English Recordings

McKee is a world expert on chronic traumatic encephalopathy, or CTE, a progressive degenerative disease similar to Alzheimer's in its symptoms – memory loss, irritability, mood changes – but with its own distinct pathology. The disease has long been recognised: it was first described in 1928 and for many years was thought to be confined to boxers, hence the name "punch drunk" syndrome or "dementia pugilistica". But in the past three years, largely as a result of the work of McKee's brain bank, it has come to be seen as a danger to anyone who suffers repetitive concussions.
McKee begins her examination of the unidentified football star's brain by turning it in her surgically gloved hands with the tender concentration of a fruit-lover inspecting a pineapple. "It's too small for an adult male's brain," she says. "There's shrinkage pretty much throughout the brain."
Using a long knife, she cuts the organ sideways – from ear to ear, as it were – so that the front half is separated from the back. The sliced surface glistens under the morgue's neon lighting.
The dissection reveals three huge holes in the brain – one large triangle right in the centre of the brain, and two ovals parallel to each other at the base. It is apparent that McKee, who has studied more athletes' brains than probably any other person, is shocked by what she sees.
"This is an extreme case," she says, "but it is also very characteristic." She points to the triangular hole, consisting of the lateral ventricles, and says it clearly shows "tremendous disruption". There should be a membrane separating the two ventricles, but it has been so battered by the footballer's repeated blows to the head that only the thinnest of filaments is left. The two oval holes are the ventricles of the temporal lobe and they too are extremely enlarged to compensate for tissue lost from the lobes themselves, another classic sign of having your head bashed repeatedly. "The temporal lobes are crucial to memory and learning and you can see they are very, very small, as miniaturised as possible."
McKee takes a deep look at the cross-section of this brain and momentarily appears sad. "This is a brain at the end-stage of disease," she says. "I would assume that with this amount of damage the person was very cognitively impaired. I would assume they were demented, had substantial problems with their speech and gait, that this person was Parkinsonian, was slow to speak and walk, if he could walk at all."

The Center for the Study of Traumatic Encephalopathy – a research facility so clunkily named that it's unsurprising Duerson used a semi-accurate abbreviation, "the NFL's brain bank" – sits in the pleasantly green and airy grounds of the Bedford VA medical centre in Massachusetts, about an hour's drive outside Boston. It was set up three years ago by concerned former athletes who joined forces with Boston University scientists to grapple with the long-term effects of concussions on sportsmen and women, soldiers and other people subjected to brain injuries.
Security is tight as you enter the building through heavily bolted metal doors. We pass rooms lined with shelves of jars carrying human brains pickled in formaldehyde. At the end of a corridor, we arrive at a small room into which several stainless steel refrigerators have been packed, one of which is marked: "Feet first. Head by door."
In this morgue the world's largest bank of athletes' brains is being stored on dry ice. It has grown exponentially in the past couple of years to include 75 brains, mostly of American football players but also of hockey enforcers – the tough guys who do the bare-knuckle fighting – and of former soldiers caught in bomb blasts. A further 400 living athletes have promised to donate their brains upon death, including some of the biggest names in their sports. They include "Irish" Micky Ward, the boxer played by Mark Wahlberg in the film The Fighter, and American footballers Matt Birk (Baltimore Ravens), Lofa Tatupu (Seattle Seahawks) and Sean Morey (Arizona Cardinals).
Neuropathologist Dr Ann McKee, a leading expert on degenerative diseases caused by repetitive blows to the head, looks at the brain of an American football player who recently died Dr Ann McKee, a neuropathologist who jointly heads the lab, retrieves a brain from a plastic container and places it carefully on a workbench. At the request of the family, she will not tell me who the brain belonged to, other than to say "he was a very skilled NFL player, very well known".
If you were a fan of American football, I ask her, would you know the name?
"Right," she replies.

