It was as his family suspected: Doug MacIver may have died of a heart attack earlier this year, but the former CFL defensive lineman was suffering from degenerative brain disease.
Officials from Boston University's Center for the Study of Traumatic Encephalopathy informed the MacIver family of their findings last Friday.
Doctors said an external examination of MacIver's brain showed no abnormalities. Once dissected, the inside of the brain told a different story.
At 58, MacIver was suffering from "moderately advanced" chronic traumatic encephalopathy (CTE) when he died Jan. 26. His condition would have worsened had he lived.
MacIver's son, Doug Jr., said the doctors' reports brought a definitive answer to his father's struggles to communicate and control his moods.
"It was extremely emotional going through [the conference call]," he said Monday. "I think there was a sense of relief knowing there was a reason."
MacIver played nine CFL seasons – three each with the Toronto Argonauts, Saskatchewan Roughriders and Winnipeg Blue Bombers (winning the 1984 Grey Cup with Winnipeg).
A nose guard, he'd lineup in the middle of the defensive line and take on as many blockers as he could. It was a punishing position to play with continuous helmet-to-helmet contact.
Researchers have found CTE in athletes who have experienced concussions and repeated head trauma.
The CSTE in Boston has examined the brains of 19 NFL players and discovered CTE in 18 of them, including former Chicago Bears defender Dave Duerson, who took his life by shooting himself in the chest to preserve his brain for science.
The brains of six former CFL players have been tested at the Krembil Neuroscience Centre at Toronto Western Hospital.
Jay Roberts, who died of dementia and lung cancer, and Bobby Kuntz, who died of Parkinson's disease, had CTE. Tony Proudfoot and Peter Ribbins died of ALS and Parkinson's, but did not have CTE. Two unnamed players are being examined.
"It's safe to say brain trauma is the only known cause for CTE," said Chris Nowinski, CSTE co-director, who declined to speak directly about the MacIver case but did underline its importance.
(The MacIver family also donated Doug's spinal fluid and eyes for a study on the early detection of CTE.)
"Most everything we've learned the last two years has come through studying the brains of athletes and others," added Nowinski, a former professional wrestler. "We learn something new from every case because each individual is unique."
MacIver had told his family he'd once been hospitalized after suffering a concussion playing football for the University of Manitoba. In total, he had been knocked unconscious three times and on other occasions was left "seeing stars."
Even though MacIver Jr. had been concussed playing in the OHL, and knew the aftereffects, the son was startled by his father's erratic behaviour.
"When I came to work with my dad [at a Winnipeg auto dealership], he was all over the place. We were in his office – this was months before he died – and he was rambling. I said to him: 'I have no idea what you're talking about.' He broke down."
There was another telling incident.
"His problems affected his mood swings and, we were told, an area of the brain that regulates body temperature. I remembered he was always cold or hot. We were in Las Vegas and it was 127 degrees [F] in June and my dad was so cold in the casinos we had lunch on a rooftop. The rest of us were all dying in the heat."
MacIver talked about donating his brain after hearing the CSTE had dissected the brain of former NHL enforcer Derek Boogaard and found significant tissue damage. MacIver Jr., who once fought Boogaard at an NHL rookie camp, insisted he has a better appreciation now for what his dad was going through, the frustrations and uncertainty.
"My dad sacrificed so much for the love of the game, just the overall abuse you go through," he said. "I think we'll look back with a lot more understanding."