How head injuries finished the rugby career of Cillian Willis

'Unless you have to be dragged off you wouldn’t leave a pitch. That’s the reality.'

The professional rugby career of Cillian Willis ended on March 10th, 2013. Not from the third head blow he suffered playing for Sale Sharks against Saracens. No, Willis was allowed continue until the fourth and final knockout.

The former Leinster scrumhalf believes he should have been taken off. He remembers the oxygen mask. He remembers waking up in an awful state. He's seen the footage, too many times.

He knows what happened and how it was allowed to happen.

Nowadays, the only lingering distress is imagining Caitríona, his wife, helplessly looking on in the main stand.

Following a prolonged legal saga, only ending last month in Manchester under the cloak of a confidentiality agreement, the 34-year-old can finally talk about the brain injuries that forced his retirement from professional rugby aged 28.

Against Saracens he sustained two accidental bangs to the head in quick succession. “I effectively got knocked out by [Sale teammate] Danny Cipriani’s knee in a ruck, and while laying prone got a boot in the face.”

After on-field treatment – and having just returned from a three-month layoff due to concussions sustained against Wasps and Worcester in December 2012 – Willis continued playing to half-time. Then, somehow, he was allowed return for the second half of this LV Cup semi-final.

This despite Caitríona Willis coming down from her seat to express concern. This despite all the evidence demanding his protection.

“About five minutes into the second half I got absolutely sparked, again. It was really, really poor and obvious; here I am lying prone on the ground motionless for six or seven seconds and my legs start shaking. It was pretty severe and again I was attended to for three, four minutes and then I play on.”

That was the third concussive blow.

“It got to the point where I am crawling around on my knees, not able to stand on my feet for about three or four minutes, then charging into contact. You can imagine how distressing this was for my wife.”

We cannot begin to imagine.

“It is still pretty shocking.”

* * * * *

Cillian Willis almost retired from rugby in 2011 but Joe Schmidt convinced him to return to Leinster from Connacht on a short-term deal as cover during the World Cup. That led to a contract with the Sale Sharks.

He never wanted to be a “test case” for concussion in rugby union but his subsequent legal action, taken against Sale and two medical doctors, has been framed as such.

Ultimately, the legal quagmire he has just emerged from will become a cautionary tale. “If someone is looking for accountability or some sort of closure, for me the judicial system is not a place where you will necessarily find natural justice. I think it is a place you can get lost.

“If you have real desire for natural justice to play out perhaps the media is the most appropriate place as the media ultimately provides accountability.”

In 2016, three seasons after Willis was forced to retire, and with the case ongoing, Sale director of rugby Steve Diamond stated: “The pressure’s on the medical people under the new HIA [head injury assessment] regulations. All you need to have is a slap on the head and they have you off the field for 13 minutes now. I don’t know where we are going with it.”

"Tom's fine," said Diamond after England flanker Tom Curry was stretchered off with a head injury in September 2018. "He got a knock to the head but nothing serious. If you're out, and I think he was momentarily knocked out, that's [medical precautions] what they have to go through."

"There's six minutes until half-time, he's staying on," Diamond was heard saying, reported Sam Peters in the Independent, three weeks later when Ben Curry, Tom's twin, lay prone on the pitch with a neck injury.

Curry played on.

Willis versus Sale Sharks never had its day in court, as the club stated in January: “Mr Willis subsequently discontinued that claim in March 2018, without any payment of compensation being made by Sale Sharks.”

There is a line in this statement about Sale’s “exemplary record with regards to player welfare and wellbeing” that Willis cannot swallow.

“That irked me. I thought it was disingenuous. There was no need for it. Linking player welfare to my case was not an accurate portrayal of proceedings.”

When contacted by The Irish Times and informed that Willis stated "Sale left him on the field of play after receiving concussive blows", the club, via media and communications manager Sam Diamond, referred back to their January statement.

“This is the first and last time I will speak about this,” said Willis. “I’d like to set the record straight.”

* * * * *

Gavin Cummiskey: The case was heard in Manchester last month?

Cillian Willis: "There were effectively three defendants. The case against Sale, as per the statement they released, means it has just been a question of unwinding, cost recovery, because the other defendants are not really at the nub of the issue."

You mean the doctors?

“Yeah. In many respects they are collateral damage. I think it is very difficult positions that the medics find themselves in, particularly in relation to the professional game where there is a bit of an inverse power structure in the set-up. Effectively, it has been a bit of a test case for rugby around concussion.”

How could Sale release that statement in January?

“Because proceedings have now ceased. Listen, I’ve two daughters and if they go search my name they will find pages and pages of news stories on litigation and there are authors of certain pieces who will draw their own conclusion on very scant and limited facts that never really played out.”

Not everyone would know who Cillian Willis is, but there is rugby in the family?

“Brian [O’Driscoll] is my cousin but that is irrelevant. Sure, people can connect to that. I get that.”

What I am asking is, how did you get into professional rugby?

“I was fortunate, probably by virtue of going to a private school in Dublin and getting good coaching. I had a pretty unexceptional career but it got me great experiences, great exposure.