The NFL star and the brain injuries that destroyed him
Before the former American football player Dave Duerson killed himself, he asked that his brain be left to researchers studying head injuries among athletes. What it revealed shocked the scientists
Dave Duerson had so much going for him. A former professional American football player, he still carried himself with the bearing of a star. In Chicago, he was feted as a member of the legendary 1985 Bears that won the Super Bowl, thrashing the New England Patriots 46-10. In New York, too, he was fondly remembered as a member of the Giants team that took the Super Bowl championship five years later, squeaking to victory over the Buffalo Bills by just one point.
He had friends throughout the sport, acquired over an 11-year career with the National Football League (NFL) and many years subsequently helping younger and less fortunate players find their way. He had a loving family with three sons and a daughter and a former wife, Alicia, who kept in regular touch, as well as a girlfriend to whom he had recently become engaged. He lived in a condominium that he owned on Sunny Isles Beach in Florida, a barrier island close to Miami dubbed the Venice of America. He was smart, charming, as kind and gentle off the field as he had been aggressive and ruthless on it.
But he knew that he had a problem. There were the outward signs of difficulties – the collapse of his business, the breakup of his marriage, the debts. But there were also the internal changes. The lapses in memory, the mood swings, the piercing headaches on the left side of his head, the difficulty spelling simple words, the blurred eyesight. And hanging over it all was his fear that both his material and physical decline might not be coincidental, that they might have been caused by injuries to his brain suffered playing the game he loved so much – football.
On 17 February 2011, aged 50, Duerson killed himself inside his Florida apartment. He did so in a manner that was in keeping with his unimpaired earlier self – meticulously, neatly, and with a thought to others. He had placed his NFL Man of the Year trophy, awarded in 1987, on a table beside the spot at which he fell, along with several notes setting out his financial and other arrangements. One of the notes carried a request that he repeated in a text message earlier that day to his ex-wife, Alicia. "Please, see that my brain is given to the NFL's brain bank," he said.
The request might have been deemed a quirk had it not tallied with the unusual method of Duerson's suicide. He shot himself in the heart.

“Frankly, they called me when they knew I would meet a journalist and translator and they did their best to get your descriptions and the date you would come,” she went on to say. “They asked me about the date many times. They know the way to the hospital. They would be waiting for you and would kill you. They said to me, ‘If you will do that for us, we will help you escape from the hospital, even from prison.’ They asked for other details: ‘What were your names; what did you look like?’ ”
She seemed excited now at the thought of our capture. “They do not want to kill you, but to torture you and make lunch of your flesh. I could not do anything to help you.”
She described seeing — she didn’t say how — an American soldier the group had kidnapped. “They took out his eyes and burned his body,” she said. “God keep you safe.”
As she described the case, I realized it was one I knew. I covered the trial of three of the men involved in the murder. I asked her what year she saw this; she got it right, 2006. I felt nauseated. Members of what would become the Islamic State of Iraq kidnapped three young soldiers guarding a bridge. One was killed immediately, but the other two were slowly tortured to death. One had his eyes gouged out and his body was tied to the back of a truck and dragged along the roads.
“They showed it to the women because women have a soft heart so they must see it so that they get used to it,” she said.
I looked at my watch; I worried we had stayed too long. I got up hurriedly, knocking my notebooks to the floor. I adjusted my veil, thanked her for her time, for teaching me about jihad and for making me understand how dangerous her world was.
Baida was smiling again. “If I had not seen you before and talked to you, I would kill you with my own hands,” she said pleasantly. “Do not be deceived by my peaceful face. I have a heart of stone.”
A few days later Baida was transferred back to the provincial jail in Baquba after doctors at Rashad hospital determined that she had no psychological disorder. (Baida said the doctors told her early on: “You have a brain like a computer. You shouldn’t be here.”) At this writing she is still in jail. For now, she tells whoever asks that she’s prepared to go out and kill the enemy; but if she were to start saying that she no longer would do that, I imagine she would be released quite quickly. And I have no reason to doubt that she would then carry out her dream of blowing herself up.

