Before Brendan Cowell could write Plum’s story, he had to hear the stories.

Plum, an ABC limited series based on Cowell’s 2018 novel of the same name, and its title character – a retired rugby league legend and Cronulla demi-god named Peter “The Plum” – draws from many sources, not least of which is Cowell himself.

He wrote the novel during a difficult time in his own life, during the COVID lockdown which kept him cooped up in his London basement flat.

Cowell was fresh out of a relationship, filming on the latest Avatar movie had been postponed and he was trying hard to stay off the drink because “it was an arm wrestle I bowed out of”.

So he started to spin a yarn that was originally a comedy about a rugby league player who moonlighted as a poet before it evolved into much more.

“I wanted it to be about a bloke who was trying to change because I was trying to change,” Cowell said.

“I thought about how poetry saved me when I was 13 or 14 – my parents were getting divorced, I had some bad experiences at school, impostor syndrome, being bullied, feeling like the weird drama kid and having dark thoughts cross my mind.

“I wrote poems and they rescued me and it started my relationship with writing.

“I thought ‘who is the last guy who would do this’ and that’s when the idea of a plum came, the stone inside the beautiful flesh. Peter Lum, Peter “The Plum” Lum.

“And then it just began, as soon as I had his name I could see his rough head and his big heart and his son and his ex-wife and I thought ‘I know this man’, and it all started coming out of me.”

Plum, which stars Cowell and Asher Keddie and premiers on ABC TV on Sunday, October 20, is a story about a man reckoning with the life he’s lived, about fathers and sons and family, about rugby league and getting older and the power of the written word, about Charles Bukowski and Sylvia Plath and self-expression and how it can be easy to change for other people but much harder to change for ourselves.

It’s also about concussions and the impact they can have as a former athlete grows older, which is where the other stories come in.

Cowell spoke to numerous former rugby league players about the impact of head knocks in order to portray Plum’s struggles as accurately as possible.

The result is confronting, but realistic. CTE, or chronic traumatic encephalopathy, cannot be diagnosed until after death but signs of cognitive decline or degenerative brain issues can be seen long before that. 

“Guys talk about how it can come on when you’re driving your car with your kid in the back and how scary it can be when you can’t feel the brake,” said Cowell.

“There’s the sudden, spontaneous and really bizarre ways that CTE  can be waves of joy. Indescribable waves of joy or rage or deja vu.

“The seizures can even feel beautiful – one former player talked about how he kind of enjoys them now, he’ll ask his mates for a second and he’ll go lie on the grass and feel like he’s levitating.

“It’s very bizarre, the brain, and it can play tricks on you when it’s damaged. A lot of players might be happier if they don’t know if they have it, I’ve heard a lot of them talk about that.”

Plum’s experience rings true for former stars

What Plum experiences is something that rings true to many former athletes. It certainly did for James Graham, who has spoken at length about his evolving views on head knocks in recent years.

Graham was a consultant for the show and also makes a cameo alongside rugby league figures like Paul Gallen, Andrew Johns and Mark Carroll. His acting debut comes as the kind of rugby league figure who was once commonplace – a coach who demands a concussed Plum be allowed to return to the field.

The scene is set in the early 2000s, just a few years before Graham began his journey from Liverpool, England, to rugby league stardom on both sides of the globe.

“The game gave me a magnificent life, it really did. I know the value it can bring to an individual, their family, their community and society in general. But it can come at a cost,” Graham said.

“When Brendan approached me to appear in a series that highlights some of the issues a lot of people who have family members who are ex-contact sport athletes are facing, I wanted to be involved.

“I was very nervous, but I thought ‘what’s the worst that can happen’, and I wanted to take it on as a challenge, something new.”

Through his 17-year rugby league career, Graham played in over 450 matches for St Helens, Canterbury, St George Illawarra, England and Great Britain and he established a reputation as one of the modern game’s fiercest and most passionate competitors.

The way Graham used to speak about concussion was honest to the point it made some uncomfortable — he’s said in the past that there were times in his life he thought he’d been looking for something to die for and he found it in rugby league, so the long-term effects of head knocks didn’t worry him.

Graham isn’t that person anymore, but he stands astride two distinct eras of the sport – when he debuted back in 2003, players could be knocked cold and return to the field within minutes.

By the time he hung up the boots in 2020, attitudes had changed. Graham, who once said he would sign a waiver to be allowed to play on following a concussion, found the evolution difficult but worthwhile. 

“As a player, especially at the beginning, I was very anti-interference because it was all I’d ever known. But small movements in the right direction can bring about a culture change,” he said.

“Culture is everyday environment and the everyday environment used to be proving how tough you are through reckless action, continuing on no matter what.

“The game has already come a long way – look at the finals recently, there were several players who suffered concussions on kick-offs and there’s been a conversation on maybe changing the game in that regard.

