Dr. David Kruse doesn't mean to be downer. He understands that Super Bowl Sunday is a festive American cultural event, a day to gather with friends, eat, drink, laugh at commercials that cost as much as independent films, and watch hulking and highly specialized NFL players get medieval in pursuit of the Vince Lombardi Trophy.
He's not ashamed to say it, albeit slowly and loaded with obvious reservation: "Yes, I am a football fan. I grew up a football fan."
But Kruse, 37, of Huntington Beach, is also concerned and conflicted. As we all should be. At least a little bit.
Kruse treats ailing, hobbled and sore athletes across all sports as the concussion specialist for the Hoag Orthopedic Institute in Irvine and a primary care sports medicine specialist at the Orthopedic Specialty Institute in Orange.
"I'm seeing contact sports from a different perspective because I'm watching a lot of athletes take these impacts ... and wonder they'll suffer consequences down the road," he said.
"Watching the Super Bowl, I am torn."
When you're a medical expert suspecting these NFL combatants might be causing themselves irreparable harm, it's hard to cheer on the physical spectacle of a goal-line stand, the pads-cracking contact of violent highlight-reel hit or the repetitive background noise of linemen ferociously colliding on every down.
Enjoying the Super Bowl demands a great amount of disconnect for Kruse or anyone who has been following the litigious crusade of a growing group of former NFL players who now say the repetitive head trauma, including concussions, that they sustained during their football careers has been ruining their NFL afterlife.
They're suing the NFL, saying their brain damaged, tortured by painful, chronic and sometime debilitating headaches and wrestling with memory loss, attention deficits, irritability, mood swings, depression and suicidal thoughts.
And those are complaints from the retired players who can, at least, desperately hang on to some cognitive skills. Some former players have disappeared into dementia or Alzheimer's. Some, sadly, called their own Hail Mary, prematurely.
Former Chargers linebacker Junior Seau, former Atlanta safety Ray Easterling and former Chicago defensive back Dave Duerson each died from self-inflicted gunshot wounds within the past two years.
Duerson, 50, who shot himself in the chest on Feb. 17, 2011 in his South Florida condominium, left a chilling message for whomever found him, his family and maybe the NFL and all of us: "Please, see that my brain is given to the NFL's brain bank."
Neuropathological exams of brain tissue from Seau, Easterling and Duerson revealed the tangled, clumped presence of tau proteins associated with the degenerative condition known as chronic traumatic encephalopathy (CTE).
Of the 34 brains of former NFL players examined posthumously by Boston University's Center for the Study of Traumatic Encephalopathy, 33 showed abnormalities consistent with CTE. The disease, experts suggest, might have resulted from head trauma inflicted while playing tackle football.
The science at this stage is imperfect and incomplete because the research subjects are deceased former players who've exhibited symptoms of brain dysfunction without regard to pre-existing conditions, family history or mental health problems triggered by their post-career transition.
Still the findings are compelling.
"The ex-NFL athlete brain autopsy studies show a lot of strong evidence for organic changes within the brain that are consistent with CTE but they are retrospective studies and it's really hard to make a 1-to-1 relationship (establishing the causality between playing NFL football and long-term brain disease)," Kruse said.
"But these studies bring awareness to the fact that there is a higher level and higher prevalence of CTE in the ex-NFL athlete population and that brings into the question the link."
Gary Small, the leader researcher in a recently released UCLA pilot study of tau proteins in five former NFL players, believes the ability to identify tau in living players could help further establish the cause-and-effect relationship between football-related impact and brain disease.
"When I heard what President Obama said about not wanting his son to play football, I thought of how I was out at my son's soccer game," Small said. "I was cheering him on, wanting him to get in the game but, at the same time, I didn't want him to get in the game."
Small and Kruse believe football guidelines can be changed to improve player safety by minimizing contact drills during practice, increasing penalties for illegal hits to the head and raising awareness about acute and long-term head injuries.
Dr. Alan Beyer, the executive medical director of the Hoag Orthopedic Institute who has been a sideline presence at Orange County high school football games for more than 30 years, said that awareness and treatment of head injuries have improved significantly in the past two years because of the increased public scrutiny.
Beyer, like many coaches, team doctors and athletic trainers in all of sports, have been extremely cautious if they suspect a head injury, sitting athletes immediately and refusing to activate them until they've passed a neurological exam.
"Still, if I had a son, I would encourage him not to play football," Beyer said. "It's a physics problem now, with bigger, stronger, faster players making for a more dangerous, high-impact game."
Knowing more, as the doctors treating the injuries, the scientists searching for answers and the families of some former players do, kind of kills the Super Bowl party mood.