Dan Carcillo’s NHL career ended after concussions. Now he wants the league to better protect players from the same fate.

Dan Carcillo retired from the NHL three years ago at the age of 30. During his nine-year career, he was one of hockey’s most notorious agitators. You loved him when he was wearing your team’s jersey and loved to hate him when he wasn’t. But now the player who earned nine career suspensions is trying to make a different kind of impact. He is speaking out about the dangers of concussions and calling on the NHL to do more to protect and educate its players.

The NHL reached a tentative non-class settlement in November in a lawsuit brought by more than 100 retired players, including Carcillo. The lawsuit alleged NHL negligence in the treatment of head injuries and also claimed that the league withheld information on the long-term risks of head trauma associated with playing hockey. The agreement included payments that cannot exceed $18.92 million in total, but did not require the NHL to admit liability for any of the plaintiffs’ claims. Carcillo says he will opt out to continue his fight for accountability.

From Agitator to Advocate

The mission to change the way the hockey world and the general public think about concussions, traumatic brain injuries (TBIs), and Chronic Traumatic Encephalopathy (CTE) is personal for the two-time Stanley Cup winner.

It began on Feb. 15, 2015 when Steve Montador passed away at age 35, three years removed from an 11-year NHL career. Montador and Carcillo became teammates in Chicago in 2011 and the two men bonded over struggles with addiction. Carcillo credits Montador with helping him live a sober life and calls him his best friend in hockey. The presence of CTE was discovered posthumously in Montador by the Canadian Sports Concussion Project. He was the fifth former NHL player to be diagnosed with it.

“[He’s] the reason I’m an advocate,” Carcillo told SB Nation. “The day that I got the phone call on Feb. 15, it was a day before a game. My phone had been ringing off the hook and my son had been born in November, so I was worried it had something to do with that. When I picked up it was a friend and she was crying hysterically saying that Steve was gone.”

Just one month after Montador’s death, Carcillo played in what would ultimately be his last game before sitting out the remainder of the season after being diagnosed with concussion-like symptoms. In April 2015, he published a heartfelt video on The Players’ Tribune discussing his friend’s passing.

”When you have a concussion, and you go through that, it’s a dark, dark place,” Carcillo said in the video. “I just recently had one. I fell into a lull, into a depression, especially after Monty’s passing.”

In September 2015, Carcillo announced his retirement in The Players’ Tribune. In that essay, he announced he was establishing the Chapter 5 Foundation along with his wife, Ela, to help players transition to life after hockey. His openness captured the sport’s attention. More than three years later, he still has it.

Photo by Bruce Bennett/Getty Images

In May 2018, Carcillo pledged his brain to the Carrick Institute, an institution he credits with saving his life twice over, for further study into the consequences of traumatic brain injury. A month later, The Players’ Tribune published a video in which Carcillo discussed his feeling that the NHL is failing players by not embracing all available concussion treatment options. His doctor told The New York Times in November that Carcillo suffered seven diagnosed concussions during his career. All the while, his Twitter feed has been filled with advocacy for concussion treatment and mental health awareness, as well as song lyrics, his thoughts on suspensions, and other NHL news.

“Treatment is available and you can optimize yourself,” Carcillo said when asked about the message he hopes to impart. “It can save your life.”

Accountability

Within months of publishing his first testimonial with The Players’ Tribune, Carcillo joined the list of NHL players suing the league over brain injuries suffered during their playing careers and the lack of warnings over the risks of head trauma.

“I was held accountable for my actions in the league — if I was late or if I played outside of the rules I got suspended, I got fined, and I took it. They held me accountable. And now that’s all I’m trying to do [with] these guys, who are responsible for lying to us.”

The NHL introduced a “Concussion Evaluation and Management Protocol” for teams to follow before the 2016-17 season, but Carcillo has not been alone in finding it inadequate. Intended to help teams with education, testing, identification, evaluation, and management of concussions, it has been scrutinized ever since it was implemented. Prominent among the perceived shortcomings of the system are the use of spotters in the stands to identify players showing signs of head trauma, the way that tests determining a player’s eligibility to return can be manipulated, and the lack of updated education around the long-term impacts of head trauma, including CTE.

“They could have shown us a slideshow on the risks of getting hit in the head with a bare knuckle if it’s for fighters,” Carcillo said of even the minimal things he believed the league could have done for players entering the league. “They could have shown superstars a video of Crosby getting those concussions.”

Photo by Kevin Hoffman/Getty Images

Another related issue that frustrates Carcillo when it comes to the NHL’s treatment of players suffering from concussions – and one that was raised during the lawsuit – is the potentially dangerous way medications are prescribed to players by doctors. Jeffrey Kutcher, a neuropsychologist who has treated NHL players with concussion-related problems and consulted with the the NHLPA, stated that he has seen instances where NHL players have been prescribed antidepressants; amantadine, a drug that Kutcher said is typically administered to patients with conditions such as multiple sclerosis or Parkinson’s disease; and in rare cases opioids to deal concussion symptoms.

“Once you go down this rabbit hole,” Carcillo said, “it’s really disgusting, you know, the way that they treat human beings, the way that they treat kids.”

Throughout his tenure as NHL commissioner, Gary Bettman has been dismissive of any potential link between hockey and the long-term effects of head injuries that can be caused from playing, including CTE. Meanwhile, numerous research groups — including Boston University, the Brain Injury Research Institute, and National Institute of Health — have conducted studies showing links between contact sports and CTE. Boston University and the Brain Injury Research Institute, among others, have done work with hockey specifically, including examining the brains of deceased former NHL players.

