October 3, 2022

Scott Vermillion’s family members are still struggling to express the jumble of emotions they felt last November when they received the phone call from the doctors.

Vermillion, a former MLS player, had died nearly a year earlier on Christmas Day 2020 at age 44. The direct cause was acute alcohol and prescription drug intoxication, his family said, an austere coda to a troubled life: An American high school and college student who played four seasons in MLS, Vermillion had spent the last decade of his life withdrawing from his family as he struggled with substance abuse and progressively erratic behavior.

Late last year, doctors at Boston University offered another explanation: After examining Vermillion’s brain, UB experts told his family he had traumatic encephalopathy. chronic, or CTE, a degenerative brain disease linked to symptoms such as memory loss, depression, and aggressive or impulsive behavior. .

The diagnosis gave Vermillion the grave distinction of being the first American professional football player with a public case of CTE. It was also a solemn milestone for MLS, a league that even in its young history has seen the consequences of the type of brain damage more often associated with collision sports like football, boxing and hockey.

“Football is clearly a risk to CTE – not as much as football, but clearly a risk,” said Dr. Ann McKee, director of Boston University’s CTE Center.

A neuropathologist, McKee has discovered the disease in hundreds of athletes, including Vermillion.

For Vermillion’s family, the diagnosis brought a sense of clarity, however small, to a life littered with questions. He didn’t answer everything – he just couldn’t, given that CTE can only be diagnosed posthumously. It triggered feelings of doubt, guilt, anger, relief. But it was, finally, something.

The specter of CTE first began to loom over the NFL nearly two decades ago, when the first cases of the disease were discovered in the brains of former professional football players. Since then, CTE, which is associated with repeated blows to the head, has been discovered in the brains of more than 300 former NFL players.

In football, however, research and public conversation around CTE and head injuries continue to emerge, even as confirmed cases increase. An English striker. A Brazilian World Cup winner. An American hobbyist.

Former MLS players Alecko Eskandarian and Taylor Twellman have opened up about how concussions ended their careers and affected their personal lives. Two-time Women’s World Cup winner Brandi Chastain publicly pledged in 2016 to donate her brain for CTE research.

“We have to understand the seriousness of the situation,” Chastain said. “Talking about concussions in soccer is not just a hot topic. It’s a real thing. He needs real attention.

Last year, leagues and tournaments around the world, including MLS, began experimenting with so-called concussion substitutes, which grant teams additional substitutions to deal with players with potential brain damage. MLS has joined other sports leagues in implementing a variety of other protocols, including the use of independent specialists and spotters to assess potential concussions during games.

“MLS has comprehensive policies to educate players, coaches, officials and medical staff on the importance of head injury identification, early reporting and treatment,” said Dr Margot Putukian, the league’s chief medical officer, in a statement. “There is always more progress to be made, and MLS is firmly committed to this important work.”

However, the focus is not just on treating concussions. In a growing effort to prevent head impacts of all kinds, players at all levels are seeing more and more guidelines to limit headers.

A 2019 study by Glasgow researchers showed that former professional football players were three and a half times more likely than members of the general population to die from a neurodegenerative disease (and less likely to die from a disease heart disease and certain cancers). Vermillion’s story then becomes the latest in a recent series of cautionary tales.

“CTE never even crossed our minds,” said Cami Jones, who was married to Vermillion from 1999 to 2004.

Vermillion started playing football in Olathe, Kansas when he was 5 years old. He loved the game’s relentless movement, swashbuckling action, family members said. His coaches in elementary school, in the interests of sportsmanship, often kept him on the bench for long periods because he scored too many goals, his father, David Vermillion, said.

His talent eventually earned him spots on elite regional club teams and the U.S. youth national teams as a teenager. This took him to the University of Virginia, where he was a third-team All-American in his freshman year. This led him to MLS, where he joined his local club Kansas City Wizards, now known as Sporting Kansas City, in 1998 at the age of 21.

But Vermillion, a scrappy defender, never fully blossomed as a pro. He moved on to two other clubs before a lingering ankle injury forced him into early retirement after the 2001 season. His fledgling league career earnings were meager; his dad remembers his son’s salary was around $40,000 a year when he left the game.

“It was a blow,” said David Vermillion. “He spent his whole life climbing that hill, climbing it, becoming a good player, and ending it abruptly was tough.”

Scott Vermillion tried to find a place in his life after football. He ran a family store. He coached local youth teams. He pursued a degree in nursing. But his relationship was slowly unraveling.

Although Vermillion’s behavior became most concerning in the decade before his death, Jones said she noticed changes in him even before his career was over: he was often lethargic, which seemed strange to her. a professional athlete, and frequently complained of headaches.

“When I met Scott, he was a dynamic, outgoing professional athlete, super fun, prankster,” said Jones, who divorced Vermillion in 2004, three years after her career ended when their children had 1 and 3 years old. “I watched him change very quickly, and it was scary.

Over the next decade, Vermillion continued to withdraw from his family. His drinking became extreme and his behavior more erratic, family members said. He married a second time, but this union only lasted about a year. In 2018 he was arrested, charged with aggravated domestic battery after an incident with a girlfriend. He went in and out of rehab programs for alcohol and prescription drugs, only to come out to insist to his family that the programs weren’t helping him, that he was unable to be assistance.

His daughter, Ava-Grace, has gotten used to him missing her dance recitals. Her son, Braeden, now 22, was devastated when he failed to graduate from high school.

“He promised a lot of things and just made excuses and didn’t show up for us,” 20-year-old Ava-Grace Vermillion said.

Dr. Stephanie Alessi-LaRosa, a sports neurologist in Hartford, Connecticut, cautioned against drawing causal links between posthumous diagnoses of CTE and behavioral patterns over a person’s lifetime. She said research on the subject was still in its early stages and doctors were still trying to figure out why some athletes got CTE while others didn’t.

“I have patients who are reluctant to go into psychiatric treatment because they think they have CTE and they’re doomed,” she said. “I think it’s important that patients get the help they need and, if their family is concerned, see a sports neurologist.”

Alessi-LaRosa said she believed the benefits of the sport outweighed the risks, but echoed the growing view that the lead in football should be limited to young players.

In 2015, US Soccer – resolving a lawsuit – announced a ban on heading in games and practices by players under the age of 10 and created guidelines to restrict the practice of heading for older players. And last year, English football officials issued heading guidelines, recommending professional players limit so-called ‘higher strength headers’ to 10 a week in training. (How, exactly, this should be applied has been less clear.)

Vermillion’s mother, Phyllis Lamers, contacted the Boston lab to have her son’s brain examined after his death. CTE has four stages, the final stage associated with dementia; Scott Vermillion was discovered to have stage 2 CTE

His family said they hope telling his story, painful as it is to relive, can help educate families about the hidden risks of football. They said they regretted how tough they had been on him, how they cut him off when his behavior became too much to handle. They agonized over whether they could have done more.

Ava-Grace Vermillion recalls texting her father on December 23, 2020, her 44th birthday. She hadn’t seen him in almost a year, she said, and as she prepared to leave for college in California to study dance, she said she felt compelled to break the ice.

“I remember that day so vividly,” she said. “I was at work and just thought it was about time I reached out to her. I hadn’t spoken to her in a while. I texted her saying, ‘I hope you are well .’ He called me back, and I couldn’t answer, and he died two days later.

Ken Belson contributed report.