beginning. guess who you bring up an extraordinary question in the history of united states and george washington's example was ignored. let me just amendelo but what you said. all the declaration did and that was written by thomas jefferson who owned 100 human beings and didn't see the hypocrisy of the contradiction and more partlyy did not free and if you slaves. in fact the constitution of the united states tolerates slaverye and made the purposes of the portion meant and legislative districts. a free we are free people proclaiming to the world that all men are created equal that we will tolerate for the next four score in five years until the civil war begins chattel slavery. in 1861 the work begins 4 million africans are owned by, 4 million americans are owned by other americans which just couldn't work and they think we are still trying to figure out how to escape the specific gravity of this great original sin many historic and -- just door and call it.sin for americans or original sin was born in the contradiction of proclaiming to the world and to ourselves that all men are created equal and the guy that evoke that could let that out in the civil war clearly is a direct causal effect from that. but i think what we are seeing even today with all of the end to any windows having an african-american president who is also subject to show is a criticism not just for policy or content of character but the color of the skin tears racing dr. king. we have still got a long way to go. >> host: on the line for republicans bunnies in oklahoma city, oklahoma. ronnie, good morning. >> caller: good morning it good morning to mr. burns. the civil war documentary and everything you put out i always follow so i appreciate your scholarship and your scholarly work. i was just wanting to know, i'm getting more well read in my research.ic i am an african-american and i was just wondering why is it do you think that african history isn't taught outside of slaveryn and knowing that african peoplen existed long before slavery started. why isn't it that african history is taught a little bitit you know more inclusive so people have a broader idea of wa what africans may have contributed to civilization other than you now just the african history started as slaves. it is a >> host: got your point ronnie, ken burns. >> guest: this is a huge essential point is something i've been talked about. we have black history month andt we think of african-american history as a politically correct addendum to our national heritage. we have an argument with regard to the confederate flag in many aspects of our complicated history with regard to race and a lot of people complain in a reactionary mode that we aretr trying to take away history. i think what you are suggestingr is how to expand our history? how do we tell history that includes everyone? for a long time absolute film history the newest the western one. things began in ancient greece and went around in christianity happened and all of a sudden here we are having created the united states of america and its white and essentially european and it excluded asian andh african history and many other peoples history. the more you know it doesn't mean the less you care about the others. the more you know is the more you know and the fact is we are impoverished if we don't include everybody now given example. i was just in charleston talking about race after the terrible tragedy there in charleston is n place where 48% and we think of africans stolen from africa and brought to the united states like ellis island without a welcoming statue of liberty. as we talk about the confederate flag people are saying your turn to take away your heritage. nobody wants to do that. what would want to do is expand some of his three wood on the that includes all people, all americans because let's remembe. the first place united states and 6019. that sea prefer the mayflower so it is really intertwined with our history and you can't segregate it if you wish in february but it ought to be integrated slowly and integration just meanssi expansion. as you excellently suggest the more we know the more we know. >> host: the confederate flag something that jacqui robinson robinson --. >> guest: history repeats itself. >> host: i want to show our viewers one more segment from the jacqui robinson documentary. >> one day we had a birthday party for p. we. in the fifth inning the game wae called. we gave him eight -- and we sang happy birthday. and while the lights were down ran up a small confederate fla . because he was from louisville kentucky. we were in the clubhouse after he came and jackie is irate. i mean he was livid. who would ever let jim crow back in the ballpark? >> i think it's very difficult for many people to understand the indignities that a black person had to endure and jackie robinson was -- an incredible amount of race riots of the reason he should have to have things of that story. >> host: that from the 50s this article in "new york times" today church killings of band could set it -- confederate symbols that alters. >> guest: is not surprising. that's one reason they started with him to get a conversation of race that goes beyond just the initial oh is that said, let's remove the confederate flag from the statehouse grounds in columbia which happened and everybody goes now we don't need to talk about or what we forgot is the confederate flag meant spiderlike people say you'reed taking away my heritage. >> host: the conversation on race you're talking about the u. been doing trusting continuing tonight at george washington. >> guest: that was another dream doors open at seven at the brooklyn academy of music on wednesday night. we just want to have a conversation with all americans and talk to them all of us about what we can do and what i think is that the past can help us pull out the fuel rods of our passion. we like to think that history repeats itself he and mark twain supposedly said it rhymes.te in "jackie robinson" jackie robinson is alive because his story in the past has all of this stuff, stop-and-frisk driving while black and confederate flag and all these things but the confederate flag that we are talking about was one battle flag of the army of northern virginia. it wasn't the official flag of the confederacy so it only came into prominence in the late 1890s when there was a surge of white supremacy. he came back again after 1954 when the brown versus board of education that this is about taking away heritage. it's about taking away resistance the idea that all men are created equal.ou if you don't believe that we have to have another conversation because that's the american creed. what we want to do is tell a more inclusive history and it's sad that there are still some 1800 monuments to the to the confederacy around the country. we need to look at each one of those and understand the way in which all of our citizens relate to it. >> host: our conversation with ken burns about "jackie robinson" document erasing america continues for the next 35 minutes or so. let's go to bill in chicago illinois on our line for democrats. bill, good morning. >> caller: good morning. i read -- met jackie robinson here in chicago and he came because of a campsite. i was assigned to him as his bodyguard and i picked him up at o'hare and i made the mistake -- and that ticked him off. i didn't get a chance to talk to him privately like i wanted to.h >> host: what would you have said bill if you have that chance? >> caller: i wanted to tell him that just be a moderator. >> host: what you mean by that? >> caller: i knew he was, when the crowd rushed him they were very upset. it was my job to see to it, didn't make the rules, i enforce the rules. >> guest: there's a wonderful thing about jackie robinson that even though i felt like i knew him the film burns mcmahon and i made we had to strip away a lot of the mythology and made him a complicated and dimensional person. one of the things understood is that he got up every day to make the lives of other people better. he understood that was his work and a lot of us talk the talk but he actually walked the walk and it's incredibly moving that he was willing to dedicate his full life to the sacrifices of other people. p he was so dedicated to equality which is of course the american birthright just like the pledge of allegiance and you will understand that and he was willing to work for that. his own tombstone life isn't worth anything but as measured by the effect it has on other people.as he worked every day of his life knowing he is a christian story. jackie robinson was a republican and worked very hard. he saw that as the