Scott Vermillion’s family members are still struggling to articulate the emotions of the jumble they felt last November when they received a phone call from the doctors.
Vermillion, a former MLS player, died almost a year ago, on Christmas Day in 2020, at age 44. The direct cause was acute alcohol and prescription drug poisoning, his family said, a dour coda to a troubled life: a high school And the college all-American 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, the BU experts told his family he had chronic traumatic encephalopathy, or CTE, a degenerative brain disease linked to symptoms like memory loss, depression and aggressive or impulsive behavior. General Chat Chat Lounge
The diagnosis gave Vermillion the grave distinction of being the first American professional soccer player in a public case of CTE. Brain injuries are more commonly associated with collision sports like football, boxing and hockey.
“Soccer is clearly a risk for CTE – not as much football, but clearly a risk,” said Dr. Ann McKee, Director of the CTE Center at Boston University.
A neuropathologist, McKee has found 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. It did not answer everything – it simply could not, given that CTE could only be diagnosed posthumously. It triggers feelings of doubt, guilt, anger, relief. But it was, at long last, something.
The specter of CTE began hovering over the NFL almost two decades ago, when the first cases of the disease were found 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 soccer, though, the research and public conversations surrounding CTE and head injuries are still emerging, even as confirmed cases mount. An English striker. A Brazilian World Cup winner. An American amateur.
The former MLS players Alecko Eskandarian and Taylor Twellman have been vocal about how concussions ended their careers and affected their personal lives. Brandi Chastain, a two-time Women’s World Cup winner, publicly pledged in 2016 to donate her brain for CTE research.
“We have to understand the gravity of the situation,” Chastain said. “Talking about concussions in soccer is not just a hot-button topic. It’s a real thing. It 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 potential brain injuries. MLS has joined several 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 about the importance of head injury identification, early reporting, and treatment,” Dr. Margot Putukian, the league’s chief medical officer, said in a statement. “There is always more progress to be made, and MLS is staunchly committed to this important work.”
The focus, though, is not only on treating concussions. In all kinds of preventative head impacts, players at every level are seeing more guidelines at limiting headers.
Head Injuries and CTE in Sports
The permanent damage caused by brain injuries to athletes can have devastating effects.
A study in 2019 by researchers in Glasgow showed former professional soccer players were three and a half times more likely than members of the general population to die from neurodegenerative disease (and less likely to die of heart disease and some cancers). Vermillion’s story, then, becomes the latest in a recent string of cautionary tales.
“CTE had never even crossed our minds,” said Cami Jones, who was married to Vermillion from 1999 to 2004.
Vermillion started playing soccer in Olathe, Kan., When he was 5 years old. He loved the incessant movement of the game, the swashbuckling action, family members said. His coaches in elementary school, in the interest of sportsmanship, often kept him on the bench for long stretches because he would score too many goals, said his father, David Vermillion.
His talent eventually earned him places on elite regional club teams and the US youth national teams as a teenager. It took him to the University of Virginia, where he was a third-team All-American in his junior year. It took him to MLS, where he joined his local club, the Kansas City Wizards, now known as Sporting Kansas City, in 1998 at age 21.
But Vermillion, a scrappy defender, never fully blossomed as a pro. He moved on to two other clubs before a nagging ankle injury forced his early retirement after the 2001 season. His career earnings in the fledgling league were meager; His father recalled his son’s salary being about $ 40,000 a year when he left the game.
“It was a big blow,” said David Vermillion. “He spent all of his life climbing that hill, moving up, making himself a good player, and to abruptly have it end was tough.”
Scott Vermillion tried to find some footing in soccer after his life. He managed a family store. He coached local youth teams. He pursued a nursing degree. But his relationships were slowly unraveling.
Although Vermillion’s behavior would have been most concerning in the decade before his death, Jones said he noticed changes in him even before his career was over: He was often lethargic, which led to his acting as a professional athlete, and often complained of headaches.
“When I met Scott, he was a vibrant, outgoing pro athlete, super fun, a jokester,” said Jones, who divorced Vermillion in 2004, three years after his career ended, when his children were 1 and 3. “I watched him Change is really fast, 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 was married a second time, but that union lasted only 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 rehabilitation programs for alcohol and prescription drugs, emerging only to insist his family that the programs did not help him, that he was being incapable of being helped.
His daughter, Ava-Grace, got accustomed to missing her dance recitals. His son, Braeden, now 22, was devastated when he missed his high school graduation.
“He would promise a lot of things and basically just make excuses and not show up for us,” said Ava-Grace Vermillion, 20.
Dr. Stephanie Alessi-LaRosa, a sports neurologist in Hartford, Conn., Cautioned against drawing causal links between posthumous CTE diagnoses and patterns of behavior in a person’s lifetime. She said research on the subject was still in its early stages, and that doctors were still trying to understand why some athletes got CTE while others didn’t.
“I have patients who are hesitant to get psychiatric treatment because they think they have CTE and are doomed,” she said. “I think it’s important for patients to get the help they need, and if their family is concerned, get them to a sports neurologist.”
Alessi-LaRossa said she thought the benefits of sports outweighed the risks, but the emerging widespread idea that heading into soccer should be restricted for young players.
In 2015, US Soccer – resolving a lawsuit – announced a ban on heading in games and practices by players under 10 and created guidelines for restricting heading practices in older players. And last year, English soccer officials released guidelines for guidance, recommending professional players limit so-called “higher force headers” to 10 per week. (How, exactly, this should have been enforced has been less clear.)
Vermillion’s mother, Phyllis Lamers, contacted the Boston laboratory about her son’s brain examination after his death. CTE has four stages, the final stage associated with dementia; Scott Vermillion was found to have Stage 2 CTE
His family said they hoped coming forward with his story, though painful it might be to relive, could help inform families about the hidden risks of soccer. They said they regretted how hard they were at him, how they cut him off at times when his behavior became too difficult to handle. They are agonized wondering if they could have done more.
Ava-Grace Vermillion recalled texting her father on Dec. 23, 2020, his 44th birthday. She had not seen him in close to a year, she said, and as she prepared to head off to college to study in California, she said she felt compelled to break the ice.
“I remember the day so well,” she said. “I was at work and just thought it was time I reached out to him. I hadn’t talked to him in a while. I sent him a text saying, ‘Hope you are doing well.’ He called me back, and I didn’t get to answer. And he died two days later. “
Ken Belson contributed reporting.