceton, Tennessee, in a double-wide trailer off a dirt road. By the tender age of 10, he was working full time picking cotton. His father was abusive and a drug addict. Sports were his “escape” from the pain at home. But football was an escape in another way: It earned him a scholarship to Ole Miss and, eventually, a place in the NFL.

If a Yale athlete, with a million options from which to choose, will play with a concussion for an Ivy League title, it’s easy to see why future professional athletes, with no other choice, will do the same.

Yet Willis stepped away from the game after eight seasons. In those years, he was a Pro Bowler seven times and an All-Pro on five occasions. It hardly seemed like he was in decline when he retired. But he had played through injury after injury. Surprisingly, it was not concussions that forced him to hang up his cleats. It was the lower body pain. In his retirement speech, he was forthright.

“Honestly, I pay attention to guys when they’re finished playing, walking around like they’ve got no hips and they can’t play with their kids,” he said holding back tears. “They can barely walk … people see that and they feel sorry, but they don’t realize it’s because he played a few extra years.”

Hip, knee and foot injuries are nothing at which to scoff. More dangerously, however, studies demonstrate that the overt injuries — the crushing head-to-head collisions, the noncontact torn ACLs — might not be where the real damage lies. Left tackle D’Brickashaw Ferguson played 10 seasons in the NFL. He missed only one snap. Like Willis, he retired seemingly still at the peak of his powers. In his Sports Illustrated op-ed, he explained why:

“As I understood it, concussions dealt with big collisions, typically occurring at the skill positions, such as a wide receiver or defensive back trying to making a catch and receiving a hit in return from a player he didn’t account for,” he wrote. “As I’ve come to find out, it isn’t just the large collisions that can be problematic, but rather the smaller collisions that don’t even amount to concussions but happen far more frequently, that are the real catalysts leading to CTE.”

So if the regular, every-down contact in football can cause irreparable damage to the brain, what are we to think? That is to say, at what cost will athletes continue to play? When we think of Willis’s case, it’s easy to comprehend why he played through eight seasons in the NFL: It got him out of a horrible situation, which in turn, allowed him to get his siblings out of that same situation.

But what about those that have another choice? What about the Yale athlete on the sideline, standing with a slight ringing in his ears?

At the end of the day, I don’t think that football should be consigned to the scrap heap. The important thing is that we’re able to unearth and understand the toll that playing can take on an athlete. We need to discern the cognitive and degenerative effects on the brain. Yet, it’s not for a fan to pass a qualitative judgment on the risk and reward in football. Only the player wearing the helmet — or, in my case, his overbearing mother — can make that call. But we need to ensure that players have the requisite knowledge to choose for themselves.

Kevin Bendesky | kevin.bendesky@yale.edu