party of lincoln and a party of opportunity. he was continually disappointedr when candidates like richard nixon or barry goldwater or other seem to betray the original birthright of the republican party which wasy, founded in slavery in theen country that was dithering about it. >> host: on line for public and the call from culver city california, good morning. >> caller: first of all ken burns you are one of the most finest filmmakers in the world but i have to tell you your documentaries, you don't seem to try to persuade or push an agenda. you put out facts and people ca. deduct what they wanted from the documentary. your documentaries are outstanding but let me tell you real quick a story. in 1972 in june of 1972 jackie robinson made an appearance at dodger stadium the only apparent ever made at dodger stadium. he came out -- what happened was it was an old-timers game and they were going to retire jackie robinson and sandy koufaxnu numbers that day. i was standing right behind the dodgers dugout and there were players on the field like mickey mantle stan musial joe dimaggio they were all there in the field before the game signing autographs and talking with people and things like that. i'm telling you when jackie robinson and the last one toio walk out on the field, he came out on the field with a guy by the name of brett junior local sportswriter in los angeles and because brad fein had to help him out. he had to hold this honor because he could hardly see. he walked out on the field andhe i'm telling you trust me when i tell you this it was like royalty walked out on that field >> guest: this is absolutely right. we cannot diminish what a powerful force jackie robinson was in american history. this is not just a good sports story. this is not just a good american story this is a story for the ages. this is an extraordinary human domick the highest levels to be able to have a competitive person who for three years could turn the other cheek and did it against all the threats and abuse he had faced as a baseball player. george will was apple poised to do it. look what happened when michael jordan were the greatest basketball players tried it. here's jackie robinson coming at any realize the power. after his first year he was more popular than dwight eisenhower or popular than eleanor roosevelt more popular than frank sonata only behind bing crosby. go figure for the most popular person and that had a lot to do with the sacrifice but of course the other part of us, the part of us that is resistance to this change that cannot be beyond the color for persons skin would make his life incredibly hard and difficult. i think what we see in jackie is our best selves. we are looking at what abrahames lincoln called the better angels of our nature. we want to be that. you remember in 1993 there was a jewish family in billings montana and somebody threw a rock through their window than they were displaying the menorah. the billings newspaper printed on a fault page menorahs in christian families put that up in their windows as a show of solidarity. that's the america i want to be in. that's the america the jackie robinson was fighting or and i think we are sort of feeling right now but maybe we are losing a little bit of touch with that america is easier to sort of gravitate toward the mob mentality than it is to do the harder and more difficult christian thing to turn the other cheek or to appeal to our better angels. i think what jackie's example is what clearly the crowd at dodger stadium felt a few months before he died, there is the embodiment of our best selves. >> host: toledo ohio honor labor democrats calvin. you are on with ken burns. >> caller: i would like to talk about where in the biggest cohort in american history and that is where they kicked all the african-americans, not all of them but for 5% african-american fans in baseball today. the media and even some of the african-american players like reggie jackson, dusty baker, hank aaron, i'm not sure about hank aaron but they knew what was going on but make kick all the african-americans out of baseball. and what happened was soon it went down to the minor league's. that's when they cut all the investigation out as they knew g they were cutting all the african-americans out from the minor league and getting rid of them and major leagues. >> guest: i don't knowly specifically with what you are referring. there was a time in the late 1800's when they were a handful of african-americans and what was the equivalent of major league ace paul that had formed in the way we know it now with bud fowler and some other folks that have played the game and a gentleman's agreement so-called gentlemen's agreement had been investigated by number of white players including the chicago white socks. it would be several decades before jackie robinson came up and african-americans were included and came to dominate the sport. african-americans have enormous opportunities and represented 75% national football league and more in the national basketball league and we notice there are fewer african-americans in baseball and while many of us including the current commission want that to change when nonetheless realized that's the variety of choices that african-americans have choosing to go to football or basketball or other sports that they excel at that on and see a conspiracy and i will certainly look at l what you said that we are set to be mindful that once jackie came to the door.e. >> host: . >> host: monday interview sea cow but jackie robinson documentary airing on pbs next month on april 11 and 12th among the interview sea cow or president obama and first lady michelle obama. here is a bit for me to be and then i want to show our viewers. >> it involves enormous stress finding yourself questions in terms of whether you should be where you are. to be able to go back and have refuge with someone who you know loves you and you know has your back, that's priceless. >> just being able to find that solace in that piece to withstand all the negative energy, it's hard to do that. so there's nothing moree important in family than a real partnership which is probably what has made him such a great man because he had the judgment to find a partner and i think that's true. i think that's a sign of his character, that he chose a woman that twisted sequel. i don't think you would have had jackie robinson without rachel. >> host: that moment in the documentary, a question from twitter is where having this conversation. do you think that jackie robinson would be happy with how president obama has handled race relations in this country? >> guest: i think so. i think the president admitted in the state of the union he is frustrated by the fact that he hasn't been able to change the division that we have in this country and impart that has to do with the race. the onion, the satirical onion when he was inaugurated said its headline when all of us were trapping the fact that we are in a post-racial society and i was cautioning saying i don't think so. they said a black man given the worst job in the world and i believe in some ways that's true. it's interesting to watch jackie and rachel try to negotiate underneath the rocky shoals of this. he goes to the door. you have another couple in a different space and time, the president first lady and you begin to realize how much they need each other and the sense of sanctuary and how much they are ordinary couples trying to deal with what we all know is marriage is complicated. they did it so magnificently and i think it's very clear without rachel there would have been no jackie and perhaps without much other would be no president. they're both sort of struggling and understanding that they love that incredibly moving and incredibly funny but also an incredibly transformed and air ordinary. anyone who has been married, there's the nervous laughter and whatever. the larger thing is that we hope that we could escape this burden of race. it has not happened and the president is not to blame. i think there has been an addition to our better selves the selves that are more interested in the mob mentality and those people have also had their soil fertilized by the presence of an african-american president. what we need to do is just stand back, relies who we are as americans and struggle really hard to appeal to those better angels of our nature. not only is it easy to tell the other how they should be but it's a lot harder to tell yourself how to be. it's a lot harder to measure who you are and say i'm falling short here. i tend to say they are them and see other americans as just that, other rather than part of a