Comatose football player found doctor who would let him play

THE BALTIMORE SUN

LONG BEACH, Calif. -- Lying in a coma, Scott Kahale' muscular body, covered with only a towel, looks sadly vulnerable. Tubes feed into his nose and puncture his arms, while machines keep his heart pumping. The 20-year-old Cerritos College offensive guard loved football so much he chose to accept a medical opinion that allowed him to play after learning, on Sept. 12, that he had a cyst on his brain.

But even after doctors at two hospitals warned that playing football was dangerous in his condition, Kahale was overjoyed when he found a physician who OK'd his return to the playing field.

"I believe in miracles, Mom," he told his mother after getting that news on Sept. 28.

The next night he suited up in his blue-and-white uniform, and his coach sent him into the game against San Diego City College. His father was there, but his mother, who said she was sick with worry over the fact he was playing, decided not to go.

Kahale played only briefly. Minutes after he returned to the sidelines, he collapsed and was rushed by ambulance to Pioneer Hospital in Artesia, where he underwent emergency brain surgery.

Within his skull, surgeons discovered a hematoma -- a tumorlike collection of blood -- compressing the brain and pushing it to one side.

He was moved Oct. 3 to Memorial Medical Center in Long Beach for further brain surgery. There he lies today, in a medically induced coma that doctors hope will save his life.

Two weeks after Scott Kahale's collapse, people are still wondering why it happened.

The doctor who signed Kahale's medical release stands by his decision to let the young man play football.

Kahale's parents, who shared in the decision to let him play, say that if not for the medical release, their son might not be in a coma.

College officials, who insist football had nothing to do with Kahale's injury, say they followed their policy "to the letter" by letting him into the game. "I don't second-guess doctors," said one.

But although no one is sure whether playing football that night triggered Kahale's collapse, all agree that Scott Kahale continued to play football because he saw it as the key to his future.

A sophomore, Kahale is a popular student who was a top vote-getter in the school's student senate election this semester. He told his parents he wanted to be a counselor because he

enjoyed people, especially children.

The 6-foot-1, 265-pound adopted child of a Cerritos couple, Kahale nicknamed himself "Blala" -- Hawaiian for "big and tough." Yet this big, tough football lineman also volunteered as a baseball umpire and Cerritos Little League coach, said John Kahale, his father.

In order to achieve his dreams, Kahale wanted to get a college degree from the University of Southern California or another well-known four-year university, his father said. Unable to afford the high cost of a private university, Kahale knew he needed to get a football scholarship.

"He was playing to get a scholarship," said John Kahale. "He would say, 'I gotta play because I need the money.' "

That explains why he was driven to continue playing football, says his mother, Dori Kahale, a tiny woman whose home reflects the Polynesian atmosphere in which her son was raised.

So, for seven years, he dressed in bulky padding and cleats and conditioned his body to take the abuse suffered by a football player who plays offensive guard.

He began playing as a Cerritos High School freshman, graduating to Cerritos College. He sat out only one year, to maintain his eligibility as a college athlete.

But this season, something went wrong.

After the first game -- Sept. 8 against Palomar College -- Kahale suffered a headache severe enough to send him to the Pioneer Hospital emergency room the following Monday, Sept. 10.

Kahale was seen by Dr. Laurence Carnay, a neurologist, who took a magnetic resonance imaging picture and computerized tomography scan of his brain. Carnay conferred with neurosurgeon Barry Ceverha over Kahale's case.

The doctors say they found a cyst on Kahale's brain that was causing pressure. They told him to come back in three weeks. When he asked if he could play football, they said no.

"He was a high risk, and until we could follow his progress over time and see what was happening with that cyst, then our opinion was that he should not play football," Carnay said in an interview.

Carnay told Kahale and his parents that the cyst might require surgical removal. Concerned by this diagnosis, the Kahales went to Kaiser Permanente hospital in Bellfower for a second opinion.

But what they got was the same diagnosis.

"We told him not to play football," said Ruth Lucci, doctor of internal medicine at the Bellflower Kaiser hospital. "I talked with him and his mom a couple times, but he wanted to continue to play and continue with his activities."

