Recovering From a Concussion: The Perspective of an NHL Team Doctor Who Sustained Three Head Injuries

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Donald Chow, MD, is an orthopedic and spine surgeon at The Ottawa Hospital, where he is also a trauma-team leader. Dr. Chow has been the National Hockey League (NHL) team doctor for the Ottawa Senators since their NHL debut in 1992. In addition to acting as the team doctor to the Ottawa Senators, Dr. Chow is also a team doctor for the Canadian Olympic team, where he often performs rink-side examinations for the diagnosis of concussion and head injury.

Dr. Chow also sustained three head injuries, and graciously allowed us to interview him about his unique perspective as both a patient and a surgeon.

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Given Dr. Chow’s incredible credentials and experience, one is completely taken aback at how unpretentious and open he is. It is no wonder that he has personally inspired many young students to become surgeons themselves, mentoring them as they grow from his students to his colleagues. In fact, he sustained his first head injury while covering for another doctor. In August 2010, he was riding his motorcycle to see a patient when he collided with an oncoming car that suddenly turned left in front of him. Along with a concussion, Dr. Chow suffered from 15 broken ribs, complete right-wrist dislocation with ulnar nerve injury, and serious heart and left lung contusions. For this head injury, he was treated by a neurosurgeon, Vasco Da Silva, MD. His injuries were so extensive that his family was asked about the possibility of organ donation. He was in a coma for several days to allow his heart and lung to heal.

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Transverse and sagittal views of Dr. Donald Chow’s subdural hematoma in 2015. With permission from Dr. Chow.

When he got out of the coma, he worked extensively so he could return to the role of surgeon. Dr. Chow asked the occupational therapist how many surgeons he had rehabilitated and the therapist responded, “None.” Undeterred, Dr. Chow proceeded to incessantly suture the different layers of a ham hock, a procedure he’d taught to a multitude of medical students. Early in his rehab, Dr. Chow used his shoulder to supinate while doing sutures, and as he healed, he was able to return to using his wrist. Dr. Chow was able to return to work the next summer, first as a surgical assistant to his protégée Stephan Kingwell, MD, and then, a full year after the accident, a full-fledged surgeon.

Recovering from His Second and Third Head Injuries
In September 2013, Dr. Chow suffered a second accident when a car turned into the path of his motorcycle. He suffered a broken right clavicle as well as another concussion. An expert in concussion assessment, Dr. Chow recalls that the resident examining him in the emergency room was struggling with the concussion assessment. Dr. Chow ended up teaching the Sports Concussion Assessment Tool (SCAT) to the resident who was examining him. He was able to return to work with limited duties only two days after this accident.

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Dr. Donald Chow attending his first Ottawa Senators game after his major accident in 2010 with his son Alexi Chow.

In February 2015, Dr. Chow suffered a third head injury when an oncoming pickup truck lost control while making a left turn. When he was being examined in the emergency room, he noticed a headache that was worsening. Imaging later revealed that he had suffered a subdural bleed, and was followed by neurosurgeon, John Sinclair, MD, FAANS, for this injury. Dr. Chow noted that he had fewer challenges than the average patient because he was able to understand what his physicians told him better and because he knew what was going on.

“I found the most challenging [concern] not [as] a head-injury patient, but [as] a rehab patient; not being a patient, but being impatient. Most surgeons are surgeons because we are not the type of people who let Mother Nature take her course. We want to do something about it. My personality was more of a problem than anything else. If it takes the average person three or four months to recover, I wanted to do it in three to four weeks. That’s just a basic impatience in my personality and was the worst thing for me. I trusted [Dr. Sinclair] and listened when he told me to take things easy, even if I wanted to push myself harder,” commented Dr. Chow.

When asked what the most difficult part of recovering from a subdural hematoma, Dr. Chow responded, “Doctors are some of the best patients when everything your treating physician tells you comes to fruition. We are the worst patients, and the most skeptical of skeptics, when something else happens.” Dr. Chow later realized after talking with his doctor that his case was almost textbook when his headaches lessened and blood clot reabsorbed, just as he said it would.

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Dr. Chow with Canadian gold medalist Shae Webber at the
2014 Sochi Olympics.

