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Racking their brains – Repeat concussions take a toll on athletes, such as Matthew Barnaby, causing confusion, pain and fear

By Bucky Gleason, News NHL Columnist, Buffalo News.com, May 23, 2011, 5:20 PM

Matthew Barnaby still remembers his first visit to La-La Land, at which he arrived on a nonstop flight via Steve Searles' right hand during the 1991-92 season. Barnaby was carving a name for himself as a feisty 18-year-old winger for Beauport in the Quebec Major Junior Hockey League.

If you thought Barnaby was a mouthy, pugnacious scrapper during his NHL career, you should have watched him in his early days. He had 29 goals and 66 points in 63 games in 1991-92, impressive numbers dwarfed by his 476 penalty minutes, including 33 fighting majors that accentuated his style over his ability.

He weighed 148 pounds when he reported to Sabres' training camp in 1992 and was involved in 13 fights in his first three days. He had 77 fights in junior, 27 in the American Hockey League and 185 more in the NHL. His eagerness to take on the world explains why, upon waking up in the dressing room from the Searles fight, he had an immediate response to this question:

"Are you ready to go?" coach Allain Chainey asked.

"Abso-freaking-lutely," Barnaby said.

He gained his feet, took a few wobbly steps and fell on his face like a newborn calf.

It marked the first severe concussion of Barnaby's career, but it was hardly the last. Now, with new research into head injuries and a growing list of athletes falling victim to them, he fears he could someday experience much bigger problems. Scientists who for years studied concussions found similarities among athletes who have suffered head trauma and varying degrees of brain damage.

The list of concussed athletes who failed to reach the average life span of a male in the United States is long and disturbing. Many weren't aware that they had problems until much later in life before suffering downward and sometimes tragic turns.

"Obviously, it's scary and it's nerve-racking when you hear about these things happening to people," Barnaby said last week. "Maybe 'scared' is the wrong word because I don't know. Not knowing is what's nerve-racking, but I live pretty well day to day. You just don't know. There's a chance we're all going to get cancer."

Barnaby's mentality was the same between his first major concussion and his last. The former Sabres winger estimated he had at least a dozen concussions in all, about half of which were diagnosed. It sounds about right. He played as if he had taken too many shots to the head. He was a loose cannon, an agitator, an instigator, a punk.

Here's a little secret: It was an act, an orchestrated approach to stay in the NHL by any means possible. He says he purposely took punches until his opponent grew tired so he could rally in the end. Remember his exit from Buffalo, when he ran his mouth until the Sabres could take no more and traded him to Pittsburgh? Contrived.

"When I was crazy and nuts, it was all calculated," Barnaby said. "I thought about it for hours, days and months. The trade thing [in Buffalo], I went home and thought about it. How can I make more money and how can I be used more effectively? It wasn't a knee-jerk reaction to be an idiot. I thought about these things. I weighed everything."

Perception doesn't always match reality.

Barnaby appeared to make a smooth transition into retirement. He was a natural as an analyst for ESPN and TSN. He was intelligent, insightful, witty, well-spoken and, of course, bold in his opinions. By most accounts, he had his life together after the cheering stopped.

Here's the irony: Barnaby came off like a kook when he played but actually had everything in order. When everything appeared to be fine, his life was a mess. The domestic dispute May 13 involving his estranged wife, the former Christine Cardarella, and her male friend appears to fall in line with other erratic behavior after he left the game.

Barnaby spent a night in jail and was released on his own recognizance. He would not comment on the case, which is pending.

Known as a good guy off the ice, Barnaby's behavior became unpredictable in the first two years after he retired in 2007. He was short-tempered and irritable, two qualities among many he now believes cost him his marriage and turned him into a different man. Looking back, he's convinced the concussions compounded problems he already had while adjusting to life after hockey.

During an interview in November, he did not solely blame the shots to his head for his problems, but he wondered if they were contributing factors.

"I was always cocky on the ice because that's the way I had to play, but when I left the rink I was always a good guy to my friends and my family," Barnaby said at the time. "And I lost that. I lost it. It happened right after I retired and after two bad concussions, back to back. There has to be a direct correlation between the two."

Recent research into concussions could support his theory.

"My attitude for two straight years changed who I was," he said. "I lost a sense of who I was for two years. I didn't like the father I was becoming. I didn't like anything. The biggest part of me is that I snap, and I snap on anything. I would have a temper. I've never been one to snap off [the ice]. I was totally away from my family and what I was proud to become. I got away from that."