larger expanding family. our strength as in metallurgy is much stronger than the various constituent parts. there are a lot of americans who think oh no we should only do one thing or the other. in fact what it's been a strength and got mr. the most difficult of times is when we have created a much stronger and glad i'm interested in my work to nap.ho husk of her viewers viewers during this conversation wouldld encourage you to tune in at 1:00 p.m. on c-span2 will be covering your national press t club event. again at 1:00 p.m. on c-span, conversation on race in america will be appearing with henryav louis gates, professor gates as well but we have 25 minutes left with ken burns.walter, on the r walter and butler indiana line for republicans who are out. >> caller: thank you very much for taking my call. i think it's very interesting than we talk about race in this country and we talk about thein injustices on both sides of the fence white, black hispanic whatever the case may be whenbe you speak about saying an african-american that's factually incorrect. you are not an african-american, you are an american and you have ancestry from africa so i think what happens is when we try to say it with one hand and we all want to become the fabric of this country which is a beautiful thing to way was meant to be and then you turn around and you have things such as the naacp, black magazines in black newspapers, lacma's america and on and on it goes into say that x amount of college seats or -- if at that particular group in a special class that puts them ing a special little bubble. it says to the rest of us whoever does the majority that these people are going to be treated differently and i think the greatest injustice to the african-american in this country is just that.happened in everybody would happen in the past is a horrible thing. we are going to move forward and we are not going to treat youle different. >> host: ken burns this is a hugely important question and so much of the anger and i think the misunderstanding to. let's remember if you went torei say montana in 1880 went to the mind there are few would find every sign in 14 different languages including croatian. you would find 14 elementary schools including croatian elementary schools. o you look at the mayor of new york city who got us through 9/11. he would call himself a proud italian americans so every ethnic group comes and goes to assimilate but also to protect and cherish that aspect of their heritage. it's very american and very understandable. we have done it good job of doing that. the one place we haven't done a good job with that as africans have come to this country and from 1619 until the mid-60s when we could say at least the message of jim crow had and released and there was a law in the voting rights act and the civil rights act by including some of those magazines, some of those beauty pageants were created because they weren't allowed into those things. actio when we talk about affirmative action we have to be very careful to understand that you do not just say okay we no longer believe in discrimination because as the comedian chris rock says in i don't know whether you are black or white, that chris rock says i'm a multimillionaire but you wouldn't change places with me for a second meaning there are very few people who can talk about equality in the abstract but actually would not want to live as an african-american still with regard to wages, still with regard to discrimination. a 12-year-old kid is dead in cleveland. if he was white he would not be dead. trayvon martin died several years and porter would not be dead if he was a white americans of there are differences and i think what we have done in fits and starts to try to figure outn everything is an equal so affirmative action and other things however flawed they might be however they might suggest american things we don't understand in a peculiar experience african-americans have.en they have the experience of being unfree and a free land. that actually sets in motion things that italian americans who are discriminated against, irish-americans who were discriminated against, other hyphenated americans and they call themselves come he can go to parts of chicago and still find croatian american things that are happening. we have to owe it to ourselves and the special burden we have read we created this institution of slavery and be perpetuatedpe for a long time. we fought a civil war that killed 750,000. and the vestiges of that are still with us, good and bad. we still look to that laborer who abandoned what he did and wrote amazing grace.e. they are awful lot of americans who are still in favor of discrimination. i think we americans ought not to focus just on the moment and say that it's her first discrimination but say how do we make ourselves whole? >> the patient proclamation liberated not only slaves but slaveowners. who wants to be a slave on a particular in a country that is celebrating individual liberty? who wants to be a slave owner? had we free ourselves of our history in addition to -- the white man to free african-americans from their history and how do we live out this doctor king said the true meaning of our creed? that's a wonderful question and your question addresses the buckley also to understand it's very different than the experience as catholic americans were discriminated against. i made it through about prohibition out smith ran as the first catholic president. vituperative rhetoric was beyond the pale and it sounds like but good deal of -- but catholics have been fully integrated for the most part into american life. that is not true yet for african-americans. let's go let's go to missouri richer waiting on line for democrats. richard, go ahead. >> caller: yes i was listening to the program about race relations and you know i thought we have come along a long ways until he got a black president and there was no tea party until they got a black resident. a bl. that kind of upset me know and actually i'm 78 years old and m first thought about slavery was the second grade teacher read us uncle tom's kevin pit i don't know if they still regard to the kids in school are not that impressed me quite a bit. it's fortunate that a lot of black athletes had made history in this country, the williams sisters and the golfer and all have created quite an impression over what we can do in this country. .. the president says it is nice to have someone who loves you and has her back. when you're able to see someone for their accomplishments and .ot for the color of their skin people do not look at then we will be able to live out what our founding fathers proposed. thomas jefferson had made those words bake enough. all white and free of debt. about the children and the >> we don't mean that anymore. and the handicaps. we debate the unborn. all of these things the children and the elderly and handicapped. all of these things. america is always in good shape.we the notion that all men are created equal. in pursuit of happiness, we focus on what is happiness. achieving material things, lifelong learning in the marketplace of ideas. but the key is not even happiness, it's the pursuit.orrm lincol a nation in the process of becoming something else,n, something better. our better selves. so this is at the heart of it. every once in a while we get a robot. protect what is mine. being convinced that we are in a terrible, terrible place right now. did not crash too deeply. a lot of people are hurting. fairly stagnant the beginning to come up. other countries that are supposed to be running rings around us are having huge environment censorship problems. relatively stable. the net stable. the net integration of mexicans this country is negative. i'm not sure you need tour build a wall. those who do stay create y crimes and one 3rd the rate per capita of americans who are already here. addressing the facts of our circumstances and not just permitting rabble-rousers who say. get him. >> a lot of calls waiting for you. waiting in atlanta, georgia. >> good morning. >> good morning. i am so sorry. mod i watch you so much and i don't know your name right now. >> it's john. go ahead. >> good morning. my 1st point is in america we are going to always give the history of slavery wrong first of all, we do not mention the 1st slaves here to america were coming out of england. they came here, got the name of indentured servants. and so we get that right history they are going to have a problem. o second, it is not mentioned in our history, the christian love that was given in the slaves did understand god's laws andd love and came. they were given freedom. >> you