UW's Burt ready to return, but is it worth the risk?

By Greg Bishop
Seattle Times staff reporter

ROD MAR / THE SEATTLE TIMES Kayla Burt, in pink, standing with her UW teammates, had a defibrillator implanted after an episode on New Year's Eve 2002.

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During the early-morning hours of New Year's Eve 2002 — the day Kayla Burt's heart stopped and five teammates steered her life away from death — the game of basketball lost one of its own.

One week later, Washington made that official, announcing the end of Burt's promising career. Her saga morphed into a tale of national inspiration. Her life swerved toward uncertainty, the great unknown, albeit anchored by one certain fact: She would never play competitive basketball again.

That day referred all further questions to the most fundamental of them all: Life or death?

Life won. And now, 18 months later, basketball might, too.

Because Burt loves the game so much, because she identifies with it, because it still tugs on the heart now equipped with a defibrillator to prevent another episode, she's willing to risk her life for the chance to play again.

Sources within the Washington women's basketball team and the school's administration confirmed last week that Burt is exploring the possibility of playing as early as next season, even though the school's official line remains, "Her status hasn't changed."

She is playing pickup at full speed. She has been to doctors to determine what exactly went wrong on that New Year's Eve. She has broached the subject with university administration.

The likelihood of such a comeback remains elusive, but it has been done before. Some experts call the idea crazy, pointing to medical guidelines and court precedents that specifically rule it out. Others believe that advances in technology, coupled with the right circumstances and precautions, render those guidelines obsolete.

This much is certain: Burt's return would be a major coup for a team that lost three of its best players to graduation and saw three others retire prematurely. A sharpshooter who was averaging 8.0 points her sophomore season and leading the Pac-10 in three-point percentage when her career ended, Burt would likely become the Huskies' best player.

This much is uncertain: Is the return of their former starting guard with a heart condition worth the risk?

"As of now, nothing has changed," said Teri Burt, Kayla's mother, this week. "But that doesn't mean it can't in the very near future."

Eight years ago, Nick Knapp paved the path Burt walks down. The sting lingers enough that Knapp avoids these kind of interviews, but when he heard about Kayla Burt and her comeback aspirations, he called and asked, "Is there any way that I can help her?"

With a scholarship to Northwestern in the bank, Knapp collapsed during a pickup game in summer 1994. His initial medical advice (no more basketball), circumstances (an implanted defibrillator) and words mirrored those of Burt in January 2003.

"I was basically dead," Burt said.

"I was technically dead," Knapp said.

Doctors were clear. No more basketball. No more workouts. No more exertion.

Northwestern honored its commitment, allowing Knapp to retain his scholarship but forbidding him to so much as hold a basketball during the practices he was required to attend.

Knapp followed that advice just long enough for the scars to heal. Then he started lifting weights, running through full-court basketball drills, dreaming of the day he'd prove them wrong.

He sought second, third and fourth opinions from doctors who told him "you're safer than your teammates when you have a defibrillator" and "the risks are absolutely minimal" and "there's no reason why you shouldn't be allowed to play." Northwestern, one of the 100 schools that recruited Knapp initially, stood firm.

"If they want you to play, you'll play," said Terry Knapp, Nick's father. "If they don't want you to play, there are enough resources out there to say that you probably shouldn't."

So Knapp sued the school under the Americans with Disabilities Act. He won in the lower courts, then lost on appeal, setting the current precedent — because of the liability involved, the final say rests with team doctors, who are essentially an extension of the university. Signed waivers won't negate the liability.

	STEVE RINGMAN / THE SEATTLE TIMES Kayla Burt, right, here stealing the ball from Iowa State's Holly Bordewyk in a December 2002 game, likely would be one of the Huskies' top players if she returned.

"It was a political nightmare," said Terry Knapp, who estimates he spent $131,000 in court. "He scored a 32 (highest is 36) on his ACT, was valedictorian of his class. He was Mr. Everything. Everybody in the country wanted this kid. And overnight he became a pariah."

Knapp transferred, first to Northeastern Illinois, which shut down its athletic program two weeks after he got there, then to Ashland, a Division II school in Ohio, where he played for two seasons, defibrillator in tow.

Burt could also transfer, and doctors say it's likely at least one school would clear her to play. But those close to Burt indicate that transferring is not even a possibility.

In his first workout at Ashland, Knapp ran 7 miles. In his third game, he started in front of 16,000 screaming fans against Nolan Richardson and the Arkansas Razorbacks.

"There was nothing abnormal about it," Knapp said. "It's what I should have been doing all along. It felt natural."

But Knapp wasn't out of the woods yet. One defibrillator-related concern doctors cite is the possibility of the device firing when it's not supposed to. Knapp's did.

On three separate occasions.

One time, it misfired at the airport, knocking him to the ground, then shocked him again. Another time, it misfired while he warmed up shooting free throws.

"It's a jolt," Knapp said. "I liken it to somebody taking a bat and swinging it and hitting you in the back of the neck as hard as they can."