“Go back two decades and those players who were knocked out cold would likely come back on, so the dial is starting to move and what we once accepted is now no longer acceptable.

“I wrestle today with what I should have done, how I would have felt about a medical suspension. But if that’s the norm, if that’s all I’ve ever known, it would be much easier to accept.

“I did see the attitudes change and I wonder if I should have taken more responsibility. I wanted to go all in, it meant more to me than my long-term health and I have to live with that.”

The sort of changes Graham is talking about have slowly become more normalised in recent years for rugby league. 

At the elite level, HIA’s (head injury assessment) and the 11-day mandatory stand-down following a concussion have become an accepted part of the sport, and players like former Australian captain Boyd Cordner have retired before their time due to the impact of repeated concussions. 

The baseline understanding of concussions and their long-term effects has improved but there’s still a way to go. Graham believes individuals taking responsibility for their own health is the key, which means honesty becomes paramount. 

“The most important thing for all stakeholders is honesty,” Graham said.

“Recently, in the finals series of 2023, Joseph Suaalii didn’t come back on for the second half and there had been no HIA or independent doctor intervention.

“He said to the club doctor ‘I think I’ve had a head knock’, and they did a test and he sat out that game. That was him taking responsibility for his future well-being.

“We have concussion spotters but the game moves at such a high speed it can be an impossible task.

“Fundamentally, it comes down to the person because of the complex nature of the injury.”

But the management of concussions goes far beyond the NRL and spreads further than just rugby league.

Plum tells the story through that context — Cowell refers to the game as the language of the story, rather than the point of it — but Adrian Cohen, founding CEO of Headspace, also acted as a consultant on the show and is hopeful its message can form part of a wider evolution of the understanding around head knocks.

“This is a very real portrayal that many people will be able to relate to. They will know people like Plum. They will have seen deterioration in their friends, their loved ones, their partners, their families,” Dr Cohen said.

“Whether it’s memory loss or a change in behaviour, they’ll notice these things and realise this is exactly what’s happening to their loved ones.

“The book and the show are very true to the conditions, Brendan put in so much time to get the facts right. It’s very true to life, it’s very accurate, so it’s must-see CTE TV.

“I think this will make people look, listen and act. I hope the sporting codes don’t try and shut it down and say it isn’t us. It’s not just rugby league or rugby union or AFL, just about every sport has contact and repeated head impacts.”

Crucially, the issue isn’t just restricted to professional sport or contact sport, but given those avenues are big enough to set an example and determine policy, the knock-on effect can be far-reaching.

“If we’re looking at the long-term damage of repeated head knocks or injuries, it’s all about the number of impacts you have in your life multiplied by the size of those impacts,” said Dr Cohen.

“If you played at a really high level you have a lot of big impacts, because the players are bigger and faster, but your career is probably shorter.

“It can also impact at a lower level, where you play a lot and go right into your 30s or 40s or even 50s.

“It can also affect young people. After the death of Keith Titmuss, for a completely unrelated reason which should also have never happened, his family insisted his brain be donated to the Australian Sports Brain Bank and when it was examined, this 20-year-old had signs of CTE. It can happen at all levels of the game and to all ages.”

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Through the series, Plum isolates himself from his family, friends and community who want nothing more than to support him. Dr Cohen recognised the tactic as a key symptom of repeated head trauma.

“You don’t want external distractions, you can’t cope with the information coming at you, it all gets too much and eventually you shrivel up in the corner, holding your head,” Dr Cohen said.

“What happens to Plum and what happens to his family, he refuses to admit he has a problem.

“You have to own it, you have to own it early, you have to ask for help.”

Plum also battles with a transition away from not just the game that was his life, but from the mentality that made him so decorated. 

A key theme is the way he grapples with the fact that the “never take a backward step” mentality which served him so well on the field isn’t adequate for his new life.

“I looked at the fear it could elicit in a man who isn’t used to being afraid of anything,” said Cowell.

“He doesn’t know how to lose and he’s going to win the only way he knows, which is to run straight through the wall. But that’s what’s put him here.

“It’s kind of like drinking, you go out and get hammered because you feel anxious and sad and displaced.

“You wake up the next day and you wake up and you feel a hundred times more anxious, sad and displaced than you did, which is why you had a drink, so you have another drink.

“The way Plum behaves is what got him into the mess, but he behaves the same way to get out of the mess, making the mess worse.”

For Graham, it’s a mentality that hit close to home and one he has fought hard to change in his own life.

The Englishman estimates he suffered about 100 concussions in his career and his journey towards understanding what might happen to him in the future was detailed in raw and revealing fashion in his 2022 podcast series Head Noise.

“What I did for a living, I’ll pay a price for that but I know there’s things I can do to slow the decline,” Graham said.

