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Slice of life: Hard at work in the midst of play
| Two weeks ago, hundreds of thousands of people switched on their televisions and took part in a Saturday night tradition. They tuned in to "Hockey Night in Canada."
What they hadn't counted on was very nearly watching a man moments before he died.
As Philadelphia Flyers defenceman Chris Therien prepared to fire the puck at the Montreal net, Canadiens forward Trent McCleary crouched down to block the shot.
Therien unleashed a cannon of a shot and the puck struck McCleary's throat straight on. McCleary collapsed, rose up to skate towards his dressing room, then fell in a heap once again, gasping for air. The shot had crushed his larynx. He couldn't breathe.
McGill medical professors David Mulder and Vincent Lacroix sped to McCleary's side. Another McGill medical professor, breast cancer specialist David Fleiszer, happened to be watching the game in the stands. He rushed down to help.
As Mulder and Fleiszer worked on McCleary, Lacroix called the Montreal General Hospital to ensure that an operating room would be ready for McCleary's arrival.
Mulder and Fleiszer accompanied the player on the five-minute ambulance ride to the hospital, doing what they could to help the struggling player breathe. Once at the General, Mulder performed an emergency tracheotomy, inserting a tube through a hole cut at the base of McCleary's throat to reinflate the athlete's right lung, which had collapsed.
McCleary could breathe. He would live.
Two other McGill professors, otolaryngologists Françoise Chagnon and Nader Sadeghi, repaired McCleary's fractured larynx two days later.
At a press conference last week, Mulder said McCleary was lucky. "Until we performed the tracheotomy, he was in great danger. It was as close as I think you could come. It was a matter of seconds" before death.
Whenever a professional athlete sustains an injury in Montreal, it's a safe bet that he'll be treated by a McGill doctor.
Mulder heads up a team of McGill professors, including Lacroix, orthopedic surgeon Eric Lenczner and eye specialist John Little, that looks after the health needs of the Canadiens. Lacroix and ER specialist Scott Delaney, both from the McGill Sports Medicine Clinic, serve as team physicians for the Montreal Alouettes. The Montreal Expos' team surgeon is McGill's Larry Coughlin. Sports medicine expert Alan Vernec tends to the needs of the Montreal Impact soccer squad.
The dean of sports doctors in Canada is unquestionably Doug Kinnear. The McGill veteran was fêted recently during the NHL all-star celebrations by his fellow team physicians. After serving as the Canadiens' chief physician since 1962, Kinnear semi-retired last fall, handing over the reins to Mulder.
Mulder began his hockey doctoring as a surgical resident at the Montreal General Hospital in 1963. Kinnear was hunting for someone to help him look after the needs of a local junior hockey league team. "I played hockey growing up in Saskatchewan," Mulder says. "I jumped at the chance."
After a two-year stay at the University of Iowa, Mulder returned to Montreal to take up an appointment at McGill. He hooked up with Kinnear again, this time to look after the Canadiens' farm team, the Voyageurs. He has been a hockey doctor ever since.
The NHL requires at least two doctors to be present at every game, ready to look after the medical needs of both the home and visiting teams. Mulder and his colleagues split the duties during the season.
"You have to be a sports nut to do this," says Mulder. "It does eat up a lot of time."
"A lot of people think it's easy-going," says Lacroix. "It's not. We're ready for anything during a game. You see a big hit and right away, you're assessing the chances for injury. We're not drinking beer with our feet up.
"You relax once the game is over."
"We have an outstanding relationship with the Montreal General and McGill," says Mulder. "There probably isn't another hockey team out there that has such a close relationship with a teaching hospital and a university."
Part of that relationship extends to the Canadiens' training camp each fall, when about 70 players from the Montreal organization turn up at McGill's Seagram Sport Science Centre to have physical education professor David Montgomery run them through their paces.
The players take part in a battery of physiological tests that measure upper body strength, power, flexibility and aerobic fitness. "We identify their strengths and weaknesses," says Montgomery, so that Canadiens coaches and trainers know what their different players need to concentrate on in terms of exercise and training.
"Twenty years ago, the players wouldn't arrive here in the top shape we see them in today," says Montgomery. "They used to use training camp to get into shape. But there are a lot of dollars at stake now. You don't want to look bad right off the bat."
