Then Missy moved to Chicago, and in 2011, so did Steve. Steve’s body, like that of every player, would begin a season fit and healthy, and under the weight of accumulated spasms, tightnesses, and other insults, gradually break down. He was looking for a chiropractor, and had heard about Missy from other players. He became one of her clients. She manipulated his muscles and joints, and gave him acupuncture; he asked her questions. “He wanted to understand everything,” Missy says. “Why his body was working, or why it wasn’t.” She began preparing for his appointments. What was he going to ask? He also wanted to know everything about her. Missy was used to pick-up questions; with Steve, it was like he really wanted to know. She found him fascinating, and exhausting.
Missy liked athletes. She liked their energy and purpose, their physicality, and they liked her. She was cute and fun. She talked like a jock and thought like a jock. She liked to hang around athletes and they liked to hang around her. She was not like any chiropractor any of them had ever met. She was one of them.
Steve and Missy were not girlfriend and boyfriend. Steve saw many other women; Missy saw other men. They were soulmates, kindred spirits, and roommates. They could spend hour after hour with each other, doing exciting things, or nothing at all. It’s as if they hung out in each other’s minds. And unlike almost every other woman Steve had met, Missy could keep up with him. He could do ten things a day; she could do ten things a day. He could find every next thing totally interesting; so could she. And while Steve could talk for hours and hours, Missy could talk for hours and hours at warp speed. When it came to talking, she was Rogers to his Astaire. She could do everything he did, but going backwards and in high heels. At times, it was too much for Steve. “Quiet time, Missy,” he would say to her. Many of Steve’s friends thought she was perfect for him.
Missy had met Steve first during his drinking years in Calgary, saw him infrequently during his healthy years, and got to know him during his increasingly fragile years. He was still good that first fall in Chicago, Missy recalls.
Then the concussions came.
On January 8, the Blackhawks played Detroit. When the game was over, Steve went to see Dr. Michael Terry, one of the Blackhawks’ physicians. He had been hit in the face with a punch, he told Terry, and as Terry later recorded in his notes, had “a brief period where his consciousness was altered,” where he “felt like he was a little hypoglycemic” and “a little bit hazy.” Terry put him through some tests and wrote:
[H]e was able to perform serial 7s. Three word recall was intact. His modification of SCAT was otherwise normal although he was unable to do 3 number reverse recall and 4 number reverse recall without prompting. Otherwise normal neuro exam. Cranial nerves 2 through 12 are intact. His balance is normal. His affect was normal.
In his notes, Terry concluded: “A/P [Assessment and Plan]: concussion. We are going to put him through our protocol for return to play.” On Steve’s Fitness to Play Determination Form, which he signed, Terry wrote: “Disabled.”
Two days later, January 10, before the Blackhawks game against Columbus, Steve was given a neuropsychological examination by Dr. Elizabeth Pieroth under the NHL Concussion Program. Steve described his injury and symptoms to Pieroth, as he had done with Terry. Pieroth later wrote in her report that: “The player was a poor historian regarding his concussive history. He stated his most recent concussion occurred February 2011 but he could not recall how he was injured. He denied loss of consciousness or retrograde/anterograde amnesia and experienced only headache and neck pain. Steve believes he missed 2–3 games and thinks this was due to neck pain.” Further, Pieroth reported, “In 2009 he was hit in a practice and missed 2 games but wasn’t sure if he had actually suffered a concussion at that time. The player also reported that in September 2000 he received a blow to the head and was out of play for one week but does not recall what symptoms he experienced or how long [they] lasted.” Pieroth checked Steve’s recollections against those he had reported on his earlier NHL tests and found them “not entirely consistent.” In addition, “Steve cannot state if these were all concussive injuries. He denied any other head injuries or significant medical history.”
Pieroth went on, describing his present symptoms after the hit two days before. “Currently Steve did report trouble falling asleep and irritability but stated this was secondary to personal issues and not related to his concussions. He has also completed the Blackhawks’ exertional protocol without eliciting any symptoms. Therefore he can be cleared to play in this evening’s game with the team physician’s approval.”
