Head knocker

George Visger is losing his mind. He has no short-term memory. Say something to the former San Francisco 49er defensive lineman and immediately ask him what was just said, and he’ll repeat it back verbatim. Ask him five minutes later, and chances are he won’t have the foggiest notion, as if the words were a dimly struck bell that failed to register before its tone faded.

To cope, Visger jots down anything of importance with a pen he keeps behind his ear and the notebook he always has at hand. The notebook is his memory, and after dealing with his condition for the past 20 years, he has boxes and boxes filled with them.

He remembers the past well, at least the part before the nine brain surgeries. He first had his “bell rung” in the ninth grade, playing football for the West Stockton Bears in 1972. The practice drill was called Bull in the Ring; the players formed a circle 30 yards in diameter, with a football placed at the center. The coach then called out two numbers, and the two players rushed to see who could get to the ball first.

Visger faced off against the junior high school team’s fullback; they collided helmet to helmet at full speed. Visger came to and found himself staring facedown at the turf. He struggled to his feet, took one step and fell on his face again. At the hospital, he was diagnosed with his first concussion. There would be countless others during a playing career that spanned championship-winning teams at the high school, college and professional levels. The repeated blows to the head took their toll, and now Visger is paying dearly.

While head trauma has always been a concern in contact sports, during the past decade, researchers have discovered that repeated blows to the head while playing football can cause depression, loss of memory and, in extreme cases, dementia that mimics Alzheimer’s disease. The condition now has a name—chronic traumatic encephalopathy—and Visger, along with scores of other players, has many of its symptoms.

For its part, the NFL has yet to acknowledge CTE as legitimate syndrome, and many players have not been compensated fully for its debilitating effects. Visger battled for years before settling a workers’ compensation case with the 49ers. In recent months, athlete organizations such as Sports Legacy Institute have been pushing the NFL to take action, both to protect today’s players and care for those injured in the past. The controversy has recently played out on the front pages of The New York Times and on 60 Minutes; late last month several injured players testified before a congressional commission.

If Visger had known then what he knows now about multiple concussions and their consequences, there’s a chance he might have trotted off that field in Stockton and never played football again. Then again, maybe not. Like tens of thousands of youngsters still do today, George Visger had a dream, to become the best player in the NFL, and nothing was going to stop him from fulfilling it.

He came damn close compared to most of us. He has an Orange Bowl ring, a Super Bowl ring and a shunt that drains spinal fluid from his scarred brain to prove it.

Visger, 51, lives in Grass Valley with his wife of 14 years, Kristie, 47, their two children, Amanda, 12, and Jack, 10, and his stepdaughter, Stephanie, 18, who is Kristie’s first child. The kids call him Giant, and he is: 6 feet 5 inches, 210 pounds, trimmed down from the 275 pounds he played at in the NFL.

He works as a wildlife biologist and Kristie teaches; they have a modest three-bedroom home with a detached garage and a swimming pool off Ridge Road in the hills above town. There was a sizeable Halloween display in the front yard on the day I visited; the only sign of football was the NFL alumni sticker on Visger’s silver Dodge pickup.

How do you interview a man with no short-term memory? Would he remember the questions? What if he forgot the appointment? Inside the house, I could hear phones ringing and Visger scurrying around. He’s too busy, I thought, I’ll come back another day. I rang the bell anyway, and there he was, a towering behemoth of Lebanese and German descent who looks more than a little like Arnold Vosloo, the actor who played High Priest Imhotep in the 1999 version of The Mummy.

A friendly mummy, though, who invited me in, asked me if I wanted coffee, set the cup down on the kitchen table in front of me and then promptly disappeared.