“One thing that was difficult for me,” Dr. Chow continued. “Was with [Dr. Sinclair] asking me about all my symptoms … I know that the hockey players who come back a little bit too soon after concussion have symptoms that last much longer than they should. I knew I couldn’t come back until my peers thought it was safe. The most challenging part, for me, was controlling the impatience.”

The Patient Experience as a Physician
As an experienced physician, it is no wonder that Dr. Chow said very little surprised him about being a patient. “Being a physician sets you up. After 25 years of answering questions from my patients, I already knew the answers to most questions, such as, ‘When are these headaches going to get better? When do you think I’ll be able to get back to work? What is my level of function going to be?’ … I knew exactly what to ask [Dr. Sinclair]. He really made me feel at ease because everything he told me made sense. So it was very non-challenging in the sense that once you trust the doctors around you, it’s easy to accept what they say. Everything he was telling me was coming true. He would tell me that ‘this was going to happen,’ or, ‘you are going to notice this.’ Sure enough, that’s what happened. Because he was good at informing me, and I was a little more understanding of the situation than most, being a patient was really easy for this last head injury.”

Dr. Chow noted that the experience of being a patient has changed how he deals with his patients, and now spends more time with them. “The nurses noticed that I was seeing less patients per hour as I used to. Basically, I spent more time talking with them. I try to teach my patients, because the word doctor really means teacher. If you can teach the patient about what’s happening in the future, you are a good doctor. That’s a very simplistic thing that I tell the residents: If you want to be a good doctor, then you have to be a good teacher.”

Whereas some could become consumed by fear after several injuries, Dr. Chow demonstrates incredible optimism and energy. When asked how these injuries have changed him as a person, he responded, “There’s a fear you have when rehabilitating that you’ll be missing something. I noticed I’m more aware of my hands and more wary of injury than I was before my first accident. I had less energy after each accident. I’m the kind of person that used to work anywhere from 18 to 20 hours a day.”

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Dr. Chow was team doctor for Team Canada at the
2014 Sochi Olympic Games.

Teaching the Brain to Recover
Given Dr. Chow’s experience both as a treating physician and a patient, one would be interested in his advice regarding recovering from a head injury. His response: “One thing I’ve learned both from my background with concussions and being injured myself is that the most important thing about the brain is to teach it to recover. If you don’t let the brain heal, you will run into trouble. With the first accident I had, I had all these other problems. I was more worried about my hand not being able to do surgery than anything else and I eventually did all this hand rehab stuff, but not until I let my brain heal. You can’t just go from zero, turn on the toggle light switch and go to 100 percent. That’s what causes people to crash and burn. It’s more like a dimmer switch; go slow and build up.”

The most important thing is talk to people who have treated lots of head injuries, Dr. Chow noted. “For me, talking to John Sinclair was perfect because he saw guys with brain injuries that he didn’t require surgery. But, he also sees some that are worse. Once he gives you that advice, on how not to [worsen your injury,] you learn to get better faster.”

Being back with the Senators was something that made him feel like he was fully recovered. “Jason Spezza was born in 1983, which was the same year as my son. Every one of those kids you see on the ice has a father, [who wonders] like me, ‘Is that guy in good enough shape to take care of my son playing hockey in another city?’ That’s the way I look at it. So, if the Senators go to LA, [I ask myself] if the guy there is good enough to take care of my kids; and if the answer is yes, then it’s yes for me. Let me back to work only if I’m good enough to be treating your mother, father, sister or brother. If I’m not good enough to take care of them, then I’ll sit back and buy a ticket and just enjoy the hockey.”

Dr. Chow has shown great courage both as a patient and a physician. He has conquered many challenges on his road to recovery. Dr Chow’s wish is that his story will help give patients insight and hope, especially those on the difficult path to recovery. Having properly cared for himself, he now continues to care for his patients and, of course, our community.

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Eve C. Tsai, MD, PhD, FAANS
Dr. Eve Tsai is associate scientist in the neuroscience program at the Ottawa Hospital Research Institute, associate professor in the department of surgery division of neurosurgery at University of Ottawa and Suruchi Bhargava chair in spinal cord and brain regeneration research. Her main surgical interests focus on all types of spine and spinal cord diseases such as spinal cord injury, spinal cord and spine tumors, syringomyelia, and myelopathy.