They Made History at Alabama. But Football Stardom Had a Price.

TUSCALOOSA, Ala. — Near the end, his brain deteriorated after almost a lifetime around football, Ray Perkins was still captivated by the sport.

Perkins, who played and coached at Alabama and led the N.F.L.’s Giants and Tampa Bay Buccaneers, asked once for his whistle. Twice, he clutched his aged briefcase and announced that he had a meeting. Years out of coaching, he sometimes looked through his playbooks anyway.

Then, in the months before his death in 2020 at 79, the Perkins family edged toward letting scientists study his brain once he was gone. The eventual findings were bracingly familiar to experts and players and their families: chronic traumatic encephalopathy, a neurological disorder linked to blows to the head and sometimes seen in men who played elite football.

“In my heart, I knew he had it,” Lisa Perkins, Perkins’s widow, said in an interview with The New York Times, the family’s first public disclosure of the medical history of a man who played at Alabama under Coach Bear Bryant and later succeeded him.

More than a half-century after one of Alabama’s football renaissances began, the cost is edging into view. Pathologists have confirmed in recent years that at least four fixtures of Alabama’s fearsome, Bryant-led teams of the 1960s, including at least one from each of Alabama’s three national-champion squads that decade, developed C.T.E.

The 1965 team, which capped its title run with a victory over Nebraska in the Orange Bowl, had at least three men known to have died with C.T.E., and at least two others whose families would come to think they had developed the disease.

In turn, players and their families spent years grappling with the harsh, worsening consequences of athletic careers, even as they reveled in the football successes of the past and in Alabama’s more recent ones, including six national titles since 2009.

The repercussions of C.T.E., which cannot be definitively diagnosed until after a person’s death but is routinely found in football players when researchers are allowed to conduct post-mortem examinations, can be jarringly conspicuous: episodes of confusion and memory loss, spasms of anger and argument and steep declines in communication and decision-making skills.

“You just see them really turn into someone totally different,” said Heike Crane, the widow of Paul Crane, who played center and linebacker for Alabama and ultimately developed C.T.E. before his death in 2020.

About 60 years ago, though, long before C.T.E. was a recognized risk, football at a place like Alabama was a waypoint to wealth, stature and envy. Even now, amid their agony, players and their families are often reluctant to wish football away from campuses or American culture. Change the sport, some say, but keep playing it.

For many of the men who played, health threats were worthy personal sacrifices back then.

“I was from kind of a small town in Tennessee,” said Steve Sloan, an Alabama starting quarterback in the 1960s who was later the athletic director there and the football coach at Duke, Mississippi, Texas Tech and Vanderbilt.

“I wanted to get a scholarship, and I wanted to get a degree, and if it took hits in the head, then it was all right,” said Sloan, who said he had not experienced the severe symptoms of C.T.E. “I’m just lucky.”

The Decline of a Merry Life

Much like Sloan, Ray Perkins came to Tuscaloosa in search of a life beyond the rural town where he was raised. Bryant, who won six national championships before his death in 1983 and whose name is now on the 100,077-seat campus stadium, was the draw.

As a tight end and wide receiver, Perkins recorded 908 yards across three seasons of varsity football. Alabama won national championships in two of those seasons, and Perkins was a team captain for the third.

He played for the Baltimore Colts before turning to coaching and helping to build the careers of Bill Belichick, Romeo Crennel and Bill Parcells.

Between stints coaching the Giants, where he was in charge between 1979 and 1982, and the Buccaneers, he took over for Bryant. He went 32-15-1 at Alabama, where in 1986, his final season, he led the Crimson Tide as high as the No. 2 ranking.

Less than a decade ago, he was still coaching at a junior college and then as a volunteer at a high school.

Within a few years of the end of Perkins’s coaching career, though, his family began to notice problems. He became repetitive, his memory creaking. A neurologist thought it was probably just ordinary aging, and Perkins lived a merry life. There were events for his daughters and Alabama football games, dinners at Chuck’s Fish and a fabled foray to Innisfree, a pub near City Hall.

But his symptoms became far more pronounced and frequent — so much so, his family said, that he noticed them and would grow upset. He would show flashes of fury and defiance. He struggled with speaking. He apologized to a daughter, Shelby, for his failing memory.

“I went outside, and I started crying,” his other daughter, Rachael Perkins, recalled of the minutes after the exchange. “In that moment, I thought, ‘On my wedding day, he’s not going to know who I am.’”

Ray Perkins died weeks after the apology in 2020. A later examination of his brain showed Stage 3 C.T.E., which is classified using an ascending four-stage scale. Dr. Thor Stein, a Boston University neuropathologist who conducted the review, also saw evidence of Alzheimer’s disease and a type of degeneration that is thought to be linked to aging.