The victims

The past two years, Barnaby said, have been better despite his recent marital issues. Others have experienced much worse. A study conducted by Boston University found evidence that appeared to link head trauma in sports with health issues and untimely deaths.

West Seneca native and former Pittsburgh Steelers tackle Justin Strzelczyk died in a chase with police that ended when he crashed his vehicle into a gasoline tanker on the Thruway.

Hard-hitting Eagles safety Andre Waters and Steelers offensive lineman Terry Long committed suicide several years after they retired.

Professional wrestler Chris Benoit killed his wife and son before committing suicide. University of Pennsylvania football player Owen Thomas killed himself. Steelers center Mike Webster died of a heart attack at age 50 after spending years homeless while battling depression and memory loss and becoming more violent.

Former Bears safety Dave Duerson, a man known for his intelligence before he headed into a downward spiral, committed suicide in February. In 2007, he testified for the NFLPA's player benefits board at a Senate Commerce Committee hearing, questioning whether his problems were related to football.

Doctors found evidence that all suffered from Chronic Traumatic Encephalopathy, a disease that's caused by repeated hits to the head. Boston University released a study in which experts believe there's a direct link between head injuries and Lou Gehrig's Disease.

"I don't want to say that was the reason," Alicia Duerson, his ex-wife, told the Chicago Tribune shortly after his death. "I don't want to give a reason because I don't know. I only know what he told me: Get my brain to the NFL. I think there is something wrong with the left side of my brain.'"

The aforementioned are among the athletes whose families have donated samples of their brains for extensive examination to Sports Legacy Institute, which is working with BU. The nonprofit group was co-founded by former Harvard football player and pro wrestler Chris Nowinski, whose own career ended after several concussions. A few years ago, Nowinski started a movement to collect the brains of athletes upon their deaths. About 400 agreed to donate their brains to science. Barnaby said he planned to add his name to the registry.

"It's a shame it took so long because a lot of athletes have been suffering unnecessary brain damage along the way," Nowinski said. "It's certainly disturbing to look at the amount of destruction to the brain for contact-sport athletes, especially football players. Just to think that playing football as a young man can cause a disease that destroys your brain cells, destroys your being, in as early as your 30s or 40s, is disturbing."

On the same day Barnaby was arrested, New York Rangers tough guy Derek Boogaard was found dead in his Minnesota apartment. The 28-year-old had not played since suffering a concussion in December. A medical examiner ruled he died accidentally after mixing alcohol and oxycodone, a powerful painkiller. Was the concoction related to a deeper problem? His family donated his brain to BU, where doctors will examine his brain for CTE.

Late hockey tough guy Bob Probert, who had drug and alcohol problems before he died of an apparent heart attack at age 45, was found to have suffered from CTE.

Dr. Robert Cantu, who with Nowinski co-founded Sports Legacy, wonders if former Bills great O.J. Simpson is a living victim of CTE. Simpson's erratic and violent behavior is consistent with that of others who suffered from the disease.

"There's a brain I would love to study," said Cantu, a clinical professor of neurosurgery at Boston University School of Medicine and one of the nation's top sports concussion specialists. "I don't know, but I really wonder. With his inability to handle frustrating circumstances, violence and all that stuff, it could be.

"It's hard to know. I'm not suggesting I know the answer, but if and when the time comes I would give anything for him to be on our registry."

Experts said all irrational behavior cannot be blamed on CTE, but it also cannot be ruled out when it comes to athletes or others who have suffered multiple concussions. Cantu wondered if former NFL linebacker Junior Seau, who last year drove his vehicle off a cliff after a domestic dispute, could be suffering from the disease. Nobody knows for sure. Doctors cannot diagnose CTE in living people, leaving many unanswered questions until their deaths.

"It's difficult to connect brain disease to specific actions," Nowinski said. "We know when you look at the group, they're far more likely to be having memory problems, impulsive-control issues, behavioral problems and depression.

"When you combine those symptoms, it helps understand abnormal behavior. It makes sense that people are more susceptible to having these sorts of breakdowns, if you will, with this disease, but you can never say the disease caused them to kill themselves, for example."

Said Barnaby: "It's not the concussions that make me do anything. It skews your point of view or can give you a not-care attitude when you don't [recognize] what triggers it. I'm responsible for my actions. Concussions don't make you do anything. You're always responsible for you're own actions. Anyone who says they aren't is absolutely lying."