But still, because of the basketball on his brain, because of the love for the game he shares with Burt, Knapp was willing to assume the risk, which he was assured was negligible. And Terry Knapp, for all his fatherly concerns, wasn't going to stand in the way.

"My kid wanted to play," he said. "He's my son. I love him. If something would have happened, sure, I would have felt bad. At the same time, he's an educated kid who knew what the risks were going in."

Knapp's doctors told him one thing. Other experts in the cardiology field beg to differ.

They point first to the 26th Bethesda Conference, a set of professional guidelines published in 1994. Drawn up by a group of 29 experts from diverse fields such as sports medicine, athletic associations, the legal profession and cardiovascular medical specialties, Bethesda established guidelines for situations such as Burt's and Knapp's.

In large block letters, at the bottom of the page, it reads: COMPETITIVE SPORTS NOT RECOMMENDED.

"I don't know of any school that would take that on," said Dr. Mark Link, a cardiology expert with the New England Medical Association. "The problem is that these are national guidelines by a big panel of independent doctors from the American Heart Association. They carry a significant amount of weight.

"There are personal issues for patients, safety issues for them. And then the risk. The question is, what level of risk are universities and individuals willing to live with?"

	Nick Knapp sued to play at Northwestern, but lost.

The risks of playing with a defibrillator are numerous and far-reaching. Exertion speeds up the heart rate, which could lead to inappropriate shocks like Knapp's or wear down the leads that extend from the generator to the heart valves. After Knapp's third misfire, doctors noted that the leads were cracked.

Some suggest that a misfire could lead to an injury of another player because of the violent shock. Or the defibrillator itself could be damaged because a mesh jersey isn't enough protection from big bodies and flying elbows.

Will Kimble, a 6-foot-10 forward whose career at Pepperdine was cut short because of a heart condition, is attempting to attain eligibility at UC-Riverside. Because of concerns like the one above, doctors told him he would have to wear a Kevlar flak jacket during games.

"The device was never designed to operate in intercollegiate basketball," said Dr. Barry Maron, who testified for Northwestern in the Knapp trial. "The reliability and all those factors are unknown."

So why try?

"I don't know why anyone would want to do that," Maron continued. "Most responsible people would say that it doesn't make any sense to play with a defibrillator. It doesn't make any sense. Period.

"If they need that kind of advice, Bethesda (guidelines) say one of the things you cannot do is college basketball. There are always people, sometimes even responsible people, who arrive at a completely opposite view. Even if it's dangerous."

1990: Loyola-Marymount star Hank Gathers doesn't take his medication for an irregular heartbeat, collapses on the court and dies during a game against the University of Portland.

1993: Reggie Lewis of the Boston Celtics collapses during an April playoff game and tests are inconclusive. He collapses again in June and dies.

What, if anything, is different here?

Technology, for one. Back then, implanted defibrillators didn't exist, and they've improved rapidly since Knapp had his implanted.

Case-by-case examples, for another. Knapp played two seasons of college basketball with a defibrillator in his chest, but he had to transfer. Kimble is attempting to do the same. Oklahoma softball player Nicole Denes had corrective surgery performed after being diagnosed with a heart arrhythmia last season, and she has been cleared to play.

Of course, every case is different, save one constant — the risk.

Another intriguing Knapp parallel emerges here. When Knapp fought with Northwestern over his right to play, the university was trying to fire the late Ricky Byrdsong due to a poor coaching record. At the same time, the team was under investigation for a player scandal that involved gambling and point shaving before Knapp got there. Why would a university take on that kind of liability in the midst of such bad press, Knapp wonders? A university much like Washington after the events of this past year.

"You can't give away liability," Maron said. "It's up to the team physician. That's what the court said. In the end, the physician represents the university. He's responsible, in conjunction with the university, for that decision. He lives with it. And so do they."

So Kayla Burt presses on, visiting doctors at the Mayo Clinic in Minnesota to determine what made her heart stop, playing pickup at Edmundson Pavilion and the Intramural Activities Building, talking with the administration about the possibility of playing again, trying to achieve what few before her could.

The Huskies' coach, June Daugherty, did not return calls to comment. Burt and her family would say very little. University officials repeated, "Her status hasn't changed."

Notice they didn't say it couldn't.

Meanwhile, Knapp surveys the situation from Peoria, Ill., still lifting weights, still running stairs, still very much alive. Doctors say he should never have played again. Knapp laughs at the conundrum, at the dozens of varying opinions, at the Bethesda guidelines that are rewritten every 10 years, making this year the year that doctors will review the documents and determine if they need to make any changes.

"Despite what doctors told me, I'm still very active," he said. "If I followed the advice of my first doctor, I'd be about 400 pounds and sitting in a rocking chair in my mom's basement, shades pulled, worrying about my heart.

"I'd tell Kayla to get as many opinions as she can, decide what's best for her and her family and go after that. Whatever she decides to do, it's possible. And tell her I said, 'Good luck.' "

Greg Bishop: 206-464-3191 or gbishop@seattletimes.com

Copyright © 2004 The Seattle Times Company

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