The Dangers of Safety

Stephen J. DUBNER: What comes to mind risk wise when I say the following things: shark attacks …

Steven D. LEVITT: The biggest joke of all time.

DUBNER: All right. Terrorist attacks.

LEVITT: The biggest waste of time ever.

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DUBNER: How about the risk of something almost everybody does every day: driving your car?

LEVITT: Incredibly low. If nothing were to kill you except driving your car, and all you did was drive your car day and night, you’d expect to live for 250 years.

Steve Levitt is the guy I write books with, Freakonomics and SuperFreakonomics. He’s a professor at the University of Chicago. And he looks like a professor — skinny, thick glasses, comfortable shoes. No one’s ever going to mistake him for a tough guy. But there aren’t many things he’s afraid of. You know why? Because he’s a data guy who’s spent a lot of time figuring out what’ll kill you and what won’t. So he thinks most of our fears are vastly overrated.

LEVITT: I think it’s a survival instinct, for one thing. If you think about spiders and tigers and rhinos, things we shouldn’t be afraid of, but we’re terrified of them. But I think people are predisposed to be frightened of things, and in a world of media where we’re now bombarded — I think kidnapping is a great example. People used to be kidnapped a lot more than they are today. But you wouldn’t hear about the little blonde girl who’s being kidnapped in Utah if you lived in Chicago, or New York. But now, a little blond girl gets kidnapped, and it’s national news. The media promotes fears because people love to read about scary stuff. Who in their right mind — if someone came from Mars — would think that horror movies would be this incredibly successful genre, where people would try to scare themselves a lot. People who are afraid of needles don’t go to the hospital and have the needle stuck in them just so they can get the fear. It’s strange how peoples’ brains work that way.

You know what’s even stranger? Football. Instead of running away from scary things that are highly improbable, football players run into each other — on purpose — really hard. Without fear.

Terence NEWMAN: All right, I’m Terence Newman of the Dallas Cowboys.

Terence Newman is one of the hardest hitters in the N.F.L. You might think he’s a big guy, but he’s not. He’s about 5′ 11″, 190 pounds. That said, he’s a rock-hard dude — or, as he puts it, “swole,” as in swollen with muscle. On the field, Newman is famous for launch his body like a missile.

DUBNER: If you’re cornerback, what’s your favorite thing to do?

NEWMAN: Favorite thing is, obviously, get interceptions, running them back for touchdowns.

DUBNER: All right, second favorite thing, then?

NEWMAN: Second favorite thing is blowing up receivers.

DUBNER: All right and for those who don’t know what blowing up a receiver means, what does that mean exactly?

NEWMAN: Or a running back. It just means catching them with a good solid hit, and basically de-cleat them. When you hit them and they go backwards and you go running over the top of em and celebrating, doing all that crazy stuff.

Robert C. CANTU: Robert C. Cantu. C-A-N-T-U.

DUBNER: And how old are you?

CANTU: Older than you might think. 71.

Robert Cantu is a professor of neurosurgery at Boston University and he specializes in the study of traumatic encephalopathy, or major blows to the brain.

DUBNER: So let’s talk about the N.F.L. I love the N.F.L. You love the N.F.L.?

CANTU: Yes!

Dr. Cantu and I are not alone. The Superbowl has become a national holiday. More people watch it on TV than any other show. Millions of kids grow up with the dream of playing in the N.F.L., my own son included. He’s 9 years old, 4’2”, 54 pounds. He ain’t exactly “swole.”

DUBNER: When is the last time that you know of that there’s been an on the field death in football?

CANTU: There have been on the field deaths in football every single year since 1931 with the exception of 1990. Last year, there were five on-field deaths. This year, there have been two. All five last year and both this year were due to brain injuries. So fatalities still occur, but they occur at relatively low rates compared with 36, 37, 38 deaths a year that were seen 40 years ago.

Four or five deaths! That’s about the same number of people killed every year around the world in shark attacks. But who’s afraid of football? Cantu says most football deaths occur in high school and college. There hasn’t been a single on-field death in the N.F.L. I’m guessing if a cornerback like Terence Newman blew up a receiver like Chad Ochocinco on national TV and he never got up again, people would be a lot more afraid of football than they are.

Quintin MIKELL: I don’t play with fear. I guess you get a little nervous about assignments or getting beat on certain things, but, in terms of contact or anything like that. I’m not scared of anything.

Quintin Mikell plays strong safety for the Philadelphia Eagles. He’s roughly the same size as Terence Newman. He too is known for hitting very, very hard.

