- Wayne Drehs
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INDIANAPOLIS -- On the third floor of the Indiana University cancer center, a 38-year-old man sits in a leather recliner, fighting for his life. He wears an unflattering mint green hospital gown that seems too big for his frame. His thin, black hair stands defiantly atop his head. It has yet to begin falling out. But it will.
The calendar on the back of the bathroom door says it's the middle of December. The final countdown to Christmas has begun. But in this room, for now, there are far more important things to worry about than holiday cheer.
Six weeks earlier, everything seemed normal. Didymus Academia was watching television that night in his family's home in Muncie, Ind., when he heard the new coach of his favorite football team, the Indianapolis Colts, deliver a moving postgame speech.
Until that moment, no one had seen or heard much from Chuck Pagano since the coach left the Colts in September after doctors revealed he had acute promyelocytic leukemia, a rare cancer of the bone marrow. After more than a month of chemotherapy, Pagano's hair was thinning. His body looked frail. Yet the words coming out of his mouth were powerful. He spoke of living not "in circumstances" but rather "in a vision." His, he said, included dancing with two more daughters at their weddings and winning the Vince Lombardi Trophy. (His oldest daughter is already married.) The players standing around him nodded in approval.
A TV camera caught the scene, and it was shared with the world. Eventually, it found a screen in front of Academia, a married father of 10- and 11-year-old girls.
"It touched me like everyone else," Academia says. "When he talked about dancing with his daughters you want to see him dance at those weddings. I felt sad for him.
"But I had no idea."
Academia pauses. He gazes out the window to the street below. It's a dreary, gray afternoon. Students hustle to class, bundled with hats, scarves and parkas. In his room, the temperature is climate-controlled perfection. After a brief silence, Academia turns back and begins to tell the rest of his story.
The first day Larry Cripe met Chuck Pagano, the doctor walked right past the coach. The mistake was understandable. Cripe isn't much of a football fan and didn't know a thing about Pagano. A day earlier, he had been told that his newest potential patient was the coach for the hometown Colts. He pictured someone else.
"Some sort of big, gruff, jewelry-laden guy," Cripe said. "Ditka. Belichick. Someone like that. Instead, here is the relatively diminutive guy in a Colts sweatshirt and jeans and a cup of coffee. He just seemed like a regular guy."
That's how Chuck Pagano has always liked it. Substance over style. Results over appearance. Pagano grew up in Colorado the son of a longtime high school coach and played college football at Wyoming. His 29-year coaching résumé has kept moving companies in business, with 14 stops ranging from the University of Miami to Boise State, from the Oakland Raiders to the Baltimore Ravens. Each step along the way, he built a reputation as a man with a presence, a man whom players follow. Players, coaches, training staff -- they marvel at how Pagano treats the building janitor with as much respect as the star quarterback. And how he never forgets a name.
"Wherever he goes, he puts a smile on someone's face," said Colts defensive lineman Cory Redding, who also played for Pagano last season in Baltimore. "It may not be the cleanest language. It may not be, you know, politically correct. But he gets his point across in a way that makes you feel warm, accepted and loved. He's a great man. He lives his life right. And he just has this presence about him. People gravitate towards someone like that. I'd do anything for the man."
These were the characteristics Colts general manager Ryan Grigson was seeking when he hired Pagano in January. The team had just finished 2-14, its worst record in 20 years. There were decisions to make about quarterback Peyton Manning and the No. 1 pick in the NFL draft. And there was a fan base to re-energize.
Enter Pagano. From the moment he accepted the job, saying to Grigson, "Let's hunt," he talked about trust, loyalty and respect -- words he put on a wall under the horseshoe at the Colts' training facility. He talked about serving others, helping the community and winning football games. And when someone needed a pick-me-up, Pagano would be the first one there with what would become a familiar refrain. "I've got your back."
The Colts' bye came in the fourth week this season. For most players and staff, it was time to head home and be with family. For Pagano, it was time to see the doctor. As far back as training camp, he had noticed unusual bruising on his body. And lately he had been experiencing fatigue. A blood test with the team physician revealed something was seriously wrong. Pagano was quickly referred to Cripe, a leading oncologist with the IU Simon Cancer Center. Cripe took one look at Pagano's blood under a microscope and knew.
"He was very ill," Cripe said. "It went from, 'Maybe we can let you go and start treatment in a couple days,' to, 'You're not leaving this place, we're starting treatment in 30 minutes and here's what this is all about.'"
