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A Coach’s Victory

Family, football and faith were my life. My cancer diagnosis tested them all.

Coach Pagano returns to the field after a victorious battle with cancer.
Credit: Sam Riche

I talked to the team doctor more to ease my wife’s mind than my own. Yes, I was tired, but exhaustion is part of the job description for any NFL coach, and I was in my first year as head coach of the Indianapolis Colts.

Exhaustion didn’t explain the bruises on my arms and torso, though. I didn’t remember bumping into anything or anyone, but the bruises had cropped up during training camp and worsened as we started the regular season.

One night, Tina noticed the dark purple splotches on my side. I told her I’d probably gotten them playing with our grandkids, but she said, “You’d better get those checked out.”

I knew she’d keep after me if I didn’t, so I asked the team doctor to take a quick look one day at the Colts complex. He had a nurse draw some blood and sent it out for tests, and I got right back to work.

That night the team doctor called me. “Some of your counts were low,” he said. “I made an appointment for you to see a specialist, Dr. Larry Cripe, tomorrow.”

“Tomorrow? We have practice and things to clean up heading into the bye week.”

“This is not optional, Chuck. You need to be at Indiana University’s Simon Cancer Center tomorrow for the appointment. Make sure your wife goes with you.”

That’s when I knew something serious was up.

Still, it didn’t seem real the next day when Dr. Cripe told me, “You have acute promyelocytic leukemia. It’s a cancer of the white blood cells.”

No way, I thought. This isn’t happening. Tina’s hand tightened on mine.

“It’s treatable,” Dr. Cripe said. “But you will need to begin chemotherapy immediately.”

Tina and I looked at each other, tears in our eyes. Why would I finally get my dream job–the opportunity that I’d been working toward all these years, that Tina and our girls had sacrificed so much for, moving every time my career took me to another team–only to be slammed with this?

Then my coaching instinct broke in. There are no pity parties in football. I asked Dr. Cripe, “What are my chances? Give me some numbers.”

He said that APL is highly curable, with long-term survival rates as high as 90 percent. Better than decent odds. Better than the odds on any given Sunday in the NFL, for sure. “What do we need to do to beat this?” I asked.

Dr. Cripe laid everything out for me. APL is treated with an oral drug, all-trans retinoic acid (ATRA), in combination with intravenous chemotherapy.

“The treatment is intensive,” he warned, “but it’s the only way to kill the cancer cells. The next six weeks are going to be rough on your body. You’ll likely be hospitalized the entire time, because your blood counts will be extremely low and we don’t want to risk infection.”

“I can handle it,” I said. It’s all your mindset and your attitude. I chose to focus on my position, not my condition. My position would be that I would beat cancer and stick around for a long time for my family.

I was admitted to the hospital right away to start treatment. I only had time to call our general manager, Ryan Grigson. Tina had to make the hardest calls, the ones to our daughters and to my parents.

Half an hour after the diagnosis, a nurse inserted a PICC line, a type of central catheter, in my upper arm, and the chemo drugs began flowing into my bloodstream. Dr. Cripe put a whiteboard up on the bathroom door to track my progress.

There was a calendar on the board, and each day nurses would write my blood counts, white cells, hemoglobin, platelets. I liked numbers. They were tangible measures, something I could hold on to.

The first week of treatment wasn’t too bad. Then the side effects kicked in with a vengeance. I thought I was tired before. Now I was totally wiped out. Like other NFL coaches, I was accustomed to working 18 hours a day during the season.

There were some days in the hospital when I slept 18 hours and still barely had the energy to shuffle to the bathroom and brush my teeth. It wasn’t a restful sleep either, I’d get the sweats, fevers, chills. My body ached all over. I got dry mouth from the chemo and lost my taste buds. Not that it mattered, since I had zero appetite.

ATRA had such debilitating effects, fluid buildup in my lungs, crushing migraines, that Dr. Cripe had to take me off it for a few days to give my body a chance to recover before putting me back on.

The pain meds for the migraines caused gastrointestinal problems. I had to take something else to deal with those. It was a vicious cycle.

I did all I could to try to take my mind off everything that was going wrong with my body. The Colts set me up with a laptop and a video monitor, so I reviewed practice tapes and e-mailed my coaches and players whenever I felt up to it.

Of course I watched games on the TV in my hospital room. Staying connected to the team might not have brought up my blood counts, but it definitely lifted my spirits. So did all the messages from my friends. Especially Kevin Elko, whom I’d met back when I was with the University of Miami.

Elks, that’s what I call him, is a sports psychologist and motivational speaker, and he works with pro and college football teams. We’d gotten to be good friends over the years, and I looked to him as something of a spiritual coach.

As soon as he heard about my diagnosis, he called. “Chuck, you’ve got to fight this on two different planes,” he said “The physical plane and the spiritual plane.”

Dr. Cripe and the oncology team were giving me the weapons for the physical battle. The spiritual, that was up to me. I would have to dig in with my faith, deeper than I ever had before.

Elks promised to back me up on the spiritual front, and he did. Three or four times a week, I’d get something from him, an e-mail, a voice mail, a podcast, with a thought or Scripture I needed.

Two weeks into treatment, though, he left me a message that I couldn’t quite wrap my head around. “Chuck, don’t just ask God to heal you. Thank him for your complete recovery.”

How could I be thankful for something that hadn’t happened yet? Recovery was pretty far off, if the numbers on my whiteboard were any indication.

A few nights later my body was racked with the worst fever and chills yet. I woke up every couple of hours, my clothes completely soaked. I would change into something dry, only to sweat through it again.

The chills were so bad that Tina, who’d been sleeping on a little couch in my hospital room every night, got in bed with me and tried to use her body heat to warm me.

Lord, I don’t know how much more of this I can take. I couldn’t even summon the strength to speak. It felt like the fight had been sucked right out of me.

Tina gave me hope. “You’re going to get through this,” she said “Don’t think about how bad you feel right now. Picture yourself going home, hugging the girls, chasing our grandkids around the yard. Picture yourself on the home sideline at Lucas Oil Stadium, firing up the team.”

Picture myself… I always urged my players to visualize victory. It was a way of deepening their belief in themselves. Was this what Elks was getting at when he told me to give thanks for my healing? To deepen my belief that it would happen, deepen my faith?

That was what I had to hold on to when the tangibles, my body, the numbers I liked so much, were breaking down.

“Thank you, God, for healing me,” I whispered “For fully healing me.”

That was a turning point for me. More on the spiritual plane than the physical. There were bad days that followed, but I knew how to get through them. I talked to family and friends on the phone. Replayed Elks’s messages. Tina read me letters from fans and we’d write replies.

We prayed together too, giving thanks for the many blessings in our lives, including the unexpected gift of this time for the two of us. Coaching had taken me away from home so much in our 25 years of marriage that we had never spent this many days in a row together before.

We also gave thanks for blessings still to come. And they did come. The numbers on my whiteboard started trending up. Dr. Cripe let me walk a few laps around the oncology floor. Twenty-six days into treatment, my blood counts were good enough for me to go home.

The next two months of outpatient chemotherapy zoomed by. My blood counts went back to normal. Dr. Cripe did one last test, an analysis of my blood on the molecular level. Five days later, he called with the results. Complete molecular remission. No sign of cancer cells.

Tina and I held each other and cried again. This time, they were tears of joy. Gratitude. Victory.

EDITOR’S NOTE: On December 30, 2012, Head Coach Chuck Pagano returned to the sideline at Lucas Oil Stadium in Indianapolis.

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