They say that heart is valued most in hockey, but they have the wrong organ.
It should be the brain.
Heart may have a great deal to do with how a hard-checking and even harder-shooting defenceman with the Nashville Predators, Shea Weber, will make $14-million (U.S.) this season, or how a driven centre, Sidney Crosby, can be paid $12-million a year to play for the Pittsburgh Penguins.
But it is the brain that costs NHL players, costs the league and insurance companies and, for that matter, costs everyone involved in future earnings in everything from contracts that injured players will never sign to endorsements they will never receive.
Charles Tator of Toronto Western Hospital is acutely aware of the physical costs of injuries to the head. The Canadian neurosurgeon is a leading international expert in concussion research and treatment, and as founder of ThinkFirst Canada and a board member of Parachute Canada, has dedicated his career to injury prevention and the healthy enjoyment of life.
This Saturday at the Krembil Neuroscience Centre at Toronto Western, Tator and two colleagues – Richard Wennberg and researcher Carmen Hiploylee – will be key presenters at the Canadian Sports Concussion Project's third annual symposium.
Their academic journal paper, "The Financial Toll of Career-Ending Concussions in Professional Hockey," is an attempt to apply dollar signs to an injury professional hockey is increasingly reluctant to discuss. Dr. Tator's hope is that "by showing a huge financial loss, you have another motivator to make the game more safe."
Motivation is critical, he feels. As public awareness of the effects of head injuries grows, the word "concussion" has become increasingly stigmatic, to be avoided if possible by teams, coaches and even players affected.
The NHL prefers not to discuss the topic – though the league was asked by The Globe and Mail, as was the NHL Players' Association – and there may well be legal reasons behind such reticence.
Last week in St. Paul, Minn., the league sought to have dismissed a class-action legal suit brought by former players with concussion-related injuries. The suit, filed by more than 200 former NHLers on behalf of some 5,000 living former players, is roughly similar to the one filed by former NFL athletes, which resulted in their league offering a $765-million settlement in 2013 that would cover nearly 20,000 players over the past 65 years.
Six former NHLers – Gary Leeman, Bernie Nicholls, Mike Peluso, Dan LaCouture, Reed Larson and David Christian – are serving as class representatives in the suit. U.S. District Court Judge Susan Richard Nelson listened to the legal arguments from both sides during a five-hour hearing this month without making a ruling. The judge gave no timetable for a decision.
In gaining an appreciation for the financial impact for both sides – league as well as injured players – Judge Nelson might be wise to consider the paper that will be tabled in Toronto this weekend.
The researchers concerned themselves with post-concussion syndrome (PCS) that fails to be resolved in what medical circles would consider a normal time frame. The players studied lost their hockey careers to PCS. It could, however, still get worse for some of them, as there is now ample scientific evidence that multiple concussions can lead to chronic traumatic encephalopathy (CTE). CTE is a progressive condition that can lead to brain degeneration and manifest itself as dementia and other mental and neurological disorders such as depression, anger and violence. Former football and hockey players who committed suicide in recent years have been found to have evidence of CTE when their brains have been examined.
The researchers hope that by applying dollar signs to such injuries they can prompt more action on the player safety front. Of great concern is when there are, to an expert, obvious signs of a concussion suffered during a game and yet the player remains on the bench and is never diagnosed. It is believed 10 per cent of concussions are missed this way.
The researchers tabulated a variety of factors during the period 1995-2014. They narrowed their list to players who could be said to have suffered career-ending concussions while playing in the NHL. They gathered their data from news reports and online sources, and had access to hockey experts who helped with such matters as insurance coverage.
After the list had been narrowed to 35 players – multiple players were dropped from the list because they had suffered their final concussion in another league or else data could not be confirmed – the researchers were able to produce an overall cost: $117,191,045.
The list begins with Brett Lindros, just 19 years old when a third concussion brought an end to his days with the New York Islanders. The salary cost of such an unexpected turn was calculated at more than $4-million.
Nine years later, Eric Lindros, Brett's highly gifted older brother, was forced out of the game at age 30, having suffered a sixth concussion. His salary cost was in excess of $1-million.
