| Across the café table sits Dr Helen Murray, another prominent expert in the same field and a top-level sportsperson herself. Her “other” life playing on the left wing for the Ice Fernz, New Zealand’s women’s ice hockey team, makes her uniquely qualified to discuss the pros and cons of contact sport. “You don’t need to get to the end looking pretty,” she tells the Breakdown. “But we want to make sure you get to the end with a high quality of life.” Not everyone, sadly, has that luxury. Last year New Zealand rugby was rocked by the death, aged 33, of Billy Guyton, the former Tasman and Māori All Black half-back. He had been suffering from the after-effects of repeated concussions and was the first professional rugby player in New Zealand to be publicly diagnosed with confirmed chronic traumatic encephalopathy (CTE) after his death. His family, who had witnessed his anxiety, depression and increasing mental confusion, donated his brain to the Brain Bank to try to assist others. His tragic case is part of a rising tide of concerning stories. Murray says she receives at least one email per week from people who believe they may have CTE. “We know more people are out there but they haven’t had the official diagnosis,” she confirms. In New Zealand alone there are already around 40 former rugby players in that category, with at least another 200 in Australia. The experts will also tell you that it goes well beyond those who played top-level rugby. “When we started we thought we might get one case a year,” says Curtis, who now receives a couple of brain donation offers per week. “We’re generally dealing with people who played rugby many years ago or did so more recently and have had an early demise. But, actually, CTE is also evident in people who played long term school and club rugby.” Many have yet to go public. As Curtis says: “The ones who don’t make the headlines are the ones that suffer in silence.” None of this, self-evidently, is what rugby wants to hear. The ongoing court action in the UK involving hundreds of former players is concentrating minds globally but liaising with the families of those affected, such as the Guytons, is what is really driving the neuroscientists at the sharp end in Auckland. “I was particularly moved when Billy’s dad was asked if he would let his younger son, who is about 10, play rugby,” says Curtis. “And he just said no. I guess he just hasn’t seen enough change in the game.” He also quotes the recent newspaper article in New Zealand written by Geoff Cooper, whose father – also called Geoff – adored rugby and played it for over half a century. Ultimately it did not love him back. “My father didn’t intend to die doing what he loved,” wrote his son. “Fifty-seven years of playing rugby gave Geoffrey Joseph Cooper friends and fitness. But it also gave him chronic traumatic encephalopathy.” Which adds even more weight to the work being done both in Auckland and internationally. Might, for example, certain treatments for Alzheimer’s prove even more effective in the treatment of CTE? The holy grail is a brain scan or a bio-marker – ideally a simple blood test – that can detect the danger signs early. “For us it’s about how we give people a diagnosis that tells them what is actually going on,” says Dr Murray. “How do we take the knowledge we have from the brain tissue and translate that into something that’s measurable and says you have this or that condition?” A breakthrough may soon be forthcoming. “The Americans will tell you within five years,” continues Murray. “They’ve started big bio-marker blood studies in the last year. But you never know.” In Auckland, in an ideal world, they would like to recruit a cohort of people who have CTE symptoms and monitor them over a longer period. If the Brain Bank could attract just $NZ1m in annual funding – whether from government, sporting bodies or private individuals – Curtis believes it would “make a huge difference” to a lot of people. “There are a number of parts of the rock face being worked on but this is cutting edge research, for sure. [But] it currently seems to be under funded across the board. It’s politically challenging and, in a way, it’s easier to study more complex diseases. If you’re a funder you probably go: ‘Just stop the rugby.’” | 