“I’ve been looking for this for weeks!” he said several minutes later from a back room. He set down a plastic waterproof box about twice the size of a deck of cards on the kitchen table and popped the top off. Inside, a butterfly needle, surgical tubing, a king-sized hypodermic syringe, a razor blade and the following instructions:

In case of coma when hospital is not available:

1. Feel for reservoir, a lump the size of a nickel behind right ear.

2. Shave hair over reservoir.

3. Wash skin over reservoir for 5 minutes.

4. Puncture reservoir with butterfly and allow fluid to drip out for three minutes.

5. May attach syringe but try to avoid aspirating.

Here’s the score. Visger’s head got knocked around so much playing football, scar tissue formed over the ducts in the brain that supply fluid to the spine. When the fluid builds up enough pressure, it crushes Visger’s brain from the inside out, against the hard, bony skull. If the pressure is not alleviated, his brain will hemorrhage, he’ll go into a coma and die. That’s what the shunt surgically installed in his brain is for, to relieve the pressure. If the shunt should clog—which it has done often in the past, thus the multiple brain surgeries—the pressure builds up inside his skull, causing an intense headache and nausea. If the pressure doesn’t subside, then Visger is supposed to jam the needle in the side of his head and drain off the excess fluid.

The medical name for his condition is hydrocephalus, or water on the brain. Most people who have it don’t carry around an emergency “brain drain” kit like Visger. But Visger is what used to be called a man’s man, an avid outdoorsman who has gone on big game hunts as far away as Argentina. In the early 1990s, he was hunting elk north of Winnemucca, Nev. He’d just bagged a bull when the headache started. He was alone, and by the time he’d packed the elk 8 miles back to the truck, he realized he was in serious trouble. He just barely made it to the hospital before slipping into a coma. A new shunt was installed, and Visger begged his neurosurgeon for some sort of device to use if a similar emergency should arise again. No such device existed, so the doctor cobbled together the brain drain kit. So far, Visger hasn’t had to use it.

If hydrocephalus was Visger’s only problem, his life might be more manageable. But he’s clearly experiencing many of the symptoms associated with CTE, including loss of short-term memory and impulse control. These symptoms manifest themselves in subtle, complex and occasionally explosive ways.

The loss of short-term memory can be as harmless as forgetting that he promised to buy Amanda and Jack ice cream on the way home from a school function. Sometimes, they trick him and say he promised them ice cream when he didn’t. But it also can be incredibly frustrating. Visger runs his own environmental consulting firm, and he often forgets to bill his clients. He writes checks when there’s not enough money in the bank. Sometimes, because he has diminished impulse control, he blows up for no reason at all. Visger is the first person to tell you his family has suffered much more than him.

That’s debatable. In one sense, caring more about the welfare of people other than himself is just the way Visger is wired. When he first started earning a paycheck from the New York Jets in 1980, he refused to abandon the battered old pickup truck he’d been driving for years and bought his sister-in-law a new car instead. One night coming home from 49ers practice, he encountered a homeless man on the street and gave him $5, which was enough to buy a good hot meal back then. “God bless you,” the man said. Visger was so jazzed, he organized an annual Visger Christmas Eve dinner for the homeless in the 1980s, which was held near the Salvation Army in downtown Sacramento.

Today, he participates in charity walks to raise funds for hydrocephalus patients, most of whom are children. He also recently began conducting “Coaches Concussion Clinics” for the Sports Legacy Institute, the organization that’s been at the forefront of the efforts to force the NFL to acknowledge CTE.

There’s a certain level of denial in Visger’s attitude toward his own medical condition. In the late 1980s, his shunt went out four times, requiring four surgeries to repair it. At the time, he was attempting to finish a degree in wildlife biology at Sacramento State, and rather than miss an important test, he showed up in class the day after surgery with his hair shaved and surgical staples holding the sutures together. He had a severe seizure midtest. His fellow students scrambled over chairs to escape the frothing, convulsing Frankenstein in their midst.

That denial extends to big-game hunting. Who in their right mind treks into the wilderness knowing they might not get out alive if their brain shunt fails? Call it courage. Call it foolishness—there’s a fine line between the two. Visger’s short-term memory may be gone, but the same drive that allowed him to shrug off countless concussions during his football career remains with him today.

When asked to account for his seemingly risky behavior, Visger simply replies that after his first brain surgery ended his short-lived career with the San Francisco 49ers in 1981, he made up what was left of his mind “to start living for today.”

