In case you have missed it the New York Times has been publishing a comprehensive look at Derek Boogaard, in a three-part series. Not only the circumstances surrounding his death, but the wonderful life he had. With the revelation that Boogaard was confirmed to have CTE all of this information is relevant to the concussion front.
The Times began the series with a look at Boogaards rise to the NHL, from an awkward skater with little scoring prowess to the massive man on skates that would fight anyone at any time, “A Boy Learns to Brawl“;
Boogaard rarely complained about the toll — the crumpled and broken hands, the aching back and the concussions that nobody cared to count. But those who believe Boogaard loved to fight have it wrong. He loved what it brought: a continuation of an unlikely hockey career. And he loved what it meant: vengeance against a lifetime of perceived doubters and the gratitude of teammates glad that he would do a job they could not imagine.
He did not acknowledge the damage to his brain, the changes in his personality, even the addictions that ultimately killed him in the prime of his career. If he did recognize the toll, he dismissed it as the mere cost of getting everything he ever wanted.
In the second installment “Blood on the Ice“, the Times looked at the inner-workings of the hockey enforcer;
Such adoration is not unusual. The enforcer, sometimes mocked as a goon or euphemized as a tough guy, may be hockey’s favorite archetype. Enforcers are seen as working-class superheroes — understated types with an alter ego willing to do the sport’s most dangerous work to protect others. And they are underdogs, men who otherwise might have no business in the game.
Boogaard went nearly five years between N.H.L. goals and scored three times in 277 games. He spent 1,411 minutes on the ice and 589 minutes in the penalty box.
In the last story in the series “A Brain ‘Going Bad‘”, the toll of being an enforcer was revealed;
The Boogaard family waited for results. One month. Two. Three. Two other N.H.L. enforcers died, reportedly suicides, stoking a debate about the toll of their role in hockey.
Four months. Five. The news came in a conference call to the family in October.
Boogaard had chronic traumatic encephalopathy, commonly known as C.T.E., a close relative of Alzheimer’s disease. It is believed to be caused by repeated blows to the head. It can be diagnosed only posthumously, but scientists say it shows itself in symptoms like memory loss, impulsiveness, mood swings, even addiction.
More than 20 dead former N.F.L. players and many boxers have had C.T.E. diagnosed. It generally hollowed out the final years of their lives into something unrecognizable to loved ones.
And now, the fourth hockey player, of four examined, was found to have had it, too.
But this was different. The others were not in their 20s, not in the prime of their careers.
The scientists on the far end of the conference call told the Boogaard family that they were shocked to see so much damage in someone so young. It appeared to be spreading through his brain. Had Derek Boogaard lived, they said, his condition likely would have worsened into middle-age dementia.
And that was when Len Boogaard’s own mind went numb.
People and leagues can continue to doubt the issue of CTE; after all it will shake the foundation of the sport we know. What is rather apparent at this point in the research is that this condition only seems to be present with brains that have been exposed to repeated head trauma. What is more, if the original injury to the brain was allowed to heal properly we don’t know if that would have help. Simply because the major issue is the mismanagement of concussions.
If you have time I suggest reading the series and watching the accompanying videos.
The Concussion Blog 
Nothing surprising other than the degree of damage. He was a boxer on skates as were the others who died recently.
The sad part is the science deniers who will say it is not proven. Concussion and sub-concussion are not fully understood either. True, but what you are really saying, is keep things the same I need to get a pay check. Who cares what happens to the players.
It is the same for the military.
Try this one:
Testing Program Fails Soldiers, Leaving Brain Injuries Undetected:
http://www.propublica.org/article/testing-program-fails-soldiers-leaving-brain-injuries-undetected
Much like the NFL buying off scientific authors to mask the problem, the DoD went a step further and put in its own editor to review it own articles.