Montgomery says the testing can be quite competitive — certain players show up at training camp knowing they have to make a good impression if they want to crack the team's NHL roster. "They know who they have to beat for their jobs.
"There's also a lot of pride at stake," says Montgomery. The players are ranked in each category. "[Former Canadien] Vincent Damphousse was always the highest in aerobic fitness. His goal was always to be number one."
Players sometimes return for more testing during the season. If a player is recovering from an injury, Montgomery and his team can help pinpoint the areas the player needs to concentrate on to get back to peak condition. He also sees players return for follow-up tests during long lay-offs from game action, such as when the NHL takes a break in Winter Olympic years, for instance.
"It's a good psychological ploy by management. When players know they'll have to undergo another assessment, they tend not to take it too easy during the break."
Canadiens players also undergo roughly 100 treatments each year in the centre's hyperbaric oxygen chamber, which helps speed the healing process by increasing tissue oxygenation.
Kinnear says team doctors establish close relationships with the players over the years.
"You get to know their various idiosyncrasies. They get to trust your judgement. I love the game and I like the people in it. Hockey players are a good crowd."
"They're very good patients, by and large. They work hard on their rehabilitation," says Mulder. "They generally do everything they can to get back on the ice as soon as they can."
"Sometimes they see you as the company doctor — they worry that you have the team's interests at heart instead of theirs," says Lacroix. "We see that with new players on occasion. Once they're here for a while, though, they know we're there for them."
"People think we're pressured by management to get players back into action as soon as we can," adds Kinnear. "But the vast majority of coaches are ex-players. They remember being injured themselves. They don't want to risk anybody's career."
Lacroix says players themselves can be too anxious to get back into action following an injury. "Especially with concussions. We're doing cutting-edge research at McGill on concussions, so we know how serious these injuries can be. But if a player is feeling okay, he doesn't always understand it when you tell him to wait another week."
"They've been at this for quite a while," says Kinnear of pro hockey players, most of whom have been at their craft since early childhood. "They're almost inured to pain in their development. I have great admiration for their pain thresholds."
With more teams, more free agency and more big-money contracts, players switch teams far more than they did in the past. The days of a Jean Beliveau or Maurice Richard spending his entire career with the Canadiens seem to be over.
"It's gotten to the point now, there's so much player movement, that whenever another team comes into town for a game, there are invariably two or three players who used to be with us." says Kinnear. "You get fond of the players, so it can be upsetting when they go somewhere else."
"I find that very hard sometimes," says Mulder, "particularly when it's a really classy guy like [former Canadiens captain] Guy Carbonneau who is moving on."
When asked what change he would make to the NHL rule book if given the opportunity, Kinnear doesn't hesitate.
"I would bar cross-checking [players] from behind into the boards. That scares doctors silly. There's always a chance of someone breaking his neck."
"I'm concerned about all the stick work," says Mulder. "The two-handed slashes, I'd like to see that eliminated."
Lacroix, a former assistant coach of the University's men's basketball team, was the first McGill doctor to earn specialized training as an Ed Ricard sports medicine fellow — named for the late Ricard, an Imasco executive with a passion for sports.
Apart from medical training, Lacroix also learned about biomechanics and physical fitness principles from physical education professors like Mongomery and Hélène Perrault.
It's training Lacroix thinks more doctors should have — not just to treat elite athletes, but also to be able to offer good advice about exercise to a sports-minded kid suffering from asthma or to a senior who wants to carefully get back into shape.
At the Sports Medicine Clinic, Lacroix and his colleagues take care of 589 McGill varsity athletes, as well as members of the general public who sustain injuries "as weekend warriors in garage leagues."
Asked to compare pro football and hockey players, Lacroix says, "With football, there's more of a sense that players are part of the team. They aren't quite as individualistic.
"If you're a wide receiver, you need the quarterback to throw a good pass and you need the offensive linesmen to block if you're going to be able to do your job.
"In hockey, you see a guy like Jaromir Jagr change the outcome of a game pretty much all by himself."
Kinnear says it's no mystery why time-strapped doctors sign on to work with pro sports teams. "What kid wouldn't give up his right arm to be on a first-name basis with the Montreal Canadiens?"