Baida looked tired and much less ebullient than when I saw her in jail. I could tell she found it difficult to live with people who were so strange. I had brought her a bag of fresh mandarin oranges. She accepted them with a weak smile and only asked: “When will you come back? Tomorrow?” I worried she needed the company of more normal people.
When we returned to the Times bureau, one of our other interpreters took me aside. A military interpreter before he switched to journalism, he was streetwise; a Shiite who lived in a Sunni neighborhood; a survivor. He told me Baida called the bureau many times in the last three weeks wanting to know when I would visit the hospital — a bad sign, he said. Our security adviser agreed. There are no sureties when dealing with insurgents, but one rule is not to tell them exactly when you will be in a particular place. If they know, they can plan an ambush or a kidnapping or detonate an I.E.D. under your car. “Don’t go to see her again,” the interpreter said.
For the next meeting with Baida, our security adviser set a time limit, estimating that as soon as we arrived at the hospital, she might hear we were there and make a phone call to her jihadist friends. Baida called us twice to see “exactly when you are coming.” We lied, keeping it vague. Setting an ambush would be tricky at the hospital but manageable just outside the gate.
When we did finally go, we met with Baida alone, sitting together on a bed in the nurse’s office because there were no chairs. I asked her gently, and as nonjudgmentally as I could, whether she wanted to kill me because I was a foreigner.
“Frankly, yes.” Then she added, to soften it, “Not specifically you, because I know you.”
Would she tell her extremist cousins or her friends about me? Would she give them my description and tell them enough that they could find me?
“I won’t sacrifice my friendship,” she said. A moment later she reversed herself. “But, if they insisted, yes, I would, yes. As a foreigner it is halal to kill you.”
She continued: “If they kill Americans they will do a big huge banquet for dinner.”
She smiled beatifically. As Major Hosham had said, “She is honest.”

“There was a moment, only a moment, when Ranya felt afraid of death,” Major Hosham said. Ranya told me she just wanted to see her mother. You can imagine that moment: realizing that your life might be about to end and you aren’t ready.
When Um Fatima saw that she had lost Ranya, she fled the market, throwing away the remote detonator she was planning to use if Ranya failed to explode herself, the police said. The police later found the detonator. Meanwhile Ranya, wearing her suicide vest, unsure where she was going, wandered Baquba’s back alleys. As she approached a checkpoint manned by members of the Awakening, the American-backed neighborhood watch formed to fight Al Qaeda in Mesopotamia, they ordered her to stop, according to Lt. Kadhim Ahmed al-Tamimi, a detective involved in the case. The Awakening guards thought it suspicious that she was alone and wearing a big abaya. “When they were in doubt about whether she was a suicide bomber they asked a woman on the street to search her, the woman opened the abaya, and when she saw all the wires, she cried out and ran away,” Lieutenant Kadhim said. A few hours later Ranya was in jail along with her mother. Ranya was convicted on Aug. 3 under Iraq’s terrorism law and sentenced to seven and a half years in prison.
ONE DAY IN March, an interpreter told me that Baida had called several times from the psychiatric hospital and wanted to see us again. I felt we had gained her confidence. Maybe she would open up more. We called and told her we would come the next morning.
The Rashad Psychiatric Hospital lies at the very end of the sprawling Shiite slum of Sadr City. On that particular day there was a dust storm, and it was hard to see more than a short distance. The sky was a brownish¬tan color, and we could taste the grit. The hospital, spread over extensive grounds, had been neglected for years: the grass was shoulder high in places, the plantings were scruffy and the wards were almost bare of furnishings. (Much of it had been looted immediately after the American invasion.) Some patients wandered about, talking to themselves. Some wore soiled clothes and looked as if they had not washed in months. As we approached Baida’s ward, a woman, stark naked, came running out screaming; she was pursued by members of the hospital staff as well as by other patients and eventually was covered in a large blanket and brought back inside.
We met Baida in the office of the head nurse for the criminally insane. Baida told us she felt great affection for the head nurse, who was a dwarf, perfectly groomed in a white veil, her face meticulously made up. She would let Baida do anything, including keep her telephone in the hospital, Baida told us.

