Nightmare of the Mind : Malarchuk Lives in a World Where Choices Are Driven, Not Made

Time was when Clint Malarchuk was best known as the NHL goaltender who nearly bled to death on the ice.

On March 22, 1989, the skate of Steve Tuttle slashed Malarchuk’s throat like a cutlass, severing the jugular vein. Malarchuk’s blood formed a pool at his feet.

A red, ropy scar remains today, clinging like a leech to the right side of his neck, but Malarchuk came back from that incident. It used to be the one big life story for Malarchuk to retell.

Now, though, Clint Malarchuk is known as the NHL goaltender who got lost. The guy who had the problem. But no one can say exactly what it was that drove Malarchuk from the league after 10 years. That is what his problem is all about: secrecy, shame, misunderstanding and daily struggle.

A year ago, Malarchuk, 31, was found to have obsessive-compulsive disorder, a seldom talked-about but increasingly common malfunction of brain chemistry. OCD is what drove Malarchuk from the NHL to the San Diego Gulls of the International Hockey League. OCD is also what has robbed him of his most precious possession--peace of mind.

The life of an obsessive-compulsive is one of horrifying and immobilizing thoughts and the irresistible drive to perform routines and rituals, sometimes hundreds of times a day.

There are “checkers,” people who may sleep only a few hours a night because they keep getting up to make sure the doors are locked and the lights are off. There are people whose dressing routine has them putting on and taking off their clothes dozens of times. Some are convinced that they cannot walk through a doorway without twirling a certain number of times. Hand washers. Hair pullers. Counters.

The behavior of those afflicted with obsessive-compulsive disorder is difficult to understand. Many mistake the habits of OCD for interesting quirks, but they aren’t. The rituals and repetitions of OCD are not the same as those of a perfectionist. Their insistence on specific patterns and methods are not superstitions.

An obsessive person cannot control his or her thoughts. A compulsive person must act on the thoughts.

If it all sounds strange and frightening--and Malarchuk agrees that it does--consider that OCD is more common than asthma or diabetes. It’s not often talked about, but one in 40 of us have it. Doctors are calling it the disease of the ‘90s.

Although the disease is called OCD, it is possible to be afflicted with only the obsessions--the thoughts--and not the compulsions, the actions. According to some doctors, treating the obsessive is more difficult. It is easier to break down the rituals of a compulsive than plumb the mind of an obsessive.

“How would you like to be forced not to think about a pink elephant?” asked Dr. Stephen Stahl, a professor in UC San Diego’s psychiatry department and a specialist in the treatment of OCD. “You must not think about it. Of course, you do think about a pink elephant. You can’t tell someone not to think about something. It’s very difficult for these people to concentrate. They experience thoughts that are intrusive. They don’t want them. It’s more difficult to treat that than behavior.”

Malarchuk has been living with, and hiding, the disease for most of his life. How he got through his 10 seasons with Quebec, Washington and Buffalo while struggling daily to control his thoughts is a tribute to both his love of hockey and, perhaps, his need to feel normal.

“I knew my thoughts and actions were not normal,” Malarchuk said. “At times I thought I was crazy. There are (OCD) people with rituals that are beyond belief, that take them hours to perform. Yet they are able to work eight hours and put it on a shelf. That’s what I was able to do. I would be terrible the day of a game, because the anxiety of the game increased the pressure. I would obsess so much easier. The night before a game it would start.

“Sometimes they give a goalie his own room. To me, that was the biggest relief in the world. I could do my preparation--which every goalie does, but in private. Pacing, acting out. Mine was a little excessive. You know what the funniest thing is? Goalies have this stigma attached to them that they are crazy and flaky. I’ve had more people tell me that I was the most normal goalie they’d ever met. Inside me I was saying, ‘If you only knew.’ ”

Malarchuk saw the face of his disease in a violent and defining moment about a year ago.

