‘His brain was shot to pieces’: The ex-Wallaby, the CTE diagnosis, and some comfort for his widow

Carolyn Roxburgh, the widow of the late Sydney University and Wallabies prop James Roxburgh, says that when her husband was first diagnosed with dementia in 2018, he made the selfless decision to donate his brain to the Australian Sports Brain Bank.

James was one of the seven anti-apartheid Wallabies who boycotted South Africa’s tour of Australia in 1971, but his contribution to society was not yet finished.

James died in August 2024, aged 77, and last month, on September 23, Carolyn and other family members joined a Zoom meeting to receive the report on James’ brain that they had been waiting for. It was delivered by Professor Michael Buckland, head of the Department of Neuropathology at Royal Prince Alfred Hospital and founder of the Australian Sports Brain Bank.

The assessment was “high-level CTE” – the brain disease caused by exposure to traumatic brain injuries that can only be diagnosed after death.

“His brain was absolutely shot to pieces,” Carolyn tells the Herald.

A moving obituary penned by Anthony Abrahams, another of the seven anti-apartheid Wallabies, and published in the Herald last year, described Roxburgh as a beautiful human being.

James and Carolyn Roxburgh on their wedding day in 1968.Credit:

In light of his CTE diagnosis, Abrahams’ obituary also includes a newspaper assessment of James’ performance against the All Blacks in 1968 that now seems painfully poignant.

“Roxburgh played a mighty game at Ballymore,” the report said. “He won the admiration of the crowd for the courage he showed in repeatedly hauling himself, battered, from the turf after continued treatment from the All Black forwards and one in particular. His mobility is a feature of his game. He gets away from rucks and mauls quickly and, as a consequence, is in more tackling than the average front-rower.”

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

“I’ve got seven grandsons, and they all played soccer. Then one, when he was 14, decided he’d play rugby – and I cried.

Carolyn Roxburgh in North Sydney on Wednesday.Credit: Steven Siewert

“That’s the very last thing I wanted any of them to do. Luckily, he stopped after a year and has not gone back.

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

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

Despite attempts at reassurance from James’ friends, including the late Paul Darveniza, the former Wallaby and neurophysician, that he “was always a bit vague”, Carolyn knew in her heart that something wasn’t right.

“It’s really interesting when you go back and analyse their behaviour and try to ascertain whether it was the CTE that was exacerbating characteristics or not,” Carolyn says. “So, I’d say at least five years [before the 2018 diagnosis] I had been saying to Paul Darveniza, ‘Something is wrong, I know something is wrong,’ and he would say, ‘He’s always been like that. He’s always been forgetful.’ So that was a fairly slow process, and probably if I’d acted on my own feelings, I would’ve done it a lot sooner.”

The symptoms associated with high-level CTE – cognitive difficulties, including memory impairment or loss, and changes in mood – aligned with what Carolyn was seeing in her husband. No one knew James better than she did.

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

“He did sometimes come off the field, and he would not remember the game,” Carolyn says. “And there were occurrences where he was in pain, lying in a bedroom that was really dark and obviously suffering.

“And then after that – you know, that happened on the Saturday – he’d be back training on the Tuesday.”

James and Carolyn Roxburgh together in 2023.Credit:

For his part, Professor Buckland remains “flabbergasted” that rugby bodies have not conceded a causal link between the sport and CTE, noting that he has never diagnosed the condition in anyone who didn’t have a history of head trauma – mostly through contact sports, but occasionally in tragic circumstances such as prolonged domestic abuse.

His assessment of the relationship between CTE and dementia is also telling in relation to James’ case.

“What we don’t know is: is it the CTE itself that accelerates these other diseases, or is it that the exposure to repeated head impacts that causes CTE also disrupts some fundamental mechanism in the brain that causes all these other diseases to kick off as well?

“I don’t think we know that yet. I suspect, as do others, that the exposure to repeated head impacts is breaking some waste-clearance mechanism in the brain, so lots of these abnormal proteins are accumulating.”

James’ 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 CTE diagnosis has offered her comfort – and the knowledge that James’ brain has contributed to the broader understanding of brain diseases, including dementia.

“It’s really helped me enormously in the whole grieving process,” she says. “To have something definitive ... it’s been really, really helpful.

“And I want to encourage people to donate their brains. The more analysis they get, you know, the better the education should be about how to prevent it – if there is any prevention.”