Until 2007, it was too dangerous for the Iraqi Army and the Iraqi police to enter the area. When they finally did, they found a strange community. “When we entered Makhisa we didn’t find a TV because it’s forbidden,” Col. Khalid Mohammed al-Ameri, who was in the army under Saddam Hussein and has served all over the country, told me. “And no ice, no cigarettes and no tomatoes and cucumbers mixed together at the same shop.”
The strictest Sunni extremists believe that people should not have anything that did not exist in the early days of Islam. Since there was no electricity in the seventh century, there could be neither refrigeration nor ice and no television. The aversion to mixing tomatoes and cucumbers is because cucumbers are viewed as a male vegetable and tomatoes are female, and mixing them in a box is seen as lascivious, Colonel Khalid said, shaking his head.
Ranya, like Baida, was from an insurgent family. There was her aunt Wijdan, who police say was a recruiter of women; her father, who the police believed was involved in making bombs for the insurgency; and a brother who was abducted and may also have been involved. A year after Ranya’s father was kidnapped and killed by a Shiite militia, her mother acquiesced to Ranya’s marriage in 2007 to a minor figure in the Islamic State of Iraq.
Less than a year after she was married, Ranya’s husband brought her to a house in Baquba where two women he described as cousins outfitted her with a suicide vest: “They gave me something to eat and something to drink; it had a nice smell,” she recalled. “Then they put the explosive belt on me, those two girls did. I remember there were red wires, but I didn’t know what was inside it. They put it over my head.” Baida later told me that, from her own conversations in jail with Ranya, it was clear that she knew exactly what she was doing and was proud of it.
After Ranya was outfitted with the vest, she told me, a woman in the house, named Um Fatima, took her shopping. They went to one of Baquba’s bazaars and, as Um Fatima looked at pots and pans, Ranya drifted off.

“As soon as I get out I will explode myself against the invaders,” she told me.
A few moments before we left, I asked when it would be convenient to come see her again. She said she was being moved soon to a psychiatric hospital in Baghdad, and she was afraid. I promised her we would visit her there and asked how we could get in touch. It turned out that she had smuggled a cellphone into the jail — or perhaps appealed to some guard not to take it from her. She never left the sim card in the phone; it was hidden in her underwear, she said. One time, the phone itself was discovered — she had hidden it in a ceiling-light fixture — and confiscated, but she still had the sim card and had somehow got access to another phone.
“They don’t know,” she said softly, nodding at the policemen in the room, who were staring at a music video. I felt a wave of unease. She was not a beginner.
THE ROAD TO the Abu Sayda district in Diyala should cross a giant highway bridge, but it was bombed more than a year ago and has yet to be repaired. Cars snake single file into a deep gully, travel parallel to a line of towering girders and eventually crawl up the other side of the ravine. The district lies near a bend in the Diyala River, and many of the farms and villages are cut off on three sides by water, making it a haven for insurgents.
One of the district’s villages is Makhisa, which was home to at least three women who became suicide bombers. A settlement on the edge of Makhisa was for many years the home of Baida’s cellmate, Ranya Ibrahim. It had the dubious distinction of being the town favored by the notorious Al Qaeda in Mesopotamia leader Abu Musab al-Zarqawi. Police told me that he married a woman from Makhisa and sometimes stayed in the village until he was killed on June 7, 2006.
The town, set among thick date-palm and pomegranate orchards, consists of little more than a few streets lined with low slung, mostly rickety houses, many with simple palm-thatch porches. On the outskirts, one in every four vehicles is a wooden horse-drawn wagon. The animals pull canisters filled with gas used for cooking, transport wood and serve as an informal bus service for local women and children. The most recent suicide bombing near here occurred this spring. It killed at least 47 people, many of them Iranian Shiite pilgrims.

