The hit that changed LaFontaine’s life, a vicious blindside elbow to the head from a massive defenseman, sent his helmet flying in one direction and his body in another. His bare forehead bounced off the ice, leaving him unconscious and knocking him out of that game and the following one. Relying on his competitive instinct and the doctors’ reassurances that he was fine, LaFontaine went back to play, pushing on through seven more games despite the headaches and the beams of light particles that he alone saw on the ice. Finally, after a loss in which the action seemed to be moving faster than his mind could process, he gathered his teammates around him in the Buffalo Sabres locker room and emotionally apologized for his inexplicably poor play. The next day, when he broke down in tears during a conference with the team’s coach, he was instructed to take time off and get some medical help.
LaFontaine told the first neurologist he saw about the pounding headaches and fatigue, about the tears and mood swings, about the loss of enthusiasm and motivation. The doctor attributed the symptoms to the stresses of being a family man, a professional athlete in a slump, and the captain of a floundering team. “You know,” he said plainly, as if dispensing a prescription, “I’m sure if you go out and score a couple of goals, you’ll feel better and everything will be fine.”
A frown of despair and disbelief spread across LaFontaine’s boyish face. “Doc, I don’t care about scoring goals,” he explained, his voice cracking. “I don’t care anymore. I’m scared. Something’s not right.”
The neurologist replied reassuringly, “I’m sure everything’s going to be fine. Maybe you just need a few days to get some rest.”
What LaFontaine’s brain needed was more like a few months or a few years of rest. He spent the last six months of the 1996–97 season confined to his house and what he called the dark tunnel of his life. Each day brought migraines, nausea, crying jags, cognitive problems so debilitating he couldn’t read a bedtime story to his daughters, depression so crippling he couldn’t drag himself out of bed in the morning. The source of those symptoms remained a mystery until doctors at the Mayo Clinic finally explained that he was suffering from the cumulative effects of his six diagnosed concussions. The only cure, they told him, was complete rest.
When his post-concussion syndrome finally began to abate in the spring, LaFontaine decided he wanted to do what hockey players always do in the face of adversity: lace up the skates and charge back onto the ice. His wife begged him not to. She reminded him that they were financially secure, especially since the rest of his multiyear contract was guaranteed whether he played again or not. She reminded him that his place in hockey history was likewise secure, his election to the Hall of Fame already assured by his fourteen glorious NHL seasons. She reminded him that his own team didn’t want him to play anymore, since the same Sabres doctors who’d once dismissed his symptoms now were refusing to clear him because of his concussion history.
Still, LaFontaine was determined to play on. He rationalized that he had more things to prove to himself and the world. He got the medical clearance he needed from Dr. James Kelly, the renowned neurologist who had authored the most widely followed return-to-play guidelines, and a contract to play for the New York Rangers. LaFontaine couldn’t wait to thrill the same Rangers fans who had once rocked an ambulance attempting to whisk him to the hospital after a playoff game in which he’d suffered a bad concussion while starring for the archrival New York Islanders. He instantly won them over by playing the way he always had, firing shots and flicking passes while tumbling to the ice or diving through the air.
Just six months into his comeback, however, an accidental collision with a teammate ended his season with another concussion. That summer, Kelly told LaFontaine that the risk of permanent brain damage was now too great for him to go on playing. Hard as it was to accept, LaFontaine knew that the decision had been made for him by one of the nation’s leading concussion experts. He had no choice but to retire at the age of thirty-three.
Fans had barely absorbed the reality of LaFontaine’s forced departure when they were jolted by the spectacle of yet another star center being repeatedly felled by concussions. This time, it wasn’t another undersized finesse player in a physical sport that traditionally valued strength as much as speed. It was Eric Lindros, the imposing six-foot-four, 245-pound goliath whose rare blend of raw power and pure skill had heralded his NHL arrival as the expected successor to Wayne Gretzky, The Great One himself. For all his hype as “The Next One,” Lindros would ironically succumb to the same type of punishing hits that made him such a fearsome force. He sustained four concussions over a five-month span in 2000, a career-threatening barrage that prompted him to publicly blame the Philadelphia Flyers’ medical staff for minimizing and mismanaging his head injuries. By the time Lindros was forced into retirement several years later at age thirty-three, post-concussion syndrome had claimed dozens of other NHL careers.
As the concussion epidemic spread down to all levels of play, hockey was proving more perilous than football. NHL players were five times more likely to suffer a concussion than those in the NFL, according to one report. In U.S. college hockey, men were sustaining concussions at a rate 10 percent higher than their football-playing counterparts. The NCAA stats were even more astounding when it came to women’s hockey: the concussion rate among females was more than twice that of male skaters and almost two and a half times that of college football players. And just imagine how much more dire those study findings might have been if not for NCAA safety reforms. Unlike the NHL, where reformers advocating safer rules were derisively accused of trying to turn ice hockey into the Ice Capades, at least the authorities at the lower levels were willing to ban dangerous acts like hits to the head.
