A Distress Test

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TAMAQUA, Pa. – The pain, Pat Brogan said, is like having hammers continually pound the back of your neck.

On a recent day, as he talked to his high school basketball players about being in position and ready to shoot, Brogan pushed the palm of his hand against his forehead.

Was this a bad day? No, a good one. Over Christmas, Brogan said, it was as if “you had a blowtorch going into my spine.”

For the last 31/2 years, Brogan has endured one physical trial after another, since the early morning of Sept. 25, 2001, when a bicycle ride in Easton almost cost him his life – and changed it forever.

After being knocked to the road by a hit-and-run driver, Brogan has been afflicted with dystonia, a neurological movement disorder that causes muscles to continually spasm.

Brogan, a 37-year-old former assistant at Lafayette and Penn State, and a volunteer assistant last season at Georgia Tech, has always been one of the most approachable guys in the college game, a coach who treats the game with reverence. He has seen his world both expand and contract because of the pain he can’t ignore. Even his wife and parents thought he was crazy to take a coaching job at a small high school not far from his upstate hometown. But he knew what the game could offer.

“I probably need this job more than you need to give me this job,” he remembered telling school administrators last summer at Tamaqua High. “I need it to force me to get better.”

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There is no known cure for dystonia, but in September, Brogan underwent 101/2 hours of surgery at the Cleveland Clinic, awake for the whole thing, as surgeons implanted electrodes in his brain. Electrical pulses are now sent to specific areas in his brain through wires from two stimulators placed in his chest, in the hope of correcting abnormal brain circuits and alleviating his symptoms. And for five glorious days after the procedure, Brogan’s symptoms were relieved.

“Then they came back with a vengeance,” Brogan said. “It’s just frustrating. They’re trying everything, and nothing seems to work.”

Except Brogan himself. Realizing he couldn’t put in the hours required to be a full-time college coach, he spent the 2003-04 season as a volunteer assistant at Georgia Tech, which meant he was along for a ride to the Final Four. Last summer, he returned to his hometown of Hazleton and applied for the coaching job in nearby Tamaqua. The season has been a rough one, with only a couple of victories on the court. Brogan remains optimistic that the wires implanted in his body will eventually relieve his pain – he visits his doctors about once a month so they can fiddle with the circuitry. But it hasn’t happened yet.

He is a basketball lifer. After playing at Dickinson College, Brogan spent a year with an Irish semipro team, with an emphasis more on the semi than the pro. Not all the players had sneakers, he said, so they would exchange shoes during time-outs.

His first college coaching job was as an assistant at Division III Muhlenberg. Even the head coach there didn’t know Brogan spent two years living rent-free in the locker room. Then he moved on to Lafayette, drawing a $2,000 initial salary, until the athletic director gave him the biggest percentage raise in the department, which meant he was up to $2,100.

Before marrying his wife, Cathy, two years ago, they dated for about 11. She was an assistant girls’ coach at Hazleton High when they met.

“He knew I had keys to the gym,” Cathy Brogan said. “I think that was the reason he asked me out.”

“Did he tell you about the time in college his coach kicked the whole team out of practice?” Lafayette coach Fran O’Hanlon asked. “Pat said, ‘Nobody is kicking me out of my gym.’ He broke in and slept there.”

Brogan eventually drew a real salary when he was O’Hanlon’s top assistant at Lafayette as the school went to the NCAA tournament in 1999 and 2000, and it was O’Hanlon whom Brogan called after he woke up in the hospital, after an accident he still can’t fully remember. He had been training for a triathlon, cycling to the Easton YMCA for a swim, just before 6 a.m.

Twenty minutes later, three women and a man driving to work at a local apparel factory saw something in the middle of the road.

“They thought I was a big trash bag, until they saw my leg sticking out,” Brogan said he came to find out. “They thought I was dead. My face was blue. My neck was twisted. Blood was everywhere. My face was mangled. Fran almost passed out when he saw me.”