make a great. time release. you were free. and of course africans were there for life until the end theylavery. they change the wedding vows permitted owners. particularly unchristianie kind of gesture. it is one of the great ironies is so many still from their culture. came and adopted christianity wholesale and represent the finest in christianity which is affirmations in the face of adversity, turning the other cheek, centuries of patients. essential aspec it can be a lesson for all of us to understand an essential aspect of christianity there again it proves my. the bigger history we have. beginning to add some of the points that you so excellently make, but it permits us to see those persons as our brothers from our sisters, people that share of faith but have a common objective. believing in the united states of america. there's aa scene where he is asked to testify. made some statements, sympathetic to the soviet union that black americans would not fight in the case of war against the soviet union.sk so he says i think that's silly. one of the 1st casualties of the american revolution, he, is an african-american who dies in support of liberty.rrived. in the civil war, they have been supporting the ideals of freedom. that is one of the extraordinary transformations.caller: >> waiting in houston texas.wa'. >> thank you for taking my call. i was born in the 40s.w amongst agora but a lot of this. people we know amongst ourselves.ame th basically the way they act. a the stupid.d i have been playinh but i play golf. my biggest problemif i was to do discriminate face-to-face.i and if i was to do that, they would call me a racist. w i think that needs to be goodsized more. and i think other people would treat them. aren't -- if >> let's remember if there are no cycles of history what is there? what has been will be again. sat there is nothing new under the sun.e seemingly random human nature remains the same.sedly all the random or seemingly random chaos of events. careful patterns and themes, you can hear them. it did not repeat. my job is to listen. yellow, gre human nature remains the same. there are people who are good, people who are bad. turn the other cheek and sacrifice themselves.shelby it is always there. -- shelby the problem, i remember i was interviewing. talking with me about race. foo. standing on a rainy streetcorner in a car comes by and splashes you, i get wet. if the car happens to be felt tell a story this car with black people came by and splashed me. i really hard time when it is the other we need to look c back and our own society tomorrow collection of folks , the racism toward one another that is as old as the old testament. quest >> i enjoy your programs.africao >> the contributions of the africans to came through. yeste. >> a hugely important question. we talk about the number of african-americans murdered by police. but we don't talk about the violence that they commit on one another all the time. but it is really, really true. the complicity is not just bad why people went they're and did it. the proves my earlier. human nature remains.we are alle we are all combination. we know we do good and bad things. the purpose of this is to learn. you have to tell the complete story. something like 15 million africans were stolen from africa and the slavery. only about 400 plus thousand came to the united states.. all arrest when in.we you suddenly go wait a 2nd one 30th of all slaves taken from africa. by the timeby the time of the civil war that a grown the 4 million people command that is now nearly 50 million americans. but we ought to be able to have a conversation in which we look at ourselves in the eye. you hear many talking about political correctness.ought to r the absence of political correctness ought to be the ability for all of us to talk freely about the truth of what actually happens. we have to be careful.they belin there are people who are laboring under false understandings. they believe in some conspiracy. certain african-americans africs have been banned from baseball. i did not happen. we. we need to be careful aboutbe what we say. to say to ourselvee the cia plot. i think we need to say to ourselves, the african slave trade, one of the most important aspects of human nature is colorblind in terms of perpetrators, and let's be honest about that. let's not say then see, we have to just understand. none of us have the experience of being a slave and particularly one of the united states of america. ho enjoy this thing that we take for granted like the year that we breathe.nathan >> two or three minutes left. democrats from old saber connecticut. >> i want to thank c-span. guest: for the valuable wisdom we are hearing this morning. >> thank you very much. a vast wasteland.1960's and our after he retired from baseball.sc grew up in the 60s. gray-haired to speak about the dangers of drug addiction because of his son's tragic experience with drugs, can you validate my memory? >> you are absolutely correct. this >> we think that the celebrities are immune. tragedy within his life as well as trying to forestall in his our life with regard to racism in crossing the color line.life doing crossing the color line. he spent his whole life doing that. but his namesake succumbed to the ravages of drug addiction he went around command you can see in our film, incredibly honest. fiercely honest not just about the other person butut about ourselves. trying to sympathize with them. change the lives of so many other people. about that. virginia had to get into drugs. i don't know about that. he was willing to submit himself in his actions to the most rigorous scrutiny. i think if we do that for ourselves each and every one of us for we have the possibility. i like to say that man is made in god's image.we need t my feeling is in order for that to be true when you do the latch on the folks like jackie robinson, abraham lincoln to.us in the direction of what it's like, not just to spout the words, to use them as a weapon or shield, not to be a force himld against doing change the trying to convince other people they can change. so i think jackie was willing to wake us up, the most difficult and painful experiences and say let us listen to the better angels of our nature. >> eleventh and 12. the conversation on race continues. thank you so much. come back again. >> north carolina congresswoman virginia foxx but the republican agenda in the 2016 campaign. us policy toward cuba including the obama administration's decision. you can join the conversation by phone or on facebook and twitter. five each morning at seven eastern. >> campaign 2016 continues on tuesday. live coverage at seven pm eastern.7:00 p.m. eastern. taking you on the road too the white house.ootball >> the national football league vice president of health and safety said there is a link between football and degenerative brain diseases. one of a number of medical experts today appearing before a roundtable discussion hosted by the house energy and commerce committee looking at research on youth in elderly patients. c tools and how awareness can help to prevent brain injuries. this is just under 2.5 hours. [inaudible conversations] >> good afternoon. i would like to welcome all of our panelists here. this is a forum and not hearing. this is a time when members are just arriving. we will have them arriving throughout this forum here and so no one is going to be swearing to tell the whole truth. representative alone, and the other members here yet? we will introduce them. let me just start off with a brief opening statement to set the tone. i would really like to thank all of you for being here for the roundtable to evaluate research and applications from public health. we are here today because a lot of people are paying attention to therisk of concussions. there's a new provocative movie getting a lot of attention. this is help bring us into the public eye with mounting evidence regarding the prevalence of concussions in sports and military and a broader population and we know that most concussions don't even occur in sports and military. but from parents, patients, athletes, service members, people are worried, to hear more and more about the dangers of the potential long-term effects, they want to know if their family members are at risk and that has not always been the case. less than two decades ago concussions were barely a blip on the radar screen, whether you detonated a breaching charge, there was a lump or they said that you saw some stars provider bell wrong, i remember you got knocked out on the field, they weave some ammonia in front of you and you got back up and finish the play. we've come a long way with the tough it out attitude of the not-too-distant past and the public is now concerned looking for answers. where do you draw the line between the getting an injury and going to the hospital? is my memory loss due to years of college football? that wasn't me, i didn't play college football. are they somehow tied to training what took place 10 years ago to it's a good thing that we are asking these questions are it unfortunately as we sit here today we do not yet have all the answers and therein lies the challenge. the public wants answers that science is not ready to provide and so we are dealing with the challenges and the fear what we don't understand, they need to get greater clarity regarding traumatic brain injury is of the utmost importance. in 2010 it accounted for 2.5 million emergency room visits. however, it's important to note that they are not just limited to the athletic deals and basketball courts. 