The whole issue of head shots in the NHL is getting a lot of attention these days and that controversial dialogue is never a bad thing regardless of which side of the head-checking fence you sit on. It's a healthy debate.
And it has become a persistent hot-button topic because the players seem to be more concerned now than ever before about the long-range implications of concussions and repeated brain trauma and how they can severely affect their quality of life. Just ask Keith Primeau or Jeff Beukeboom or countless others who have been down that dark road. And that is why Simon Gagne has suddenly become such an advocate for the anti-head shot axis.
Also, with new and some would say frightening medical studies, notably the one through Boston University that now has athletes donating their brains to science after they die, the players are quickly realizing the stakes are far higher than perhaps they ever realized.
Good for the players; it's their brains and their long-term health concerns that should be paramount.
So, for the greater good of NHL mankind, let's steer the boat in a slightly different albeit related direction today.
When is a player concussed?
Who makes that decision?
On what basis is that decision made?
And, finally, most importantly, was the correct decision made?
There was a play in the Boston-Buffalo game from Wednesday night that is interesting with regards to this broad issue.
Here is one account of it from today's Boston Globe:
In the second period, during Boston's first power play, Buffalo defenseman Toni Lydman flattened Dennis Wideman with a clean shoulder-to-kisser hit. As Wideman got to his skates, he wobbled and nearly tumbled backward into the boards. Wideman was met at the bench by trainer Don DelNegro, who helped the defenseman return to the dressing room for examination. Wideman was in the room for approximately three minutes of play, examined by team doctor Thomas Gill, before he returned to the bench. Wideman played a total of 22:34.
"Little bit of the rubber legs going there for a bit," said Wideman.
It was determined that Wideman hadn't suffered a concussion. Instead, the headaches were limited to the Sabres.
Here is the Boston Herald account of the same play:
Defenseman Dennis Wideman took a Toni Lydman shoulder hit to the head in the second period and was staggered.
"I had a little of the rubber legs going there for a bit," said Wideman. "I lost control of the puck and was kind of reaching forward for it. I was leaning forward and he caught me. My head was right at his shoulder height. I was a little off balance when I first got up. He rung my bell a little bit."
With help, Wideman made it off the ice and headed to the dressing room, where he was checked for a concussion.
"They ask you questions, and apparently if you don't answer them quickly enough or if you answer a certain amount wrong, there's cause for concern," he explained. "They're just memory questions, like what day of the week it is, who are you playing, what period is it?"
Wideman was immediately cleared, and missed only a shift or two before returning.
These types of plays happen routinely in the NHL. Players often get their "bell rung", as Wideman puts it. They don't necessarily lose consciousness. After a brief period of feeling woozy or unbalanced - "rubber legs" as Wideman puts it - they will often feel fine. It's pretty obvious players don't want to come out of the game. And teams don't want them out of the game. So they are checked by the doctor, or at least they should be, and either cleared to resume play or held out for further assessment.
And in this case, a protocol was clearly followed and Wideman was cleared by the team doctor to return to action.
Now, I don't have a medical degree - I had to scrape by just to get a journalism degree and I don't have to tell you there's a big difference between the two - so I should probably just defer to the doctor in Boston, let it go and mind my own business.
But I can't because I believe there are other doctors who, based solely on the words of Wideman himself, would suggest he may have suffered a concussion when hit by Lydman. That doesn't necessarily mean the Boston doctor did not do his job. We can't specifically criticize him because he's the doctor who was treating Wideman on the scene, he has all the pertinent information, including baseline testing and the like, and we are armchair-doctoring and hypothesizing from afar. So make no mistake, this is not an allegation of malpractice or negligence in any way. The Bruins have their protocols; they were followed.
But it is entirely fair to use this particular example of a frequent NHL play as a jumping off point to raise awareness of this subject matter and this issue. I said and did much the same thing last season when the Philadelphia Flyers' Gagne, after returning from his first concussion, was quoted in the paper on the day he was to play his first game back something to the effect that he didn't feel quite right, to which I suggested at the time that he never should have been cleared to play because not feeling quite right strongly suggests he wasn't over his original concussion. And he shouldn't have played, witness the second, season-ending concussion that followed almost immediately after that.
So this discussion is, in my opinion, fair game and it is done with the purest of intentions with no malice toward the Boston doctor or the Bruins organization. It could have been any team or any player in the NHL last night. So enough with the disclaimers already.
