The brain arrives at any time in white cardboard boxes with the inscription "RUSH!". Inside each packet is an inch and a half foam liner and a red pouch protecting an ordinary white plastic bucket.
When a courier delivered Kevin Ellison's brain to Bedford VA Medical Center, near Boston, just after 2 pm. On January 22, Dr. Victor Alvarez performed the routine he did so many times that he stopped counting.
The neuropathologist unpacked the box, weighed the brain, and examined it for bruising or bleeding. He took dozens of photos with multiple exposures to capture differences in shape and color not apparent to the naked eye.
Alvarez processes most of the brains donated to the partnership between the Department of Veterans Affairs, the Boston University CTE Center and the Concussion Legacy Foundation. He moves carefully and quickly, knowing that each brain represents a family in search of answers.
Ellison's family donated his brain to be studied for CTE, or chronic traumatic encephalopathy, the devastating neurodegenerative disease found in people who have suffered repeated head trauma but can only be diagnosed after death. Football players are their most important victims.
It had been three months since Ellison died at age 31 – and almost a decade since his days on the football field as a defender, defender, team captain and fan favorite at USC. He spent a season playing for the San Diego Chargers. The three words tattooed on his left arm summed up his approach to life: "Be the best."
Ellison was living in an apartment behind her mother's house in Inglewood. He had a degree in economics from college, but in the end he no longer drove and struggled to keep his job. He had a headache that never really came out. His neck hurt and he felt dizzy. He could not sleep, heard voices, spoke to the sky.
Sometimes old Kevin would come back, his mother remembered. But she knew when darkness was approaching. His smile faded. His eyes wandered. He took long showers to escape, the sound floating in the living room.
The final journey of K-0623, as Ellison's brain was known to researchers, went through tight laboratories and offices in Boston. The search for answers to Ellison's development took almost a year. Did football, which had brought him joy and fame, contributed to its decline? Your family would spend this time waiting for an answer.
At her funeral, the program included a letter that her mother, Judy Reisner, wrote to her son: “All my memories only reinforce the depth of the relationship between mother and child. So deep that, during the last few years, not only could I see the pain in his eyes, but I also felt it. It hurt me to the bone that I couldn't remove it. "
Judy Reisner at home with pictures of son Kevin Ellison a few days before the one-year anniversary of his death.
(Robert Gauthier / Los Angeles Times)
The family traced Ellison's decline by mid-2012. After his NFL career faltered, he joined a team from the Arena Football League in Washington state.. He started drinking, something he avoided at USC, and took prescribed painkillers. In his first Spokane Shock game in May 2012, he scored a touchdown.
Five weeks later, Ellison lit the bed in her Big Trout Lodge apartment with a pot-filled cigar. He jumped a third-floor window, then telling authorities that God commanded him to start the fire and prevent anyone from being injured.
Eventually transferred from prison to a psychiatric unit, Ellison was diagnosed with bipolar disorder and schizophrenia.
“It would restart. He would falter. He would be hospitalized, ”said Camille Ellison, his sister, during his memorial service. “He would feel better. He would start a new job. He would have to leave. He could not work long hours or drive because it required a considerable amount of concentration and his brain could not stand it. However, oh, how his spirit wanted.
On October 2, 2018, the family tried to convince Ellison to go to a hospital for a 72-hour period in psychiatry. He had not taken his psychiatric medication in weeks. The voices and paranoia returned.
Ellison ran down the street from his mother's house, told a neighbor that someone was trying to kill him, and disappeared. The family filed a missing persons report called hospitals and police departments. Two days later Camille Ellison posted on Facebook: "If you see my younger brother Kevin (ie probably walking) you can text me."
An hour before midnight a man wandered the northern slopes of 5 Freeway in the San Fernando valley. He waved his arms at the passing vehicles. Minutes after a driver named 911, a Chevrolet Astro minivan hit the man. Paramedics pronounced him dead at 11:36 pm He carried a bus pass and wore a USC sweatshirt.
The Los Angeles County coroner identified Ellison through fingerprints.