By then, he obsessed all the time. It was as if he couldn’t turn off his mind. He might be watching a movie on television in which a wife was being unfaithful to her husband. That would act as a powerful suggestion to Malarchuk. He would believe that his wife was being unfaithful--he would know it. No reassurance would satisfy him.

He could be driving down the road and hit a bump and be convinced that he had run over a pedestrian. Even doubling back and finding no body could not alleviate the real horror he felt.

That’s one of the tricks of OCD. The French call it “the doubter’s disease” because the obsessions are so strong that OCD sufferers don’t believe their own eyes: “My hands are dirty; I must wash them. Even if they look clean I know they are still dirty.”

“In a way, obsessive-compulsive people are worse off than psychotics or schizophrenics,” said Bud Rickhi, a psychiatrist in Calgary who has treated Malarchuk. “Psychotics live in an unreal world. They have no point of reference. OCD patients are perfectly rational, yet they have irrational thoughts and compulsions they can’t control. They are frightened because they recognize how abnormal this is. They are trapped in a kind of hell of the mind.”

Malarchuk fell into that hell a year ago.

“That was a time when it was worst,” Malarchuk said quietly, sitting in a coffee shop recently. “I was obsessing so bad I couldn’t turn it off. It was 24 hours a day. I hadn’t slept in two weeks. I would start dozing and it was like I couldn’t let myself fall asleep.

“I would wake up with a start and a shock in my body. I wanted to sleep so badly, but as soon as I started to fall asleep, something would shoot into my mind and I would wake up. It was like a bolt of electricity went through my body. I can remember shaking uncontrollably and being unable to swallow.

“My eyes were burning from crying and lack of sleep. I was exhausted.”

Through all this, Malarchuk remained the No. 1 goaltender for the Buffalo Sabres. Why did no one on his team recognize that Malarchuk was sick? Professional athletes are allowed--grudgingly--to be injured. But unseen diseases are the most insidious. His personality quirks were Malarchuk’s business, as long as he could play. So the team was tolerant when, in Pittsburgh the night before a game, Malarchuk paced his room and cried and vomited. He couldn’t stop his mind. At practice the next day, he was still throwing up. He was taken to a hospital, where it was found that Malarchuk’s worrying and anxiety had produced an ulcer.

In Pittsburgh, Malarchuk was given medication that eventually put him in another hospital.

At a Super Bowl party given by a teammate, Malarchuk broke his rule of drinking during the season and had a few beers. He also took painkillers and Zantac, his ulcer medicine. More than anything, Malarchuk wanted to sleep. And having read the medicine bottles that said taking the drug with alcohol would cause drowsiness, Malarchuk, in his desperation, medicated himself--almost to death.

He left the party and went home. Confused and panicking, he begged his wife, Sandra, to help him. “What is happening?” he cried. He became incoherent, then blacked out on the bedroom floor. Sandra called paramedics and performed CPR on her husband until they arrived. Finally, at the hospital, Malarchuk’s obsessive-compulsive disorder was diagnosed.

“I was in so much pain--mental pain--I was trying to put the fire out,” he said. “Unfortunately, I was using gasoline. I almost died that night.”

After hearing the diagnosis, OCD patients often re-examine events and patterns in their lives and are able to place eccentric behavior in the context of the disease. Malarchuk sees that he displayed classic OCD behavior as a child, although his family simply thought of him as being emotional.

“I had more (rituals) than usual, but they weren’t overpowering my life yet,” he said. “I can remember being very cautious. Kind of a checker. I prayed a lot. Germs were a big thing for a while. Contamination. I’m still very conscious of germs. There was a problem with bathrooms and touching doorknobs, but not to the point where it was controlling. I can remember taking stuff from home to clean the desk I was assigned to at school. I had to sterilize it.

“I was worried about everything. It wasn’t normal for a 12-year-old to be so worried about everybody and everything to the point of tears. . . . Everyone just thought I had emotional problems.

