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of the condition’s defining characteristics. There are numerous complicat- ing factors beyond repetitive brain impacts that can be alluded to as
“unknowns” in neuroscientific theorizing around why CTE materializes in the brains and lives of some athletes and not others. These unknowns emerge through the material complexity of the brain, but also the neuro- scientific emphasis on parsing the effects of brain trauma within the vast array of human experiences that shape, and are shaped by, the brain.
Multiplicity, then, like latency and imperceptibility, serves as a renewable resource in the production of uncertainty around CTE.
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scientific domains of uncertainty by providing rich, intimate details of specific experiences and social conditions.
The revaluing of experience as evidence was a crucial aspect of the for- malization of sick building syndrome (Murphy 2006). The scientific response to the ambiguity of chemical exposures was to examine the human body and office environment with more precise and sophisticated toxicological techniques, hoping to map the effects of smaller degrees of chemical exposure and more minute physiological or molecular changes.
Yet these methods could still not adequately conceptualize the impercep- tibilities and multiplicities that characterized what office workers were experiencing; the inability to detect a definitive biochemical cause for sick building syndrome left the shared experience of working in an office building as the most valuable lens for understanding associated symptoms.
The histories of sick building syndrome illustrate the power of com- municating shared experiences of illness, even when experts declare underlying causal relationships untenable. As such, sick building syn- drome offers important lessons regarding how athletes’ experiences are treated as evidence of the long-term effects of brain trauma. Experiences of memory loss, confusion, aggressive behavior, or emotional distress reported by athletes and their families exist irrespective of neuroscientific knowledge of distinct causal roots; their struggles are embodied and, indeed, “real.” The lived experiences of athletes, expressed through inter- views, memoirs, and legal proceedings, should be valued even when they cannot be explained through dominant neuroscientific frameworks.
Unlike medicalized diagnoses such as traumatic encephalopathy syn- drome, athletes’ portrayal of their own struggles represent potent “mate- rializations from below” (Murphy 2006, p. 58) through which experiences of CTE are articulated outside the narrow confines of institutional- ized science.
Similarly, the political power of sick building syndrome came not from definitive proof of causation, but rather the sheer density of complaints describing the tangible perils of office work. As Murphy (2006) con- cludes, it was precisely scientists’ inability to detect specific causes of ail- ments that enabled worker movements to articulate a broader critique of corporate capitalism. In other words, the uncertainty of sick building syndrome shifted the concern from finding and eliminating identifiable
The Tangled Multiplicities of CTE: Scientific Uncertainty…
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hazards to reassessing the corporate systems through which modern office buildings were designed and operated. The neuroscientific emphasis on the uncertainty around CTE causation has in many ways delayed or con- strained large-scale critiques of corporate or industry practices that struc- ture collision sports. Yet controversies around CTE can indeed reveal how elite sports operate as industries benefiting from the physical work of athletes and the multiple harms they incur (Benson 2017; Brayton et al. 2019).
Media stories offer a platform for athletes to detail their day-to-day struggles and express emotions within a hyper-masculine, profit-driven milieu rarely affording opportunities to do so (Ventresca 2019). These communicative acts, moreover, offer intimate details of an athlete’s qual- ity of life and challenge the drive for neuroscientific certainty and gener- alizability. The recent groundswell of athlete stories can therefore resist dominant knowledge-making practices and unequal relations of socio- economic power. An emphasis on athlete experiences as important counter- knowledge to dominant neuroscientific paradigms can also build further recognition of how elite collision sports are a site of inherently dangerous and precarious working conditions. A greater focus on lived experiences of CTE rather than the search for its root neurophysiological causes can also help foster empathy for athletes in a labor context increas- ingly characterized by exploitation and expendability (Brayton et al. 2019).
Valuing experience as counter-knowledge forces us to confront the social conditions through which repetitive brain trauma materializes in the embodied experiences of athletes. Morrison and Casper (2016) define CTE as the co-production of “masculinity and money, bodies and brutal- ity, spectacle and showmanship, health and self-image—all speaking to the multiple positions of men in terms of corporeal, social, and economic capital” (p. 165). The lessons of sick building syndrome illuminate the multiplicity of CTE and the corresponding dangers of this multiplicity:
the sources of harm represented in Morrison and Casper’s definition coalesce through the practices, policies, and values enabling the occur- rence of repetitive brain trauma in collision sports. Yet these factors are not exclusively associated with repetitive brain trauma; they also simulta- neously support manifestations of other forms of harm beyond head impacts. Instead of examining the biomechanical or chemical specificity
M. Ventresca
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of different forms of harm, emphasizing the shared social conditions underlying these processes challenges the notion that multiplicity unavoidably generates uncertainty. Rather, multiplicity can offer alterna- tive knowledges that reveal how uncertainty is actively constructed through the production and classification of scientific evidence.
Some scientists have indeed highlighted how behaviors with no appar- ent connection to TBI such as substance abuse may be at play in the materialization of tau proteins characteristic of CTE (Asken et al. 2017;
Solomon 2018). These hypotheses, however, fail to consider how the use of such substances, such as anabolic steroids, prescription painkillers, or alcohol, are practices related to the same assemblage of bodies, violence, and hyper-masculine spectacle around which repetitive brain impacts are normalized as intrinsic to collision sports (Holstein et al. 2016; King 2014; King et al. 2014). As steroids are technologies designed to produce bigger, more powerful bodies to inflict harm on opponents, painkillers offer (temporary) relief from embodied responses of such violence.
Holstein, Jones, and Koonce (2016) similarly highlight the trend for NFL players to also use alcohol as a means to cope with the physical and psychical damage of a life in football. Popular biographies of NHL enforcers who were diagnosed with CTE postmortem, such as Derek Boogaard and Steve Montador, detail how their struggles with symptoms of TBI were dangerously entangled with their extensive use of painkillers and use of alcohol or other drugs (Branch 2014; Dryden 2017). As many neuroscientists seek to isolate how factors beyond repetitive brain trauma contribute to the onset of CTE, high-profile studies such as those detailed above typically neglect to examine how these elements become entangled within the cultures of collision sports.