40% of all documented cases are due to falls and 10% to assaults and those age 65 and older had the highest rate of death which brings us to this today. today we are beginning a new chapter in the national dialogue of concussions and we are not pointing fingers, we are here to take a step back and it's not a problem. we are joined today by some of the most prominent experts in this field and this is a wonderful opportunity for members to sit back and listen to these individuals as well as decades of experience. we are here to talk about the science of concussions. what we know, how do we address the gaps which have meaningful short and long-term solutions. we are also here to make something clear that this is not a sports and military issue but a public health issue. every year millions of americans not serving in the military suffer concussions and it could have been anyone anywhere. some will recover with no noticeable effects and others will have debilitating symptoms. why the difference and the disparity? that is why we are here today to ensure that we are on the right path although it may be long to provide this answer that they deserve but we begin with a brief presentation from the cdc presentation who will provide a general overview about what we know about the injuries and the prevalence and the information providing a baseline for this conversation. then we will put forward broad discussion questions that focus on the four themes. the first is prominent misconceptions are an underappreciated fact and that knowledge gaps in understanding and specific objectives that will lead to meaningful progress and minimize the risk of concussions as well as achieving those objectives including coordination within the research community. these questions are intended to guide conversation among participants to provide us as members to have a chance to listen. august the members are welcome to ask questions are joined at this discussion. it won't be formal like a hearing but just let us know if you have a question and we will keep track of it. if we have time we will have question-and-answer to cover any outstanding areas of interest. i would like to thank the ranking member for her support on this. your wish is granted. [laughter] >> i now recognize you at. >> thank you so much, mr. chairman, for this roundtable. sometimes it seems like the format is concerning, but we did a lot of these when we worked on our initiative and it was a good way to get a lot of information in one afternoon. i would also like to thank the panel of experts who have come today to talk to us about the importance of the concussions and head, understanding the facts of impacts to the head as well as how to prevent and treat injury that results from such, which is critical to the various segments of our society. from military to parents of young athletes all around the country. so given the diversity of opinions i believe that we have the opportunity for a lively discussion and i hope that this has been communicated to us at the staff level and a beginning of hearing from us on this topic. i think that targeted discussions on this matter would be useful as we start to think about what congress' role is. as we move forward, and hearing processes going to provide us with important organizational tools as well as structure. i don't think the most important thing is that people be under oath, but i do think that it helps to have testimony on the record. you know, 10 years ago not much attention was paid to concussions as you said. as we learn more and more about the potential short and long-term effects of concussive and sub concussive situations. constituents have many questions as well as concerns about their children's involvement in contact sports. young athletes may be particularly at risk of lasting brain damage due to repetitive head even when those hits do not rise to the level of concussions. the studies have shown that young athletes who do not sustain concussions but did experience repetitive hits to the head exhibited are logical and pearman over the course of a single athletic season. according to a recently released study by the mayo clinic in december last year, about one third of men who played amateur contact sports in their youth displayed evidence of the cte typology. one third. that number is surprising and is deeply concerning as it shows that you do not have to have professional football play time or hockey play time to suffer from contact sports. while we still have not established as for cte, the study suggests strongly that the diseases more prevalent than we originally thought and frankly not just with those diseases but also with girls soccer and also other diseases affecting both the girls and boys. i do understand that with any scientific endeavor there could be a disagreement and uncertainty regarding what we know or what policy actions we should take against the backdrop of knowledge. but uncertainty does not excuse inaction. i'm interested to hear from our panelists today about what actions we should take right now as well as how we need to move forward in our continuing investigation. you know that i had to say it, as the reigning champion of the denver broncos and somebody who had their season-ticket, and someone who graduated from a division hockey one school and now represents one, the university of denver, we love playing and watching contact sports and we appreciate the fitness as well as the other benefits of the activities. but at the same time the head injuries associated with some of these activities do appear to have consequences that are long-term. and even deadly. therefore if there are ways to make these activities safer not just for the kids but also for professional athletes, we need to make sure they are being implemented. so in other words we want to enjoy the thrill of being a fan or participate in the with the confidence that as much is being done is possible to inform players of the risk and to minimize that risk that is associated with the contact sports. so thank you very much for recognizing me. i know that we have a lot to discuss and many people to hear from. i am glad that we are kicking off this effort and i yield back my time. >> fred upton, you are recognized. >> thank you. i have a statement. i want to get to the business for the day and i appreciate everyone being here. i think that we have learned a lot and we have a lot more to learn. primarily this is why the format is a little bit different than normal and it is, i understand, my friend got a letter for me and i look forward to working in a continuous space and this is not the first step. i know that we are all truly very interested in this and i intend to make sure that that happens. i visited with my thomas center at bronson hospital and one of the photo we took down is what we have identified a simple concussions are not quite as simple as they seem to be in that underscores what we are facing. i yield back my time. >> thank you. ranking member? >> i would like to thank all participants joining us. concussions are a critical situation affecting many people each year and we have strong indications that the effects of repeated brain trauma can accumulate with consequences their long-term debilitating and life-threatening. these consequences can stem from injuries once considered minor known as sub concussive hits and recent studies show that exhibit evidence shows significant brain damage to hits in the head even when they do not suffer concussions. the work of a group of researchers at purdue found significant structural changes of the brains of high school football players even among those that do not have a concussion diagnosis. what is particularly troubling is