MIKELL: The hardest hit I ever had was actually this year. It was me and the guy named Justin Fargas. He plays running back for Oakland Raiders. Basically what happened is he had a toss. He was wide open, basically screaming up the field. I was in the deep cover too.  It was funny, because he was running toward sideline. I was running towards him, and we’re both heading towards the sideline. And it was almost like neither one of us was going to back down, because we knew it was either going to be a big collision or not. Because he could have run out of bounds, but I just knew he was going to try to run me over, just watching him in films. So essentially what happened was we basically ran full speed into each other and pretty much knocked each other out. And I tried to get up a little too soon, and I fell back down, and I was wobbly kneed. Eventually the trainers pulled me out, and they were like, “You can’t go back in right now.” Actually he came out for a few plays too, so we both knocked each other out.

DUBNER: But you tried to stay in game.

MIKELL: I did. You never know what if he’s going to get up or not, so you want to be the first one to get up, and you wanna make sure that you didn’t take the loss right there. So essentially, I think I won, because I got up before he did, even though I did kinda get wobbly kneed and went back down.

DUBNER: What’d your actual head feel like immediately afterwards, and then later on?

MIKELL: It’s a really odd feeling. The first thing you get is everything starts to vibrate. Zzzz. Like you laid your head on cell phone and put it on vibrate and someone called you. That’s what it felt like for me. Instantly — like I actually saw it on film — I grab my helmet and tried to steady everything. And then after that initial vibration, it’s almost like you’re in a dream. Just floating. And your legs are like jello. You’re trying to stand up. Your mind is trying to tell your body. But your body and everything is disconnected. So you pretty much just fall flat back on your face.

Ouch. Our brains are designed to float around inside the skull to survive the daily bumps of life. But playing football is different. It’s one tough guy running full speed into another guy traveling just as fast in the opposite direction. I asked Dr. Cantu what can happen to the brain in a collision like that.

CANTU: The best analogy, or at least one that I think is useful, is to think of jello in a bowl. And if you hit the bowl very forcefully, you’ll see the jello oscillate. If you put the jello into bowl that is elliptical in shape, not round, and hit it, because you’ll invariably hit it off-center, you’ll see that the jello moves forwards and backwards and it also spins around in the bowl. And those are the primary forces that are imparted to brain, the linear forces those in one plane, front and back, or side to side, and the spinning forces are the rotational forces. And those combined forces cause shearing and straining of brain tissue. And that in turn leads to metabolic cascade of dysfunction. That is what we refer to as a concussion.

A metabolic cascade of dysfunction. In a big hit on the football field, the only thing standing between your brain and a beating like that is your helmet. Dr. Cantu is also affiliated with NOCSAE, the National Operating Committee on Standards for Athletic Equipment. It’s a group that tries to make football helmets safer.

CANTU: Helmets are better today than ever before. The actual athletic equipment that is on the market today is better than athletic equipment that’s been on the market in the past. But, the problem is what are you asking that athletic equipment to do? And if you’re asking it to prevent skull fractures, and if you’re asking it to prevent most serious subdural hematomas, it does a stellar job. But, if you’re asking it to prevent concussion, it can’t do it.

So let’s see if we have this right. Modern helmets do a good job of preventing skull fractures and on-field deaths: that’s why those numbers are way down historically. But getting lots of concussions isn’t very healthy either. To prevent them, Dr. Cantu could make a more cushioned helmet — but then you might be more worried about skull fractures again. And then there’s this problem: if you did give football players a more heavily cushioned helmet, what are they going to do with it? A lot of people think the biggest problem in the game today is that players use their helmets not so much as protection . . . but as a weapon.

CANTU: The way that we’re going to have to address this problem is to eliminate the helmet as the initial point of contact in act of tackling and even, to a certain extent, in blocking as well. Quite frankly, when people didn’t have the helmets of the security that there are today, they didn’t have the face mask, and you had to worry about your nose winding in your ear from using your face in a tackle . . . You didn’t use your face, obviously.

DUBNER: So as safety equipment gets better, our behavior becomes more aggressive?

CANTU: Absolutely. Very much more aggressive, very much more violent. We’ve seen the same thing happen in ice hockey, as well. When you put face and head protection on people, they’re not as worried about taking blows to that area. And so the aggressive nature of the activity is greatly enhanced.

So wait a minute. Let’s figure this out. If the helmet, which we think of as a safety device, is being used as a weapon — why not get rid of the weapon? There are sports we play without helmets — rugby, Australian rules football. What happens if you try to play American football like they did in the old days, without a helmet? Here’s Quintin Mikell again.

MIKELL: There’d be a lot less head injuries, I know that for a fact, and I can tell that the tackling would actually be a lot different. Nobody wants to mess their face up willingly, so you wouldn’t go in head first. You wouldn’t go in trying to destroy somebody, you’d go in just to get them on the ground. And maybe it wouldn’t be as exciting, I’m not sure, but I know there definitely wouldn’t be as many injuries.