“I did a tour of sorts, up to Ulster and over to Connacht.

“I wasn’t happy unless I could be a starting nine. In rugby, people lose perspective. A lot of professional sports people get so single-minded that you get radicalised. You hear the Irish team talking about ‘the bubble’ they are in the whole time. People live in their own bubbles. I was no different when I played. I probably rubbed people up the wrong way because I was too dogmatic.”

They used to call you “Scrappy”?

“Don’t know where they got that from!”

Joe Schmidt threw you a lifeline in 2011?

“I had actually retired. I played pretty poorly in Connacht and I just said, ‘this is killing me.’ I got so fed up not succeeding, particularly when you are going so hard after something. I only went back to Leinster on short-term cover during the World Cup, really to settle into going home. But my game completely changed for two reasons: I stopped caring as much and I was in the Joe Schmidt environment.”

What about head knocks up to that point?

“I had one in Connacht. It kept me out for three or four weeks. It was innocuous, I remember getting a small dink but when I went to train the next week I was not right. Physios drive so much of it in clubs. There was a guy called Keith Fox, he was really good.

“Around that time my father was unwell. He had a heart attack. That brings things into perspective.”

How did the move to Sale come about?

“I was chatting to Joe. ‘I am really enjoying this, I want to continue, can you throw out a few feelers?’ Tony Hanks, a fellow Kiwi, was coach of Sale and within 48 hours I was gone.”

You started plenty of games?

"Yeah, in and out between myself and Dwayne Peel. "

What sort of figure is Steve Diamond, because Irish people might not be so familiar with him?

“He’s a pretty abrasive guy. He prides himself on that northern English grit sort of mentality.”

That suited you?

“I played up to it. I compensated for ability with grit.

"It was season two that the issues with concussion began to arise. I had a couple of injuries that season, a clear out of my ankle and came back in a game against Wasps, in December 2012, when my head met the hip of Billy Vunipola [sic] when I was going down on the ball. I got sparked and got up to defend with the Wasps team. I had no issue playing on. The rest of the game went fine."

* * * * *

On Sunday, December 23rd, 2012, Cillian Willis came into the Sale versus Wasps match on 49 minutes. His first act was a pass to Richie Vernon, who was hit so hard by Vunipola that the ball came loose. When Willis scrambled to retrieve possession his head collided with Ashley Johnson’s knee. He struggled to his feet, falling at least once, to prompt Austin Healy, on BT Sports commentary, to note: “Cillian Willis is completely knocked out here. He doesn’t know where he is. He has just walked back to defend as a Wasps player.”

The head injury assessment trial laws had been introduced in the Premiership that season.

The replay shows Willis walking into the Wasps line until Stephen Jones alerts the referee. A Sale medic can be seen running towards Willis but stopping, putting a hand to his ear-piece and running back off the field, stopping again, and returning to treat the scrumhalf.

Referee JP Doyle: "You got blood, do you want to go off for blood?"

Willis: "I feel okay."

The crowd claps as three Sale medics/ physios leave the field and the game resumes.

Austin Healy: "He went and defended in the opposition line. Therefore, he has to go off and have his head tested. If you are going to have this law you are going to have to use it. It's a prime example."

* * * * *

Gavin Cummiskey: Did the Sale medics notice you going to the Wasps side?

Cillian Willis: "It would have been pretty hard to miss."

Did you suffer any other concussions before March 10th 2013?

“That was the major one, really. I played a game five days later [home to Worcester on Friday, December 28th]. I flew home for Christmas. I wasn’t right during the week so I didn’t train. I felt off.”

What do you mean by “I felt off”?

“For that one it wasn’t significant. I was drained of energy. I felt weak, just weak. I went to train and wasn’t comfortable so I was held off for the week. Was there any red lights going off in my head at that time? No, because all I was thinking about was the game. I played against Worcester just after Christmas. Went home and came back in between so I was chalking up not feeling right to the travel. After 45 minutes I came off as I had headaches. I was seeing stars from innocuous hits. Took five days off, then went into the gym to lift weights and nearly passed out. I had issues going on six weeks where I was on the graduated return to play protocols (GRTPP).

“I was well managed. I want to get that across: the medics and physios in Sale and outside go above and beyond to look after the player. You create significant relationships when you are constantly in a medical room but it is a tough environment to work in as well because it is pressurised. I think perspective gets morphed at times.”

It’s a difficult position?

“I think medics do get caught up in the team. That’s a reality.”

So, your last game was March 10th, 2013, against Saracens?

“I don’t remember the game because I got a double concussion [Cipriani knee followed by stray boot]. It was pretty severe. Obviously I’ve seen the video. I was down for about three minutes getting treatment. My wife, sister and brother- in-law were in the stand and Caitríona knew I had been out for six weeks with symptoms. This isn’t concussive symptoms like after the Wasps games; these were significant headaches, fatigue and problems with light. She was acutely aware and she was pretty concerned.”

She’s no longer watching a sporting event, she is watching her husband in serious danger?

“She comes from a sporting family, she is not one to get carried away but she was concerned enough to come down to try to understand what was going on at half-time. She got down to Dwayne Peel, who wasn’t playing, to ask him ‘What’s happening’?”