Primeau fears unknown

Former Flyers center Keith Primeau, whose career ended in 2006 with post-concussion syndrome, is among a growing number of athletes willing to donate their brains to Sports Legacy.

He still suffers from symptoms more than four years after his last one and has become one of the most vocal sports figures when it comes to identifying and treating brain injuries.

"I'm very realistic, and I know that I damaged my brain," Primeau said. "I've told my wife and children the same thing. I hope I'm here for a very long time. But there's also the reality that I damaged my brain. I'm not afraid of when it's going to turn but how quick it will be. I don't think it's going to be tomorrow, but you never know."

Primeau said he never contemplated suicide, but he wondered during his lowest moments if death was somehow a better option than living with concussion-related problems. He was essentially a recluse in his South Jersey home 18 months after his last blow. He once found himself crying uncontrollably over his fate.

"When you wake up every day and you have a headache, or you're in a fog, or your vision is blurred, or it's something that just doesn't feel right, it puts huge stress on your level of emotion," Primeau said. "I just broke down in tears. I couldn't believe I felt the way I did that far removed from the injury. It feels like it's never going to get better."

Solutions

The NHL years ago addressed the issue with guidelines teams and players were encouraged to follow. Players showing signs of a concussion must be examined by a doctor and be symptom free for a week before resuming activity.

The NFL, after years of loose guidelines, has become aggressive in monitoring shots to the head. Both leagues have issued fines and suspensions for head hits they deemed were deliberate against other players.

One key element of treatment is awareness. Former Bills quarterback Jim Kelly once prescribed a couple of beers for himself after getting dinged. Players for generations have dismissed concussions after making a quick recovery from getting their "bell rung." Cantu, the neurologist, said most don't know they likely suffered at least a mild concussion.

"I remember fighting Stu Grimson one night in Anaheim and playing the next night," former Sabres tough guy Rob Ray said. "I went out for warm-up [in Los Angeles] and couldn't turn left. All I could do was turn right and skate in circles. It's different now. Back then, you were so afraid of losing your job, so you sucked it up."

Nowinski pointed to a study that showed only 10 percent of all concussions are diagnosed. Fifty percent of football, hockey and soccer players have concussion symptoms every year, but only 5 percent are reported. In many cases, players don't realize they have had a concussion because their brains aren't properly functioning.

"Teammates almost always know when a guy is banged up," Nowinski said. "They have to report each other. If you knew your buddy could die if he stayed in the game and took another hit to the head, you're obligated to speak up."

According to SportsConcussions.org, 19 states have passed laws designed to manage concussions. Some include mandatory removal of athletes from any game or practice when a concussion is merely suspected, and the player would not be allowed to participate until he was cleared by a doctor. More than 20 other states, including New York, have similar bills pending. Congress is considering legislation that could become a national law.

Prevention is almost impossible given the nature of contact sports, but there are ways to dramatically reduce concussions. One way to limit them is decreasing the amount and intensity of hitting in practice.

"High school players are taking almost 2,000 blows to the head at over 20 G's [gravitational acceleration] per year with 75 percent happening in practice," Nowinski said. "You can change that tomorrow. You dramatically reduce that in practice and everybody's exposure is reduced by half. It's a simple solution."

Another is eliminating the macho mentality that often comes with athletes. Many on all levels are slow to acknowledge any injury because they want to prove their toughness, believe they can overcome pain, or fear losing their places in the lineup.

Experts say there's no connection between concussions and a lack of toughness. Simply, a brain injury is a brain injury. But it's not enough to stop everybody.

Fifteen years after his first concussion, Barnaby was playing for Dallas when he squared off with Anaheim winger Shawn Thornton, now with Boston, in what looked like an ordinary fight. Barnaby temporarily lost vision in his left eye, which hardly stopped him from charging Thornton later in the game and getting ejected.

Barnaby returned the next night and played six more games for the Stars. He had another fight against Phoenix's Josh Gratton on Jan. 9, 2007, before telling team doctors he had a few minor headaches.

In truth, he had lost vision again in the same eye. It was the last game of his memorable 14-year career.

"There's nothing I can do about it now," Barnaby said. "There's nothing preventative now. Time will tell, but I can't live my life every day thinking I might die because of it. It's not the way I live my life. If I die a few years earlier, I had a pretty damn good life."