DUBNER: Would it be as much fun? I assume you really like to hit, right? Hitting is —

MIKELL: Yeah, yeah. I like the contact. That’s what makes the game fun. You’ve got these receivers out there taunting you, and you finally get a chance to wallop them. So that’s good for me.

DUBNER: So for someone like you who loves to hit, especially these spindly little receivers who are always yapping, right? You get to pay em back once in a while. And if you took away helmets, could you still have a lot of fun playing the game?

MIKELL: I don’t think I would.

You have to wonder if a guy like Quintin Mikell doesn’t have fun playing football without the amazing collisions, how much fun would we have watching it? And if you think it’s fun watching two football players run into each other, head-first, at 20 miles an hour, how about 20 cars crashing into each other at 180?

Randy LAJOIE: I started my career with a bad wreck in 1983 at Daytona.

This is Randy LaJoie. He was a NASCAR driver for about 20 years. He won 15 races and more than $7 million.

LAJOIE: And I was passing Sterlin Marlin, to qualify for the Daytona 500, and the car hit the bump, got sideways, slid a long ways. Richard Petty had told me a story two weeks earlier while we were testing. He goes, “Man, you’re going fast down here. You’re going to crash. And when you do, there’s two things that’re going to happen.” He said, “You’re going to either crash real quick and slide a long way, or you’re going to slide a long way, and crash real hard.” He goes, “If you can remember, before you crash, to reach down and pull your belts as tight as you can get them and take a deep breath, you’ll be a lot better.” Well, as I’m sliding, and I see where I’m going to hit, I reach down and tugged on my belts as hard as I could. And in your early years, you learn not to let go of the steering wheel, so I put my hand back on the steering wheel. When I looked out the windshield, and all I could see was sky, I thought, “Well, it’s about time. I need to take a deep breath.” I woke up in the hospital that night, had a severe concussion, was dizzy for — you know, some people say I’m still dizzy. I had a headache for a couple weeks, but three weeks later I was back NASCAR North Racing, and we won the championship. It didn’t bother me, it didn’t kill me, and I went back to win three races at Daytona.

So Randy has seen sky. He’s seen wall. And he’s seen safety gear get better and better. Now that he’s retired, he makes super-safe aluminum seats for racecars.

LAJOIE: Some of the equipment, the fire suits and the helmets, were definitely as good as they could have been. But one of the things that we have realized [was missing was] a head and neck restraint, something that holds your head on. Because if your body’s strapped in, your head’s not attached to anything and you’ll get the Dale Earnhardt. Kenny Irwin, Adam Petty, Tony Roper, Blaze Alexander — those guys before him that passed away with the same injury that we lost Dale with . . . Once we lost the best we had, NASCAR says, “Okay, we got to stop this.” I mean, if something happens when you put that helmet on and pull that strap tight, people say your brains go out the window. And that’s a very good possibility.

DUBNER: Tell me how safety in NASCAR, especially since ’01, has changed the sport from a spectator perspective, or from a strategy perspective, or whatnot?

LAJOIE: Well, I’m not going to anymore funerals, which is good. How it has changed the sport? The new generation drivers, they’re not as sore on a Monday, a Tuesday, as older generation drivers. You look at a 50-year-old NASCAR driver that’s retired, other than Mark Martin, they have trouble tying their own shoes because they were beat up pretty hard. Your body’s stretched. They have trouble walking. Not a lot of difference than the older football players. But we didn’t get as many concussions as they did. But there’s still a lot of guys out there that’ve hit their head. If I hit my head one more time, I could probably hide my own Easter eggs.

DUBNER: Now the risk is that — in other realms, maybe in racing as well — the more safety features you add on, the more reckless or the more aggressive people tend to get. And in racing, there’s a lot of aggression already. Do you think about that? Do you think about the fact that, as the walls, the cars and the equipment get safer, that there’s going to be more aggression in the end?

LAJOIE: Well, I mean, racers were always aggressive. The walls that I’ve hit, before there were the soft walls, hurt a lot more more. The concrete walls hurt a lot more than that safer barrier does. And one of the things that the drivers of this era haven’t felt is a concrete wall.

It makes sense. If you’re not worried about hitting a concrete wall, you might drive a little harder, take a few more chances. If you’re all strapped into your car, surrounded by a big exoskeleton, you don’t feel so vulnerable anymore.

DUBNER: As a kid, tell me what was the car you remember riding as a kid in the back seat with your parents? What’d they drive?

