Tuesday, 9 April 2013

Canadien René Bourque needs to consult Atlanta doctors for his concussion

 Regarding the discussion on whether the Canadiens doctors "are the best" or not, since they couldn't 'cure' René Bourque, we have to remember that doctors have various disciplines and areas of expertise.  This may be changing, but in the past NHL doctors would tend to be in orthopedics, focusing on broken bones and sprained joints.  As concussion awareness seeps through the culture, more and more neurologists trained to detect them and treat them are joining medical staffs.

Even so, not every specialists, in neurology or other disciplines, approach every patient the same way, with the same techniques and therapies.  The Pittsburgh doctors who were treating Sidney Crosby were no doubt top notch, but a different doctor or team had a different perspective, a different solution that he responded to.  Specifically, his symptoms were relieved when they addressed his problem as a neck issue, rather than just a head issue.  This is in line with pretty much everyone's anecdotal evidence, of one doctor being incapable of treating a rash or ailment, yet when another doc is consulted the problem clears up immediately.

Interestingly, a friend of mine and colleague at Snowboard School had a bad concussion sustained in a collision with another instructor (Were we going too fast you ask?  Of course we were.)  He was off work for months, and he really struggled with the life change, the headaches, the fear it would never get better.  We have a mutual physiotherapist, and one day she came back from a conference in which she learned about neck injuries, and she was all excited because she thought a lot of that was applicable to his case.  Sure enough, a new treatment regimen, different doctors and a chiropractor alleviated his symptoms almost instantaneously, and he's back on snow loving life, and had no further issues years later.

Another Whistler example is how we treat broken wrists here.  These are common with beginner snowboarders, and doctors struggled to find a way to provide better treatment, which in the case of bad displaced fractures involved injecting an anesthetic into the injury site and manipulating the bones back into place, then quickly casting the arm.  IF you can imagine the pain of jabbing a needle into a fracture site and the trauma it causes for children and their attending parents, you'll understand the docs thinking there had to be a different way.  They researched and innovated a little bit, and began using a Bier block, which cuts off circulation in the affected arm with a blood-pressure cuff, and then anesthetizing the entire limb below the cuff.  This is kind of cool, your arm feels totally dead, kids mostly think the experience is fun, you have to prevent them from waving it around too much.  Add in a portable X-ray machine, and we have a solution that works here.  While none of the equipment used was 'invented' here, they are applied in way that is uncommon enough that orthopedists from around the world are intrigued when they see it being used, sometimes to treat a family member, and you can see the wheels turning in their head as they wonder how they could apply this approach to their practice back home.

So the takeaway from the René Bourque case is not that the Canadiens' medical staff were unable to 'cure' him, but rather that there was an openness to new avenues, and a willingness to allow the player to seek out other opinions.  They tried their best, and when they found it wasn't working, went with a different plan, not much different than what happens when the coaching staff makes between-periods adjustments to the gameplan.

For me, the way Mr. Bourque talks of his experience is entirely positive, and again describes an interaction with GM Marc Bergevin in a very favourable light.  These impressions add up, and will percolate around the league.  When René Bourque speaks of the Canadiens organization, he's likely to do so in an approving manner, and this will be helpful when he's in contact with players and their agents who have to make decisions on where they'd like to sign contracts.

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