LOS ANGELES -- On a postcard-perfect Southern California morning, George Visger is pissing blood. This comes as a relief. For me, mostly. But also for him. Things could be worse. He could be having a seizure. Or slipping into a coma. Which means I could be jamming a one-inch butterfly needle into a thumbnail-sized hole in the side of his skull, trying to siphon off excess spinal fluid while avoiding what Visger calls "the white stuff."

The white stuff being brain tissue.

Don't get the wrong idea. Pissing blood still hurts. It hurts because Visger's kidney stones hurt, and if he had health insurance -- or a job, for that matter -- he'd be seeing a doctor. Instead, he's brushing his teeth in a drab, popcorn-ceilinged hotel room near the airport, across town from the brain clinic. Football brought him here. Once upon a time, Visger played the sport. Offensive and defensive line. Pee Wee and prep. College and pro. He won a Super Bowl ring with the San Francisco 49ers, his nascent career cut short by a head injury. He suffered his first concussion in ninth grade, on a helmet-breaking hit that left a bloody divot in his forehead. He loved the game, lived its balls-out ethos, attacked every play the way his father taught him to attack life. Hey ace, shoot your best shot. He was 6-feet-5 inches and 275 pounds of grinning, stubborn self-belief, hell-bent on becoming a legend, hit by punishing hit.

Today, Visger is 54 years old, a little lighter, a lot more sore. He sports perpetually bloodshot eyes, a dark, furrowed brow and a surprisingly vibrant smile. He still has a forehead divot. He is an outspoken advocate for brain-damaged former players, ferociously self-sufficient men who get lost while driving in their neighborhoods, whose tempers frighten their wives and children, who largely suffer in shame and silence. Men who have sued the National Football League en masse, essentially alleging the worst kind of negligence; men who were taught to neither blame nor complain; men who occasionally take their own lives out of frustration and despair.

Men, in other words, like himself.

"I don't see my flight," Visger says. "Am I on Southwest?"

Delta, I say.

"Oh."

Visger lives in Sacramento, in a trailer behind his brother's house. He says he's struggling financially. He has trouble remembering things, such as what he was talking about five minutes ago. Reading a newspaper can take him all day. Reading the comics can be a chore. In a comprehensive neuropsychological evaluation, he scored above average on tests of verbal reasoning and the ability to recall information learned in school, but far below average on tests involving short-term memory, information processing speed and abstract thinking; a doctor described his overall intellectual functioning as "difficult to summarize by a single score." Visger has been diagnosed with chronic traumatic brain injury, frontal and temporal lobe disorders, generalized seizure disorder and cognitive impairment. He believes he also suffers from chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease similar to Alzheimer's that has been linked to absorbing repeated blows to the head. Visger has a bum knee, too, and a right arm he can barely lift over his head. His kidney stones burn like hot coals. He sometimes goes four days without sleeping.

Nevertheless, he's still fighting.

While attending Sacramento State University following his retirement from professional football, Visger underwent the sixth of his nine brain surgeries. Two days later, he recalls, he was back in chemistry class, 35 metal staples jutting from his shaved scalp. In addition to his other ailments, he suffers from hydrocephalus, a medical condition also known as "water on the brain." In healthy people, spinal fluid circulates through and drains from the brain; in Visger's case, concussion-induced scar tissue blocks that flow. The resulting intracranial pressure ultimately can result in coma and death, crushing his brain from the inside out.

The compression, Visger says, feels like a beer can being shoved into the middle of his skull.

In records provided by Visger of a 1984 workers' compensation case he brought against the 49ers, a doctor stated that while congenital factors have contributed to Visger's hydrocephalus, football-induced head trauma also played a role. A judge agreed. (Two representatives of the California Workers' Compensation Appeals Board said state records of the case had been destroyed, making it impossible to verify Visger's documents. The attorneys listed on the case could not be located.). Surgeons have installed a shunt in Visger's brain to empty excess fluid into his abdomen. But the shunt can clog. It can fail. It has failed, more than once. Hence the butterfly needle. Visger keeps the needle in a small plastic box, along with surgical tubing, an antiseptic gauze pad, a razor, a large syringe and a doctor's note:

In case of coma when hospital is not available:

1. Feel for reservoir, a lump the size of a nickel behind right ear.

2. Shave hair over reservoir.

3. Wash skin over reservoir for 5 minutes.

4. Puncture reservoir with butterfly and allow fluid to drip out for three minutes.

5. May attach syringe but try to avoid aspirating.

Visger calls this his "brain drain" kit. He stashes it in his truck. Takes it on trips. You can't buy it at a drugstore. Visger's old neurosurgeon made it for him. Because Visger demanded it. He needed something that would allow him to continue his fieldwork as a wildlife biologist, to keep leading two-week hunting trips in the Argentine backcountry. He needed to live his life. Because he was -- and still is -- a man, dammit.

Visger remembers it like this: While playing for San Francisco in 1981, he began experiencing daily headaches. Nightly projectile vomiting. He would see bright balls of light. His hearing would cut in and out with every heartbeat. Later, he says, doctors told him hydrocephalus was to blame -- the lights, for instance, were the result of pressure on his optic nerve from his swollen brain -- but at the time, he says, a team doctor misdiagnosed him with high blood pressure.

Visger needed surgery. Instead, he was given pills.

One night after a game against the Chicago Bears, Visger and teammates Terry Tautolo and Scott Stauch went out drinking. Visger's head was pounding worse than usual. He went home to the apartment the three men shared. Started puking. Couldn't hear or see. Tautolo and Stauch returned after last call, kept going in and out of Visger's bedroom.

Dude, let us take you to the hospital.

Nah. Nah. I'm OK.

Around dawn, Visger's right arm began curling up to his armpit -- focal point paralysis. Hunched over a bowl, vomiting blood, he straightened...