It turned out to be a pretty good trick, considering he didn’t remember anything, anything at all, for the next two years.

George Visger was destined to play football. He got the size from his father, who’d been recruited by the New York Knicks shortly before he signed up with the Navy, at age 17, to fight in World War II. He got the tenacity from growing up in the “hottest house in the world,” a one-bedroom hovel in Stockton with no air conditioning or heat. His parents, two brothers and three sisters sweltered under water-soaked sheets in the blistering summers and shared sleeping bags in the frigid winters. His father passed away in 1999, but the rest of the family remains close to this day.

By the time Visger joined his first Pee Wee Pop Warner team, the 1970 West Stockton Bear Cubs, he’d already made up his mind to become the best player the NFL had ever seen. It was no idle dream. Three of the pre-teen players on the Bear Cubs, including Visger, later earned full college football scholarships and went on to play in the NFL.

Back then, concussions were not as broadly defined as they are today. By definition, any blow to the head that causes a transitive change in the mental faculties is considered a concussion. Upon impact, the brain crunches against the inside of skull, and bad things happen: headache, nausea, flashing lights, slurred speech, loss of consciousness. Today, if you’ve been hit in the head hard enough to see stars, it’s a concussion. Back then, you had to get knocked out. “If you weren’t seeing stars on every down, you weren’t playing hard enough,” Visger says.

He had no way of knowing it then, but the very first concussion he incurred during that Bull in the Ring drill—“a meaningless exercise that taught you nothing,” he calls it today—increased the likelihood he would have more concussions in the future. And he did. As a member of Stockton’s all-conquering Stagg High School varsity football team—ranked No. 3 in the state in 1975, with an 11-0 record—he now figures he suffered perhaps a dozen “minor” concussions, minor meaning he wasn’t knocked out. Minor though they may have been, each concussion damaged his brain to some extent. As researchers who’ve dissected the brains of deceased NFL players are discovering, the damage adds up.

The scouts took notice of Visger’s play, on both the offensive and defensive lines, and he was recruited by the University of Colorado Buffaloes in 1976. His championship run continued; the Buffs won the Big Eight that year and the next year played Woody Hayes’ Ohio State Buckeyes in the Orange Bowl. The Buffs lost, 27-10, but the runner-up ring, an orange stone set in gold, still looks pretty impressive on Visger’s massive ring finger. He maintains close friendships with many of his former Colorado teammates today. In addition to the ring and the friends, he figures he incurred at least three more major concussions—this time meaning his “bell was rung,” but he wasn’t knocked out—and countless minor concussions.

A three-year starter who remains No. 11 on the Buffs’ all-time sack list, Visger was drafted in the sixth round by the New York Jets in 1980. As the 149th overall pick in the draft, he was a long ways from realizing his dream of becoming the best NFL player of all time. Nevertheless, it was a start. He showed up for the Jets’ spring mini-camp in high spirits, weighing in at 259 pounds, the heaviest he had ever played. It wasn’t heavy enough. The Jets’ defensive line coach put his arm around Visger and told him if he could put on 20 to 25 more pounds before the season started, there was a place on the team for him.

Visger understood the subtext of the conversation and returned to Colorado, where he obtained a prescription for steroids. This was the era when pro players kept getting bigger and bigger and everyone in the league pretended they didn’t know why. He was competing against such pumped-up luminaries as Jets’ defensive end Mark Gastineau, who weighed 280 pounds, had a body fat percentage of 11 percent and ran the 40-yard dash in 4.4 seconds. Visger bulked up to 275 pounds before camp, cut his body fat down to 14 percent and ran the 40 in 4.9 seconds. He made the team and started the third pre-season game before he was cut from the squad.

A number of teams were still interested in the defensive lineman from Colorado. He traveled to Calgary to try out for the Canadian Football League’s Stampeders. He impressed the coaches, but his heart was still set on playing in the NFL. On the day he returned from Calgary, the 49ers and the Denver Broncos called. He tried out for the Niners, then flew to Colorado to try out for the Broncos. In Colorado, his agent informed him that his contract with San Francisco was signed, sealed and delivered. He practiced with the team Thursday and Friday, then flew with them to Dallas, where the 49ers were to play the Cowboys on Saturday’s NFL Game of the Week.

