Tua Tagovailoa and the NFL’s Horrible Handling of Head Injuries

The NFL has no choice but to tell the truth about what happened to Tua Tagovailoa. We all saw the replays Thursday night: the close-up, slow-motion videos of the moment his arms shot up and fingers splayed out in the fencing response—the thing our bodies are designed to do when our brains shut off. The replays were gruesome and difficult to watch, but they served one critical purpose: Because we all saw them, the NFL can’t try to convince us it was anything but a traumatic brain injury. Not this time.

In Sunday’s game against the Buffalo Bills, the young Miami Dolphins quarterback took a hit that certainly seemed to cause a traumatic brain injury. After his head slammed into the turf, Tagovailoa got up and staggered, repeatedly shaking his head and failing to stay on his feet. The official word from the Dolphins and the NFL that day was that Tagovailoa had actually suffered a back injury. It was a thin story. The video didn’t really back it up; concussion experts suspected that it was bogus; the NFLPA opened an investigation. But it was hypothetically plausible. Tagovailoa didn’t appear inhibited when he returned to play in the second half and helped lead his team to a win. Dolphins coach Mike McDaniel and Tagovailoa himself seconded the back story. (McDaniel remains adamant that Tagovailoa did not suffer a head injury on Sunday.)

Just four days later, Tagovailoa returned to play in a highly anticipated Thursday Night Football matchup with the Bengals. The Thursday games have long been criticized from a player safety perspective—including prominently by Richard Sherman, now employed by Amazon as an analyst—but the league, through its $1 billion deal with Amazon, has doubled down on its investment in the Thursday-night product. Because Tagovailoa technically never entered the concussion protocol on Sunday, he didn’t need additional clearance to play Thursday. Chris Nowinski of the Concussion Legacy Foundation sent an ominous tweet on Thursday afternoon: “If Tua takes the field tonight, it’s a massive step back for #concussion care in the NFL,” Nowinski wrote. “If he has a 2nd concussion that destroys his season or career, everyone involved will be sued & should lose their jobs, coaches included.”

It was a horrifically prescient tweet. In the first half of the game Thursday, Tagovailoa’s head once again slammed into the turf—and this time, he didn’t get up. He remained motionless on the ground for an extended period of time, and was eventually stretchered off the field and taken by ambulance to a local hospital. After the game, the Dolphins said that Tagovailoa would be discharged from the hospital and fly home with the team.

The incident leaves numerous questions that the NFL and the Dolphins must answer. Was Tagovailoa’s injury on Sunday really a back issue? If not, was the mischaracterization of the injury an honest mistake or a deliberate falsehood to provide cover to get Tagovailoa back on the field? If so, who knew? And why wasn’t the NFL and the union able to complete their investigation in time for Thursday night’s game, considering the potential risk of exposing a young star’s brain to multiple traumatic injuries in one week? Based on the answers to those questions, this could be anything from an honest, unfortunate mistake to an act of medical negligence that should lead to a reckoning within the Dolphins’ organization and the NFL.

There have long been questions about the NFL’s handling of concussions. The league is able to claim that it is battling concussions through small adjustments like safer helmets or more stringent roughing-the-passer penalties—but we know that its main goal is to avoid consequences rather than actually solve the issue. We know because the league had to settle a lawsuit about it; we know because it tried to cut down on its settlement payments by claiming Black players had less brainpower to lose than white ones (this really happened); we know because the science says that football does horrible things to the human brain, no matter how many helmet improvements are made, no matter how many independent neurologists the league hires and protocols they put in place.

Normally, the NFL’s strategy works, because the players want to play. Tagovailoa was eager to remain in the game on Sunday against the Bills and eager to suit up Thursday night—and those thoughts were coming directly from a brain that many experts said was in danger. And nobody stopped him. After all, coaches want their best players to play, and fans want to watch the best players play. A lot of people have a lot invested in young, exciting players like Tagovailoa playing as often as possible—and unlike a broken leg, it’s hard for us to fully grasp the nature of a traumatic brain injury. The NFL’s plan works because the worst consequences of concussions tend to happen well after the games are over and the cameras are off.

But not this time. The effects of putting a star QB’s brain at risk were extremely visible, captured in great detail by high-def cameras. And that means the league has to tell the truth.