Brett Lindros lowered his shoulder to deliver a crunching open-ice check, the type of hit for which the 6-foot-4-inch, 220-pound New York Islanders right wing was known.
The Islanders’ bench cheered as the impact sent the Buffalo Sabres’ Brent Hughes, 5 inches shorter and 25 pounds lighter, flying to the ice.
It was the kind of check fans love.
In the stands at Memorial Auditorium that November night almost 2 1/2 years ago, Carl Lindros watched the hit, one he had seen his son deliver many times before. Little did he know it would be the last one.
“I saw Brett in the dressing room, and when he didn’t come out for third period, it was the first time I realized he had a serious problem,” Carl Lindros said. “I remember it was a Friday night. Saturday morning, I went right to the research library in the center of Toronto and read up as much as I could on concussions.”
Only eight days earlier, young Lindros had suffered a concussion from a cross-check to the head by Los Angeles Kings winger Eric Lacroix.
Carl Lindros’ concern proved warranted. Six months and several specialists later, his son, 20, was forced to retire before his promising NHL career had barely begun. The news came a year after his older brother, Eric, of the Philadelphia Flyers won the Hart Trophy as the NHL’s most valuable player.
“I don’t think Brett ever thought his career was in jeopardy,” Carl Lindros said. “But there were points in time that Brett could not drive a car, dial a phone or read.”
Lindros had played only 51 NHL games, with two goals, five assists and, most significantly, four concussions. Three specialists told the Lindroses the same thing: His brain had suffered enough repeat trauma, and he would risk permanent brain damage if he continued to play.
The diagnosis stunned many around the NHL.
“The brain seems to be the last frontier in hockey,” said Kings General Manager Dave Taylor, who retired in the middle of the 1993-94 season after what he figures was his 10th concussion. “We know a lot about shoulder and knees and other injuries. Now we’re just starting to get more information about the brain.”
A concussion is an alteration in the mental status because of the brain shaking inside its protective skull. A concussion does not require a direct blow to the head, and can occur with or without loss of consciousness, according to the American Academy of Neurology.
Players have been getting concussions in the NHL for years. But it was not until the 1995-96 season that concussions were recognized as a major, leaguewide problem. That season 66 players, including Lindros and seven of his Islanders teammates, suffered concussions, missing 328 games.
The issue has been kept on the front burner by the high-profile cases of the New York Rangers’ Pat LaFontaine, who suffered severe post-concussion syndrome for several months and nearly retired during the off-season, and the Anaheim Mighty Ducks’ Paul Kariya, who missed the 1998 Winter Olympics and is still having symptoms a month after his fourth concussion.
“We’ve known about concussions for a long time; it’s just more popular now,” said Dr. Robert Gordon of the Institute of Sports Medicine in Toronto. “It’s just like drinking and driving or smoking was 20 years ago. We knew about the dangers, but people ignored it.”
Kariya still has headaches, dizziness and concentration difficulties. On Feb. 1, he was cross-checked to the jaw by Blackhawks defenseman Gary Suter, who was suspended four games.
Ducks team doctor Craig Milhouse said Kariya is “slowly getting better. He’s still symptomatic. Obviously, the symptoms have lingered longer than we’d hoped. I told Paul, `I know you’re going to get better. I wish I could tell you when. I still feel you absolutely will play again.’
“I know anybody who looks at the situation has the lingering thought or feeling come to mind that the season is ticking away. That might happen, but I still don’t look at it as his career being in jeopardy.”
Gordon, who has not been involved with Kariya’s case, acknowledges he takes a conservative approach when dealing with multiple serious concussions.
“I’m an advocate for the future, not the present,” he said. “Does Paul want to get married and have kids and enjoy those kids 10 years from now? He has to make that decision. But if he were my son, I’d tell him to retire.”
It is taking Kariya longer to recover from this concussion than his previous one, even though the previous one was more severe. In November 1995, Kariya was elbowed in the jaw by Toronto Maple Leafs defenseman Mathieu Schnieder and was hospitalized overnight. But he missed only two games.
This time Kariya was “not as loopy,” according to team personnel. Milhouse called the concussion “mild,” and Kariya felt fairly good the next day and thought he might not miss a game.
That was a zillion headaches ago.
Taylor understands what Kariya is going through.
“In my experience, the more concussions you’ve had, the less of a blow it takes to bring on the symptoms again,” he said. “And the symptoms seem to last longer and longer.”
Said Gordon: “In a lifetime, the brain you wrecked five years ago is still wrecked the same way five years later. It’s not like a busted bone and the calcium comes and forms a new bone. You degenerate brain tissue. You lose 20,000 brain cells a day after age 25. That’s why memories are not the same as you age. The cells never grow back. Smacking the brain increases the (losing) process. You’re hurting the brain cells.”
James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago, said the cumulative effect of concussions, even minor ones, has been overlooked.
“People throw around the phrase `minor concussion,’ but there is no such thing as a minor concussion,” Kelly said. “Repeated concussions can cause not only permanent damage to the brain, but even death.”
The NHL has made it mandatory for all teams to conduct neuropsychological testing. The tests measure every player’s baseline of mental acuity, including memory and spatial and visual awareness, and provide a basis for comparison after concussions. That way a player is not allowed to come back too soon.
The NHL has adopted the guidelines of “Management of Concussion in Sports” that were developed by Kelly and Dr. Jay H. Rosenberg of Kaiser Permanente’s San Diego Medical Center and endorsed by 14 prominent medical and athletic organizations.
“I learned that the brain, unlike a muscle, cannot be `rehabbed’ time and time again,” Brett Lindros said during the unveiling of the guidelines in March 1997. “Athletes at all levels must realize their vulnerability, particularly concerning the risks of concussion.”
The guidelines were designed primarily for football and hockey, in which concussions are most prevalent.
“The key thing is time and not rushing back; that’s one of the real problems,” Carl Lindros said. “Historically, players ignored concussions. Everybody. Players, coaches, trainers, team doctors. There was not enough regard for minor concussions. You have to treat it with respect.”
Under Gordon and Rosenberg’s guidelines, there are three grades of concussions. The chart of when a player is allowed to return to play is based on the grade and the number of concussions.
For example, a player with multiple Grade 2 concussions–which Kariya has had–should not return to play until he is asymptomatic with normal neurologic assessment at rest and with exercise for two weeks.
Milhouse said initially that Kariya has to be asymptomatic for a minimum of seven days, but Milhouse said that because of the persistence of the symptoms, that figure has increased to about a month.
Under the old unwritten code that hockey players were tough and played hurt, not playing when a person felt fine was almost unheard of.
“Oh, definitely, there is more awareness now,” Taylor said. “Not just with management and coaches, but with players themselves. Their livelihoods are at stake. It’s not just the money they make now. Their health is also at stake.
“Now we do the baseline studies during training camp. If somebody does suffer an injury to the brain, we now know they shouldn’t return until they’re 100 percent. We have guidelines of when it’s safe to let them back. We use caution.”
Long-terms problems could include mood disorders, memory trouble, visual trouble, nausea and vomiting, motor problems, headaches, depression.
