In 1991, just shy of his 60th birthday, Tom Catlin suffered two heart attacks in the same week. At age 66, Fritz Shurmur succumbed to cancer in the summer of 1999. Early in 2003, Steve Sidwell, 58 years old and barely into retirement, had a stroke. Last month, Ray Rhodes, 54, was stricken by a stroke as well.
The four men had at least two things in common: They lived in the Seattle area and were, at various points, all assistant coaches on the Seattle Seahawks' staff.
The locale likely had little to do with their health problems. Their livelihood, on the other hand, might have.
"I'm pretty sure it wasn't something in the drinking water in Seattle," said longtime NFL assistant Larry Kennan, now the executive director of the NFL Coaches Association. "It's more about the stress of the [coaching] profession, the lifestyle that comes with it and the manner in which guys take care of themselves, or, more [appropriately], don't take care of themselves. I'm amazed that the stress doesn't kill more of them. I'm surprised, quite frankly, more [coaches] don't just drop dead."
The heart problems which forced St. Louis coach Mike Martz to request an indefinite leave of absence earlier this week from the Rams figure to again direct focus on the perils of the profession. The dangerous bacterial infection, preliminarily diagnosed as endocarditis, attacked Martz's heart and caused him to consider resigning. The condition, however, might not be same physical manifestation of stress other coaches have demonstrated, which some experts feel are directly attributable to the demands of the job.
No matter, because there are plenty more pertinent examples, it seems.
Although there is a modest body of scientific examination on how playing in the NFL for even a short time can render long-lasting physical ramifications -- ranging from nagging to debilitating, and perhaps even early death -- there are no such studies on the effects of coaching in the league. Despite the dearth of empirical data, though, there is substantial anecdotal evidence that standing on the sideline might, in the long run, exact a toll similar to that of standing in the pocket.
There might not be as many tales about NFL coaches requiring knee or hip replacement surgeries as there are stories of former players needing such procedures years after their careers have ended. But there seems little doubt the stress imposed on coaches is an insidious thing, obvious in manifestations like cardiac problems, hypertension and even some psychoses.
"When my father got out of coaching in 1984, his health couldn't have been any worse," said Atlanta Falcons president and general manager Rich McKay, whose famous father, John McKay, was the first coach of the Tampa Bay Buccaneers, following a celebrated career at Southern California. "His heart was bad, he had all kinds of other stuff going on, and it took two or three years after his retirement until he started feeling better. And there is no doubt in my mind that much of it was brought on by the stress and the lifestyle of the [coaching] profession. So, yeah, it's definitely a concern."
As the pressures of the game mount on coaches who are counted on by their owners to provide instant gratification, and stress levels soar, that concern could increase.
In 1986, then-Indianapolis Colts coach Rod Dowhower, whose team was 0-12 at the time, sat in his office just three days before he would be fired. Knowing the ax was about to fall, Dowhower systematically removed all his personal belongings from his office over a period of a few weeks, and the room was devoid of just about everything except his desk and a few chairs and empty filing cabinets. In one corner of the desk was a bottle of Stress-tabs.
If he was still coaching, Dowhower might need an industrial-sized vat of the medication, and he wouldn't be alone.
"It's a problem, no doubt about it, for these guys," said Dr. Jim Taylor, a psychologist who is renowned, in part, for his extensive work with athletes and coaches and the stress with which they most cope. "You take the stress, the long hours, the poor eating and the bad exercise habits that come with it and these guys are kind of like the perfect storm for unhealthiness. Those things spin off into all kinds of [physical] ramifications."
Consider the physical toll just this year alone: Even before the season began, Falcons offensive line coach Alex Gibbs, always known for being wound a little too tight, opted to reduce his status to consultant because he had problems dealing with the emotional demands of the job for the second time in his career. Rhodes suffered a mild stroke from which he is still recovering. Jacksonville offensive line coach Paul Boudreau collapsed in the locker room and was later diagnosed with being dehydrated and fatigued. Green Bay offensive coordinator Tom Rossley, who underwent emergency angioplasty a year ago, again had to undergo a battery of tests two weeks ago when he experienced discomfort in his chest. Two well-known coordinators and one head coach, none of whom wanted to be cited by name, told ESPN.com this week that they recently went on newly-prescribed medications because of dangerously high blood pressure.