Despite all the safety rules adopted for amateur players, nothing could banish the macho play-through-pain mentality permeating the sport. Peewees were just as likely as pros to minimize concussions and to lie about symptoms. In a study of Canadians aged eleven to seventeen, player surveys of symptoms found concussion rates up to a hundred times greater than those officially reported to youth hockey authorities.
That came as no surprise to Dr. J. Scott Delaney, a sports medicine and emergency medicine specialist at Montreal’s McGill University. As a native of Montreal, the birthplace of organized hockey, Delaney understood how it was Canadians could passionately play through injuries inherent in a rough sport that defined their national identity more than football did for Americans. What Delaney had a harder time understanding was what he witnessed from the sidelines in his role as the team physician for McGill’s football and soccer programs. He could see that his college football and soccer players were frequently getting concussed, but when he pressed them, they often denied or minimized their symptoms. He couldn’t reconcile what he was observing on the field with the low concussion incidence reported by fellow researchers. He’d scratch his head and think, “Are they dreaming? Have they ever seen how violent this game is? Or are they just living in a lab somewhere? They can’t actually believe those results.”
Delaney resolved to ferret out the true incidence of concussion among his college athletes. He copied the methodology he’d used in a previous study of pros in the Canadian Football League, where he also served as team physician for the Montreal Alouettes. For that CFL study, he had initially asked players to sign their surveys but quickly discovered that few were willing to admit to concussions for fear that the information would get back to their teams. When he then made the survey anonymous and asked only about head injury symptoms, the number of concussions soared. Equally alarming, the study found that only 19 percent of the concussed CFL players recognized that their symptoms meant they’d sustained a concussion. Delaney’s McGill study would yield strikingly similar results among the college athletes. Only 23 percent of concussed college football players realized that they had suffered a concussion during the 1998 season. What’s more, only 20 percent of concussed soccer players realized that they had suffered a concussion.<
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It was clear now that the problem extended beyond the so-called collision sports like football and hockey, where hard hits—tackling and blocking on the gridiron, bodychecking on the ice—are intrinsic to the game. Indeed, the problem reached deep into the so-called contact sports like soccer and basketball, where jolts to the head are incidental yet inevitable.
In an effort to assess the risks faced by student-athletes in a wide range of men’s and women’s sports, University of Akron researchers screened incoming freshmen each year from 1995 to 2001 about their concussion history, their attitudes toward head injuries, and their understanding of the dangers. Remarkably, more than half of all athletes indicated that they had absolutely no knowledge of the possible consequences of a head injury. An alarming number of the athletes had continued to compete or practice while symptomatic—30 percent saying they played through headaches, 28 percent saying they played through dizziness. Though the failure to report such symptoms to coaches or trainers was more common in football than the other five sports in the study, it was a surprisingly big problem in soccer as well.
That problem trickled down to the high school level and beyond. In a subsequent multiyear study showing that 41 percent of high school athletes returned to play before their concussions could heal, the rate of noncompliance with published guidelines was higher in boys’ and girls’ soccer than in football.
What made soccer’s own concussion crisis so scary were the raw numbers of both boys and girls who had transformed the world’s most popular sport into America’s fastest-growing sport. Providing kicks for nearly twenty million kids across the United States, soccer participation surpassed all other sports on the youth level and all team sports save football and basketball on the high school level. High school soccer players were sustaining concussions at a greater rate than every sport except football, with the girls’ rate 64 percent higher than the boys’. In college soccer, where men were sustaining concussions at a rate significantly higher than every sport except football and ice hockey, the risk proved far worse for women. Not only were women sustaining concussions at a rate 29 percent higher than their male counterparts on the soccer field, but they were also getting concussed at a greater rate than even football players.
Those stats should give pause to every soccer mom and dad in America.
• • •
Melissa Inzitari wasn’t always a soccer mom. When she was her daughter’s age, Inzitari was a “ball kid,” just like Willie Baun. Although her sport was different than his, she played it as aggressively as Willie or any other boy played football. From the instant she scored her first goal in a coed league game as a six-year-old, there was no stopping Melissa on the soccer field. Soccer was what drove her and defined her, what made her feel invincible and invulnerable.
It didn’t matter if she was the smallest player out there. As a college freshman shorter than the teammate already nicknamed Midget, Melissa was dubbed Toy. That nickname only fueled her competitive fire. She may have measured all of four foot eleven in her cleats, but there was nothing small about the way she played. She was a dynamo, racing headlong into the fray, sometimes literally running up the back of an opposing player to get as much height as possible.
Nothing epitomized her aggressive style of play better than the signature move she relied on to cut taller opponents down to size. Whenever the ball sailed overhead, she would zero in on its projected flight path to time her leap, soar high into the air to meet it, then drive it hard off the side of her head. She prided herself on her ability to win those headers over taller opponents. Often she would get to the ball first, but sometimes another player would invade her airspace just as she was about to head it. To Melissa, the resulting midair collisions were as much a part of the sport as kicks to the shin.