Glenn BECK: 1972 Impala station wagon. I think it was a ’72, maybe it was a ’74, I can’t remember. It was the one with the rounded back and the tailgate went down underneath the car. Do you remember that? It didn’t swing open. Oh, it was ugly. Woo, it was ugly.

You might recognize this voice. It’s Glenn Beck, the talk-show host.

DUBNER: Now, your younger children are under 10? So compare the kind of environment you were in, safety-wise, as a kid —

BECK: I mean, we didn’t even wear seat belts. I remember sitting next to my dad — maybe I was 8 — and I’m like, “Dad, let me drive.” And he’d say, “Here, steer a little bit!” It was nuts. Now, everybody’s belted and in safety harnesses and car seats. [My wife and I] were [driving] someplace recently, and this kid [in the car next to us] must have been maybe 6. We were at a stoplight, and she saw the kid stand up out of the seat and lean over the shoulder of her dad who was, you know, driving the car. My wife was like, “Oh my gosh, they are not belted.” It was like, “We gotta call SWAT! Quick, get the Belt Police out!” I mean, it happened, we all lived, we survived, it’s okay.

These days, Beck drives a Mercedes sedan. It’s new, shiny and black; everything is in its place. I hopped a ride home with him the other day. And I asked him, “Why’d you buy this car in particular?”

BECK: I was standing in the dealership, and the [salesman] said to me, “This has some amazing safety features. It knows when the car is going to roll. If you’re window is rolled down, it immediately rolls the window up. It has the side airbags. Depending on what the car senses it’s going to do, it puts your seats put in right position.” You know, it makes me want to flip the car! I’m going to put my seat in the most awkward position, and I’m going to flip it! This is, like, the safest car on the road, he used the term “Death Proof.” But honestly I didn’t even think about it until we were  — until I was driving it. And I thought — I really was taking a corner a little too fast, and I’m like “I can handle it, what’s the worst that can happen?”

So Glenn Beck buys a car that a salesman calls “deathproof” and finds himself driving a little more recklessly. Football players get better helmets and they start using them as weapons. Is there a way to describe this behavior? Economists like Steve Levitt know it as the Peltzman Effect.

LEVITT: So the Peltzman Effect — which is named after a good friend of mine, Sam Peltzman, a colleague of mine, one of the most outlandish dressers who’s ever walked the earth — it’s the idea that you can put in a safety device and people can then feel so much safer in the activity they’re engaging in, that they take more and more risk, to the point where you actually have the opposite effect. By putting in the safety device, you actually lead to more people being hurt or killed. And the classic example people talk about is seat belts in cars. And the idea would be without a seat belt, you feel at risk, and with a seat belt you drive with a much more dangerous fashion, and that could lead to more deaths. Now —

DUBNER: You sound skeptical.

LEVITT: I do not believe that there ever has been convincing evidence of a single Peltzman Effect. Now, there are little bits and pieces of evidence you can find. For instance, it does seem true that after you put seat belts in cars, there might have been a minuscule increase in number of pedestrians who were killed. But that was overwhelmingly swamped by the number of drivers who were not killed and passengers who were not killed because they wear them. One thing that economists understand well is that people respond to incentives. What economics is, at its root, is trying to understand how people respond to incentives. The Peltzman Effect is a very deviant, over the top example of that, in which people respond so strongly to the incentives that they actually end up undoing the benefit that the safety device was supposed to have in the first place.

I have to agree with Levitt, at least when it comes to driving. There are fewer traffic deaths per mile in the U.S. than ever before — and that’s because of safety measures like seat belts, not despite them. Sure, Glenn Beck might feel invulnerable in his “deathproof” car — but since his own safety is at stake here — and that of his wife and kids — he surely doesn’t want to get too reckless.

But what about safety gear that protects you while harming someone else — like a football helmet? Or, what about all the radiation we absorb in medical tests — radiation that probably causes cancer? And what about a safety net like . . . legalized abortion? When you can reverse the effect of risky behavior — like unprotected sex — aren’t people more likely to engage in such behavior?

The fact is that our craving for safety has its costs. The other fact is, we spend way too much time being scared of things like shark attacks and terrorist attacks — things that, in the end, are astronomically unlikely. We’re getting more and more hyped-up about a world that’s less and less dangerous.

And you know what’s really weird? A lot of the dangerous stuff that we do these days — like football — is stuff we do for kicks, not out of necessity, but on our own volition.

If you think about it, risk is becoming a luxury good — kind of like Glenn Beck’s “deathproof” Mercedes.

BECK: “What? So I didn’t stop at the stop light and I’m going a hundred and ninety. What? I can flip it, I’ll survive, it’s the death proof car!” What a dope!