"You find out," Rossley said, "that you'd better make some lifestyle changes. You've got to pay some attention to yourself. Not an easy thing, though, [for coaches] to do."
Rossley now budgets time into his schedule for walks and has changed his eating habits. Even before Packers home games, just a couple hours before kickoff, he walks briskly through the Lambeau Field parking lot, ironically, the site of some of the most artery-clogging tailgate parties in the league, with beer-and-brats the local specialty. It relieves some of the stress, Rossley acknowledged last year, but doesn't eliminate it entirely.
Widely known for his explosive temper and aggressive style, Rhodes now keeps a string tied around his finger, a reminder to at least try to remain calm even in the most pressure-packed situations. It has been, and will continue to be for Rhodes, a tough transition, but a lifestyle and temperament metamorphosis he realizes must be undertaken.
"It was a big-time scare, the biggest, man," said Rhodes, who missed the Seahawks' season opener following his stroke on Sept. 4. "As much as I love this game, and have lived for this game, it was a warning sign. It was a message. If you don't have your health, you've got nothing, so I've got no choice but to change. I don't want to walk away from the game wondering if maybe I should have worked an extra couple hours. I might not have said that before."
Indeed, the league has enhanced some of its benefits package, already one of the best in any business, to help coaches with their retirements. The bigger issue, though, might be to help coaches get to retirement without some of the physical ailments brought on by years of job-related stress.
Given the increased demands of the position, and the financial elements that have been added because of the salary cap and the lucrative salaries in the game, stress levels are likely to spiral upward at the same rate as NFL payrolls. Add to that the fact that, in a profession where shelf-life has always been determined by winning, average tenures are being reduced by owners who demand speedy results.
There are just 11 current head coaches with at least five years of continuous service to the same franchise. The current tenure of the 32 head coaches with their current teams was just 3.6 seasons entering 2005. Turnover is speedy. In many cases, the physical and emotional upheaval is an obvious byproduct of the pressures inherent to the profession.
"It's a vicious cycle," said Dr. Lawrence Lane, a sports psychologist who has treated coaches at the college level and who said the same effects are probably seen even more often in the NFL. "Some of these guys, they're incredibly unhealthy, and it all goes to the pressures of the job."
Of course, stress in coaching is hardly a new part of the job description, as NFL history has demonstrated in many instances.
In 1988, then-Chicago Bears coach Mike Ditka suffered a heart attack he acknowledges was attributable to the lifestyle he adopted as a hard-charging and even hard-driven boss. Dick Vermeil resigned from the Philadelphia Eagles after the '82 season, citing the catch-all term "burnout" as the cause of his departure. In large part because of Vermeil's early exit from the game at age 46 (he returned to the NFL, of course, 15 years later) the term "burnout" became part of the league's lexicon. Sam Wyche, during his stints as a head coach in Cincinnati and Tampa Bay, would go days without sleep. Jim Mora the elder, father of current Falcons coach Jim Mora, became the poster boy for coaching meltdowns after very public incidents during tenures with the New Orleans Saints and Colts. Joe Gibbs took an 11-year hiatus because of the mental and physical grind that even a successful stint, like winning three Super Bowl titles, can have on a man.
But after just one season back on the job, Gibbs, who also has diabetes, underwent surgery this April to have a stent inserted into a heart artery. Six weeks before he coached the Falcons in Super Bowl XXXIII, Dan Reeves underwent emergency quadruple bypass surgery. Bill Parcells has had four angioplasty procedures and a bypass operation. Reeves and Parcells have acknowledged their heart problems were at least in part attributable to the stress and lifestyle of their profession.
"It just wears you down," the elder Mora said. "It eats you up."
And, in some cases, it spits you out, too.
Sidwell retired in 2002 after a long career in the league and after the Seahawks fired him. He figured his reward would be golf and travel. Instead it was a stroke. These days, he tries to relax by serving as an assistant at the Massachusetts high school where his son is the head football coach and athletic director, and where the angst level isn't quite so high. But there are, Sidwell's wife told the Tacoma (Wash.) News-Tribune, some bad days mixed with the good, and reminders of a once-hectic lifestyle.
"Is coaching dangerous to your health?" Katy Sidwell said. "Yes. That's the answer. But you can't take people away from their own adventure. I've learned that you can't change some things [about] human nature. Some people live to be 100, sitting in their rocking chairs safe and sound, [but] complaining about how boring life is."
