PITTSBURGH — About 35 years ago, legendary Pittsburgh Steelers head coach Chuck Noll, upon being told by team neurosurgeon Dr. Joseph Maroon that then-quarterback Bubby Brister should sit out a few weeks following a concussion, challenged that assessment with a simple question.

“‘Why shouldn’t he play? He looks good to me,'” Maroon recalls Noll saying. “‘Who decides (he should sit out for) two weeks? Or three weeks? Why not one week? Look, I want objective data if you want me to keep somebody off the field, not non-evidence based guidelines.'”

“That was Chuck Noll,” Maroon said.

And so Maroon, with the help of neuropsychologist Dr. Mark Lovell, set out to create evidence-based guidelines that would reduce the risk of brain injuries. They came up with a test (now known as the ImPACT test) to assess cognitive health and track recovery of an athlete post-concussion. But selling that idea to the NFL proved a challenge all its own.

“I said, to Coach Noll, ‘If you want me to be objective, I have to do baseline studies on all the players.’ As you can imagine, that brought the players’ agents out of the woodwork. ‘You want to do neuropsychological testing on my athlete?,'” Maroon recalled. “We overcame that. Fast-forward and the NHL in 1997 mandated it for the whole league. It took the NFL 10 additional years to get to that point, but then it was mandated as a precondition, prior to contact, and if you have a concussion, you have to get back to your ImPACT baseline score before you can play.”

Since its inception, more than 25 million athletes from all levels and all sports have been ImPACT tested. It’s used in NASCAR, Formula One, and is mandated for every high school athlete in America. There’s also a pediatric version available for youth involved in hockey, soccer and other sports.

It’s fair to say, in 2025, that the ImPACT test has changed the way we administer and coach sports — particularly contact sports. Forty years ago, when a high school or college player took a hard shot to the head, a coach likely would tell them to “shake it off” and get back in the game. That doesn’t happen often today — and Maroon, taking up Noll’s challenge, is a key reason why.

Revolutionizing sports medicine has been the keystone of Maroon’s career. And today, May 10, his life’s work is being honored with an induction into the Ellis Island Honors Society at the Ellis Island Great Hall in New York.

For Maroon, now 84, being honored in the same spot where both sets of his grandparents stood upon reaching the United States will have a very special meeting.

“It is, quite frankly, the culmination of my career. Recognition at this level for contributing to the betterment of society and its people — what else is there? I’m so honored by this recognition,” Maroon said.

Early days in the Ohio Valley

Joseph Maroon was born in Wheeling in 1940, raised in Bridgeport and is a graduate of the former St. John’s Central High School in Bellaire. He spent his formative years around strong men — “my dad was a pistol, which made me a son of a gun” — and to this day places much of his success on his Ohio Valley roots.

Maroon has spent his career innovating the field of neurosurgery. But during an interview Tuesday at his office at UPMC Presbyterian in Pittsburgh, the field he said may have had the most impact on his development is one he took as a youth when he played alongside Phil Niekro and John Havlicek on the American Legion Post 227 squad in Bridgeport, Ohio.

That team — as Maroon recalls, 13 sons of coal miners and steelworkers — went on to win the 1957 American Legion Ohio state championship. He points to that opportunity for fueling a competitive desire within him that, almost 70 years later, continues to serve as the backdrop of his life.

“Gen. (Douglas) MacArthur, when he was superintendent at West Point, had a plaque placed facing the playing fields. It reads, ‘Upon the fields of friendly strife are sown the seeds that, on other fields, on other days, will bear the fruits of victory.’ I often think of that, because it really was the athletic opportunity that I had as a kid playing American Legion baseball in Bridgeport with John and Phil, that’s why I’m sitting here. I wouldn’t be here without that opportunity. What I’m saying is that emphasizing the importance of … competitive sports at a young age, instead of allowing children to sit in their rooms, eat Fritos, drink soda and play video games all day, it pushes children to be more — and to be healthy. That’s more important now than ever.”

After graduating from St. John Central in Bellaire, Maroon headed to Indiana University, where he played football. He didn’t have a firm career track in mind at that time — “imagine, my father wanted me to be an attorney” — but discussions with pre-med students in his dorm helped clear his path.

“When I went to IU, all I wanted to do was play football,” Maroon said. “As I was signing up for classes, one of the pre-med students said to me, ‘Well, what do you want to do when you grow up? Have you ever thought of medicine?’ Well, not really, but my mother mentioned it once or twice. ‘Well, why don’t we sign you up for pre-med classes? If you don’t like it, you can always drop down to law.’ I’ll never forget that, you can always drop down to law. I ended up doing pretty well in the sciences, and then got accepted to med school at IU, and here we are.”

After medical school and his residency, Maroon’s father wanted him to return to the Ohio Valley to start his practice. He credits his mother — “she had really good values” — in helping him set a path for both personal and professional growth.

The start of a personal — and professional — mission

Despite all the advances he’s been part of in the field of neurosurgery, that was not Maroon’s initial career choice. In fact, after growing up in this region, he figured psychiatry — he was always interested in the brain — would be something of benefit to local residents.

But life put him where he was meant to be and he entered the field of neurosurgery, landing in Pittsburgh at UPMC.

He worked as a neurosurgeon for a time before his father died unexpectedly. Maroon returned to Wheeling, his life out of sorts. He was out of shape, smoking, drinking, and generally not a healthy person. He spent his days working at the family’s truck stop in Wheeling, pumping gas. Returning to an active practice and heavy caseload was the furthest thing from his mind.