Acute promyelocytic leukemia, or APML, is a rare form of leukemia in which the body's bone marrow produces abnormal white blood cells. Pagano's prognosis was favorable; the disease had been caught early. According to the National Cancer Institute, 90 percent of patients with APML survive more than five years. Chemotherapy would start that day. Pagano would be hospitalized for six to eight weeks. After that, he likely would need at least two more rounds of outpatient chemotherapy before he could return to coaching. If he could return to coaching.
The next four days, Cripe explained to Pagano and his wife, Tina, were critical. Once treatment began, the coach was at risk of infection, lung failure or even bleeding to death.
"Those first four days are always troubling," Cripe said. "Anything can happen. Nothing would have surprised me. He could have died. He was a very sick man. I told him in that first hour, 'Look, I don't know who you are, but I'm not an idiot. I know how important you are to this community. But I'm going to forget about that.' He told me, 'That's fine. I'm nobody important.'"
Five days later, at Pagano's request, Cripe headed to the Colts' practice facility, where he stood in a room full of players, coaches and management and explained exactly what was going on.
"It was like someone sucked all the air out of the room," receiver Reggie Wayne said. "You couldn't hear anybody breathing or anything. I mean, that's our general. That's our leader. And when you hear what he's going through it took me some time to process it. I struggled in practice for a while."
After talking to the team, Cripe then spoke at a news conference. He, Pagano and the hospital public relations staff had discussed at length what sort of information they did and didn't want to reveal. In the end, Pagano decided there would be very few secrets. Although Pagano himself wouldn't speak and did not talk for this story, he trusted the doctor to share his story with the world. Maybe it would help someone.
For the past four weeks, the room Didymus Academia has called home is as luxurious and convenient as any inpatient oncology floor could possibly be. Hardwood floors. A comfy recliner. A leather couch. And a direct line to room service, which Academia's wife, Aimee, calls each day to order two peanut butter-and-jelly sandwiches on whole wheat toast.
But there is no amenity in the world that can hide the reality of exactly what's happening. Inserted into the upper half of Academia's left arm is a PICC line, a catheter through which he receives fluids, antibiotics and chemotherapy.
On the night he watched Pagano's famous speech, Academia says, he felt completely normal. The physical therapist had recently beaten a longtime rival in tennis and considered himself "in the best shape of my life." But a few weeks later, he began suffering from a sore throat that wouldn't go away. He felt achy, fatigued. "Something wasn't right," he said. After a complete physical and a battery of blood tests, he found himself in an examination room at the IU Simon Cancer Center. Standing across the room was a colleague of Dr. Larry Cripe.
A bone marrow test had confirmed what doctors in Muncie already feared. Academia had acute myeloid leukemia.
While he tried to absorb the sobering diagnosis and wonder what it meant, Academia's thoughts raced to 52-year-old Pagano -- a man whose spirit, whose fight and whose 83-second speech now meant more than Academia could have imagined when he first saw it.
"When the doctor says, 'You have leukemia,' your first thought is, 'What's next?'" Academia says. "But then I thought about Chuck Pagano."
Unlike Pagano's form of leukemia, which carries a favorable survival rate, AML is far more vicious. The National Cancer Institute says roughly 25 percent of AML patients will survive beyond five years.
On this day, Academia insists that he feels fine. He smiles. He laughs. He says he worries more about how the disease affects his wife and daughters than about how it is attacking his body.
"I can see the pain in their faces," he says. "I don't worry about myself. I can handle myself. I worry about them. I want to be strong for them."
He tells friends that he has the same doctor as Chuck Pagano. It makes them feel better. He chats online every day with relatives in the Philippines. They don't know the coach. But lately they've told Academia that whatever is going on, they think it's working. He looks better, they say.
"I don't know about that," he says with a laugh. "I mean, you can't really tell with the lighting and everything in here."
Academia says he hasn't cried much. Not once has he wondered, "Why me?" The only time he's emotional, he says, is when he sees others fall to tears.
On this day, his focus is on getting better so he can go home. On a dry-erase calendar on a wall in his room, nurses write his daily counts for white blood cells, hemoglobin and platelets. Each day that the numbers creep higher, he gets closer to sleeping in his own bed.
Four days later, Cripe and his staff arrive with good news. Academia's numbers have elevated to a point that it is safe for him to go home. The first round of this fight is over. He won. But there is much more to come. There is talk of a possible bone marrow transplant, and as many as three or four additional rounds of outpatient chemo.
"Whatever it takes," Academia says.
Pagano gives him hope. Each time he watches a Colts game and sees the coach in the press box, he's optimistic that he, too, can get back to normal life.
