- Dr. Jack Ramsay, NBA
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The following is from the book "Dr. Jack on Winning Basketball." In the prologue, Dr. Jack wrote about his long fight with cancer. This piece was originally published in 2011 and republished on the occasion of his death.
Cancer is the ugliest, scariest, most dreaded word in the English language. My credentials for saying so? Head-to-head, firsthand close encounters with different versions of the fiendish devil. And ...
Whoa, there. This is supposed to be a book about basketball, not cancer. You're right. Absolutely right. But bear with me for a minute. I want to make the case that my long life in basketball helped me cope successfully with that other thing. But to do so, I must first explain my urgent need to draw on all those rich memories of the game I love.
Now, where was I? Oh, yes ...
I went through my entire athletic life as a basketball player with only minimal physical setbacks, the worst being a couple of brain concussions, one in a college game in 1948, the other in 1954 while playing in the Eastern League, from which I recovered without permanent damage.
DR. JACK ON WINNING BASKETBALL
And all the stress and general wear and tear on body and soul from 37 years of coaching at the high school, college, and professional levels? Hard to measure, of course, but I don't regret a single minute that I spent on the sidelines of the game to which I've devoted my entire adult life.
Then, in 1999, a routine medical exam turned up an opponent I hadn't reckoned with -- prostate cancer. Fortunately, it was caught early on, and after radiation therapy and a procedure that shot radioactive iodine pellets into the prostate gland, my doctors assured me that they'd gotten it all. Arranging my treatments around my work schedule, I didn't miss a single game that season as a TV color commentator with the Miami Heat.
I didn't tell anyone about my condition, not even my family. Why worry them? I was convinced I could overcome the Big C on my own. I tried to live as I usually did, getting in my daily run and swim workouts at the beach and staying on top of my duties at home caring for my wife and on the job doing television commentary for ESPN and the Miami Heat. I felt a little more fatigue than normal during workouts on radiation treatment days, but other than that I felt fine. My most recent scans in the fall of 2010 revealed no tumors anywhere.
But in October 2004 I went up against the toughest opponent I had yet to face anywhere at any time in my life -- melanoma cancer. It started tamely enough, with three small spots under the skin on the instep of my left foot. I'd been running barefoot a lot on the beach near our summer home in Ocean City, N.J., and I figured I must have picked up a few thorns. No big deal. But the spots didn't go away, so I had them examined back in Florida that fall by my dermatologist, Dr. Jerry Lugo, who ordered up biopsies "just to be on the safe side." Two days later Dr. Lugo called with the results: melanoma.
I had recently lost a close friend to melanoma, so I asked, "This is like a death sentence, isn't it, Doc?" He responded quickly, completing an exchange that I remember as if it had taken place yesterday: "No, no, Jack. Some people live with this three years."
He recommended that I see Dr. David Ritter, a Naples, Fla., oncology surgeon, who promptly ordered up a PET scan procedure that revealed that the melanoma had quickly metastasized from my foot to my calf. Not a good sign.
I had outpatient surgery three days later to remove the melanoma from my foot and my calf. When I awoke from the anesthesia, Dr. Ritter told me that he had removed most of the sole of my left foot and a part of my calf to get to the melanoma and that he had taken seven lymph nodes from my groin and five from around my spine for closer examination. I left the hospital on crutches and was driven home by a friend. I felt OK -- not great, but OK. At least they'd caught it soon enough to get the damned things out of my leg.
A few days later, it was more bad news: they found a melanoma in one of the lymph nodes taken from my left groin. I passed that information on to Dr. Bruce Nakfoor, my prostate physician (and good friend), who told me, "You've got to go to Anderson."
That would be the M.D. Anderson Cancer Center in Houston, where Bruce had a connection with a Dr. Merrick Ross. Bruce called Dr. Ross, explained the details of my condition, and then put me on the phone.
"I know who you are, Dr. Jack," Dr. Ross said after I introduced myself. "I listen to you all the time on NBA games. We've got to get you better." He then explained a procedure called isolated limb perfusion, in which high-dosage chemotherapy would be pumped into a vein in my left leg and circulated there to kill any existing cancer cells. Also, all the lymph nodes in my left leg would be removed for testing.
Hey, fine, OK, let's get it done. Sooner the better, right?
