Sam Donnellon: Retired Flyer Primeau on concussions, Westbrook

KEITH PRIMEAU feels good, speaks clearly, shows less and less of the symptoms that have plagued other professional athletes who have suffered the number of severe concussions that he did as the Flyers captain earlier this decade.

Except that, "When my immunity goes down, it goes straight to my head," he said yesterday.

Or . . . "My head pressure is a lot better, but I still get pressure there."

Oh, one more thing.

"For me the most frustrating symptom still is that I can't elevate my heart rate. Whenever I exert energy I get lightheaded and dizzy. And I'm unable to do any kind of exercise."

It's "a byproduct of my case," he said, alluding to the series of concussions, at least six, that forced his early retirement from professional hockey in 2006. Now 37, Primeau says, "I am not a crusader," but is aware that his decision last spring to donate his brain to research has reinserted him into the debate over the long-term effects of multiple concussions, and how leagues and teams are managing those injuries.

"I get emotionally conflicted with what I read," he was saying. "I get disappointed. Disappointed with ignorance and naivete and angry with a lack of understanding. And compassion."

He was talking about how the Eagles handled Brian Westbrook's first concussion, and the quickness by which he returned to play and was reinjured. It's deja vu for a guy like Primeau, not just because of his own case, but several others that have come before or since. Simon Gagne returned too soon two winters ago, got banged again and was pretty much done for the year. Eric Lindros. 'Nuff said.

And then there are the NFL guys he has gotten to know through the Sports Legacy Institute, the research center he donated his brain to. Founded by a concussion-plagued wrestler, Chris Nowinski, SLI's neurologists and neuropathologists have begun a long process of examining tissue from deceased ex-athletes, including NFL players like former Eagle Andre Waters, for evidence of chronic traumatic encephalopathy, or CTE.

Normally found in brains twice their age, evidence of CTE has been discovered in six of the seven brain tissues examined. Many of the deceased, such as Waters, exhibited troubling cognitive and personality changes, some that led directly to their deaths.

Waters was 44 and had been struggling with depression when he killed himself 3 years ago.

Bennet Omalu, a Pittsburgh-based neurologist, has also discovered Alzheimer's-like evidence in the brains of deceased players such as former Steeler Mike Webster. In October, the University of Michigan's Institute for Social Research released results of a phone survey of 1,063 former players, funded by the NFL. The number of players over 50 who said they had received a diagnosis of "dementia, Alzheimer's disease or other memory-related disease" was five times the national average, and for players between the ages of 30 and 49, that jumped to 19 times the national average.

Ira Casson, who co-chairs the NFL's own commission on brain injury, has downplayed much of this, including the Michigan survey - which was funded by the league itself. Casson believes more evidence is needed, and recently implied, in a New Yorker magazine article, that players assume such risk of brain trauma when they sign to play professionally.

"We certainly know from boxers that the incidence of CTE is related to the length of your career," he said in the magazine article. "So if you want to apply that to football - and I'm not saying it does apply - then you'd have to let people play 6 years and then stop. If it comes to that, maybe we'll have to think about that. On the other hand, nobody's willing to do this in boxing. Why would a boxer at the height of his career, 6 or 7 years in, stop fighting, just when he's making million-dollar paydays?"

That approach enrages Primeau because it enables those who would like to ignore or minimize the risk to players who choose to play through wooziness, or return to the field too soon after suffering head trauma.

In an Associated Press survey of 160 current players released yesterday, 30 admitted hiding or downplaying the effects of a concussion. Half said they've had at least one playing the game and 61 said they had missed time because of it.

"I don't know the inner workings of a football locker room as compared to a hockey locker room," Primeau said. "But the play-at-all-costs mentality is greater than what we faced. I feel strongly even more so now. My opinion is that we mistreat and misinform and we misconstrue the facts. And it's not fair. Because although we're athletes and we accept part of that inherent risk, we're human beings. And we have a lot more life to live when our playing days are gone."

Thus far, the NFL has paid out approximately $5 million to former players with dementia. The Michigan survey, yesterday's AP story and the increasing number of ex-players like Primeau who have pledged their brains to science suggest that number will multiply exponentially in the years to come.

By then, of course, the damage already will have been done.

"A head is so much different than any other organ or bone or ligament in your body," Primeau said. "Without your brain you can't survive. I don't know if we lose sight of that fact. But we certainly overlook it."

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