Clinical knowledge and related esearch has existed re the detrimental effects of combining TBI with alcohol and other drug use. Unfortunately more info / education needs to expressed / written re abstaining from alcohol and other street drugs / subtances while functionally recovering from the brain injury…
The following is an excerpt from my 2004 Dissertation re NFL Players’s Knowledge of Concussions:
“Athletes should refrain from the use of alcohol while functionally recovering from a concussion since alcohol use may impede the healing process of an adversely impacted central nervous system (D. Winstrom, personal communication, January 12, 2000; E. Nitka, personal communication, November 14, 1990; Sparadeo, & Gill, D., 1989). Furthermore, substance use and abuse should be avoided, as Barker et al. (1999) found. Utilizing quantitative MRI techniques, Barker’s study discovered that greater atrophic changes occurred in the brains of patients who experienced both TBI and substance abuse than in patients who experienced only one of the two traumas.”
Don,
I know both concussion and sub-concussion are serious injuries imperically. Both of us are aware of the hard science that stands behind these statements. The problem for most players, parents and coaches the damage does not obviously manifest themselves for decades after the injury. So one likes to believe that the poor care provided the player years before did not impact them in later life.
Unfortunately, many people want to believe or like to believe the drivel sold by the NFL, NHL, NCAA and the DoD.
Joe,
An aside first…did you receive a copy of my Dissertation from a mutual contact person?
Now I wish to respond to your reply…
1- I agree with you re the significant amount of clinical and experimental evidence existing re the adverse implications of suffering a concussion. The opening two paragraphs of my 2004 NFL Concussion-related research take that position…and I carefully chose the concept of ‘functionally recover’ rather than the misnomer of ‘recover’ based on reputable research findings.
The Dissertation excerpt follows:
Discussion, Conclusions, and Recommendations
The preponderance of credible experimental and clinical evidence pertaining to the adverse effects of concussion indicates that the brain is injured as the result of a concussion. The adverse and destructive consequences of a concussion may follow a continuum from subtle to grossly overt. Altered cell functioning and cell death along with subtle to more visible neurological, neurocognitive, psychological, and other medical problems reflect a diverse range of lifelong negative consequences of a concussion. Symptomatic concussions may also create a fertile environment for the Second Impact Syndrome and possible death of the concussed athlete.
Since a concussion results in brain injury, the term functional recovery–rather than recovery–should be employed when discussing an athlete’s “recovery” from a concussion. The term recovery implies full recovery of the brain from the sustained injury with no residual effects. Functional recovery implies partial and sufficient recovery of the brain to resume various daily life activities. Gronwall (1991) pointed out that typical postconcussion test scores should not be viewed as a return to a typical and pre-concussion level of functioning. It is possible that the concussed person expended an unusually higher amount of energy to achieve these scores. Furthermore, the cumulative effect of concussions supports inferential conclusions that the brain sustains further permanent injury when multiple concussions occur. That there have been numerous professional athletes who sustained multiple and, eventually, premature career-ending concussions, provides further support and clinical evidence for the adverse cumulative effect of concussions.
2- If I was able to uncover much supportive documentation while completing my Dissertation…with limited graduate school financial resources and person manpower…then it seems very plausible that credible medical and sport-related organizations could easily obtain this info…!!!
3- Unfortunately I believe our U.S. culture has IDEALIZED participation in Sport and has also ignored and/or minimized the risks of athletic participation.
4- Meeuwisse (2002) cautioned the sport-related concussion arena to be wary of over relying on ‘scientific evidence’ at the expense of clinical judgment… in the following excerpt from my Dissertation:
In the same vein, Meeuwisse (2002), after recently attending the first International Symposium on Concussion in Sport held in Vienna, not only warned, but also highlighted the possibility of over-relying on “objective scientific evidence” when assessing concussions. This concern was emphasized in the following statement: “the pendulum of [sports-related concussion] science has swung too far by focusing too much on rigorous methodology and complex statistical tests which therefore lose sight of logical and relevant clinically based interpretations or biological plausibility.” He further cautioned that these errors of isolated focus and thinking create “’nonsignificant’ findings/conclusions and a façade of ‘science’ pertaining to these erroneous conclusions” (p 1).
Don,
I did get and I do agree with your statements.
The series on Boogard is truly excellent. I happened upon it by accident the other day. Haven’t had a chance to watch all the videos, but what I’ve read is truly excellent – and I think groundbreaking. Nice work, NYT.