Pieroth concluded her report:
Steve was also provided with education on concussive injuries and we discussed the current signs of multiple concussions. I explained to him that it is difficult to determine if he has demonstrated increased recovery time or increased vulnerability to concussive injuries given his poor recollection of his past injuries. However, given his report, the player does seem that he has recovered along expected lines from his previous concussions. Steve stated that he understood my concerns but is comfortable with assuming the risk associated with continued play at the professional level.
Steve’s Fitness to Play Determination Form, again signed by Dr. Terry, reads: “Not disabled.” Steve played that night against Columbus.
Almost a month later, on February 8, Adam Jahns of the Chicago Sun-Times reported that Steve had left the game the night before against Colorado in the second period, “and didn’t return because of an upper-body injury. He underwent X-rays for his injury before the Hawks left the Pepsi Center. His injury isn’t thought to be serious. ‘He’s doing OK today,’ [Blackhawks coach Joel] Quenneville said. ‘We’ll see how he is [tomorrow].’”
The next day, Steve was put on the injured reserve list.
Nearly three weeks later, having seen Dr. Terry again and still feeling symptoms, Steve decided to seek another opinion. He went to see Dr. Jeffrey Kutcher at the Michigan NeuroSport Clinic at the University of Michigan hospital in Ann Arbor.
Kutcher, in his report, filled in some of the details between Steve’s initial injury on January 8, his examinations by Terry and Pieroth, and his injury against Colorado on February 7. Kutcher noted that after his January 8 injury, Steve played the next four games “without any symptoms or difficulties.” Then, he wrote:
On January 18th, he was struck in the head by an opponent’s shoulder which caused a more significant constellation of symptoms. For the next 2 weeks, he felt forgetful, emotional, and ‘out of it.’ He was beginning to sleep poorly. He was having mild diffuse generalized head pain. Despite this, he continued to participate in hockey.
On February 3rd, Steve was in a game when he was hit from behind causing a whiplash-type of movement. This resulted in perhaps a short duration of loss of consciousness. He continued to play, however; and on February 7th, while playing a game at Colorado he was involved in a more subtle hit, but one that caused an immediate flash of a green fence in his vision. He played the rest of the period, but then removed himself from participation.
A “green fence” is one of a variety of visual images, which appear in different colours, that concussed people recall seeing at the time of impact.
Steve had been injured first on January 8, then again ten days later on January 18, then two weeks after that on February 3, then four days later on February 7. His meeting with Kutcher occurred twenty days after his last injury in Colorado. Kutcher described his symptoms that day:
“Currently he is continuing to experience focal pounding headaches that last anywhere from 5 min. to 2 hours. They occur sporadically, but also with minimal exertion. Symptoms at baseline have improved otherwise, but he still describes having problems with sleep, mood, and appetite. As he has improved, he has attempted to return to physical activity with two trials on a stationary bike. One was on February 23rd for 10 min. and when his heart rate got to approximately 120 he had a significant increase in head pain. He again tried this on the 24th with essentially th
e same results.”
Kutcher also gave Steve a general examination, and described what he found as “unremarkable.” He put him through additional tests while he was at rest, then after twenty-two minutes of exertion on a stationary bike. The next day he gave him the same bike test, then some agility drills in the gym followed by drills on the ice. “He did very well tolerating exertional levels much higher than previously noted,” and “without any significant increase in symptoms,” Kutcher wrote.
He concluded: “I was encouraged today by his performance and the rather subtle symptoms that he expressed.” Kutcher added a note of caution: “At this point, while I’m encouraged, I would like to be very careful moving forward,” and he suggested “we progress along a very careful rehabilitation program that stresses both increased exertional levels as well as agility, movement, visuo-spatial tasks, and the cognitive aspects of playing hockey.”
Kutcher added: “[W]e discussed the possibility of medications to help. He would like to forego any medications at this time, but we will continue to monitor his symptoms and he may reconsider this in the future.”