“He was really a pretty typical case in the sense that he had a lot of years of play, he had the characteristic findings of C.T.E. and then he had these other comorbid pathologies,” Stein said.

Doctors could not identify C.T.E. as the cause of Perkins’s death, but specialists said they believed it had contributed significantly to his diminished quality of life in his final years. His brain, after all, had once been larger.

“You could tell that he had had a much bigger brain earlier in his life,” Stein said. “He had lost tissue.”

A Roster of Cases

It is unlikely that Stein would have had a chance to study Perkins’s brain without Paul Crane, a member of the Jets team that won the Super Bowl for the 1968 season after he played at Alabama. He coached the Crimson Tide and at Mississippi before settling into an easygoing life marked by boating and fishing.

But his body’s deterioration gradually became overwhelming, too. In one instance, instead of driving to his Alabama home after an appointment, he wound up in Florida. He later required 24-hour care. As Perkins faded similarly, he noticed how his old friend’s life was drawing to a close.

“It would bother him really bad, and he’d say, ‘I hope I’m not like that. I hope I don’t get like that,’” Lisa Perkins recalled, adding that Crane’s condition had been a significant factor in her decision to donate her husband’s brain for study.

Other Alabama players have also shown signs of trouble over the years.

Joe Namath, 79, perhaps the most celebrated Alabama player from the 1960s, has spoken publicly about how he thought football damaged his brain. After Ray Abruzzese, a roommate of Namath’s at Alabama, died in 2011, researchers determined that he had C.T.E. Ken Stabler, a sensational quarterback, had C.T.E. Steve Bowman, who also went on to the N.F.L., believed before his death in 2017 that he had C.T.E. after he had trouble with balance, coordination and mobility. The family of Dennis Homan, a first-round draft pick after his years at Alabama, thinks that he has the disease, too.

His wife, Charlotte Homan, joyously recalled his years teaching Sunday school and how, back then, “there was nobody who knew the Bible like he did.”

“Today,” she said this summer, “he doesn’t know if he ate, what he ate, if he showered, if his daughter has called, if his granddaughter has called.” Every now and then, she said, he will crack wise: “‘I think I’ve been hit one too many times.’”

Not every player worries or feels that he needs to. Although former players have sometimes noticed symptoms in their long-ago teammates, the men reuniting at games, golf tournaments or funerals don’t often engage in conversations about brain damage.

“It never comes up,” said Dr. Gaylon McCollough, a surgeon in Gulf Shores, Ala., and a center on the 1964 team. “I think maybe some of them are concerned but maybe just don’t even want to talk about it.”

Some, perhaps, are like McCollough, who had two concussions during his college playing days but no conspicuous neurological troubles since.

“I’m just very fortunate is the way I look at it,” he said.

A study published in June found that a genetic variant could lead to more severe C.T.E. in people who had faced repeated hits to their heads.

‘My dad went away.’

Heike Crane studied art on Long Island and met her future husband, Paul, when he came in with other Jets players during her shift at a restaurant. The teammates ordered pitchers of beer; Paul Crane had an orange juice and began chatting up the server with no interest in football. They would eventually be married until his death.

Grieving and alone with her dog, she does not regret that he played.

“I never would have met him if he hadn’t played,” she said, adding that “a lot of things that happened to him and to us were because of football.”

Charlotte Homan, who is watching her husband decline and also has a grandson playing long snapper at Alabama, similarly does not hesitate to offer absolution for the past since experts did not directly tie C.T.E. to football until after Dennis Homan competed for the Crimson Tide.

“We don’t blame this on Alabama,” she said. “We blame it on something that no one could have known.”

And the Perkins family, which has lobbied for players to pledge their brains for research, wants to see enhanced educational efforts and shifts in how the game is taught to young people, including a greater emphasis on flag football for players under 14 years old.

“We can still have football, but now there’s all of this research and we know C.T.E. is real,” said Rachael Perkins, who recently started working for the Concussion Legacy Foundation.

“People are so scared of football dying or going away because of C.T.E. and concussions,” she said as she sat in her family’s living room, adorned with memorabilia from her father’s football career. “But my answer is that my dad went away. So if you have a son, if you have a brother, if you have a husband, are you willing just to let them go away? I don’t want football to, but I think we need to worry about the people in our lives.”

No matter the changes that may come, C.T.E.’s toll is expected to grow in the coming years as more players die of various causes and allow their brains to be studied. Dennis Homan agreed to donate his after Stabler did.

“I think he thought, ‘Well, if it happened to Kenny, it can happen to me. I’m not above it, and if he was brave enough to do this, I’m going to do it,’” Charlotte Homan said.

“It was like,” she added, “we’re still a team, we’re in this together — whatever that means and wherever that leads.”