Some costs proved impossible to calculate fully. Steve Moore of the Colorado Avalanche, as all hockey fans recall, lost his career at age 25 following a vicious hit from behind by Todd Bertuzzi, then with the Vancouver Canucks. It was Moore's first concussion and he never played again. In pure NHL terms, the financial amount came to $67,378.05 in lost salary. No one knows, however, how many millions were involved in last year's out-of-court settlement reached in the case following Moore's long-fought civil suit.
"We had no way of handling that," Hiploylee says.
"One of the problems in society is that settlements are confidential," Tator adds.
"Knowing what that settlement was could be a useful deterrent."
There are a number of NHL superstars on the list. Hall-of-Famer Pat LaFontaine kept trying to play on with the New York Rangers after a third concussion but, at 33, finally had to retire in 1998. Paul Kariya was trying to come back from concussion with the St. Louis Blues in 2009 when he decided to pack it in at 35.
Hiploylee says the list is extremely "conservative" for a variety of reasons – one of which is told in the stories of LaFontaine and Kariya. LaFontaine's financial loss is listed at less than $1-million and Kariya's at less than half a million, as each were considered gambles by their current teams and unable to command the salaries or contracts they could have if healthy. Both players missed vast amounts of playing time recovering from previous head injuries; that lost time would have raised the overall cost by millions of dollars.
"The salaries lost to concussion when the players are in the prime of their careers is hard to calculate," Tator says.
The impact of once-healthy stars suddenly losing their careers is shown by two of the final names on the list. Marc Savard, who had several concussions prior to the 2011 injury that put him out of hockey, had nonetheless recently signed a massive deal with the Boston Bruins; when he left the game at 33, the financial loss was calculated at more than $24-million. That same year, 37-year-old Philadelphia Flyers defenceman Chris Pronger suffered a second concussion and was unable to continue playing, leaving a loss of more than $25-million.
The researchers say the Savard-Pronger situation is "unusual" in that the figures account for 40 per cent of the total costs in the study. "I don't think we foresaw that," Wennberg says.
They believe, however, that the financial shock of these two lost contracts may have proved beneficial to players who came along later.
"The rule change to make intentional hits to the head illegal in 2010-2011 and 2011-2012 [originally introduced as Rule 48] and the downward trend [in employing] enforcers may have helped mitigate concussion-induced retirement," the researchers say in their paper.
"I wonder if the league itself took that as an indication of what lies ahead if we do not do something," Tator says.
This season the NHL appears to have all but eliminated the "goon" who brings no other attribute than his fists to the game, and "staged fights" have virtually disappeared.
"This has got to be attributable to the concussion concerns," Tator says. "If there is anything positive that we can say it is that it looks as if the league is going in the right direction."
The researchers would just wish it would move a little more quickly.
At the end of their report, they list a number of simple recommendations that the scientists believe would help make the game safer for players at all levels of competition.
They would like to see the NHL take to the larger European ice surface. More space for today's larger, faster and stronger players would be its own safety zone. None of the current NHL rinks has that extra width, though Olympic hockey – so beloved by North American fans – is usually played on the larger rink.
"This has long been my particular hobby horse," Wennberg says.
"But I don't know how you get the message out to those who need to hear it."
The researchers would like to see injury determination fall to the diagnosis of independent physicians rather than team doctors, who might feel some obligation to have the player, particularly a star, return to action more quickly than he or she should.
They would want to see "zero tolerance" for hits to the head of any type. The NHL currently has harsh punishment for those who "target" heads during body contact. The researchers accept the difference between intended hits and accidental ones, but they believe in penalties for all head hits, with deliberate hits receiving increased punishment.
And finally, the scientists believe the time has come for real penalties for fighting rather than meaningless majors that have no effect whatsoever on the two teams playing. They would also like to see an escalation of penalties for repeat offenders.
Tator believes that, "with a stroke of the pen, you could write fighting out of the game."
He also believes that attitudes are changing.
"A corner has been turned," he says, when new rules begin appearing at the same time as players whose role is violence are disappearing.
"It's not just about money," he says.
It's also about lives.