Although he had suffered bruises on seven vertebrae and a concussion, Brogan was back to work about a week later. But during the next basketball season, he said, neck pains set in and started to get worse. He’d take a lot of long, hot showers, and made it through the year, but the pain kept getting worse after he took an assistant’s job at Penn State, where he worked in 2002-03. He finally got the diagnosis of dystonia.

“Just constant spasms in my muscles,” Brogan said, describing the symptoms of cervical dystonia, which attacks his neck and shoulder muscles. “You try to work against it, and it triggers other muscles, so you’re constantly working against yourself.”

After spending the following year at Georgia Tech, with all sorts of less invasive treatments failing, he agreed to the surgery. At first, Brogan was reluctant to tell the outside world about his condition, figuring it might hurt him in getting a coaching job after he got better. But he found out that most people afflicted with dystonia don’t hold jobs and are all but incapacitated. He decided he had a role to play. He has become active with the Dystonia Medical Research Foundation, and allowed a documentary crew to film his surgery and follow him around, even on his worst days. He also sends the crew film he has taken himself, particularly on rough nights, when he has to continually fight from letting his head pull to the right.

“Gravity has an effect on your neck,” he said.

He regularly returns to the Cleveland Clinic as his doctors try to pinpoint the exact area of the brain to give him relief from the dystonia, which may be inherited or caused by specific factors such as trauma. According to the Dystonia Medical Research Foundation, it affects about 300,000 North Americans. Most victims never know the cause of it, although Brogan doesn’t question the link between the accident and his condition.

This season, Brogan completely geared his days toward the two hours of coaching, so his symptoms would be the least severe during that time.

“He puts in a good hour of stretching before practice,” his wife said.

Usually, you can’t see the spasms, just Brogan’s reaction to them, as he pushes against his neck or forehead or nose. He’s been on some heavy-duty painkillers but in recent days went off them.

“You might get relief for 15, 20 minutes, but it’s almost like a false relief. Then your body would just crash,” Brogan said of the medicines. “Your mood swings, the ups and downs were just brutal. The dosage would be highest at night. You’d need them to sleep, but it wasn’t like a good sleep; it was a medicated sleep. It’s difficult. Never mind the losing by 30 points and traveling on a school bus. I don’t see more than an hour [of sleep] at a time. Either your body’s in tremors or the constant pain keeps you awake.”

Also, he said, “I don’t want the medication to mask any improvement.”

His doctors are hopeful, he said, especially since he saw the brief improvement after the surgery.

“Most of the people, within six months to two years, feel improvement,” Brogan said.

When Brogan recites his tortures, he does it in almost a clinical way, as if he’s recalling the events of a memorable basketball game. He considers the year he spent with Paul Hewitt and his staff at Georgia Tech a gift that he wouldn’t have had if not for the dystonia. He speaks with great fondness of his eight years at Lafayette.

His friends in the business all understand how tough Brogan has it right now. But O’Hanlon put Brogan’s approach to life this way: “If there’s ever a guy who’s going to light a candle rather than curse the darkness, it’s Pat.”

On a good day, Brogan said, “you don’t want to go to sleep.” He plays jazz and pop tunes on a piano in his living room, works part time as a bartender, bought a storage facility in Hazleton as an investment, walks his cancer-stricken golden retriever, and keeps a journal of his experiences. He self-published a book of poetic meditations from before and after the accident.

“My life was spared or was it?” he wrote one year after the accident. “Part of me died and part of me was reborn and created.”

There’s no happy ending here yet. Brogan doesn’t know if the immediate future can include a coaching job, even at the high school level, until the spasms are dealt with, although he did get one piece of good news from his surgeon.

“He said I had the thickest skull he had ever operated on,” Brogan said.

My mom and I wanted to thank you for hosting such a great symposium this year. This was our third year and we are looking forward to next years. E. Mathews