There is nothing boring about being an NFL coach.
By nature, the coaching profession is a demanding one, but it is, both psychologists and medical doctors agree, unnatural to be so all-consumed with any endeavor. It is that all-consuming drive that creates problems. At the root of those problems, it seem, is stress.
Fifteen years ago, "Jobs Rated Almanac," a book that rates occupations and breaks them down into several categories, including the stress imposed by people in a given vocation, rated coaching among the most stressful occupations. Even now, in updated versions of the book, coaching is viewed in the same high-stress range as professions such as air traffic controller, surgeon, policeman or fireman.
"When you think of professions generally related to high stress, I typically find them to be jobs where there is some threat to life," Dr. Taylor said. "Air traffic controllers, surgeons, those are professions that, by their nature, mandate having people's lives in your hands, very literally. Coaches aren't so much dealing with a threat to life, although they do control, with [personnel] moves, the futures of men. But to me, it's more a threat to ego that they experience. And when your ego is threatened, you dig in, work harder, try to do more and that's the cycle. Long hours. Poor eating habits. No exercise. Being overweight and out of shape. All those things add up. Honestly, I don't know how these guys have any family life at all. They've either got very indulgent wives or they end up divorced, I suppose."
Taylor recommends to his coaching clients, or those he has counseled, to seek some sort of escape, no matter how brief. He tells them to take time out for dinner, to get exercise even if it means installing a treadmill in the office, to generally live healthier. Telling coaches to do so, though, is light-years removed from having them heed the advice.
McKay said that when Tony Dungy became the head coach in Tampa Bay, he mandated his coaches keep a regular schedule and that they were out of the office at certain times every day. No sleeping on cots in the office, McKay said, for the Bucs coaches during Dungy's stewardship there.
In Atlanta, the Falcons cater in meals for their coaches during the week, in part to ensure the staff has the opportunity for some regularity in its collective diet. Coach Jim Mora the younger, who at times appears to have inherited some of his father's propensity for being tightly wound, emphasizes to his staff the need for family time and exercise.
"The more support you can give your staff, the more you can do to make their lives and [their livelihoods] a little easier, the better off it will be," McKay said. "Look, there are a lot of people in a lot of professions who work long hours. But for these guys, the pressure never seems to end, you know? It's a constant thing. You see it and you worry about it and, yes, you think about how to ease it in some way."
There are, for sure, no easy answers. It's doubtful anyone, for example, can stop workaholic head coach Jon Gruden from reporting to his office at the Bucs complex before 3 a.m., the typical beginning to his work day. Coaches at most levels are "Type A" individuals, hot-wired with competitive characteristics and incredible drive to succeed. But the hot-wiring, as some recent incidents have indicated, can short-circuit.
For Kennan, who as head of the NFL Coaches Association is outspoken in his advocacy for easing the lot of his constituents, the only solution might be legislation, and no one even knows how viable that might be. Kennan pointed out that the NFL Players Association now has rules mandating how many offseason practices, both voluntary and mandatory, teams can ask players to attend. He has voiced concerns to league officials that, as radical as the notion might be, similar guidelines might be necessary for coaches.
Of course, ever the pragmatist, Kennan -- who recently phoned Rhodes to inquire about his recovery from last month's stroke, and to verbally lambast his longtime friend for not taking better care of himself -- understands there will probably never be a day when the league limits working hours for coaches.
"We're our own worst enemies, believe me, it's true," Kennan said. "It's not like we can blame this on the league. It's our own competitiveness. Tell me any other job where, starting in late July, you begin working 100 hours a week, where you never take any time off until maybe [the following] February, and then maybe get one month off before the same rat race starts all over again. It's just craziness. But this is a copycat league, as you know, and always has been. So if one coach is working his [staff] 100 hours a week, then every head coach is going to do the same thing. I don't know when it stops."
Probably not until the sobering reality of what coaches are doing to themselves with the stress, and the unhealthy lifestyle it nurtures, becomes more apparent.
And that reality, at least according to Lane?
"There are coaches out there who are ticking time bombs, honestly," Lane said. "There are [coaches], I'm telling you, who are just a stroke waiting to happen."
Len Pasquarelli is a senior NFL writer for ESPN.com. To check out Len's chat archive, click here.