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Starkey: Letang, Neal and hard decisions

| Tuesday, March 18, 2014, 10:33 p.m.

When Penguins general manager Ray Shero answered his phone Feb. 1, team physician Dharmesh Vyas was on the other end with a question nobody wants to hear.

“Are you sitting down?” Vyas asked.

Vyas proceeded to inform Shero that tests on defenseman Kris Letang produced an astonishing result: Letang suffered a stroke three days earlier in Los Angeles.

Shero's thoughts immediately turned to Letang the person rather than Letang the hockey player.

“He's married and has a new baby — that's what I was thinking about, and that's what I'm still thinking about,” Shero said Tuesday after the Penguins' morning skate. “A return to play, I'm still not thinking about that at all. I don't have any expectation about that. Kris has our total support no matter what.”

That includes if Letang is cleared to play but is not comfortable with the idea of returning this season.

“If he's not 100 percent behind it,” Shero said, “I'll be supportive of him.”

Letang knows that. He trusts that the Penguins have his best interests in mind. Call me naive, but I think others should, too. The charge that Letang was rushed back to full-contact practice Monday is flat wrong. The notion that the Penguins should have delayed his return as a precaution is misguided.

The plan all along was to reevaluate Letang after six weeks. That is what happened. Shero is complying with the recommendations of a team of five doctors working with Letang, under Vyas' coordination.

Letang has availed himself of a reputable UPMC neurology department (ranked eighth nationally by U.S. News & World Report) and is free to seek outside opinions. He said Tuesday that he has, indeed, spoken with outside experts but is comfortable with his team of five.

“One for my brain, one for my heart, one for my vestibular (system) — everything,” Letang said. “It wasn't (left) to me if I was allowed to skate. They made that decision. It was (left) to me if I wanted to skate.”

He wanted to skate. So that was step one. Still a long ways from an actual game. If and when Letang is cleared to play, he will be left with the final decision. As it should be.

Will he have all the answers on his medical condition before that day comes? Of course not.

Letang is no different from the rest of us. We all want definitive answers when we visit a doctor, and we often don't get them. Doctors have not identified a cause for Letang's stroke. They might never. The risk of suffering another one cannot be quantified.

So what is Letang supposed to do, live out his days in a rubber room? He could have a stroke there, too.

“It could happen tomorrow or not at all,” Letang said. “I hope I'm not going to get one on the ice or something like that, but if it happens, it's just something I'm going to have to deal with.”

Other players can relate to nebulous medical conditions. Goalie Tomas Vokoun was a starter in Nashville going into the 2006 playoffs when a series of blood clots torpedoed his season. He went eight years without a recurrence. They reappeared last summer.

James Neal was diagnosed with a concussion Friday, his second in a year, but returned to the lineup Tuesday. He was cleared with no guarantees. None is available when it comes to concussions.

“It's my decision (on whether to play after being cleared),” Neal said after the morning skate. “If I feel right and back to normal and can play, I'll go from there.”

The most you can ask from a team is to provide the best medical help possible, to support outside opinions (the collective bargaining agreement makes teams respect them) and not pressure players to return. The Penguins, by all accounts, fulfill those obligations.

Every person I've spoken with over the years — players, agents, doctors — has driven home the point that Shero cares about his players as people first. He does not try to push the injured ones back into action.

“I've never ever said to a player, ‘What's going on? We really need you,' ” Shero said. “Nobody will leave here saying they were pressured to play. Ever.”

At some point, the player must make his own decision. So if you're Letang, Neal or Vokoun, you listen to the experts. If you're cleared, you can choose to play again, knowing something bad could happen tomorrow.

Or not at all.

Joe Starkey co-hosts a show 2 to 6 p.m. weekdays on 93.7 FM. Reach him at

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