The tangled multiplicities of cte: Scientific uncertainty and the infrastructures of traumatic brain injury

Abstract

Chronic traumatic encephalopathy (CTE) is a medical diagnosis that has largely come to define sports’ “concussion crisis.” Scientific definitions typically describe CTE as a neurodegenerative condition associated with repeated exposure to traumatic brain injury (TBI) and symptoms including cognitive decline, emotional or behavioral changes, and motor impairment. Public conversations about CTE are typified by harrowing stories of psychological distress and athlete suicide; yet neuroscientific conceptions of the condition are characterized by much uncertainty, especially around whether scientists can prove if repetitive brain trauma is the direct cause of CTE. My analysis reveals the multiple, competing ways in which such uncertainty is produced. Uncertainty around CTE materializes in part through scientists’ active framing of existing bodies of knowledge as incomplete or inconclusive, but also from the limits of neuroscience in representing the material complexity of the brain and its connection to human experience. Following the work of Michelle Murphy (Sick Building Syndrome and the Problem of Uncertainty. Raleigh, NC: Duke University Press, 2006; The Scholar and Feminist Online, 11(3), 1-9, 2013), I resist citing scientific uncertainty around CTE as “proof” that collision sports do not inflict damage on athletes’ brains. I affirm that the neuroscientific paradigms driving most CTE research offer narrow parameters for conceptualizing how brain trauma occurs through sport and shapes athletes’ experiences. Given the multifaceted and overlapping ways in which athletes experience harm, identifying the sources of these harms should not revolve around isolating individual causes and effects but instead interrogating the varied assemblages of practices, values, and environments-the infrastructures of harm-that together facilitate contexts in which athletes sustain and endure damage. As such, I argue that athletes’ firsthand experiences of navigating these infrastructures should be valued as embodied counter-knowledge to scientific uncertainties around CTE.