On his very first play in a regular season game, Visger was “ear-holed,” struck viciously in the side of the head by a Dallas player’s helmet. He played the entire game, but doesn’t remember any of it. Trainers on the sidelines later told him they broke 25 to 30 smelling-salt capsules under his nose to keep him in the game.

He played the rest of the season, and played well, but that hit was the beginning of the end of Visger’s NFL career. Throughout his time in football, he’d played through a broken neck vertebrae, a broken sacral vertebrae and a mangled knee. But by the time the 1981 season started, the multiple concussions endured over the years had exacted their toll.

The 49ers’ team physician didn’t know what was wrong with him at first. Visger’s complaints of dizziness, projectile vomiting and severe headaches were diagnosed as high blood pressure. One night in September, after weeks of headaches, vomiting and insomnia, Visger was trying to sleep when his right arm spasmodically locked up, as if he was doing a bicep curl. He pulled the arm back in place—it took some doing—but it sprang right back up. The next morning, he went to the team physician again. The doctor looked into his eyes and realized something was drastically wrong.

“My god, your brain is hemorrhaging!” he said.

How do you remember when you stopped remembering? You don’t. The early 1980s are mostly a haze to Visger.

After discovering his brain was hemorrhaging, he immediately drove himself to Stanford University Medical Center, much to the horror of the neurosurgery unit, which installed his first brain shunt hours later. Visger’s become fairly adept at explaining the procedure in layman’s terms, which isn’t too surprising, considering he’s had eight more surgeries since then.

“They drilled a hole in my brain and inserted a perforated catheter into the ventricles in the middle of my brain,” he explains, drawing a diagram with a Sharpie on a legal pad. “There’s a pressure valve behind my right ear. When the spinal fluid builds up, the valve opens, and the fluid drains down a tube into my abdomen.”

He stretches his neck to show the tube that runs down into his stomach. It pops out like a tendon. He offers to let me feel one of the holes in head. My index finger sinks into it to the first knuckle.

Visger spent the next 14 days in intensive care, and even though he couldn’t play ball, the 49ers kept him on the roster. They told him he could play with the brain shunt after he recovered, he just needed to wear a special helmet. He didn’t play a down in San Francisco’s 1981-1982 championship season, but he still earned a Super Bowl ring. That’s why they call it a team sport. With an enormous, clear stone set in silver, it is considerably larger than his Orange Bowl ring.

The 49ers never officially cut him the following spring, he was just sort of eased out the door. That’s how the game is played when you’re a yeoman in the NFL. He wasn’t much use to the 49ers with a torn-up knee and a brain shunt. There was no special helmet. The coaches try out new players on the team’s off days, and the next thing you know, you’re packing up your locker. After two years in the league, Visger’s NFL dream was over.

He may have failed that challenge, but the worst was yet to come. In May 1982, Visger nearly died when his shunt clogged while on a fishing trip in Mexico with his brother Mel. Mel flew his nearly comatose brother back to Sacramento; emergency brain surgery was performed to replace the clogged shunt. The procedure wasn’t successful, and Visger was read his last rites. It was beginning to look like his macabre hunting buddies who’d put dibs on his skull and his pelt would be collecting on their markers, but he hung on, and a second surgery 10 hours later saved his life.

The next two years are a blank. Visger doesn’t remember any of it. In 1984, he was working with his brother Bob, a building contractor, on the roof of a house in Sacramento’s Fabulous 40s. At some point during the workday, Bob turned to George and said, “This is the first time I feel like I’ve talked to you in more than a year.”

Bob explained that George had been acting erratically since at least his second and third brain surgeries. He disappeared for days at a time. He yelled and screamed at his mother and sisters for no reason. It was all breaking news to the dumbfounded Visger. He immediately went to his mother and his sisters to apologize and explain that he didn’t remember most of the past two years, but that he was OK now.