that these changes persisted even 12 months later, suggesting lasting damage. many other studies have documented the sub concussive significant changes, behavioral changes and the release of biochemical markers as part of brain damage. there is also a degenerative brain disease known as cte which is a devastating disease associated with memory loss, impaired judgment and depression and eventually dementia. so i want to welcome the gentleman from boston university. she and her colleagues have defined this and examined the brain tissue of dozens of deceased nfl players as well as individuals playing football at the collegiate and even high school levels. they have discovered the presence in athletes as young as 25 and many adults that are played well since they were kids. they have confirmed that it is a unique disease with a unique signature and their work is culminated in this definition of characteristics. it's unfortunate that the work has been questioned by those who have a vested interest to maintain the status quo. i understand the unwillingness to acknowledge the linkage. it's what's called inconvenient truth. some of our greatest national pastimes, that includes lasting brain damage and that includes the mounting evidence because it is time to do something about it. there is research that still needs to be done in order to answer all the questions, they should not be an excuse for inaction. we should be examining doubling the state of this but also looking to how we can apply what we know right now to protect our service men and women and athletes and our kids. and i hope that today we are paying it forward in our discussion will not obscure the science around this issue. i'm also pleased that the chairman agreed to invite lisa today. not only the director of family relations or the foundation but advancing the science of concussions and she's also the wife of a player that had cte. we would like to hear from lisa with her experience and she will pay for to address this disease. so let me say and conclude my remarks by suggesting and that includes we need to discuss the process and how it affects everyone. you mentioned that i am sending you a letter. [laughter] asking that we jointly expand the committee explanation of prevention of concussions. i mentioned about this proposal of committee hearings that would give it the attention that it deserves, this critical public health issue. and so thank you again to all of our participants and we thank the chairman and my colleague as well for putting this together. this is only the beginning and i think that we can work together to be able to address this public health issue. i thank you again. >> i want to mentioned some of the members that are here. joe pitts of pennsylvania is also part of this. doctor michael burgess is also on the subcommittee and as well as richard hudson. it is clear that what i said before is actually part of the centuries. it is the order which i have been so do captain and director of the centers of excellence, thank you for being here, captain. >> here you are. i'm sorry i didn't see you. the director o he >> >> university school of medicine. good luck with march madness in indiana. >> jeff manley, chief nurse surgery, professor at the university of california seven cisco in. >>. [laughter] we will see how that goes. site david? from the commonwealth university from the physical medicine and rehabilitation in rehabilitation and finally director from science and engineering. [inaudible] >> director of the safe concussion outcome recovery school program. colonel, we have met before. a consultant recently retired with the dod care research program in 2008 through 2014. consulting a number of organizations including the ncaa to advance the research brain health progress improvement program. and the key, i read some of your papers recently. >> let me do this. i recognize that most of you here as scientists may know each other by papers you have read. >> is it something that you know about when we comment upon this, we are limited and have a hard stop time later on. if it's something you disagree with, part of this is part of a different science. members have comments and questions and we are going to try to keep this going and we won't be giving speeches. let me do the first tossup here. and then we want to have some baseline information. >> great, thank you very much. i want to thank the house of representatives and other members here as well with this health issue often referred to as the cochairs that have been champions for many years. as was mentioned, my job is to help to set the stage to provide an overview of traumatic brain injury including chairing the latest data on the burden to americans. the chairman noted there's a lot we don't know. [inaudible] so nobody ever wants to hear or even in admit that this is the case. [inaudible] and it ranges from a car crash to falling in a bathtub or on the stairs, provided with another player in a soccer game, assault salt or suicide attempt or the field in the military like we have seen in iraq and afghanistan. and they are frankly sustaining another caution. and they have one thing in common, it is preventable. there are many injuries related to tran-eightran-eigh t. that means that there are 500 emergency department tbi visits, 64 deaths. and this may be a significant underestimate of the burden. and that includes many presenting in urgent care or primary care settings. these are outside of the scope of our current need of ability. costs are great. many suggest the tbi untrammeled sultan $141 billion loss annually. and the leading cause of sports and recreation includes bicycling, football, basketball, playground activity and soccer. and including to this they had a better understanding of addressing the problem. and that includes actively determining the sports related concussions of youth 5-21 years old. for example our current system does not capture the concussions occur outside organized sports were those that are not seen in the emergency department and they do also not document protective equipment position played like offense or defense of lyman. and there is no record of concussion history or long-term recovery. and so the cdc is proposing a new national household survey and that includes all ages across the lifespan. and they use a symptom base situation is possible, probable or more definitive depending upon the symptoms experienced and their temporal association with this. someone that is sensitive to light could have had a possible concussion. someone who is losing consciousness for any amount of time it would be categorized as having had a concussion. this but after system has been extensively vetted to make sure it will deliver and will be able to provide state-level concussions. and we developed a survey and are ready to take this to the national scale and so the budgets are appropriated as well. and so as we look towards the future of the cdc is ready to do our part and we plan to them can better understand this and a relationship between outcomes through old-age and to improve implementation of essential and edited based strategies across this. so isn't that interesting? where is the sport to volunteer that what we're looking for and then you don't have to be a player to get a concussion. remember where this occurred where all the fans? he presented a young boy who was looking to prevent his son from getting injured. but in the course of this so throw this out as a question. what are the most common misconceptions are underappreciated fax aboutse concussions? you didn't know you'd be called on first but is there under appreciated misconceptions we need to know? and other scientists want to say something probably >> it is a pleasure to start and open a conversation. the perceptions are many unfortunately fuelled by a lack of knowledge. a and it is important to think about concussion as part of the spectrum of traumatic brain injury. it goes from the mild to the severe and it is not as though there are distinguishing costs in the progression of the stage. and the other misconception that needs to be said if you look in the brain you wouldn't see anything i don't think that's true. ended brings into the brave. so i think the biology and we will learn a lot more overtime there is a lot going on in the brain during a concussion and. thanks to the cdc and the work of multiple groups in those have been taken by those around the country and that is important. that we don't know enough to cancel parents. it is that repetitive concussion that gets the kids in trouble initially it can be bad because there is a spectrum of head injury, but the kids