Malarchuk fell to his knees and grabbed his throat. “A stream gushed out with every beat of my heart,” he describes in his book. “It’s an artery. I grabbed my neck, trying to keep the blood in, but it rushed between my fingers. It just kept coming.”

Buffalo trainer Jim Pizzutelli was at Malarchuk’s side within 10 seconds. He pressed hard on the goalie’s throat, occasionally releasing the pressure to allow him to catch a breath.

Malarchuk was so sure he wasn’t going to make it, he told the team’s equipment manager to call his mom to let her know he loved her.

At the hospital, it took surgeons 90 minutes and 300 stitches to close the wound. The skate blade had missed his internal carotid artery, and a certain death, by a millimetre.

Malarchuk checked himself out of the hospital the next day. He had been traded to Buffalo just two weeks earlier. He wanted to show his team he was tough, that he could bounce back. He received a hero’s welcome from the fans when he returned to play 10 days later.

That’s the part of the story the public knew for two decades.

• • • •

As an ESPN documentary, Cutthroat, plays for those gathered at the Habour Banquet and Conference Centre, Malarchuk leaves the room. It has been almost four years since he last saw the footage from that game.

“Counselling wasn’t offered, and I didn’t think of it either,” he says. “I was the toast of the town because Buffalo is a blue-collar sports town and I rode that support. The support was overwhelming and it got me through that season.”

While Malarchuk appeared fine to those around him, he was struggling badly. He suffered from obsessive-compulsive disorder, which he credits for helping him make it to the NHL, perfecting his skills through the endless repetition of drills. As a kid, he also suffered from severe anxiety, for which he was hospitalized, but never treated.

But after the injury, his OCD, anxiety and depression began to overwhelm him. Over the next few years, it became increasingly difficult to even leave the house. He began drinking heavily. By 1992, in what would turn out to be his final season in the NHL, Malarchuk was still bolting upright in bed with visions of the skate blade cutting his neck.

At one point, he went 10 days without sleeping. With his mind racing and desperate to sleep, took a handful of pain medication he was taking for his back and downed some whiskey. His heart stopped beating and he needed to be revived.

Though Malarchuk denied it was a suicide attempt, he finally opened up about what he had been dealing with and received some help for the first time. A year later, a doctor in San Diego began treating him.

“It was like I was cured,” Malarchuk recalled. “I said, ‘So this is what it’s like to feel normal.’”

• • • •

Before Malarchuk stepped to the podium Thursday night, Camille Quennville, the CEO of the Ontario chapter of the CMHA, told the audience about Talk Today, the program the organization launched in conjunction with the Ontario Hockey League. Initiated following the suicide of Terry Trafford of the Saginaw Spirit last year, the CMHA works with OHL teams to teach players about suicide awareness. Parents, team staff and billets also receive training about recognizing signs.

“When I played junior hockey, I wish I had someone, somewhere to open up to,” Malarchuk said. “That was a long time ago and we’ve come a long way.”

Interviewed days after his injury in Buffalo, Malarchuk was eager to get back in the net.

“The longer you wait, the tougher it is mentally,” he said.

It took a long time, but Malarchuk would discover just how wrong he was.

• • • •

In 2008, Malarchuk was working as a goalie coach for the Columbus Blue Jackets. The treatment he had received and the medication he was taking had been very effective. It allowed him to return to school to become a horse dentist between coaching jobs.

“Things had been pretty good for 10 or 12 years, but I could feel things starting to slip,” he said. “Usually, I chalked it up to a bad day and just thought I’d shake it off.”

Malarchuk had not been to see a doctor for some time and his medication was no longer having the same effect. He started drinking again to chase away the old feelings.

Then in February, Richard Zednik of the Florida Panthers had his throat cut by a teammate’s skate. The fact that it happened in Buffalo only added to the eerie similarities.

Reporters immediately began calling Malarchuk for his thoughts.

It brought back all the memories of his own injury. His drinking got out of control, he picked fights, he became convinced his wife was cheating on him.

It continued to build until one day Joanie returned to their ranch in Nevada. She found him sitting behind the tack shed with a gun beside him. They began to argue, then Malarchuk grabbed the gun, lifted it to his chin and pulled the trigger.

• • • •

Malarchuk’s book, The Crazy Game, begins with the sentence, ‘I didn’t write a note.’ He didn’t plan to commit suicide that day. And even if he did, he doubts he could have articulated why.

“People in that state, there’s so much confusion and pain, it’s hard to explain in detail,” he said. “Living with mental illness, it’s hard to explain to someone who hasn’t had that pain.”

At the time, Malarchuk blamed his wife. “I’m so ashamed of that,” he said.

But a conversation with another former NHLer, Jesse Wallin, who witnessed his father’s suicide, helped him reconcile that. Wallin told him that it wasn’t his dad who killed himself, it was the sickness.

“That made me feel better,” Malarchuk said. “It wasn’t Clint who shot himself, it was the illness. In my right mind, I would not do that; I would not say that. It’s a good message when you’re dealing with someone with a mental illness.”

Though originally reported as an accident, Joanie later told police it was in fact a suicide attempt so that Malarchuk could get the help he needed.

He went to a rehab facility in San Francisco for six months. He spent the first two months resisting treatment, before realizing he had been carrying 19 years worth of trauma from his accident. Once treatment for post-traumatic stress disorder began, he started to improve.

“I got well. They got me on the right medication. They got me dried out. They got me well,” he said. “Today, I’m doing great. Honestly, I’m happy. I’m healthy and strong, but most of all I’m happy. Having been to that place where I was so unhappy and so confused and so angry and so miserable, for me to say I’m happy is big. And to know there’s help and people can get better.”

• • • •

Suicide notes often raise as many questions as they answer. In a way, The Crazy Game, is Malarchuk’s note.

Written with a clear mind, it lays it all out there. It’s a description of what he felt, why he acted the way he did and what led him to pull the trigger that day.

Except Malarchuk survived.

He could have easily become a statistic. Approximately 4,000 Canadians commit suicide every year, making it the 11th leading cause of death. Malarchuk is helping others by telling them what it’s like to have an illness that pushes you to the brink and feel as though there is no other option.

“People (with mental illness) are so afraid to share, so Clint’s openness to share his experience is so impactful,” said Melanie McGregor, communications and health promotion specialist with the Halton branch of the CMHA. “It helps to have someone like Clint who has been there, to encourage them, to tell them they’re not the only one and that help is out there.”

“There were so many times I asked God to take me and he didn’t,” Malarchuk said. “Now I know why.”

The Crazy Game was difficult for Malarchuk to write. It once again brought up very dark times in his life. But since its release in November, Malarchuk has found it easier to talk about his past, because he knows it is helping people.

When the book came out, he was receiving 50 emails a day (he included his email address in the book) from people or family members of people suffering from mental illness. He still receives about 10 a day and answers them all.

“I’ve become like a support group, just letting people know they’re not alone. Just knowing it’s helping people makes it easier to talk about. Now, it’s my mission.”