Three days after his death, his older brother, Chris, received an unusual email.
Kevin Ellison, during his days at USC, hits Arizona receiver Syndric Steptoe.
(Wally Skalij / Los Angeles Times)
"I am very sorry to hear of your loss and I am sorry to contact you today," wrote Chris Nowinski, co-founder of the Boston-based Concussion Legacy Foundation. “I am sending an email on behalf of the Boston University CTE Center and would like to try to help your family.… If your family would like us to study Kevin's brain, we can provide a diagnosis that will help him better understand what happened. "
Chris Ellison replied a few minutes later: "I'm sure this is something we would like to do."
Nowinski, who played football at Harvard and fought professionally, has made such requests for over a decade. The first came after former Philadelphia Eagles defender Andre Waters killed himself in 2006.
Nowinski wrote a script for what to say, then worried, sweated, procrastinated. Eventually he called and asked the family for permission to study Waters's remains at CTE. They agree. Although Waters died at 44, the exam found that his brain had the characteristics of someone twice that age.
Nowinski doesn't have to send many emails now. The word spread. Families who want to donate the brains of deceased loved ones call a black flip phone charged 24 hours by the center's research assistants. They have a few minutes to evaluate if the brain would be suitable for the study. There are more donated brains – from athletes, military veterans, and others – than time to examine them.
Two hours after the email, Ellison's mother signed the consent form. All three Reisner boys suffered concussions. Keith, the middle brother, spent five seasons as a quarterback for Buffalo Bills. Chris, who played defensive for Brigham Young, works as a multiplayer agent and NFL candidate.
Kevin, the youngest, had told his sister that he had eight concussions. He has built a reputation for fierce hits on the football field. Shortly after his death, the USC athletic department tweeted a 14-second video of Ellison shooting his body at California receiver DeSean Jackson in 2006. His helmets hit each other. The announcer sang about how Ellison almost "beheaded" Jackson.
"The late Kevin Ellison," said the tweet.
At the memorial service, the Ellison family distributed bracelets with the dates of their birth and death, as well as their nickname – Kells. Near flower arrangements with "Be the Best" and "Loved by All" written on tapes, Camille Ellison described her brother's journey through the fog of mental illness.
"This beautiful human being," she said. "Still smart, competitive, handsome and a leader, caught in a cycle where his brain failed him – even as he recovered and good things started happening to him again."
Ellison's brain remained in the coroner office in Los Angeles, stored in a white plastic container filled with formalin – a pungent mixture of formaldehyde and water – for the trip to Boston.
The brains studied by Alvarez and other neuropathologists are processed at the Bedford facility or at Jamaica Plain VA Medical Center in Boston. In Jamaica Plain, a glass-door refrigerator is full of white buckets holding brains, each container labeled with the case number. Industrial freezers full of frozen brain halves occupy adjoining rooms.
About a decade ago, Alvarez went through a snowstorm to surgically remove the brain of a former college football player who had agreed to donate his brain for study. The storm knocked out the building's power, so Alvarez passed an extension cable to a generator at a nearby company. He brought the brain back to the lab and processed it without delay.
Formalin-fixed brains have a rubbery texture; Fresh brains arrive packed in ice and look like mature brie. Fresh brains are cut in half. Part is stored in a freezer at less than 80 degrees for later genetic and molecular studies. The other is put in a preservative for several weeks to firm and prevent decomposition.
About an hour after Ellison's brain arrived, Chris Ellison received an email from one of the research assistants, Laney Evers.
"We understand that you may be looking forward to the results, so know that we will do our best to … work as efficiently as possible," Evers wrote.
Given the number of brains to study, seven months passed before Alvarez dissected Ellison's brain on July 24, the same day most NFL players reported to the training camp.
The brain is sectioned with a bread knife-like tool but with an unbroken edge. Alvarez is known among colleagues for precise cuts, with a practiced and methodical technique. It begins with the left hand gently pressing on the upper brain while the right hand slides the knife horizontally near the bottom. The goal is coronal slices of about one third …