"Chuck Pagano prepared me for this. Now we're on the same plan," he said. "I'm going to beat this. I'm going to dance at my daughters' weddings. The only difference is I probably won't hoist the Lombardi trophy above my head."
On many of the nights Pagano spent in the hospital, Michelle Wells' job was to tell him to go to bed. It was often a Sunday or Monday, with Pagano still wound up after a Colts game. As the hours would creep later, the nurse would suggest that the coach close his laptop, put the video away and get some rest.
"I would tell him, 'It's good for you. Get some sleep,'" Wells said. "He'd smile, laugh a bit and then go back to watching more film."
Patients fighting a life-threatening disease often crave a sense of normalcy. It isn't unusual for patients to call to make a clinic appointment and stay on the phone to talk about the weather, the Colts or perhaps holiday shopping. Pagano and Wells talked about everything from puppy dogs to grandchildren. But for the coach, normalcy meant football. That's why there was a Colts depth chart on his hospital wall. That's why, at the request of the league and the Colts, the hospital added the NFL Network to all of its patient rooms.
In Cripe, Pagano had an entertaining and eager-to-learn student who, because of the coach, had begun watching more football. He'd hear things like "naked bootleg" and ask the coach what exactly was going on. They'd laugh. Nurse coordinator Stacey Dye asked questions, too, such as what coaches talk about on their headphones.
"And he would sit there and explain everything," Dye said. "It was great. When he talks about the team and football games, you can tell that's his passion. He's so animated. It just illuminates from him."
One day early in the season, Cripe asked Pagano how long he thought it would take before the Colts would win again. Pagano didn't understand.
"He looked right at me, he says, 'I didn't come here to rebuild. I came here to win,'" Cripe said. "It just stuck with me, this concept that this man isn't here to waste a single day. He's here to win right now."
Even without Pagano on the sideline, the team has responded to that mentality. Interim coach Bruce Arians has filled in for Pagano, and the team has played inspired football for its ailing coach. The 9-5 Colts are in the hunt to make the AFC playoffs as a wild-card team.
But Pagano's greatest impact this season has nothing to do with wins and losses. Instead, it's about life and death. It's about people who have been told they might die now having someone new to believe in. Someone who understands what it's like to stare death in the face. Someone who knows the misery that chemotherapy can bring.
At the infusion center where Pagano received two rounds of outpatient chemotherapy, patients pester nurses about which room was Pagano's. They want to sit in the same chair. They want the magic to rub off.
"I've been amazed at how many people date their hospitalizations with when the coach came in," Cripe says. "It's remarkable."
Pagano finished the last of his three chemotherapy rounds earlier this month, and Cripe says the disease appears to be in remission. Although there originally were hopes that the coach might be able to run out of the tunnel for the Colts' home finale on Dec. 30, now there is talk he might be able to slip on the headset and coach that day. Even if that happens, the fight is long from over. A patient isn't truly cured, Cripe says, until he has been in remission for five years.
"This is a tough road to walk for a long time," Cripe says. "We try to keep people focused on the positive, but at the same time leave room that, if it happens again, it's not completely devastating."
If there's anyone who could understand how unrelenting cancer can be, it's Pete Shininger, who, at age 71, has battled AML three times. He was first diagnosed in April 2011. After chemotherapy, the disease went into remission only to return 11 months later. After another series of chemotherapy treatments, the disease again went into remission. But eight weeks later, doctors told him it was back. Again. And this time, they said, there was nothing more they could do.
"They stopped all treatment and told me to go home and enjoy the rest of the summer, the fall, the winter, the spring, as long as I could," Shininger said. "They were going to stretch this out as long as they could."
Earlier this month, Shininger visited Cripe for a three-month checkup. The news was good. His blood quality was decreasing at a rate lower than what Cripe had expected.
"In other words, my progression towards dying was much slower," Shininger said.
The two discussed Shininger's possible participation in a clinical trial. Like many of Cripe's patients, Shininger asked about Pagano. He knew the doctor couldn't say much. But he wanted to pass along a message that he was thinking of the coach.
When the meeting ended and the door to the examination room opened, there was Pagano, standing in the hallway.
"I looked at him like, 'Oh my god,'" Shininger said. "He looked at me as if it was somebody he had known forever."
For some five minutes, the two men stood there and talked about cancer. Pagano asked Shininger what type of leukemia he had and what his treatment had been like. Shininger told him the truth, that his leukemia was back for a third time. Then the two men talked about never losing hope.