The following week, after I was prepped for surgery, Dr. Ross came into my room. A little pregame pep talk? Sure. Why not? I was feeling confident. But after reviewing the procedure, Dr. Ross said, "Dr. Jack, I must tell you there's a 2 percent chance that you'll lose your leg."
"Look, Dr. Ross," I said, "if you have to take off my leg, don't wake me up." I was dead serious. Soon after, the anesthesia kicked in, and the next thing I knew I was coming out of a sweet, dreamy fog in the recovery room. As soon as I could move my arm, I reached down where my left leg was supposed to be.
It was still there.
This time, I was in the hospital for nine days. I'd had six incisions on the left side of my body in a three-week period, including one from my stomach to mid-thigh that left some severed muscles and nerves. Something as simple as turning over hurt like hell. Dr. Ross visited me at least once every day. When I asked him if he had a family, he answered, "Sure, Dr. Jack. You're my family."
I kidded him, "I bet you tell that to all your patients."
But you know what? I bet he does, and I know he means it. He has that level of commitment to people he's trying to help.
Later in the week, he told me that the results of my procedure were positive but that he would need to see me in a month to check on my recovery. I left Anderson on Nov. 9, 2004, and returned home to Naples, feeling pretty good about things.
A little over two months later, on Jan. 20, 2005, I did my first NBA broadcast for ESPN Radio at Orlando, tipping off a once-a-week NBA game schedule for the rest of the season. I felt great -- mentally. But not yet physically: the incisions in my groin and foot became infected and wouldn't heal completely. My left foot was too swollen to wear a shoe, so I wore a soft moccasin. Walking was painful.
But what bothered me the most was that I couldn't get into my usual workout routine that had become a daily part of my life. I couldn't run because of the soreness in my left foot, nor swim because of the open wounds. Even my "room workout" consisting of full-body stretches, running in place, crunches, and push-ups was put on hold.
It took a year and a half before I could resume full physical activity. Years before, I had set a goal of doing a push-up for each year of my life on my birthday, and I'd been able to reach "the number" through my seventies. But I turned 82 on Feb. 21, 2007, and I didn't make it. I got stuck on 78. I'm hopeful that in 2012 I'll be back on track, but it will take 87 pumps of the body.
Then, in March 2006, during a regular checkup, Dr. Ritter recommended another PET scan to make sure that the melanoma hadn't spread. Another routine test? Fine, sure -- let's get it over with before the playoffs.
More bad news.
Make that really bad news, as in melanoma tumors in both of my lungs.
In April I returned to M.D. Anderson, where I was admitted to an experimental drug program designed to shrink and eventually eliminate the tumors in my lungs. (Surgery wasn't an option; there were too many of them.) This required weekly trips to Houston for two hours of chemotherapy. I scheduled the treatments to avoid, insofar as it was possible, conflicts with my NBA broadcasts on ESPN.
At first, the results were encouraging. The tumors in both lungs grew smaller or disappeared altogether. But in late November, an MRI of my brain showed a tumor there, and a CAT scan of my lungs turned up evidence of new tumors there.
Next stop: Massachusetts General Hospital in Boston to see Dr. Jay Loeffler, who had developed a procedure in which high-dose radiation beams are aimed directly at tumors in the brain to destroy them.
At Mass General in January 2007, Dr. Loeffler's team attached a ring-shaped metal frame to my head with four pins. Then I went to the radiation center, where they strapped me to the treatment table and secured the head frame so that I couldn't move. I held that position for about an hour while proton beams were fired directly at the tumor from different angles.
After a brief recovery period following the procedure, Dr. Loeffler gave me the news: "That tumor is gone and won't come back. You may get others, but that one is gone forever."
I liked the sound of that, but two months later I was back in Boston to go through the same procedure for a new tumor that had turned up in my brain. The procedure seemed to go a bit easier this time, or maybe it was just the confidence I felt from the previous experience. But I have to say that those trips to Boston without doing a Celtics radio broadcast got tiresome.
Meanwhile, I was given a new drug, Temodar, which is used primarily to prevent recurrence of tumors in the brain. Then a most unusual effect took place. Not only did Temodar prevent tumors from returning to my brain, but the ones in my lungs began to disappear! I was told the chances of that happening were something like 1 in 20,000. My most recent scans -- in the summer of 2010 -- revealed no tumors anywhere.