“Probably, most of my problems began when I was 12. I was admitted into hospital with extreme anxiety. I was crying uncontrollably. They couldn’t pinpoint anything. They just said, ‘What’s with this kid? He’s 12 years old and he’s got the weight of the world on his shoulders.’ I’m sure that was the beginning.”

Although OCD is known as a disease that waxes and wanes, it is always present in some form. Malarchuk sees that his reputation for discipline and hard work was a byproduct of the illness. Gull Coach Rick Dudley, who also coached Malarchuk in Buffalo, recalled that his work ethic was widely known.

“Everyone always talked about how disciplined I was,” Malarchuk said. “I used to work out 6-8 hours a day in the off-season. But discipline had nothing to do with it. I had to do it. It was part of the disease.”

Recognition of OCD is only the beginning. Patients undergo lengthy trials with anti-depressant drugs, which are believed to correct the brain’s chemical imbalance. The problems often compound as patients and their doctors wrestle, sometimes for years, to find the right combination of drugs. Because it can take weeks or months to determine if a drug is working, depression and anxiety are common companions to OCD sufferers.

That is Malarchuk’s problem now. The drug he takes, Zoloft, leaves him groggy and sick to his stomach. Others produce side effects of blurred vision, anxiety or insomnia. Malarchuk has chafed at taking his medication because of its effect on his play. That caused a problem last month.

Malarchuk began to find his form again in November, going 5-0 with a 1.0 goals-against average. The Gulls, now 34-4-4, were rolling over opponents. And Malarchuk was playing so well that he was called up to Buffalo. That was the good news. The bad news was that he didn’t play while there and didn’t react well to being taken out of his environment.

When he returned to San Diego, Malarchuk began to cut back on his medication, wanting to be sharper for games. He didn’t tell his doctors, or Dudley, who knew of his OCD and had been supportive. Malarchuk fell apart in a game when he gave up four goals in five shots.

The reversal was total, and Malarchuk was devastated when he thought about the effect his suddenly awful play would have on his dream to get back to the NHL.

“Everyone gave up on me real quickly,” he said. “You say you have anything mental, a chemical imbalance of the brain, and you are not going to touch the guy with a 10-foot pole. It was like when I cut my throat, everyone thought, ‘Is he going to be the same goalie?’ I had to overcome all that, and it’s the same now, only worse. We’re talking about the brain.”

The stigma of OCD might prove to be more difficult to overcome than the disease itself.

“The stigma is there for something people don’t understand . . . don’t have the information,” psychiatrist Stahl said.

How realistic is Malarchuk’s hope to return to the NHL? Rogie Vachon, former general manager of the Kings and now special assistant to the chairman of the club, acknowledged that Malarchuk’s struggle has been discussed in the NHL. But Vachon, a former goaltender, said the bottom line was performance.

“If a player can stop the puck and win hockey games, and his problem is under control, a team will take him,” Vachon said.

At the moment, Malarchuk’s problem is not under control. The drug, at its new low dose, has not had any effect. But his doctor says he is optimistic, that many OCD patients do control the disease. When the drugs work, patients say, it’s as if the volume in their head is turned down. Not off, but lower.

Malarchuk is facing a decision that all athletes wrestle with, the question of when to quit. Often, it is most agonizing when the decision is made for you because of injury or loss of ability. For Malarchuk, such a decision represents a burden he’s not sure he wants.

“I think I’d rather not have the choice, to be honest with you,” he said. “I’d rather have the doctors or the coach tell me. I wish I would break my leg. Then it would be easy.

“Ultimately, I want to keep playing. But I want to be happy, too. I would love to be able to resurrect my career and get back to the NHL. I would love that. I dream of beating the disease and beating the odds and coming back and having another year or two in the NHL. But I can’t lose my life doing it. I have to be happy. It’s been a struggle all my life. It’s been so much pressure that I just want it to stop. Sometimes, I wish God would come down and take it all away.”