As recently as April 2018, Bettman said during a radio interview that scientists “don’t have enough evidence to reach any conclusions” that hockey and CTE are linked. Bettman was answering a question about the research being conducted at Boston University by neuropathologist Dr. Ann McKee. She responded to his comment, noting that he was citing a conversation in 2012 when the sample size for the study was small.

“However, it is misleading for Mr. Bettman to say we haven’t reached any conclusions,” she said, via TSN. “The evidence clearly supports that CTE is associated with ice hockey play. Since that 2012 meeting with Mr. Bettman, the VA-BU-CLF [Veterans Affairs-Boston University-Concussion Legacy Foundation] research team has identified CTE in more ice hockey players, including four amateur hockey players, not all of whom had significant fighting exposure. This provides evidence that normal ice hockey head impact exposure can be associated with CTE.”

For Carcillo, there can be no meaningful change until a connection between hockey and CTE is conceded by the league and the long-term dangers of head injuries are explained to its players.

The American Association of Neurological Surgeons defines a traumatic brain injury as “a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.”

Carcillo looks at hockey and sees that risk everywhere on the ice.

“That’s a stick to the face, a crank of the brain stem, a puck to the face, your teeth get knocked out, a hard hit to the body, an unsuspecting check that isn’t a very hard hit,” he said.

Carcillo’s frustrations stem from the fact that these risks were not disclosed to players.

“All of these things that I have learned should have been fucking told to me,” Carcillo continued. “They never were, and that’s where my issue comes in. You’re risking people’s lives.”

Changing the Culture

Carcillo cringes when he shares the following story, but he also gets angry. As a player, he knew how to game the ImPACT test – the evaluation of brain function used to determine when a player could return to the ice after suffering a concussion. According to Carcillo, the key was performing poorly on the test during training camp that will be used as a baseline to compare against during the season.

“The number one symptom of a concussion is feeling foggy or slowed down,” he said. “So what do you do? You’ve seen that test, you’ve seen it every year. You know that you’re going to be a little foggy or slow, so you bomb it at the beginning of the year on purpose so that you can pass it if you do happen to get injured. That way, you can come back sooner.”

Whether motivated by a play-through-anything ethos or fear of losing a job while off the ice, players attempting to return too soon or under-reporting concussion symptoms is damaging to their future. Carcillo’s opinion is that team doctors can’t be trusted to make the players’ interests a priority when it comes to recovery timetables.

“That narrative is so old and so tired,” Carcillo said. “Telling kids and convincing kids to put themselves at risk — promoting violence and hitting and fighting, and that playing in pain is okay. To me, yes, playing in pain, sacrificing your body as an athlete that’s part of it, but it shouldn’t be advertised as such.”

NHL players have been portrayed and promoted as warriors for playing through injuries. Patrice Bergeron was commended after playing with a separated shoulder, torn cartilage, and a broken rib that punctured his lung in the 2013 Stanley Cup Final. Joe Thornton, according to his head coach, was courageous for playing through a torn MCL and ACL in the 2017 playoffs.

As Carcillo, who spent time with five teams during his career, sees it, the outdated views about playing through physical injury also make talking about mental health a taboo in locker rooms.

“[The word] ‘concussion’ was never used, even by the doctors, he said. “Mental health was never talked about,” Carcillo said.

Carcillo became uncomfortable being open about mental health issues during his career after speaking with a mental health expert provided by the Blackhawks. He says he later “found out through the grapevine” that the front office was informed of the conversation. Carcillo did not specify what information might have been shared, but shared his opinion on the impact of such a dynamic.

“That’s the stigma behind mental health,” he said. “When you come out and ask for help — especially in a job where you need to be seen as mentally tough, a mental warrior, a mental assassin — you’re having anxiety or depression, and god forbid you tell somebody, and then they go break your confidence like that. It doesn’t bode well for somebody else to come and open up. When in reality, opening up and getting that off your chest makes you more singularly focused at doing your job on the ice — so that actually makes you a better athlete, so guys shouldn’t be scared of it.”

While the players embody the NHL’s warrior mentality, Carcillo sees the league’s leadership as the group who can catalyze meaningful change.

“You need to understand who is running the NHL. You need to take a look at Colin Campbell, Gary Bettman, Bill Daly, and the guys at the PA,” Carcillo said. “All of this old school, old boys’ club, old mentality of ‘if you’re not tough, you’re a you-know-what’ and this ‘oh my God, you’re hurt so we can play hurt’ and ‘you’re a warrior now, thank you for putting your brain and body at risk for the good of the team.’ Fuck that.”

On the same day that the NHL’s lawsuit settlement with former player was announced, Bettman was inducted into the Hall of Fame as a builder.

“It’s another scheme to get your mind off of what’s really going on,” Carcillo said of Bettman’s induction, “and what’s really going on is that the NHL is putting human beings in a really, really bad position by not treating head trauma.”

While the NHL has not accepted that a link exists between hockey and the long-term impacts of head trauma, for players like Carcillo and Montador, the effects are all too real to dismiss. That lack of acceptance, paired with Carcillo’s belief that the NHL has not done enough to educate and assist players about head injuries, has led to consequences that he feels should be on the NHL’s conscience. “It’s simple. If you look at the past, you can see that they’ve killed people.”

The NHL did not respond to our request for comment.