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Giving up the game a difficult choice for concussed NHL players

This is the last in a four-part series examining a concussion lawsuit filed against the NHL by former players.

The appeal of Robin Lehner is he’s so full of life. With a piercing stare, sharp wit, folksy soft side and massive frame, he takes command and creates a buzz.

It’s hard to picture him slumped in a darkened room for 45 days, crushed by the weight of a concussion. As his eyes moisten while he recalls that unforgiving world, it clearly was worse than anyone can imagine.

“It was the worst time of my life,” said the Buffalo Sabres goaltender. “I had migraines for not a day, I had it for months. I laid in my bedroom for probably one and a half months.

“The concussion, it changes a lot of things in your head. I had a hard time waking up in the mornings. I had a hard time finding energy in my life. It’s just so many different symptoms.”

Lehner has suffered just one concussion, but it was a life-changing moment. While playing for Ottawa in February 2015, Lehner slid to his left while leaning down toward the ice. Swift-skating teammate Clarke MacArthur barreled into the goalie, striking him under the chin to propel Lehner’s head and helmet backward.

For the next five months, Lehner was a prisoner to brain trauma.

“It was a few months where it was really, really tough for me and my family,” he said. “During the summer it got better, then I started to get symptoms again through the summer when I started working out.

“Concussions, it’s nothing to play around with. It’s a serious issue.”

NHL fans have shifted their attention toward head injuries at various times during the past 20 years. Elite players such as Pat LaFontaine, Eric Lindros and Sidney Crosby have had their careers halted, permanently or temporarily, by concussions. The incidents moved the injury into the spotlight.

It’s there again for an off-ice reason. More than 100 retired players are suing the NHL because of concussions, saying the league was negligent in its care and fraudulently concealed the long-term risks of head injuries. They are seeking medical monitoring and compensatory damages.

The stories that have accompanied the lawsuit have been harrowing. Depression, memory loss, neurological disorders and suicides have stalked the former world-class athletes.

“It’s sad that there’s some guys that it doesn’t get better for,” Sabres forward Tyler Ennis said. “I’m fortunate and I’m happy that it did for me.”

Ennis missed most of this season due to multiple concussions. He suffered the first Nov. 23 and another Dec. 30, just four games after returning to the lineup. He didn’t play again, though he began skating with the Sabres during the final week of the season.

“You have bad days,” Ennis said. “It’s scary. There’s times where you’re sitting at home and you go through different emotions and things cross your mind.”

Among the thoughts was whether to play again. Unlike players from an earlier era, today’s NHLers are aware concussions may carry long-term risks. They’ve heard about the lawsuit, read the troubling stories.

Given what they know, why gamble with their health and keep playing?

“You can’t explain how fun it is to play hockey,” Ennis said, shimmying and giggling as he reveled in his livelihood. “It’s such an incredible job.”

Dr. Mark Aoyagi says there is more to it. As director of the Sport and Performance Psychology Program at the University of Denver, he studies athletes’ minds to understand their thinking process. With the stories of Lehner and Ennis cited as examples, Aoyagi theorized three reasons for hockey players’ continued desire to play after suffering a concussion:

• Acceptance of risk due to familiarity.

“We grow accustomed and comfortable to whatever we do a lot,” Aoyagi said by phone. “Most of us drive a car every day, and most of us don’t think about the consequences of getting behind a wheel every day, which for many people in different age demographics is the most dangerous thing that they’ll do.

“They’ve been playing hockey their whole lives. They’re comfortable with it. Even when something happens … enjoying playing is more important than any injury they might sustain.”

• A need to maintain their identity as professional athletes.

“A lot of times we think about the money, and the money is certainly an important factor, but I bet most of these guys if you asked them, they’d probably say they’d keep playing even if they weren’t getting paid,” Aoyagi said. “It’s really not the money a lot of the times as it is the identity. That’s how they identify themselves. That’s how other people identify them.

“It’s really hard as people to even fathom or contemplate losing your identity and starting over at age 24.”

• At age 24 and 26, respectively, Lehner and Ennis biologically don’t know any better.