that i have seen and heard about to run into trouble the first concussion their bad a couple days the second couple weeks the third is a couple of months. then it is clear so getting that out is important. it is important when there is a huge allegiance as they take themselves out of contention. >> my daughter was playing baseball in high school my senior year and was hit directly in the head and suffered a concussion and basically they said we don't know where she will play again because if it happens again you will have a serious problem. she went to college as a freshman and in she fainted but doesn't play sports anymore. and we're told that don't play contact sports in a more. although she does a job but in my concern is you don't necessarily know about it. but if you had one of these how would you even know? but it seems like more and more to cause damage. but tell me about the spectrum and the sub concussion how does that relate to the specter of the you mentioned? >> but the terminology is a little bit address so it depends on how you think of the concussion. initially somebody that lost consciousness and then it went by the wayside but now it is a change that is really recognized at the time of injury. there are changes in neurologic function in so in these that one could study to see there is the changeover time sullivan said taking care of concussions 25 years dealing with brain injury and the sky is not falling. within one dares to of a concussion not contact sports being in a darkroom staying at home is not the treatment for injury. but it is in science for its efforts of concussion it is bad for our to spread that believe we need a way more research. >> talk about that. is very hard to use a survey but months after words in to help set that up to do the research and then you make fun of a diagnosis. and their risk to get another concussion the we are all less risk to fall down in a much higher risk to get courtesies' a psychological problems if you don't go back. >> said she was hit in the face and told not to go six weeks. >> that's wrong. >> deal the reason she graduated they let her do things after tonight she should have been activated quicker spanish she was told not to. >> i know that. >> but the second time -- since mikhail alaska this after an initial confession when should they return to activity? >> in in you pointed out to me you have done a lot of research in this area. and that is a myth we need to dispel. we've made tremendous progress to match certain treatments that we need much more research to understand the timing in the dressing and collectively added is a treatable injury but what we don't want to do the pendulum has swung very rapidly pop --. it is rare so i thought it is never safer to have a concussion it is renowned in talk about putting kids with chronic anxiety in the major and his advances hourly diagnose and treat. >> but it is individualized. >> you have a question you want to elaborate? >> i'd like to make a more general background commentary but confession has gone from total obscurity 10 or 20 years ago in this sport setting and a military sector dominating the national narrative. in the unfortunate position we are in is we reach that awkward stage of maturity that we made enormous strides if to be in a position to have this discussion but at the same time the topic has been elevated into a public spotlight that all the stakeholders assume we already know the answers and there is no more unenviable position they had to catch up with the public narrative. we have made great strides to change how we take care of the sidelines and during those ensuing days the treatment regimens the expression we often use is a concussion and a supportive environment used to be managed on us which several-- prior to be a symptom 31 dash symptom free the you would be returned to full contact. we have learned about clinically canal manage them on a dial. reintroduce low-grade no risk activity under a period of no exposure to a contact and allow that athlete to graduate to stages of rehabilitation to reach a point to be completely centum free than return to activity when they are safe. we have data through 1989 in the current study there is a zero% incidence in the first 10 days in the average for those same season repeats conditions to 75 days instead of five. sold many have had a direct impact how we take care about bleeds some people from lavalin trauma centers. in we know how long it takes for the individual to tell us how to be centered three but we know very little how long it takes for the brain to recover in with those critical questions with recovery atta abrade level. >> in what he is referring to is basically what we have currently acquired adolescent and young adults not is applied to girls or young her children so we're making some leaps of faith with how we apply this to have better evidence to know. and when should i allow my child to do xyz? into those that are discussed about willie -- about sports so the application of knowledge to be more cautious no doubt and it may or may not be appropriate. that we have to better understand of a different biochemical responsive forces in the same goes with younger children as well. there is the perception that we know more about this injury but at its lowest >> and will go to dr. manley neck. >> i think i personally like to bring this conversation back to your comments representative murphy that cbi affects more than athletes. it is highlighted in your brief of the pyramid of the debt the athletes and military personnel and as our colleague just point out of these 2.5 million people per year coming into rigid to rooms with concussion and more moderate and severe traumatic brain injury at least to 3 million people that never see, medical care even when the patients get to the emergency department we have studies that showth for half our best in ourah ongoing study we're asking patients were you referred for follow-up? they were actually diagnosed in the emergency department at 11 of the best drama centers in the country have less than half are referred for follow-up so there is a very low bar to follow-up with what we go. the other misconception we have treated concussion in brain injury as an event not a process even as doctors i have been taking care traumatic brain injuryc patients for years and we don't follow up like diabetes or heart disease or cancer. so now we look like a process any we are finding a single concession can alter the course so i applaud them to bring this to the forefront millions are sustaining tv i is suffering from the aftereffects and we need to do more. thank-you. >> want 2.0 with concussions the movie was called concussion but with our experience we have never seen that to be associated with duration been head in packs and/or low level head injuries so that we do see consistently to be associated with the risk to lung replay at the higher levels the greater the risk. >> mr. chairman i appreciate that i was a heart surgeon before congress. so with primary prevention and age 23312 and i play hockey research we be done in adults but i am not an expert cutting significantly into your 20s. so what do people think we should be doing in our elementary and grade schools in what is currently available information to make carrot -- parents afraid it end with that said what is the potential differences or should we do things differently? >> who wants to respond? >> i am happy to start off the conversation. i am on the medical advisor leeboard in the meeting we had several weeks ago and at what age to reintroduce the different individuals? with the vial mechanics' hand physical maturity in and to appease these in different ways in american hockey has gone through the development model has a model system for matching the person do we modified checking or tackling and blocking into wrap those researchers around those questions. isn't by reducing the amount of contact with the sports to not put them into a competitive situation and prepared is our challenge. certainly some of the work that has been done with the football program have and we can do more we still but note that answer and we start the zaph but it goes beyond that. with physical education to understand how to rebuild that may be the preventive biologic factors? fatah we think of the introduction of sports at certain ages? her always reason i love contact sports but my eight sons and did not like that but we need to know we were prepared for. for boys and girls in frankly our bodies are built differently we need to take that into account as well. we need some studies done early. >> in there has been a transition about what level