Doc Wants Smart Approach:

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Doc wants Smart approach

By Kevin Mitchell - Vernon Morning Star

Published: September 11, 2010 10:00 AM

It was an all-star career. Two national championships. More than 500 games. Hundreds of stitches. A few shoulder separations, a broken jaw or two, and numerous ankle and knee injuries. No goals, just plenty of clutch assists.

After 11 years as doctor for the B.C. Hockey League Vernon Vipers, Gavin Smart won't be volunteering his free nights at Wesbild Centre any longer.

He was planning to retire anyways, but being shabbily mistreated after he treated a Salmon Arm SilverBack player last January in Vernon sealed the deal. He leaves the Vipers and the league in hopes no player will ever return to the ice after being told by a physician to put on civvies.

The player sustained a concussion and multiple facial lacerations. At the intermission, Smart advised the Salmon Arm coach and trainer the player had sustained a significant head injury with concussion and should not return to hockey until symptom-free and cleared by the Silverbacks' team physician in the days to come.

The visiting player returned to play after Dr. Smart placed 20 stitches into his face to close three separate gaping lacerations.

Smart said another Silverback was in the dressing room after being assessed a fighting major after the hit. Smart said the injured player appeared dazed and vacant, but he did tell Smart he had suffered a significant head injury with concussion in 2007.

As Smart prepared to start suturing the player, the first period ended and the SilverBack coach entered the dressing room. After being advised by Smart that the injured player pack up his gear, and being told that another player had questioned his authority and expertise, the coach "became defensive and the subsequent tone of our interaction became confrontational."

Smart, realizing the American player would face a hefty bill at the hospital, finished stitching his face. He didn't bill the SilverBacks for his medical supplies.

Smart, a 52-year-old father of two, was dumbfounded when he saw the injured Salmon Arm player back on the ice. He wrote letters and sent video of the play to the league.

"Concussion is the most serious injury in sports," Smart told me in an interview two weeks ago. "You have to protect your head. When the head's been rattled, it leads to other problems like depression, booze and drugs. These are huge issues."

Smart has given two presentations on concussions to large groups of physicians the past two years, using BCHL case histories. He studies the injury seriously.

Smart, in his letter to the BCHL, said he believes the primary factor driving players to return to play inappropriately is intimidation by coaches, either directly or indirectly by the attitudes created in each dressing room.

The league never responded to Smart's letter last May where he asked why the BCHL had not dealt with the incident.

I talked to league president John Grisdale this week and he says the "letter was buried in other mail" but that he had reprimanded the SilverBacks.

"I dealt with it with the Salmon Arm team" said Grisdale. "We don't expect our physicians not to be heard. Obviously, our office can't enforce whether a player returns to the ice or not. He's (Smart) volunteered in our league for so long and we have to respect him and we have to make sure our physicians are honoured. How he was treated is unacceptable."

Grisdale said the league is doing its best to ensure its players are protected, using the new Canadian Junior A Hockey League Supplement whereby coaches sign a code of conduct. Grisdale said he will visit teams to explain the new standards.

The Junior A Supplement has been created to protect junior-aged hockey players by addressing actions such as blows to the head, dangerous hits, accumulated major penalties and misconducts and instigating and unnecessary fighting.

It builds on the progressive regulations undertaken over the past decade by the participating leagues and branches to reduce bullying and violence from Junior A Hockey in Canada.

"We want to get rid of the staged fights and bullying and violence," said Grisdale, noting the Vipers were last in the league in fighting majors last year."

"We also want to get rid of the high hits to the head which lead to concussions."

Grisdale said of the league's top-six teams last season, four were listed near the bottom in scraps.

Viper head coach/GM Mark Ferner said Smart provided invaluable service.

"We joked the first year we won (Royal Bank Cup) he was our playoff MVP we had so many kids with nagging injuries. We were very lucky to have Gavin. I'm just a hockey coach. We have a responsibility to the kids and their parents to never put a kid in a situation where he could get hurt, whether he thinks he's ready or not. There's a difference from playing injured and playing hurt. With concussions, if a doctor tells me he can't play, he can't play. You have to have integrity and it's not about winning at all costs and risking further injury to a kid. This should be a fun time of their lives."

Ferner, while supporting the new standards, hopes to see the violent plays called for penalties on a consistent basis. Vernon opened the season without two elite players: Adam Thompson (concussion from a hit from behind) and Kyle Murphy (torn muscle in shoulder) after a high check-charge-elbow which wasn't penalized in the preseason.

Smart said Hockey Canada hands out a one-page pamphlet entitled "Sport Concussion Assessment Tool (SCAT)." Regarding return to play, the SCAT states in bold print "athletes should not be returned to play the same day of injury."

Wrote Smart to the BCHL: "If the attention generated through the media by this incident influences one coach or trainer to not return a concussed player to the ice to risk further injury or empowers one player to say 'I'm not returning to play' until reevaluated and cleared to return to play by a qualified professional, I will regard my efforts to have been successful."