But then an encounter with Don Jebbia changed everything. Jebbia invited Maroon to run with him on the track at Triadelphia Middle School. He went that first day and ran four laps — a mile. The next day he did five laps, then six. Exercise gave him purpose. It cleared his mind. He stopped smoking and drinking. He returned to his life’s work. And perhaps most importantly, exercise set him on a course, at the age of 40, toward a life of health and wellness that has seen him complete eight Ironman triathlons and dozens of additional triathlons and author several books on living a balanced life that deals with proper diet while managing stress and burnout.

That focus on health has stayed with Maroon for the past 44 years. Today, at 84, he retains an iron grip. His mind is sharp. He maintains a rigorous biking and swimming program. He stopped doing surgery about four years ago, but he remains involved in several important projects focused on the brain. He lives what he calls the “square method,” where work, family, personal fitness and spirituality are given equal footing to retain balance.

All these items are part of Joe Maroon today. But looking back at his early career shows some of the pieces that led him down a path of being on the leading edge of modern sports medicine.

Helping patients by preventing injuries

Early in his neurosurgery career, Dr. Maroon noted an interesting statistic in a paper he authored: in Western Pennsylvania, a longtime hotbed of high school football, every player had about a one in 10,000 chance of taking a hit that would lead to paralysis. What really caught his attention is that nationally, that statistic was about a one in 300,000 chance.

“When I first came to (Pittsburgh), I was on call at this hospital, and for the first five years, every football season, a quadriplegic high school kid was brought into the ER. I’m taking care of these 16-, 18-year-old boys with broken necks, paralysis. And I wanted to know why — and how to fix it,” he said.

He set out to study the issue, and came back with recommendations for improved blocking and tackling techniques; neck-strengthening exercises; new and better equipment; and more, all with the goal of improving player safety. That work led to Chuck Noll and Dan Rooney asking him to consult with the Steelers, and eventually become the team’s neurosurgeon. After that he developed the ImPACT test, changing how we view brain injuries.

But it’s been about so much more than that for Maroon. He co-founded the UPMC Sports Medicine Concussion Clinic, where seven neuropsychologists evaluate 7,000 new patients a year with concussion symptoms. He’s focused much of his efforts as well on preventing spinal cord injuries. And he also serves as medical director for WWE.

“As a surgeon, I’ve done about 18,000 operations. I’ve done this one person at a time over 50 years and for the most part, have been able to relieve pain or bring function back,” he said. “With the things I’ve been fortunate to do in sports medicine, particularly with the ImPACT test, we’ve touched millions of adults and children.

“Hippocrates said the first responsibility of a physician is to prevent disease. If that’s not possible, the next goal is to cure the disease. If cure is not possible, then we relieve pain and suffering. Doctors spend 98% of their time trying to cure diseases or relieve pain. Very little goes into prevention, very little. With our work here over the years, with our work focused on allowing the brain to recover, we’ll never know how many athletes did not get severe brain injury by being held out of a sport.”

Keeping busy today

After five-plus decades, it would be easy for Joe Maroon to call it a career. But there always will be problems to solve, there always will be cases to study, and quite frankly, he says he’s nowhere near ready for retirement at any level.

Today, Maroon is involved in a study with the University of South Wales on Parkinson’s, Alzheimer’s and ALS. He’s also involved in a fascinating study with naval SWCC or “Swick” operators — Special Warfare Combatant-Craft crewman who operate and maintain small, high-speed boats for special operations missions, particularly supporting Navy SEALs. The Chuck Noll Foundation just funded a study into the repeated brain trauma those operators can receive.

“These are the crewmen who pilot the boats that drop Navy SEALs off at hot spots. They drive 40 to 50 miles an hour over waves, right through hard water, and every second those waves are slamming into their brains and spines. … It’s equivalent to (helmet to helmet contact), but hundreds of times worse, because it’s non-stop, it’s constant, and then they go back the next day without any recovery,” Maroon said.

The goal now is to scan the brains of those operators and some former NFL players who have taken multiple hits and see if new developments can assist in their recovery.

“I’m totally consumed right now with these projects on Alzheimer’s and Parkinson’s and traumatic brain injury. It’s fascinating work,” he said.

And last year, he presented the first paper to NFL team doctors and trainers on using high-tech mouthguards. These are the same mouthguards mandated by World Rugby that allow doctors and trainers to see, in real time, the severity of impacts to the head.

The Ellis Island Society Honor

While Dr. Joseph Maroon on Saturday will primarily be honored by the Ellis Island Society for co-founding the ImPACT test, his life’s work is so much more.

Sports medicine. Wellness. Neurosurgery. Brain disease. Being at the leading edge of any one of those fields would be a career-maker for most people. Maroon has been at the forefront of all of those — for decades.

In noting the honor for Maroon and the 84 other inductees –this year’s class includes Oscar-winning actor Adrian Brody, journalist Christiane Amanpour, Pfizer Chairman and CEO Albert Bourla and Moderna Co-Founder Robert Langer, among others — Ellis Island Society Chairman Nasser J. Kazeminy noted the perseverance, accomplishment and service of those being inducted.

“These honorees, representing a wide range of disciplines, exemplify the extraordinary potential of a nation built on freedom and opportunity,” he said. “America’s rapid progress is a testament to its ability to harness the energy and ingenuity of its people. Nowhere else in history has freedom and individual dignity been more accessible and protected. When people think of the ‘Land of the Free,’ the United States stands alone.”

Just as Dr. Joseph Maroon stands alone in how he’s innovated the field of sports medicine and more over the past half-century.