kids can check the is to be fairly young trying to teach that was pretty hard sell when people are yonder whether football or soccer honestly usa hockey is out front and it is important. >> one of the cdc most successful communication campaigns is called heads up for recognition to have around for over a decade with over 6 million materials 3 million coaches nonrecognition migrated from health care professionals so now the next phase is focused on kids so we have some really creative ideas how to bridge into the older part -- population with a game like rocket blades so one of the tools and the tool chest is raising awareness and trying to do that now for over a decade. >> awareness awareness awareness. nine will be as good as yours but it is unbelievable to teach kids but without the awareness of the coaches and the parent doesn't matter. even if awareness is good chemistry developed health care professionals that understand how to reintegrate people back in their lives we would have relieved frustrated parents. that is to come to our center in their vote -- more focused on the fear in this organ they in their overall wilderness. >> in looking at the archaeological evidence. and some of guidelines. >> can we see them? >> of course, . >> it is live in the young and in the old. and those that suffered the most consequence is from the elderly in declined rapidly. and it comes down to a matter of balance parents should not be afraid of the head injury the value of sports needs to be emphasized with teamwork and exercise of personal development sports has a viable contribution taurus society. oh we need to do a better job with youth in particular that there are no standards in coaching even up of high school level even if they draw short straws. but when you coach kids to have trading in a way that would demonstrate and work needs to go one to raise the level or the knowledge of those who are responsible. event this year once they had a concussion that there is a mark that they should never participate again. the risk from a repeat concussion depend on a number of factors one is a time from the previous consent -- concussion in the characteristic of the individual senate and the next question. >> in to look at sports as a public health model and three things are very important that can address the whole culture. one is that all 48 national bodies from the american development model in all the parent organizations to look at it as a long-term rally develops process. that is currently not happening well enough but everyone is on board and concussion in is a part of that. to be a coach believe have to do is hold up a shingle to say i of a coach that is distinctly different in europe for you past several hundred hours of trading. and this is what pnc has been involved with. and we're doing specific conferences with the concept of coaching education but it has to start with what is exceptionally important. and also someone to protect our kids to empower the a flooded traders into be on-site from any type of contact an even in the state of california they're not even regulated. to say i am an athletic trainer or new york city there is a one athletic trader than people really need to be empowered. we recently passed legislation were redefined the providers as traders and team physicians. to get those signatories to empower those that led traders those three things combined can do more than anything that i know of. >> it came to our attention that 37 percent have full-time athletic traders. 63% don't. that is ridiculous. the easiest way to protect our kids with the injuries of competitive sports whether football or any of their. on the prevention and the trio decided to have kids that have catastrophic injuries seen -- a newly dead is a public health question believe has started programs and we will have an announcement tomorrow but it is a dramatic way and that is something we will continued to work on. and with the supporters around the country to get these laws passed. this came up from the young man who suffered a traumatic brain injury as a 13 year-old to play the ball then returned to saloon in had catastrophic injuries and then have survived it is our inspiration they are pretty simplistic from any sport at least a baseline for those of our participating in youth sports but the first time it has been done in a model for improving youth sports. as the football program was to educate you coaches 150,000 coaches have been trained on concussion identification but that is what i did 50,000 purchased it didn't know anything about concussion. but it isn't insurmountable. so you can make real progress. >> i still remember the press conference is set for a number of concussions and somehow it was determined he cannot tolerate one more concussion or there would be trouble i did not know what metric was used or what test was used but i assume there was of mr. corry test where you could tell that is enough. in those two had repetitive episodes of head trauma. spin again to beat successful but only in football but put the question is a medical and with each team physician we have added an affiliated doctors in terms of lowe's diagnostics per as well as further independent experts before you return to play. so the standard is never that medical staff comes to for that individual there is no concrete answers for those reasons why to know more about diagnostics. >> that was 36 years ago i would have expected the science to have advanced more than it has. because of the enormous investment the nfl has at risk. i did not see the movie but i did read the book but what you call the index base was webster from the pittsburgh steelers in a case pending for compensation for his long-term injuries and was eventually awarded compensation three years after his death. so the question is, is that process better now part of that? is she does work as an advocate for retired players a and the answer is in those toward the retired player program. in addition there are numbers in place. in has been diagnosed. but there are more than 300 players. >> we will get into these. >> as we read about this illness is devastating for the family there is a non going to continue on to go from the family is perspective. >> i am not a doctor but i hope i can press a poillon have a difficult in tragic disease that this is. i hesitate to think of what they go through the day my husband died he had no idea what was happening. to have the benefit of knowing there is a biological cause into blade himself but for the family is devastating i cannot overstate that disease with 180 your 190. for all those individuals that passed away very often very often ex wives to feel very guilty for not holding things together benefaction leave more surprised there are sound benefits from the nfl to provide but part of the problem because even for the former players that they have to be vested in for treatment in in compensation. and i can tell you they are in dire straits in those individuals who are really struggling. >> a year-and-a-half ago this committee was involved with domestic abuse in with the continuing of this disease while we focus on that is the issue with the nfl needed to focus but that there is already a component that makes itself apparent. >> unfortunately that is probably the case is the very strange thing that we may have gotten off easy that they do that the baby's cries set him off vizier raged that is a very fall a tile combination and it would be a concern. for those similar symptoms. >> with the dot those that are physically active as a psychiatrist we're not seeing people with a concussion but downstream assets a psychiatrist need to have ptsd with epee and disorder in folks just don't the the diagnostic clarification in a couple loved places with those very nexus that has policy issues and the like. many who have been diagnosed in the past have similar symptoms with short temper in now they realize. >> is very challenging to ascertain. it is tempting to use that sports medicine bottle so it is a lot more to lerner have a two year-old he hit his head about 300 times before i tell him to walk off read some church it how can i possibly assess him? it strikes me my patients can give me a history about what happened then when it happened. >> cry just want to add because we're mixing a couple of things they concussion incident how du treat that and when you go back on the field? in in the second question is repeated. but it could be a long history of repetition i am not a doctor but i am not sure we have that scientific data to support all of that. so what you are looking at in the movie was all about. to see we were looking for.