The scenario has become grimly familiar to football fans: A former player experiencing cognitive issues kills himself with a gunshot to his chest, rather than his head, to allow for his brain to be examined for the disease linked to repeated blows sustained on the field.
Dave Duerson, the Chicago Bears great, took his life that way in 2011, and Junior Seau, a Hall of Fame linebacker, did the same a year later. Even a teenager in Missouri, Wyatt Bramwell, killed himself that way in 2019, after recording a sober farewell to his family. He requested that his father donate his brain to researchers.
“I would like that to be done,” Mr. Bramwell said into the camera in a video shared with The New York Times by his parents. “I want you all to be happy that I’m free and that I can rest easy, because my life for the past four years has been a living hell inside of my head. I love you. And goodbye.”
The shooter in Midtown Manhattan on Monday was the latest former football player to choose this fate, though only after more carnage. The gunman, Shane Tamura, shot himself in the chest after killing four others. The police said Mr. Tamura, who played high school football in California, carried a note that referred to chronic traumatic encephalopathy, or C.T.E., the degenerative brain disease that has been linked to repeated blows to the head in contact sports.
“Study my brain please,” the note said.
Mr. Duerson, Mr. Seau and Mr. Bramwell were found to have C.T.E., which can be diagnosed only posthumously.
It will take weeks, or possibly months, to determine if the gunman had C.T.E., according to neuropathology experts.
Chris Nowinski, a former professional wrestler and Harvard football player who for years has been pushing sports leagues to acknowledge the link between the brain disease and concussions, said a C.T.E. diagnosis requires the time-consuming study of 20 different regions of the brain.
Mr. Nowinski is the co-founder of the Concussion Legacy Foundation, a nonprofit group that supports athletes and others affected by concussions and C.T.E. He recalled many cases of former football players found to have C.T.E. after experiencing a drastic change of personality leading to erratic behavior, poor decision-making and, in some cases, violence that included murder.
But he warned against prematurely blaming C.T.E. for anyone’s actions.
“Mental health issues come from a lot of different places, not just from brain injuries or C.T.E.,” Mr. Nowinski said. “But I also know the history of this issue, and it’s something that keeps me up at night.”
Regarding the gunman and his request that his brain be studied for C.T.E., Mr. Nowinski said: “It is critical that his brain is studied because this is a pattern, right?”
A positive diagnosis would not mean that C.T.E. necessarily caused the gunman to be violent, experts said. Though people with C.T.E. often have problems with thinking, memory and behavior, there are many factors involved when a person decides to commit a heinous act, said Dr. Daniel H. Daneshvar, chief of brain injury rehabilitation at Harvard Medical School.
“I would never draw a direct line between someone’s brain pathology and any specific violent act because the majority of people who have C.T.E. never committed anything like this,” Dr. Daneshvar said.
He added that “the majority of people with C.T.E. never engage in violent behavior at all,” and that just “a fraction of a percent” of people with C.T.E. displayed the type of violent behavior seen in the Park Avenue shooting on Monday.
Dr. Ann McKee, the director of the Boston University C.T.E. Center, who has studied thousands of brains of athletes and others exposed to brain trauma, said very little is known about the link between violent impulsive behavior and C.T.E., and that more studies must be done.
“There is damage to the frontal lobes, which can damage decision making and judgment,” she said. “It can also cause impulsivity and rage behaviors, so it’s possible that there’s some connection between brain injury and these behaviors.”
The risk of developing C.T.E. was long considered limited to those who toiled for years in professional football or boxing, sustaining an untold number of blows to the head. But more recently it has been diagnosed in much younger athletes in a range of contact sports, including those who never played professionally — or, in some cases, did not even play in college.
In a Boston University study released in 2023, researchers examined 152 brains of contact-sport athletes who died before turning 30 and whose families had concerns about brain disease. Of the 152 athletes studied, more than 40 percent had evidence of C.T.E. Most played at no higher than the high school or college levels. Of the 63 who died with C.T.E., 48 played football.
The disease has garnered national attention in cases involving violent crime. Aaron Hernandez and Phillip Adams, both former N.F.L. players, murdered people and died by suicide. In 2012, Jovan Belcher, the former Kansas City Chiefs linebacker, killed his girlfriend before killing himself.
Mr. Nowinski said there were similar cases that had not yet been made public. A handful of former athletes — including football players — murdered people, killed themselves and later were found to have C.T.E., he said.
It is unclear if Mr. Tamura played college football or had a contract with a professional team. But even someone who played only at the high school level and never sustained a concussion could have C.T.E., Dr. McKee said, because repeated hits to the head — including those less severe than a concussion — can cause the disease.
Mr. Tamura’s mental state in recent months is unknown. Investigators are likely trying to piece together how long he planned Monday’s attack. And the medical examiner’s assessment of his brain will reveal whether he did in fact have C.T.E.
His last wish for a brain examination was similar to the request made in a note by Mr. Duerson before he died, and the video by Mr. Bramwell, the 18-year-old.
“Hello. So what this is, this is me explaining what’s wrong with me,” Mr. Bramwell said. “Um, I’ve been depressed for a long time. My head is pretty messed up and damaged. The voices and demons in my head just started to take over everything I wanted to do.
“I took a lot of hits through football, a lot of hits through football. I took a lot of concussions. And a lot of times I never told anybody about how I was feeling in my head after a hit. You know, I just kind of kept playing, which was not smart on my end. I know that.”
In a text message to The Times on Tuesday, Mr. Bramwell’s parents, Bill and Christie Bramwell, said they were “extremely saddened by the tragic loss of life,” and that the decision to let a child play football is an individual one for each family.
“With our loss of Wyatt, our new role is to inform that football injuries involve more than just broken bones. They are the unseen injuries that later show and sometimes with a devastating loss,” they said in the text message. “Continue the conversation.”
Juliet Macur is a national reporter at The Times, based in Washington, D.C., who often writes about America through the lens of sports.
John Branch writes feature stories for The Times on a wide swath of topics, including sports, climate and politics. He is based in California.
Ken Belson is a Times reporter covering sports, power and money at the N.F.L. and other professional sports leagues.
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