Determining if an athlete has been concussed has always been a challenge, but when in doubt, it pays to go to the experts.
In 2004, in Prague, the world's brightest and best medical authorities on this subject attended the Second International Symposium on Concussion in Sport and in the Summary and Agreement Statement that came out of that summit, they came up with what is referred to as The S.C.A.T. Card, which is short form for Sports Concussion Assessment Tool, which these experts in the field believe should be used as the standard in assessing and identifying concussions in sport.
This SCAT Card has apparently been endorsed and embraced by the IOC, IIHF and FIFA.
It reads, in part, as follows:
What is a concussion? A concussion is a disturbance in the function of the brain caused by a direct or indirect force to the head. It results in a variety of symptoms (like those listed below) and may, or may not, involve memory problems or loss of consciousness.
How do you feel? You should score yourself on the following symptoms, based on how you feel now.
The symptoms they refer to include: headache; pressure in head; neck pain; balance problems or dizzy; nausea or vomiting; vision problems; hearing problems/ringing; feeling "dinged" or dazed; confusion; feeling slowed down; feeling like "in a fog"; drowsiness; fatigue or low energy; more emotional than usual; irritability; difficulty concentrating; difficulty remembering.
The athlete is asked to numerically grade each symptom - 0 and 1 representing No Symptoms; 2, 3 and 4 representing Moderate Symptoms; and 5 and 6 representing Severe Symptoms.
While there is no accumulated score or grade that says unequivocally you do or do not have a concussion, the basic premise of the SCAT Card is that if you experienced some of the symptoms you are quite likely concussed and should shut it down pending further assessment, as concussion symptoms often worsen or appear out of nowhere 24 to 48 hours after the trauma was experienced.
We were not privy to the medical treatment and examination given Wideman in the game Wednesday night, although we know from his own words he was asked "memory" type questions. Interesting that the SCAT card, though, says concussion symptoms may or may not involve memory problems and loss of consciousness.
But this much we do know from the descriptions of Lydman's hit on Wideman and his own quotes after that.
After he got up from being hit, Wideman had balance problems on the ice, or as the Globe reported he "wobbled and nearly tumbled backwards into the boards", or as Wideman himself said he had "rubber legs" and had to be assisted to the dressing room.
Wideman said Lydman's hit "rung his bell a little bit" and only Wideman would know for sure if that qualifies as the SCAT symptoms of "feeling dinged or dazed" or whether it was more "confusion" or "feeling slowed down" or "feeling like in a fog" and to what degree he may have felt any of them or all of them or none of them.
The point is, I couldn't tell you with any degree of certainty whether Wideman was concussed on the Lydman hit or not, but I can tell you I can find neurologists who when presented with generic facts similar to those experienced by Wideman who would, at the very least, suspect there is reason to believe an athlete has been concussed.
Certainly, the SCAT Card would say as much.
This is and isn't about Wideman. I never like to see any Elmira Sugar King grad in a bad way and as I said, it's not fair at all to specifically second guess in any way, shape or form the medical people in Boston because that's not the intent here. Chances are, based on how often this type of things happens in the NHL, Wideman will be just fine - at least we hope so - but this is a league-wide issue that deserves discussion because it's not unreasonable to believe NHL players are, at times, put back into action with a concussion.
If we're going to spend all this time debating head shots and the resulting concussions, we also need to engage in the next level of debate and that is are concussions being consistently identified and recognized and dealt with in the proper fashion across the board and what standards are in place to assure that is the case? Because we know, and there's no disputing this, there are too many NHL clubs that won't even say the word concussion and use the euphemistic "flu-like symptoms" to describe a player who doesn't feel well after getting his "bell rung." And that is because they don't want to have follow concussion protocols for taking players out of the lineup for a week at a time.
And let's stop with that innocuous-sounding term "bell rung." Let's call it for what it is - brain trauma.
The players themselves need to better educate themselves on these issues because the players themselves have the most at stake. It's their brain, their career and their life after hockey.
Hey, you don't need to give me the 'hockey is a rough game' speech and tell me we can't be holding out every player who gets his legs buckled on a hit in a contact sport like hockey; understood on all counts.
But at the end of the day, the players should ultimately be entitled to know the score on all of this. The more they know about the issue, and what standards their team or the league are using or not using to identify concussions and clear them to get back into the game, the better it is for all concerned.