WASHINGTON -- In September 1994, after leaving the Steelers for the Chicago Bears, fullback Merril Hoge suffered a concussion, the first of his career.
"Two things went wrong," Mr. Hoge told the U.S. House of Representatives Judiciary Committee yesterday in a hearing to examine football brain injuries.
"First, I never saw a neurological doctor. Second, I was cleared five days later."
A few weeks after that, Mr. Hoge suffered another blow to the head. In the training room, his heart briefly stopped beating. In the following days, spent in intensive care, he could not recognize his wife, his son or his brother. He had to re-learn how to walk.
Now, the effects have subsided, and Mr. Hoge, 44, works as an analyst for ESPN. Bright lights and sun still can cause him headaches.
"I don't have the major symptoms that I talked about, but I do have some minor ones," said Mr. Hoge, who said players should not return to the game until seven days after concussion symptoms have disappeared. "I don't know what that's going to turn into five, 10 years from now."
With mounting medical evidence detailing the disastrous effects of a National Football League career on players' brains, Judiciary Chairman Rep. John Conyers, D-Mich., said the issue warrants congressional review. He called in NFL Commissioner Roger Goodell, NFL Players Association head DeMaurice Smith, former players, doctors and advocates for a day of testimony and questioning yesterday in an attempt to identify how to reduce the inherent risks of football.
No clear solution emerged amid discussions of brain scans, collective bargaining and lives cut short.
Mr. Hoge is one of the lucky ones. The tales of woe shared by panelists included those of Mike Webster, who was homeless when he died of a heart attack at age 50, Terry Long, who committed suicide by drinking antifreeze at 45, and Justin Strzelczyk, who died in a highway crash while fleeing police at 36.
All three were Steelers offensive linemen. All three, according to Dr. Julian Bailes, of West Virginia University, who has studied their brains, suffered from chronic traumatic encephalopathy -- severe brain trauma.
Another former Steelers lineman, Ralph Wenzel, is still alive but was unable to make it to Washington. He was diagnosed with mild cognitive impairment at age 56. Now, 10 years later, he has severe dementia, said his wife, Dr. Eleanor Perfetto, who testified yesterday.
"He can no longer dress, bathe or feed himself," Dr. Perfetto said. "He lost his dry sense of humor. He lost his warm, quiet personality. He lost it all."
Mr. Goodell insisted that tomorrow's retirees will not be in similar shape, as the league has changed its culture. In the face of occasionally harsh questioning, the commissioner defended his actions to address the problem -- from rule changes penalizing big hits, to more caution with concussions, to giving all retirees with dementia $88,000 a year.
That wasn't enough for Rep. Maxine Waters, D-Calif., who interrupted Mr. Goodell multiple times and threatened congressional intervention if actions are not taken to help the safety of current players and care for retirees.
"I think it's the responsibility of this Congress to take a look at that antitrust exemption you have and, in my opinion, take it away," said Ms. Waters, whose husband, Sid Williams, played in the NFL.
Mr. Conyers said Congress should merely act as an independent investigator into the issue, but many of the Republican members said the body shouldn't get involved at all.
"Congress should not attempt to influence the upcoming collective bargaining process the league and the players union are about to engage in," said Rep. Lamar Smith, R-Texas, the ranking Republican on the committee. "We should also avoid the temptation to legislate in this area."
Mr. Goodell and Mr. Smith pledged to make all medical data on current players available for independent review. Mr. Smith said Congress can have a strong role as an investigator and as a prod to further action. A 2007 Congressional hearing on NFL disability benefits helped spark the league to do more for its retirees.
The commissioner, meanwhile, saw no need for intervention.
"With all due respect, I was asked to come here, so I'm not asking Congress to do anything," Mr. Goodell said.
But Congress had plenty to ask him. Reps. Linda Sanchez, D-Calif., and Anthony Weiner, D-N.Y., called the NFL's brain injury studies into question because of the man who runs them: Dr. Ira Casson, who has been skeptical of findings that concussions cause dementia in football players.
Ms. Sanchez called planned inquiries by Dr. Casson, who chairs the league's concussion committee, a "charade." She said someone who is not on the league's payroll should do the study.
Panelist Gay Culverhouse, the former president of the Tampa Bay Buccaneers, said being on the payroll is part of the problem for team doctors, who push players back on the field too quickly after they have suffered brain injuries.
Steelers team neurosurgeon Dr. Joseph Maroon took offense to that.
"At no time in my 25 years of a professional career for [the Steelers] have I felt pressure that I should modify my diagnostic decision-making for any individual," Dr. Maroon said.
He also praised the league's actions, which Mr. Goodell detailed, to reduce the risk of head injuries.
"From my experience, the NFL is a model in concussion management," Dr. Maroon said.
Some of the problem might lie in players' reactions to the injuries. Ms. Culverhouse said many don't report symptoms so they can get back to the field sooner and avoid being replaced by another player.
A couple of members quizzed panelists about to see if anything can be done to player contracts to take away the incentive to return too quickly. The answer: not really.
But former New York Giants running back Tiki Barber, who now works for NBC, said money wasn't an issue for him when he decided to return to the same game twice after suffering concussions.
"For me it was a sense of pride because I loved doing my job," Mr. Barber said.
He added that better education and awareness are crucial to help players make the right call, going to the heart of what many participants hoped yesterday's hearing would do -- spotlight the issue.
Mr. Hoge now coaches youth football, and he said he recently had to keep a boy off the field after he suffered a concussion -- even though the kid's older brother deemed him ready to return to action.
"Standards and education," he said, "would help prevent mistakes being made like that."
Daniel Malloy can be reached at 202-445-9980 or firstname.lastname@example.org . Follow him on Twitter at PG_in_DC.