A few weeks later, when I met Baida again, she tried to explain to me the line dividing when it is halal (permitted) to kill a person and when it is forbidden. She said she followed the rules of her group, but her cousins had different rules: they would kill anybody. Was there a difference, I wondered, between killing American soldiers and killing American civilians, like reconstruction workers? No, she said: “I am willing to explode them, even civilians, because they are invaders and blasphemers and Jewish. I will explode them first because they are Jewish and because they feel free to take our lands.”
My interpreter asked where she stood: Was it halal to kill her?
“We consider you a spy, working with them,” Baida said.
Baida did not believe it was halal, however, to kill members of the Iraqi security forces if they were working on their own, only if they were in a convoy with the Americans.
She spoke with enthusiasm, her face animated, vividly alive. Unlike her prison companion Ranya — who claimed, implausibly, that she did not know that she was wearing a suicide belt — Baida was proud of her mission and determined to complete it.
Her choice of suicide was not entirely hers to make. The suicide vests the cell gave to participants were outfitted with remote detonators so that someone else could explode the would-be bomber if she somehow failed to do it herself. This was a relatively new aspect of suicide bombing in Iraq. A second person, with a second detonator, would go on the mission to ensure against changes of heart. “One day this woman, Shaima, said, ‘I am ready.’ I saw Shaima when they put the vest on her. It was very heavy. With Shaima, they exploded her, she did not explode herself. There were five or six killed.”
By the time I met Baida she was eager to get on with her mission, waiting for the day when she would be released from jail and able to pick up her vest, which she said was being kept for her. (She has yet to be charged with any crime.) She appeared to have let go of most earthly ties. A mother of two boys and a girl, all under 8, she had not seen them since her arrest last year. When I asked if they missed her, she said, almost airily, “Allah will take care of them.” She spoke as if much of her life was already in the past. When she mentioned her husband, whom she actively hated, she used the past tense. She was living for that moment that some might see as an ending but for her would be a moment of transformation.

Baida told me she felt much more helpless after her father died. Until then, when she was unhappy with her husband, she would go to visit her family, although they had moved by then to Husayba, the Syrian border town. Sometimes she was so upset at home that she would call one of her brothers or cousins to come to Baquba and drive her to her father’s. “You see, when my father was alive, he loved us a lot,” she said wistfully. “So when I quarreled with my husband, I felt safe because I had my father.”
After her brothers and father were killed, she began to work with some of her cousins; they were also fighters and even more radical Islamists than her brothers. One of them died in a suicide attack, but not before introducing her to a group, run from Syria, that was connected to the Islamic State of Iraq. A goal of the group was to prepare men and women for suicide missions. “Maybe I can introduce you to them,” she said warmly. “You could go meet them since they are free.”
BAIDA, HAVING JOINED the group, initially did not plan to become a suicide bomber. She was drawn to it gradually as she became more deeply involved with the cell. Her cell members announced their readiness for a suicide mission in front of others in the group, making a public commitment, signaling they had crossed an invisible border and embraced the idea of a certain kind of death that would also bring membership in a holy community.
The group dynamic seemed designed to make participants feel as if they were freely choosing their destiny. That sense of freedom was an important component of their metamorphosis into suicide bombers. It was certainly important to Baida, who felt she controlled little in her life, to feel in control of her death. Her goal was to take revenge on her brothers’ killers — American soldiers. When I brought up the reality that the vast majority of suicide bombings in Iraq kill ordinary Iraqis, she would only say that she thought killing Iraqis was haram, or forbidden.
“We had meetings of 11 people; some people came to the meeting with their faces covered,” Baida told me. “There were three women in the group. Sometimes we were having discussions of Koran, sometimes we were meeting to see who is ready to do jihad. You could choose whether you wanted to do it. They wanted me to wear the explosive belt against the police, but I refused. I said, ‘I will not do it against Iraqis.’ I said: ‘If I do it against the police I will go to hell because the police are Muslims. But if I do it against the Americans then I will go to heaven.’ ”