"I don't use the word miracle very often," Dr. Nakfoor told me later, "but this might just be one."
This seems like a good point to say that I also prayed a lot during this ordeal. As a practicing Catholic, I pray more fervently (and more frequently) at a time of crisis. Suddenly, my need was great -- very great. I found myself at Mass focusing my prayers directly at the figure of Jesus Christ suspended on the cross at the front of the church. I began to think of him as the "Big Man."
There is a prayer said aloud by the congregation in a Catholic service just before Holy Communion that goes, "Lord, I am not worthy to receive you, but only say the word and I shall be healed." Every time I went to my knees for that prayer, I silently added, "Come on, Jesus, heal me! You can do it, Big Man! Heal me!"
I have to believe the Big Man heard me.
I approached cancer as if I were preparing for a game against a tough opponent. I "scouted" it, learning as much about melanoma as I could. I took on a medical staff of "coaches" who were experts at dealing with this particular version of the disease. I followed the game plan they laid out but made adjustments when the "game" took different directions.
I used stats -- readings from scans and blood analyses -- to confirm that my body was handling chemo treatments without damage to my overall system.
This was pretty much the same approach I used to get my Portland Trail Blazers ready to go up against the Philadelphia 76ers in the 1977 NBA Finals ... only with different stakes on the line.
To win, you have to prepare yourself to win. You have to be ready. You can't expect a W to just happen. That's the credo I always expected of my players. And that's what I demanded of myself when I was battling cancer.
Knowing I was going to have to use crutches after my surgeries, I practiced with them weeks before I had the surgeries. After the surgeries at Anderson, I did leg lifts while in bed. I started using my crutches (old friends by now) to walk around the perimeter of the eighth floor as soon as they would let me -- first once around, then twice, then three times as I built up stamina.
I did isometric exercises in bed to regain my upper-body strength. I never stopped pushing myself and never ever eased up on my conditioning program, even on those days when I'd have to stop every few steps to catch my breath.
Another key basketball skill is imagery. The best players "see" situations before they happen so they can be prepared to take best advantage of them when they transpire.
I used imagery to "see" myself in pleasant surroundings while I was getting MRI and CAT scan treatments. I used imagery to see myself reaching my goals. As I got my strength back, I used imagery to see myself walking on my own, then jogging, swimming, and then playing golf again. I used imagery to stay so focused on my job that I could fall asleep inside a closely enclosed MRI machine, with all its banging and buzzing, where you have to remain absolutely still, regardless of any discomfort you might be experiencing.
The best players I have seen and known have confidence in their teammates. They know that basketball's not a one-man game. That confidence brings out the best in everybody, because it's contagious.
I had complete confidence in my medical team. They were not only superbly skilled, but they cared for me -- and every other patient they treated -- as if we were the most important people in their lives. That gave me confidence that I could win my battle with cancer.
I never thought of losing. Not once. I never let a single doubt or fear creep into my subconscious. When challenges arose, my question was always, "What can I do now?" When my doctors revised a game plan, I went at it full bore.
But understand this: my commitment to living in the now means I'll never ever say that I've beaten cancer. To do so would be living in the "tomorrow," if you will, and melanoma is far too erratic an opponent to go around making predictions. But I can tell you for sure that I'll never give in to it. Life is too precious to give it up without giving everything you've got -- now.
Not exactly what you expected to be reading about in a book from an old basketball junkie, huh? Don't worry, this book is not about cancer, a word you won't encounter from this point forward. This book is about basketball. It's about the attitudes and methods and values and people I have encountered in over 70 years of playing, coaching, and broadcasting basketball and how that unbelievably rich life experience guides me in my biggest off-court challenge.
I received truly extraordinary medical care from a great team of ferociously dedicated men and women. I will never be able to thank them enough. But I believe in my heart that without being able to draw on my life in basketball for strength, I would be dead right now.
Let's get it on. One, two, three ... WIN!
3hEthan Sherwood Strauss
1dEthan Sherwood Strauss
3hMatt Walks, ESPN.com
19mVince Masi, ESPN Stats & Information
7hArash Markazi and Ben Alamar