Steve returned to Chicago. On February 29, he was examined by Dr. Terry. The doctor’s dictation note was less encouraging: “[Steve] still is feeling foggy. He has not noticed a good deal of change but he has been exercising a bit. He says that he stops when he is symptomatic.” Nine days later, Steve saw Terry again. The doctor’s dictation note reads: “[Steve] says that he has been feeling better. Will have an occasional feeling of vertigo or dizziness. An occasional headache. He said that they are both very rare.
Overall he said he otherwise feels essentially normal with no focal symptoms.”
After Steve’s initial injury on January 8, his journal entries became more sketchy and sporadic. On March 14, he wrote:
1. Gratitude—health
2. Gratitude—game
Remaining Empowered
Concussion—stop the noise
Later the same day, he asked:
What is this teaching me about being a competitor?
• keeping things simple
• how to handle reality
• accepting fallibilities…
• overcoming adversity
More often, he began a thought in his journal and didn’t complete it. He wrote of his gratitude for the chance to play with “this unique club”: “I’m good, it’s fun, there’s tough patches but that’s OK. [My] capacity for survival is phenomenal. Pat self on back, it’s OK. I bring a lot to the team. I know my being there boosts that environment.”
A week later, on March 21, Steve saw Dr. Terry again and told him he was feeling better. Terry noticed no symptoms, and noted that Steve’s modified Standardized Concussion Assessment Tool (SCAT) was “normal.” Steve’s Fitness to Play Determination Form, signed by Terry, read: “Not disabled.” Four days later, on his dictation note, Terry affirms Steve’s status: “He has been treated for a concussion. He presents today with no symptoms. He completed his exercise protocol and impact testing and passed both. He is symptom-free and doing well. He is therefore clear to return to play.”
On March 27, 2012, thirty-five games after his initial injury, twenty-three games after his fourth injury against Colorado, Steve dressed against New Jersey. He played four minutes and twenty seconds. In the third period, playing on the wing, he crashed the Devils’ net and got an “inadvertent elbow” to the head from defenceman Mark Fayne.
The next day, Steve’s Fitness to Play Determination Form, signed by Dr. Terry, read: “Disabled.”
Steve never played in the NHL again.
—
It never seemed it would happen this way. Steve’s return to play was always a matter of time—time to allow things to settle, time to let the brain heal. A different doctor, a new treatment, a different understanding and approach to concussions, and to paraphrase what Steve had written in his journal, “Something’s gonna happen to magically make me better.” He had always gotten better before. Athletes get better. You feel, you deal, it passes, you get on with it. That’s how it had been with his back, his knee, his neck. That’s how it had been with his head. Headaches, dizziness, fatigue, sensitivity to light—symptoms that felt like they were going to last forever always went away. No scars left behind, nothing he could see in the mirror, nothing anyone else could see even on MRIs, no indications that anything had happened. It was only when he was asked by doctors about his medical history that he even remembered all those other hits to his head, that they might have been something. The time in minor peewee, that other time in junior. Those times in Calgary when he was trying to make the team, when he did a face plant on the ice and cut up his nose and cheek, when he got knocked silly by an elbow, when he got sucker-punched in a bar. The time in Florida when he ran into an opponent’s helmet with his face and broke his nose again. Then, in Buffalo, another elbow, a stick, more cuts, another break to his nose. In every instance the injury he thought he received was a break or a cut, not dizziness or headaches. It was the same earlier in the season when he slid into the boards with his face and fractured his zygomatic arch and temporarily lost his hearing. He’d had a brief loss of consciousness; but isn’t that just what happens when you break your cheekbone? If he had a banged-up shoulder and a headache, which injury was he going to focus on? Players get hurt game by game; all his big head-hits, until that season, had happened months and years apart. He’d gotten better in between. He was always fine. He had a game to play.