That’s why she didn’t give it a second thought when her head collided hard with an opposing player’s in the first half of a game early in her sophomore year at the College of New Jersey. After crashing to the ground at midfield, she instinctively picked herself up and rejoined the action just as she had following countless other midair collisions. Only this time, she felt strangely out of sync and in a fog.
At halftime, as she walked shakily off the field, she confided to a teammate that something didn’t feel right.
“You need to tell Coach,” the teammate urged.
“No-no-no, don’t tell him,” Melissa begged.
She did admit to an assistant coach at halftime that something was wrong, telling him, “I feel like I don’t know where I am.” But she was not about to give the head coach any ammunition to pull her from the game. It wasn’t only that she wanted to keep playing. As the team captain and star midfielder, she also felt that it was her duty not to let down her teammates or the coaches. So as soon as the team’s halftime meeting broke, she jogged out to her position at midfield as if nothing were wrong.
Early in the second half, while her teammates battled to move the ball across midfield, Melissa was off by herself in the defensive zone, wandering in circles, staring up at the lights. The head coach promptly waved her over to pull her from the game. In a daze, she headed to the opposing team’s bench. When she finally made it to her own team’s bench, she bizarrely kept asking her teammates for chocolate milkshakes.
The coach called for an ambulance and told her, “We have to take you to the hospital.”
“You can’t take me!” she shot back, her rage rising as she reeled off reasons not to go. Finally she threw her arms up in exasperation and snapped, “Let’s just go.”
At the nearby hospital in Trenton, doctors examined her and ordered up a CAT scan. After reading it, they assured her everything was normal and sent her home with clearance to return to play. The next day, she was back at practice, back in her regular routine as if nothing had happened. She played through the entire 1996 season with her usual intensity, heading balls even though she was still plagued by constant headaches. As her sophomore year wore on, strange symptoms began to appear. Loud noises now made her head pound worse, and she was so sensitive to light that she took to wearing sunglasses even in dark places like movie theaters.
Over the following year, the symptoms became stranger and scarier. She would lose her car in parking lots. She would get lost driving home. She would get confused on the way to class, wandering aimlessly through a two-story building searching in vain for a third-floor classroom. Her grades plummeted, a D for one class reducing her to tears. Her moods were swinging wildly. She’d never been one to cry no matter how painful the hurt, but now she found herself weeping uncontrollably over McDonald’s commercials. She’d always been buoyant and bubbly with a broad smile that attracted friends like a magnet, but now she was increasingly withdrawn and antisocial. She’d always been measured and even-keeled, but now she was impulsive and short-tempered, sometimes to the point of nastiness. The low point was the day she confronted her coach in a crowded restaurant, screaming and cursing at him over something inconsequential. Friends and family couldn’t help noticing the change. After one argument with her kid brother, she overheard him say, “She’s such a bitch now.”
What really scared her were the physical symptoms that threatened her very identity as an athlete. She would lie in bed and the room would spin as if she were drunk. She temporarily lost the vision in her left eye and the hearing in her left ear. One day, she was at home alone taking a shower when she closed her eyes to let the water wash over her face and suddenly lost her balance and fell. She began to think she must have a brain tumor. Of course, she wasn’t about to seek help for the suspected brain tumor any more than she had for the unsuspected head injury. Having endured broken ankles, fractured ribs, and countless smaller injuries, she played through these new problems dogging her every stride: the ringing in her ears, the fogginess and blurriness, the queasiness in the pit of her stomach. She would vomit at halftime, play the entire second half, then vomit again after the game.
One day after throwing up at halftime, she e
merged from the bathroom to find her boyfriend, Joe, waiting with a worried look. “Enough’s enough already,” he said sternly. After the game, Joe did what he knew his longtime girlfriend never would: he went to the coach and told him what had been going on. In the locker room right after the game, the coach approached Melissa and insisted she get medical help. He and the team physician sent her to see Jill Brooks, the neuropsychologist who also treated the athletes from Rutgers University.
The day of the appointment, Melissa expected to be at Robert Wood Johnson University Hospital just long enough to get the medical clearance she needed to return to play. Brooks had other plans. Before Melissa could mention any of the symptoms that had brought her there, Brooks hit her with a series of questions: “Are you sensitive to light? Are you forgetting things that happened yesterday? Are you more emotional? Have you noticed changes in your personality?” With each succeeding nod of her head, Melissa felt more and more relieved that someone finally understood what she’d been experiencing.
Six hours of neuropsychological testing would confirm Brooks’s opinion that Melissa had sustained a severe concussion. Melissa was perplexed by the mere mention of the word “concussion.” How could she possibly have a concussion if she’d never lost consciousness, if the doctors had found nothing wrong in the ER, if she’d been cleared to go right back to play? Brooks explained how the initial injury had been continually exacerbated because Melissa kept playing without ever giving her brain a chance to heal. Melissa let out a sigh of relief. At least she wasn’t losing her mind, she thought. At least she didn’t have a brain tumor—it was only a concussion.
Brooks could see that the message wasn’t getting through. “This is serious,” she warned. “You need to stop playing. Your body needs rest—rest from soccer, rest from all activity, rest from everything.”
The Concussion Crisis Page 8
