What to know about Tyler Hilinski and CTE

The deceased college quarterback’s brain “looked like that of a much older, elderly man,” according to a doctor.

The death of Tyler Hilinski, a Washington State quarterback who committed suicide in January, was shocking and saddening. In the months since, doctors have discovered that his brain showed signs of chronic traumatic encephalopathy (CTE), according to Sports Illustrated. His untimely passing and this subsequent finding dredges up hard conversations about the ultimate toll that the violence of the game takes on football players.

Then the test results came back. First, the Whitman County medical examiner called to say that Tyler’s toxicology report showed no trace of drugs or alcohol. (“That actually made it worse,” Mark says.) The Mayo Clinic’s findings arrived next. Kym read the sentence—“After reviewing the tissue we can confirm that he had the pathology of chronic traumatic encephalopathy (CTE)”—and started to reconsider her entire search. The diagnosis was Stage 1, the lowest level. But still, Tyler was 21 when he died, he hadn’t played that much in college and for most of his life he manned the most protected of positions. If he had CTE, anyone could. She read that depression was one symptom for Stage 1 and a doctor told her Tyler’s brain looked “like that of a much older, elderly man.”

The conversation around CTE has clearly moved from just retired players to younger players as well.

Hilinski only played in 12 college games.

There are signs that it might be nearly ubiquitous at the NFL level. We don’t exactly know when it begins to develop, but we do know that it can be at stage 3 by the time a person is 27, and it can vary from person to person, like any disease. We also don’t really know how much of an effect it has in its varying stages.

And even when we can quantify the effect from person to person, it’s still difficult to study.

CTE is a disease usually diagnosed after death, and little is known about it to this point. Repeated head injuries, including concussions, are thought to be a significant risk factor. The disease process is thought to begin early on, prior to any symptoms appearing in most cases, and “involves an increasing buildup of abnormal proteins in the brain.”

How are we trying to make football safer?

There are inherent physical risks to playing football, and everyone knows it.

But we can do stuff to make the game as safe as possible. Things like the targeting rule are clear ways to try and blunt the effects of unsafe tackling, but it takes years to change habits and for movement like heads-up tackling to become ingrained in every player. Some kinds of hits are nearly impossible to avoid without changing the nature of the sport.

Rugby tackling could and probably will become a new standard, but that’ll take time as well. When I played in high school, every opening practice of the season came with a lecture from our coaches, regarding the disclaimer on the back of the helmet that states not to use it as a weapon. But plenty of players have heard similar speeches and still suffered helmet-to-helmet hits.

You’ll never take all the violence out of the game, but minimizing it to the greatest extent possible can literally save lives.

And on top of that is a conversation about mental health in general, as Hilinski’s loved ones discuss in the SI article: how we address it and maintain it and how people voice concerns and seek treatment. CTE is not the full explanation for why any of these players killed themselves. It’s another layer in the very complex human brain.

We don’t know if any one thing would have saved Tyler’s life, and that’s the hardest part. But we should still try to understand, to the fullest extent possible.