Two other Kaiser doctors, a radiologist and a neurologist, shared Lucci's view of the case. But all three felt he should see a neurosurgeon for a definitive opinion. They sent him to Dr. William So, a neurosurgeon at Kaiser's Anaheim facility.

On Sept. 28, Dr. So gave Kahale the OK to play.

"I felt that the cyst was something he was born with," the doctor said in an interview last week. "Something one has to consider: If someone is born with an extra thumb, are we going to limit his activities the rest of his life or what?"

He declined to comment further on the case.

The release to play football, a copy of which was given to the Long Beach (Calif.) Press-Telegram by his family, states that Kahale had "no restrictions." Under "Remarks," Dr. So wrote: "Usual precautions when playing football e.g. wearing helmet."

Kaiser director of public affairs, Donna Donan-Drasner, said that the release alone doesn't tell the whole story. "That may be what you have," she said of the release, "but in consultation [Dr. So] outlined the risks to Scott."

The same day the release was signed, Kahale took it to team trainer Steve Navarro. Navarro then told Coach Frank Mazzotta that Kahale, who had missed two games, could play again.

Mazzotta let Kahale play the next night, in the Sept. 29 game against San Diego.

Since Kahale had missed two weeks of practice, Mazzotta only sent him in for three or four plays during the second quarter when Cerritos was safely ahead, the coach recalled. (The final score was 52-0.) "We wouldn't have put him in in the heat of battle," he said.

Kahale was laughing and joking when he jogged off the field after his last play, according to Mazzotta. Minutes later, he sneezed several times and then collapsed on the sidelines.

Three doctors on the scene -- team doctor Alan Strizak, along with an ophthalmologist and a general practitioner -- gave Kahale emergency treatment before the team ambulance carried him away, Mazzotta said. "All three said that what he did on the field couldn't have caused it," the coach said. He did not know the names of the ophthalmologist or the general practitioner.

After Kahale's collapse, the coach said he reviewed the videotapes of the game and saw nothing unusual.

Mazzotta is in his 13th season as head football coach at Cerritos, compiling a 70-50-4 record over his first dozen years. He looks like a head coach -- trim, graying, weathered. During an interview last week, Mazzotta appeared cool and relaxed despite the blistering sun and 95-degree heat outside the field-house locker room.

He said he is convinced that Kahale's brief participation in his last game played no role in the medical trauma that followed. In fact, Mazzotta suggested that Kahale's presence on the field that night may have saved his life.

"He was lucky," the coach said. "It couldn't have happened in a better spot. There was an ambulance ready to go and three doctors on the scene. He was rushed to Pioneer Hospital, where all his records were.

"Our doctor [orthopedic surgeon Strizak] said if it hadn't happened right here, he might not have made it."

Earlier, during the weeks when Kahale was undergoing tests, the young athlete himself kept the coach apprised of his medical treatment, Mazzotta said. Kahale did not indicate that his condition might threaten his life, according to the coach.

"They ran an MRI and a CT scan," Mazzotta said. "We knew about a lesion and the cysts on the brain. Scott told us he had them and they were keeping an eye on it. We never had anything in writing saying Scotty could not play. He never said how long he couldn't play -- we didn't know when he'd show up for practice.

"He wanted to play, so he wanted a second opinion. The day he brought in the release saying he could play, it was news to me. I didn't even see the note -- it went to the trainer. But, since the note came from a neurosurgeon, nobody questioned it.

"Scotty was checked out good. As far as I was concerned, he could play."

It's not unusual for student athletes to search for a second opinion that will permit them to play, Mazzotta said.

"A lot of kids do it," he said. "It happens all the time. Scotty definitely did this [sought another opinion] on his own initiative. I truly don't think he felt it was life-threatening."

Cerritos athletic director Richard Juliano agreed that his staff followed proper school procedure "to the letter" in the Kahale situation.

"He was told not to participate by his doctor, and he did not," Juliano said. "Then he got a second opinion that said he could play, and he played. The doctor is the person that says yes or no -- we don't argue with them. We don't break procedure.

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