Round-the-clock stress makes NFL coaching a health risk

Standing on the sideline, Dan Reeves felt the burning in his throat - a sure sign of heart trouble that could no longer be ignored.

On the flight home, he told the cardiologist about his pain but suggested they wait to do anything because there were only three games left in the season. "He told me, 'That's about the dumbest idea I've ever heard,'" Reeves said.

Within hours, Reeves, in the process of coaching the Falcons to the franchise's first Super Bowl, was on the operating table for a quadruple bypass surgery that saved his life.

That was in 1998, and nothing about the life of an NFL head coach - a life the former Cowboys running back lived for 23 years in three cities - has grown less complicated since.

These days, word of a coach making an emergency trip to the hospital has grown so common it could almost be part of the injury report. Earlier this month, Reeves' one-time backup quarterback in Denver, Gary Kubiak, cited health problems as the reason for his sudden retirement as coach of the Broncos. The Super Bowl coaches, Bill Belichick and Dan Quinn, haven't had any publicized bouts with bad health (Belichick took an unexpected trip to the trainer's room following a game in 2014, but refused to offer details), though that certainly doesn't minimize the stress and risks of signing up for an all-consuming job that grows more challenging every year.

"It's a lot of stress," Reeves said. "It's the time it takes to get the job done. And we're all human. If you are struggling, the first thing you do is say, 'I've got to work harder,' and so, you work longer."

In many ways, the job description isn't unlike that of a CEO of a billion-dollar business: work round the clock; manage dozens, if not hundreds, of people; try to exercise, eat right and maintain some semblance of family life in whatever spare time you have.

The differences: A coach's bottom line is measured in wins and losses that stem from a product that millions of people watch, dissect and analyze every week. Since the start of the 2000 season, the average tenure for an NFL coach is 3.9 years, meaning that pretty much everyone hired faces a good possibility of someday being fired, as well. And no matter how big a control freak that coach may be, his fate is ultimately tied to the performance of 50 or so men, the majority of whom are under age 30 and are holding their first full-time job.

"The notion that someone takes a job knowing they're going to be fired eventually, to me, it means they're under an enormous amount of pressure from the get-go," said Peter Schnall , a researcher at California-Irvine who studies the health effects of workplace stress. "And no matter how much control these coaches have, they never have as much as they like."

The sheer time constraints of the job dictate that most coaches don't eat as well or exercise as much as they'd like. That, plus the stress, can result in elevated heart rate and blood pressure, which contribute to heart attacks, compromised immune systems and a series of other problems - all piled on without the means to alleviate all that stress.

"When we were all hunter/gatherers, the body would scream 'danger,' and we'd all get ready to run like crazy, get the spear out and fight," Schnall said. "Football players can do it by banging into other people. But the average person, or the average coach, can't punch the boss when the boss threatens him or work piles up. They have nothing to do with all that arousal energy. It stays in the body."

None of this is new. Vince Lombardi had notoriously bad health and didn't subject himself to what would now be considered a routine colonoscopy; he died of colon cancer at 57. Bear Bryant died of a heart attack less than a month after leaving Alabama.

Mike Ditka. Bill Parcells. Reeves. All left the game, eventually, after enduring multiple bouts with bad health. Last summer, longtime NFL coach Dennis Green died of a heart attack.

The advent of free agency and the 24-hour news cycle have made a coach's job even more all-consuming. Coaches hold four or five news conferences a week. (By comparison, Donald Trump, as president-elect, held one in two-plus months.) They spend the better part of the offseason analyzing both the players on their roster and those who might join them. Parting ways, in the era of free agency, has become even more common, "and it hurts when you have to call them in and release them," Reeves said.

"And it's not about what kind of player he is, it's about how much money he makes. That's stressful," Reeves said.

Once the season is over, a quick break, then time to gear up for offseason workout programs that typically start in April.

When he stepped down, Kubiak spoke to the realities of the job the way he wanted to do it versus the way doctors were telling him to do it.

"I've taken a lot of pride that I could coach a football team, be there for the players, be there for the coaches, be there for the organization, do a game plan, call some plays on Sunday," he said. "I've always taken pride that I could do all those things. But this year, I haven't been able to do that."

Kubiak suffered a mini-stroke while coaching Houston three seasons ago, then was taken to the hospital again this season after an episode with a complex migraine. Others who made unexpected trips to the hospital just this season: Bruce Arians of the Cardinals, Todd Bowles of the Jets and Mike Zimmer of the Vikings. Kubiak's predecessor in Denver, John Fox, missed four weeks for a heart surgery he'd hoped to put off but couldn't.

It is, literally, not a job for the faint of heart. And yet, there are only 32 of these jobs available, and they remain among the most high-profile and coveted in sports.

"I can play golf, I can do all kind of things outside of football and never come close to the excitement you feel standing on the sideline when they're playing the national anthem," Reeves said. "You feel your heart rate start climbing and that's a great thing. But your heart, it's got to be at 100 percent for this job."


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