“Those two guys are actually approaching the age where your frontal lobe – basically the higher-order thinking, logical-decision-making part of your brain – becomes fully developed,” Aoyagi said. “It doesn’t become fully developed until about age 25, so basically until that age you don’t make very rational, logical decisions, at least in the way a 40-year-old might evaluate it.

“This is why teenagers are indestructible and make the choices that they make because they literally can’t comprehend the consequences of their decisions.”

While not a teen, the 5-foot-9, 160-pound Ennis has redeveloped a feeling of invincibility.

“I’m 100 percent now,” he said. “I’ve always been a smaller guy. I’ve been hit a lot. I know how to take a hit. It’s not going to bother me one bit.

“There’s going to be nothing in the back of my mind that’s going to change how I play.”

Making headway

Hockey won’t stop, and neither will head injuries. The goal is to limit them, alleviate the accompanying systems and ensure today’s players don’t endure the same late-stage ailments as the plaintiffs in the concussion case.

Among the biggest advances is the rest period. The retired players talk of suffering a concussion and not leaving the game. The NHL has since instituted “spotters.” Their job is to inform athletic trainers if they observe a player with concussion symptoms, and the player is then supposed to retreat to the “quiet room” for further evaluation by team doctors.

“The safety has come a long way,” said Sabres captain and 14-year veteran Brian Gionta. “The education has come a long way. I think guys are more aware.”

Gionta saw firsthand how players were handled during the old system. While playing for New Jersey during the 2003 Stanley Cup finals, he witnessed teammate Scott Stevens crush Anaheim’s Paul Kariya with a blindside shoulder to the skull. After lying motionless on his back for 45 seconds, a wobbly Kariya was helped off the ice.

He returned minutes later.

“You see him out cold, and he comes back in the game,” Gionta said. “Stuff like that would never fly today.”

Nor should it. The rapid reoccurrence of Ennis’ concussions was another example of athletes needing proper time to recover.

“Humans have a vulnerable brain after being injured once, and if it gets hit again before recovery, the metabolic consequences are worse and the symptoms can be worse and prolonged,” said Dr. John J. Leddy, a clinical professor and director of the University at Buffalo’s Concussion Management Clinic. “Allow the athlete to recover and return the athlete to play only once he or she is fully recovered and is deemed to be no longer vulnerable. That gives you your best chance of reducing the effects of cumulative brain trauma.”

Though the NHL’s system is improved, there are holes. Calgary’s Chris Wideman showed concussion symptoms before and after flattening linesman Don Henderson in January. The spotter reportedly informed the athletic trainer, but Wideman refused to leave.

Part of that is the “warrior mentality” of hockey players. Lehner used to be one of those athletes. Now he knows better.

“I was one of those guys before I got my concussion that could sit there and say, ‘Come on. It’s just a headache. Let’s go. Let’s get back playing,’ ” Lehner said. “That was one of the dumbest things. That’s something I’m embarrassed about being in that position before I got mine because when I got mine, reality hit me, and that reality was not a fun one.”

The unknown

The most difficult part for concussion sufferers is the uncertainty regarding recovery time. Ennis figured he’d return quickly, and being out added to his downward spiral.

“The brain is a weird thing,” he said. “I learned that it’s different for everybody. There’s a lot of similarities, but in terms of the progress, in terms of the timeline, it’s different for everybody.

“So you can get advice and you can get help and you can go to therapy and do all kinds of things, but at the end of the day it’s just one of those things that is going to take time.”

Sabres forward Marcus Foligno watched from afar as his brother, Nick, suffered a concussion in January. He knew the Columbus captain was in pain. He just didn’t know how much.

“You want to know how bad it is,” Marcus said. “The thing with a concussion is you don’t really know how bad it is. There’s no grades for a concussion. There’s rehab, but there’s no, ‘This is what you have to do in order to get back in this much time.’ ”

The retired players in the lawsuit could say the brain never returns to normal. For some, it’s been 40 years since they suffered a concussion, and they’re still suffering today.

“I can’t imagine what they’re going through and how it feels for them,” Lehner said. “It’s certainly something I don’t want to experience after my career is done because it leads to all kinds of things: to depression, to drug abuse, to alcoholism. Because at the end of the day, you’re trying to escape the reality of having constant headaches.

“Concussions are so hard. It needs a lot of research in it. I don’t want to have that problem when I retire.”