Was she told anything to allay her concerns?

“Not really, no. She didn’t go into the dressing-room. She didn’t get in.”

That sounds like rational behaviour by her, but it may have been seen otherwise?

“Not really, not internally, because everyone in the organisation knew I was having issues.”

Were you treated in the dressing- room at half-time?

“I haven’t a notion.”

I presume the place you feel most comfortable is a rugby pitch – does that contribute to players being able to play on when concussed?

“Unless you have to be dragged off you wouldn’t leave a pitch. That’s the reality. My feeling is players have a huge responsibility in terms of making decisions around injuries. It’s not up to a medic or a coach but that changes when someone loses the ability to make a decision for themselves, when someone is effectively incapacitated. When they don’t understand what they are doing.”

There was as third knock. Willis was tended to by a locum doctor, as the club doctor was on holiday. He was allowed play on.

“Some of the players said to the ref: ‘He doesn’t know where he is.’ I understand that I was standing on the far side of the pitch, looking up for two or three minutes and then one of the medics came around and got me. I didn’t know where I was going. My memory is coming to with the oxygen mask and not knowing what was going on.”

The circumstances surrounding Willis staying on the field, despite twice being treated for head injuries, is why he initiated legal proceedings.

“Whether I was going to play for another six more years or six more weeks is irrelevant; someone who has had influence on the management of the situation has taken that decision out of my hands. My reasons for initially taking legal proceedings were emotive: it was bubbling anger about what actually happened, how it happened and how it was dealt with after. The proceedings were initially around the period from the Wasps game in December through to March.”

Talk about the immediate aftermath?

“Certainly the first six weeks to three months were quite intense. I think they are well documented by other players.”

Player interviews, including Dominic Ryan's forced retirement , are mentioned.

“It is quite similar. The next time I was with the doctor, he hadn’t been at the game, he had come back, looked at the video footage and ‘it wasn’t looking good’ was the gist of our conversation.”

What happened next?

“My injury days were brought up by the club. My contract stated if I went to a certain number of injury days over a 12-month period I was going to half pay.”

Really, how many days is that?

“I think it is generally 50 per cent of the days over a 12 month period.”

Is that a standard English club contract?

“It was certainly in my contract at the time. I ended up signing a compromise agreement – during a pretty poor period, both mentally and physically – to see out the rest of my contract. The compromise agreement was effectively to pay me for the rest of that year in a tax-free manner. Basically, to get the salary I was due as a final settlement on the rest of that year with another year to go on my contract.

“I didn’t end up financially better off but I was afraid of going to half-pay. I signed it. This is what the legal disputes focused on, really, from late 2013 – this compromise agreement. There are clauses in that agreement. The compromise agreement precludes me from taking a claim for negligence in treatment against Sale.”

Which you signed while in a bad “mental and physical” state?

“Which was signed under significant pressure at a vulnerable time.”

When was that?

“April 2013. My motivation wasn’t noble. I wasn’t seeking to change rugby. I was pissed off with the way I was treated. The way I was threatened about half-pay and how my career was ended really pissed me off and, as a result, I was motivated to initiate legal proceedings. Those proceedings went up a bit of a dead end.”

Has this cost you a lot of money?

“It has, but really it has cost me a hell of a lot of time and wasted energy. Have I achieved anything out of it personally? Absolutely not. Premiership rugby at the time certainly stood to attention. So did World Rugby. I think it helped change the way head knocks were being managed. But that wasn’t my goal.”

What’s your advice for a player considering legal proceedings following concussions sustained playing rugby?

“Would I initiate legal proceedings knowing what I know now? No.”

Did Sale Sharks fail to deal with your concussions?

“Yes, I was left on the pitch playing, so yes.”

Have you any health issues now?

“No, full recovery. It took two years to wash out. The first six months were pretty manky.”

You are in the family business?

“Myself and the brother have taken over; we are branching into elements outside of nursing home care, we are involved in a healthcare recruitment company. A lot of the people you engage with are dealing with family who have loved ones at the end of their lives. Nothing brings things into perspective and shows what’s important more than death.”

You mentioned your daughters, and how you want them to someday read your side of this story.

“That’s important. At the moment there is very scant information where people are drawing their own conclusions. I don’t want my daughters looking down at their obstructionist Dad, especially when I am cantankerous in older age, I want them to see there was a time when there was reasoned cantankerism!”

How’s life as coach of Greystones RFC first XV?

“I am really enjoying it. I disconnected from rugby in a major way. This is my first year getting back involved. You get paranoid. People were always asking ‘How’s the case?’ That’s why I am doing this interview. To deal with it once and move on.”

What about your daughters playing rugby?

“Let them play. As a father I’d keep an eye on it because there will come a point, as the physicality creeps down the grades, where we may need more drastic rule changes. But Ronan, my brother, is coaching my nephew at under-10s. There are about 90 kids down there. The popularity is unreal. It flies in the face of what I am saying.”

He wishes he could say more.

Gavin Cummiskey

Gavin Cummiskey

Gavin Cummiskey is The Irish Times' Soccer Correspondent