Palm Beach Post – Oct 22, 2005 – Carlos Frías – Merril Hoge’s fears were fading. He was working out again, running, lifting weights. Concussions had ended his NFL career and put his future health in jeopardy. But a year after the hit that finally put him out of football, he was having doubts about his retirement.

He looked in the mirror, saw his 30-year-old face and physiqueâ€? the body of a former running back for the Chicago Bears and Pittsburgh Steelersâ€? and thought, “I can still play.”

He had not forgotten his doctors’ warnings. After suffering four concussions in five weeks in 1994 with the Bears, he was left with permanent damage. Bright lights caused pounding headaches. The bruises on his brain caused anxiety and paranoia for weeks. For a time, he couldn’t remember his wife’s and daughter’s names, much less his home telephone number.

“The next hit could leave me…” He paused.

In a vegetative state?

“If I was lucky,” he continued. “It could be fatal. Not even in a game. In practice.”

Bruschi’s decision

But Hoge wanted to play again. He needed to play again.

He understands what’s driving Tedy Bruschi, the New England Patriots linebacker who made a surprising return to the practice field this week nine months after suffering a stroke.

Bruschi temporarily lost his vision and was numb along the left side of his body when he was stricken just 10 days after the Patriots’ Super Bowl win against Philadelphia. Health, Bruschi said, was his first priority, but he never truly accepted the possibility of not playing again.

“There were times, in my mind, I thought I was done,” he told The Associated Press. “If I could express to you what this means to me (to return), I would, but I don’t know if I really can.”

Doctors have cleared Bruschi, telling him the condition should not keep him from playing.

Doctors big part of decisions

Hoge wasn’t as fortunate. He called Dr. Joe Maroon, the neurosurgeon who had denied him a medical clearance, to ask if there was a chance he could return to the field.

“It was sinking in, the reality of not being able to play again. I needed confirmation,” said Hoge, now an NFL analyst for ESPN. “You get better, you get healthy, and you tend to forget how long the season is, how physical it is.”

Maroon, who still works with the Steelers, put it simply:

” ‘Merril, I’m sure. I’m positive,’ ” Hoge remembers the doctor saying. “It was not easy for him, either, because I was at the top of my career.

“But he said, ‘I could not lay my head down at night knowing I let you go back and play.’ ”

Bruschi and the Patriots are confident that he is healthy enough to return.

Doctors found the problem and fixed it: a tiny hole in his heart that caused poor blood flow to his brain.

Some stroke victims are always at risk for a relapse, but Bruschi should not be one of them, said Dr. James Goldenberg, a neurologist at JFK Medical Center in Atlantis and a spokesman for the American Stroke Association.

“This is an example of something that can be fixed,” Goldenberg said. “Playing football, despite that very physical contact, shouldn’t put him at risk in the future.”

Still, when it comes to risk, elite athletes often have a difficult time walking away from their game.

Most will exhaust all medical opinions, undergo all possible surgeries, endure chronic pain, and sometimes even take risks to continue playing the sport that, in many ways, made them who they are.

“They see themselves as athletes and only athletes,” said Dr. John Murray, a Palm Beach Gardens-based sports psychologist.

Bruschi isn’t the only athlete who recently has returned to a sport despite a health issue.

Mourning understands

Eddie Curry, a 22-year-old NBA center, missed most of last season with the Chicago Bulls after doctors found he had an irregular heartbeat from a potentially fatal heart defect.

Before this season’s training camp opened, Curry refused to submit to a test the Bulls required that could have revealed a condition that killed Boston Celtics guard Reggie Lewis and collegiate star Hank Gathers.

The league eventually approved a trade to the New York Knicks, whose doctors cleared Curry to play.

Alonzo Mourning’s return from a kidney transplant has been well-chronicled. The Heat center said he can empathize with Bruschi about the moment the linebacker was told that he had a severe condition.

“What’s going through his mind is, ‘Am I healthy enough to play football?’ ” Mourning said. “For me, it was, ‘Am I healthy enough to play basketball and am I putting my life in jeopardy?’

“There’s a whole lot of things you feel: Uncertain. Impatient. Scared. Anxious.”

Mourning accepts his risks.

The kidney he received was added to his two and placed just below his abdomen. He wears a special pad to protect it when he plays.

He said he would walk away from the game if the condition meant his life was at imminent risk. But he never stopped trying to return to the court, even when he had to miss two seasons because of the illness. His family tried to encourage him to retire.

Mourning had already become rich in the sport, but he said only one message from doctors would have kept him away: “That playing ball would put my life in jeopardy. Plain and simple.”

“Every athlete has a clock to his career, and it’s up to each athlete to decide when it’s time to walk away from it,” he said.

Pain, risks seen as worthwhile

Orlando Magic forward Grant Hill was faced with retirement after missing the better part of four seasons with an ankle injury that never seemed to heal properly.

Hill endured four surgeries and a staph infection, but returned to be named an All-Star last season.

“This is what you do. This is who you are,” Hill said. “It’s something you always feel you can do.”

Constant pain isn’t enough to keep athletes from competing, Murray said, because they are conditioned to accept it and play through it.

Unlike a weekend warrior, who might hurt an ankle and take a week off, a professional athlete stops seeing pain as an indicator of something wrong.

“To them, pain can sometimes signal feeling alive,” said Murray, who studied the subject with the University of Florida football team during its 1996 national championship season. “Getting in touch with the physical pain can be therapeutic. The emotional pain of retirement can be more devastating than the temporary physical nature of pain.

“The pain of retirement means loss.”

Hoge said football players do realize that pain could signal the risk of serious injury, but they choose not to dwell on the danger.

“We understand that’s part of the game, but you just can’t function under that thought process,” Hoge said.

“If you consume yourself in thinking about that, you’re just not going to be a very good player.”

Though he was mentally and physically conditioned over years to play a dangerous sport, Hoge finally realized it was over for a good reason.

“It was hard to curb that appetite,” said Hoge, who rushed for more than 3,000 yards in an eight-year career.

Dr. John F. Murray is a sports psychologist and clinical psychologist providing sports psychology and counseling services based in Palm Beach, Florida.