Athletes have their own kind of relationship with pain. They play because they are so absorbed in playing that they don’t notice injuries when they happen. The soldier who is shot keeps on going because the imperative to go on is so much more important than the imperative to fall. The explanation for such a miraculous act is purpose more than courage.
So players play. And players expect other players to play. Someone goes down in a hockey game and is helped off the ice. “He’ll be back,” the announcer says. “He’s a hockey player.” And when a hockey player does come back, most often he is fine. Time heals. As a player, you learn quickly: Where do you want to spend your healing time? At home, moping around, feeling the pain, having nothing to do to distract you from it? Or on the ice, with your buddies, who admire you just a little more because you are there, doing what you love and doing it for the team? Like Keith Primeau and Marc Savard did. Like Steve always did.
Steve played for a month between January 8 and February 7 with concussion symptoms that kept recurring. Four times. Four separate hits. January 8, January 18, February 3, February 8. Why? Because he didn’t feel that bad. Because he was able to persuade himself that he didn’t feel that bad. Because he had played other times with a wonky shoulder, so why not a wonky head? Because he was tough and everyone knew he was tough, and he liked that he was tough. Because as lousy as he felt during those other twenty-one and a half hours of a game day, for the two and a half hours he played, he didn’t feel lousy. He felt the game. And for those games between January 21 and February 7 he especially played because the Blackhawks had lost five in a row and his teammates needed him. Because he needed to prove something to them, to Quenneville and Kitchen, to himself, to TIGER INC., to Stan Bowman, the Blackhawks general manager, who had signed him. Because not to play was unthinkable.
When he was a kid, he didn’t know anything about this long-term injury stuff, or even think about it. Why would he? He just played. Now he knew there might be some effects, but he didn’t really know—he had no idea—what those effects might be, no matter how much Dr. Terry and Dr. Pieroth and all the other experts told him and what he said back to them. I know, he’d say; I understand. But he didn’t. How could he? He’d had no idea he would feel like this. None. He’d had no idea this might go on for weeks. For months. He’d had no idea, he still had no idea. This might go on and on and never stop. This might be his life. This might be him.
When he was younger, he knew: I have to do everything in my power to make this life happe
n. Now at thirty-two, he knew: I have it, and I must not, I will not give it up.
The updates in the media about Steve’s injury became less frequent. The Blackhawks were in a playoff fight; Steve would be news only if he returned to the lineup, and no one believed that would happen. The team finished sixth in the Western Conference. Two weeks later, their season was over; they lost in the first round to the Coyotes in six games. For a team with such possibilities and appetites, this had been a bad year. Steve had been signed as a tweak to a lineup that needed only a few tweaks to return to Stanley Cup glory. His injuries, and the new needs of the team, now made his future with the Blackhawks very uncertain.
Two days after Chicago’s season ended, on April 25, Steve saw Dr. Terry again. Later, the doctor dictated this note: “[Steve] remained symptomatic from his concussion and we will continue to monitor him and take him through our protocol when it is appropriate.” Again, Steve was listed as: “Disabled.”
Four days later, he travelled to Ann Arbor to see Dr. Kutcher, who put him through two more days of tests. After the second day, Kutcher wrote: “He is doing well today with no significant symptoms….[His] examination again today was normal including intact mental status, cranial nerves which were intact to specific testing of each cranial nerve. Excellent balance and coordination was also noted again.” Kutcher said that he was encouraged by Steve’s improvement, the brain MRI hadn’t shown any obvious signs of trauma, and he was cautiously optimistic about Steve’s return to hockey.
Early in June, Steve went to see Dr. Ted Carrick at the Carrick Institute Life University Neurology Clinic in Marietta, Georgia, near Atlanta. Carrick is a chiropractor specializing in what he calls “chiropractic neurology.” He had treated Sidney Crosby and been featured prominently in the concussion press conference in September 2011, in which Crosby’s progress was outlined. Two months later, Crosby had returned to play, then was sidelined eight games later after a minor hit, then played again on March 15, twelve days before Steve made his brief return against the Devils. Carrick had been recommended to Steve by Andy O’Brien.