“I’m back,” he told his mother.

His family forgave him for the most part. The doctors that performed the first brain surgery had told them that sort of behavior was to be expected.

The American Academy of Family Physicians estimates that as many as 250,000 concussions occur each year in high-school football games; 20 percent of the players incur at least one concussion. Studies on the brains of dead NFL players such as Mike Webster—who clearly exhibited signs of dementia before dying of heart failure at age 50—show damage similar to Alzheimer’s disease in an 80-year-old patient.

How do you become a Pro Football Hall of Fame center for the Pittsburgh Steelers like “Iron Mike”?

On the field of hard knocks that is high-school football. That’s the risk of living the dream, and Visger has paid the ultimate price. It’s written all over his latest diagnosis:

“Given the history of anger issues, short attention span, memory problems and extremely poor judgment in regards to finances and relationships, and cognitive impairments and damage to the prefrontal and temporal lobes, I am concerned that George will continue to worsen in the coming decade without intense interventions. I think George is at a very high risk for developing dementia in the coming decade without intense intervention.”

After his ninth and last brain surgery in 1993, Visger came into his own outside the arena of football. His degree in wildlife biology provided him the opportunity to spend more time in his favorite place, the great outdoors. He’d spend 10 days at a time in the field, conducting wilderness surveys on practically every threatened or endangered species in California: the spotted owl, the desert tortoise, the gnat catcher. When he wasn’t working, he was guiding elk hunts in New Mexico and buffalo hunts in Argentina. (He’s forgotten entire expeditions.) He still carries the emergency brain drain kit with him—when he can find it—but his present shunt has held for 16 years.

George and Kristie met 14 years ago at the gym, and after the inevitable dinner at Chuck E. Cheese with mother and daughter, “I fell in love with her and Stephanie.” It was a pretty dramatic change for the previously confirmed bachelor, but despite the problems caused by his impaired memory, the pair have so far managed to keep their family of five together.

It’s been a real trial lately. In January, the geotechnical engineering company Visger was working for closed its Sacramento office, and Kristie was very nearly laid off due to state budget cuts. She managed to keep her teaching job, and Visger is once again running his own private consulting business, but his short-term memory isn’t what it used to be, even just a few years ago. He’s been making his system of notebooks and Post-its work for almost 20 years, but it’s beginning to falter. That, combined with the economic downturn, put the family’s finances on the ropes.

Into the ring stepped Visger’s old football buddies from the University of Colorado. They heard he’d taken a shot, so they established the Bee and Buff fund. The Buff, of course, stands for the Buffaloes. The Bee stands for the insect; it seems one of Visger’s teammates, who went on to play in the NFL before becoming an aeronautical engineer, is now a professor at Cornell, which is very famous for the research it has done on bees.

The story behind the Bee and Buff Honor Fund, as Visger tells it, goes something like this: The worker bees go out into the world and get all messed up flying around and gathering pollen. When they come back to the hive, they’re worn out, their wings are tattered. Older worker bees, using food from the hive, then nurse the worker bees back to health. With that principle in mind, his former teammates pooled their money together and began helping the Visgers pay their mortgage.

He tears up after reciting it. There was not a lot of camaraderie at the yeoman level in the NFL, but college football is forever.

Visger is not out of the woods yet, neither physically nor financially. But he hasn’t given up. His new doctor isn’t kidding about intense intervention, and Visger is now on a completely new medical and diet regime designed to slow the deterioration of his mind. Part of the treatment includes learning to communicate better with Kristie and the kids. In this economy, finances are the most pressing issue, and more than a few of the calls that came in while we were talking were from creditors.

There’s a question every journalist must ask in a story like this, so I’ll go ahead and ask it. George, if you had a second go, would you do it all over again?

Big pause.

“You know, people always ask me that question, and I used to answer ‘yes’ right away,” he says. “About a year ago, I started pausing. Football gave me a lot of good things, so I still have to say yes.”

But he sure hopes his 10-year-old son Jack doesn’t follow in his footsteps.