“I want to take responsibility for that. In my own circumstances, the mental health side of things – the depression and anxiety – a combination of medication and therapy works really well.

“I’d be a completely different person without rugby league, for better and for worse, and I probably had those mental illnesses when I was playing but I guess while I was playing I could never comprehend having those issues addressed.

“I would have been scared of losing something. But once I stopped playing I had to get that addressed and I was lucky I had a family that wanted the best for me.

“I think back to that time now, before I got the help I needed, geez I wouldn’t have been a fun person to live with. It wasn’t fun inside my own head either.

“It was June 2021, a short time after retirement, I was completely lost and like always, the people closest to you bear the brunt of it. It doesn’t need to be that way.

“What this show can do is showcase the value of intervention before it gets to that stage.

“Now I’m on the other side I can’t believe it took so long so don’t wait, get the help you deserve. Do it yesterday.

“There’s help out there, people want to do it. There’s no miracle cure for degenerative brain issues or cognitive decline and there might be a disconnect, but they might hear stories from Royce (Simmons) or Wally Lewis or watch a show like Plum and think ‘that’s me.'”

Plum is aimed at being a conversation starter

Cowell doesn’t want to position himself as some kind of CTE guru or preacher, nor is he trying to demonise contact sport or rugby league. 

He says Plum is aimed at telling a story and starting a conversation around how to ensure the survival of a sport he loves.

“How does rugby league, the greatest game of all, go forever? If you pretend it’s not happening, it will come to get you in the head,” he said.

“Let’s acknowledge this, learn about it, stir the pot, get the viewpoints and maybe make some changes.

“I don’t know what the changes need to be but I want the game, in its greatest toughness and athleticism and beauty, to continue forever.

“Some guys and women who have gone through this stuff might feel like they can share their story because they relate to this – they don’t have to have been footballers, it might be boxers or police officers or ex-soldiers who were close to explosions or roadies who were close to speakers, I want everyone to have a voice in this because CTE can come in through so many different forms.

“I don’t have the answer, but I feel like it’s time to talk about all this stuff. When has talking about something ever been a bad thing? Let’s address it, it’s real.”

Dr Cohen aims to be on the cutting edge of whatever changes can be made. He helped develop Nurocheck, a medical device that provides an objective concussion assessment in just two minutes and is working hard to increase education around the management of head knocks.

Misconceptions still abound – headgear, for example, does not prevent the transfer of injury that leads to head trauma and according to Dr Cohen, neither do mouthguards. 

Not all head injuries lead to an easy-to-spot concussion but, to paraphrase the old line on cigarettes, every head knock does at least a little bit of damage. 

“When in doubt, sit them out” can act as a golden rule, but further changes can still be made.

“What we can do is look at things that are unhealthy or practises that are unhealthy and make our games safer,” Dr Cohen said.

“We might be able to do that by starting playing contact sport later, in high school. Limit the length of the season. Decrease the number of full-contact training sessions.

“When I was a kid you went to the beach, slathered yourself in coconut oil and 30 years later you had melanoma. We learned about that and we took steps to mitigate the risk.

“It’s no different to what we’re learning about concussion now, we can keep the things we like doing and we can mitigate the risk so there’s less long-term problems.

“We’re capable of learning and adapting without throwing everything away. Sure, we can put everyone in a bubble so they never get a single head impact in their whole life, but it wouldn’t be much of a life.

“So long as we know things have consequences and we can mitigate the risks, there’s no reason why we shouldn’t.”

Graham, who has worked to change himself, knows the game has to embrace a certain amount of evolution in order to secure its long-term future.

He wants diagnostic tools to be developed so there’s less pressure on players and coaches, and he wants coaches to take as active a role in the discussion as possible because, in his experience, they’re the only ones the players really listen to.

“How much further as a game can we go or should we go? I don’t know because there are values in the sport people admire, and for some personality types there’s an attraction to the risk,” Graham said.

“That was part of the attraction for me, the physical nature and knowing I could get hurt today.

“Even saying that now I think it sounds stupid, but I have to accept who I was. I know there’s a lot of young players who are of that same mentality and attitude. The danger is part of it.”

Making that transformation wasn’t easy for Graham and it won’t be rugby league. It wasn’t for Peter Lum either but it was worth it and according to Cowell, that’s the whole point.

“I guess that’s what Peter Lum learns, you’re going to be more use to people if you’re on Earth and happy and then you can help anyone,” Cowell said.

“Maybe he doesn’t ever learn that lesson because I don’t know if that would be realistic. But he wants to break the chain of alcoholism and abandonment, of avoidance and lies, of bullshit and running. That can run through the river of a family line forever.

“Change is so hard, 360s are easy and 180s are hard. To change, you have to do the unfamiliar.”