"It was an amazing couple minutes. He just sucks you in and says, 'I'm here for you,'" Shininger said. "I never knew the man before, but I love him. What he gave me that day was exactly what I needed and exactly what I try to give to other people -- the ability, the desire, the want and the need to provide hope, to never lose faith."
As they stood on the sideline of Lucas Oil Stadium during pregame warm-ups on a recent Sunday afternoon, Cory Lane and Mickey Deputy were in awe. The two 15-year-olds, who had met at a kids' cancer survivor camp, were here as part of a coin toss program through a local children's hospital. But their stories were far different.
Mickey was born with Down syndrome. When she was 10 months old, she needed open-heart surgery to repair three holes in her heart. At 7 years old, she was diagnosed with leukemia. She underwent chemotherapy, then a clinical trial. It worked. She celebrated five years of remission earlier this year.
Cory grew up as a normal healthy boy. In 2011, he was kicking a football when he felt his leg pop. Doctors initially thought the problem was something with his IT band, then a hip flexor. But it never healed. An MRI revealed he had a tumor on his joint. Further tests unveiled osteocarcinoma, or bone cancer. He underwent chemotherapy, which ended this past July. The disease appeared to be in remission. But a little more than a month later, he was sick again. A CT scan revealed the cancer had spread to his lungs, and surgery was required to remove cancerous nodules. He started chemotherapy again Nov. 26.
"You just don't know what tomorrow is going to bring," says Cory's mother, Carrie Lane. "But you try to make the most out of it. You live the bad side every day, and you try to live in joy when you can find it. And there are a lot of things we have found joy in."
When he heard about Pagano's diagnosis, Cory wrote a card to the coach. In it, he told the story of his medical journey, then encouraged the coach to never give up. "I'm just the same as you," he wrote. "We're both going to get through this."
On this day, the two teenagers can't believe they're on the field. Mickey proudly walks around with her tightly shaved head, something she decided to do in response to a promotion in which a local haircut chain donated $10 toward leukemia research for anyone who shaved his or her head.
"When they started shaving, there were moments where we couldn't breathe," said Jenny Deputy, Mickey's mother. "It took us back to when she lost her hair. It was hard. But she just laughed it off. It didn't bother her at all."
Cory can't stop thinking about the one goal he has for today: to walk onto the field for the coin toss. His legs are weak from a year of chemotherapy. And he tires easily. For a trip of any distance, he still requires a wheelchair. But he has told himself there's no way he will let himself be wheeled onto the field this afternoon. Instead, he will use his crutches, no matter how long it takes.
As the minutes to kickoff tick away, the teenagers and their families are told someone wants to meet them. The families head through the Colts tunnel and into a hallway beneath Lucas Oil Stadium. Cory looks up. He sees a familiar face walking toward him. It's Pagano. The coach approaches Mickey first. He extends his hand, then pulls the girl in for a hug.
"How are you? Doing good?" Pagano asks. "Good to see you."
He turns to Cory, whose mouth is gaping open. He shakes his hand.
"Cory, right?" Pagano asks.
The kid nods. "How are you?" he mumbles.
"I'm awesome," Pagano answers.
Mickey's mom prompts her daughter to tell the coach what she did. "I shaved my head for you," she says.
"I know," Pagano answers. "I've got a picture of it. It looks awesome."
Cory gets out of his wheelchair. He stands up. He leans on Pagano. Looking at the coach, he sees a vision of himself. He tells him he understands what he's going through. He explains that he has been fighting cancer for more than a year and is still fighting it. But he will make it. They both will make it.
"Yeah, definitely, buddy," Pagano says. "We're definitely going to make it."
Cory leans in and wraps his arms around Pagano. And they cry.
"It was just overwhelming," Cory would say later. "A raw emotion."
"Something happened in that moment," Carrie Lane added. "Whatever heartfelt connection, whatever that was 'amazing' isn't even the right word. There was just something there. It was real. It was deep. It was an experience Cory will never forget."
Earlier that week, Jenny Deputy had asked her daughter what she might say to Pagano if they ever met. Her answer touched her mother's heart. Now the moment was here. And before Pagano would head up to the press box for the game, Deputy reminded her daughter of the opportunity that she suddenly had been given.
"Do you have something you want to say to Coach?" Jenny asked.
Mickey nodded. Pagano leaned in. "What you got for me?" he said.
The girl began to speak, but the coach couldn't quite understand her. He put his arm around the girl and leaned in even closer.
"Say it again?" he asked.
"I beat it," Mickey said, as clear as can be. "And you can beat it, too."
The Indianapolis Colts coach has been as a beacon of hope for people facing their own battles with leukemia.