Former Wallaby James Roxburgh diagnosed with ‘high-level CTE’

Carolyn had no doubts about the culprit behind James’ condition in his later years. “I held rugby responsible,” he says.

“I have seven grandchildren and they all play football. Then one of them decided to play rugby when he was 14 and I cried.

“That was the last thing I wanted anyone to do. Luckily, he left after a year and didn’t come back.”

“What really worries me is when I hear that a friend’s grandson is playing rugby at a very young age.”

The CTE diagnosis also led Carolyn to re-examine James’ cognitive changes over the last decade of his life.

Despite efforts to reassure James’ friends, including former Wallaby and neurophysicist the late Paul Darveniza, that he had “always been a bit vague”, Carolyn knew in her heart something was not right.

“It gets really interesting when you go back and analyze their behavior and try to identify whether the worsening features are CTE,” says Carolyn. “So I would say at least five years [prior to the 2018 diagnosis] I was saying to Paul Darveniza, ‘Something’s wrong, I know something’s wrong’ and he’d say, ‘He’s always been like that.’ ‘He was always forgetful.’ “So it was a pretty slow process and if I had followed my own feelings I probably would have done it a lot sooner.”

The symptoms associated with high levels of CTE—cognitive difficulties and mood changes, including memory impairment or loss—were consistent with what Carolyn had seen in her husband. No one knew James better than him.

They married in the chapel at St Paul’s College in 1968 and raised three children together. Even before he got married, he was there playing rugby in a completely different era.

“Sometimes he would walk off the field and not remember the game,” Carolyn says. “And there were situations where he was in pain, lying in a bedroom that was really dark and clearly in pain.

“And after that – you know, it happened on Saturday – he would go back to training on Tuesday.”

Professor Buckland, for his part, remains “bewildered” by rugby bodies’ failure to acknowledge a causal link between sport and CTE, noting that it has not diagnosed the condition in anyone without a history of head injury – mostly through contact sports, but occasionally in tragic situations such as long-term domestic violence.

His assessment of the relationship between CTE and dementia is also relevant in James’s case.

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“What we don’t know is: Is it CTE itself that precipitates these other diseases, or is it that the repeated head impact exposure that causes CTE also disrupts some basic mechanism in the brain that causes all these other diseases to begin?

“I don’t think we know that yet. I, like others, suspect that exposure to repeated head impacts disrupts some waste-clearing mechanisms in the brain, so a lot of these abnormal proteins accumulate.”

James’s dementia in his later years was particularly wrenching as he remained physically capable. With Carolyn’s encouragement and guidance, he continued to exercise until his death.

But Carolyn says the post-mortem diagnosis of CTE brought her comfort and that James’ brain contributed to a broader understanding of brain diseases, including dementia.

“It really helped me through the whole grieving process,” she says. “Having something certain… was really helpful.

“And I want to encourage people to donate their brains. The more analysis that is done, the better the education should be on how to prevent this from happening – if there is any prevention at all.”