February 4, 2016

  • Jackie MacMullanESPN Senior Writer

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    • Award-winning columnist and author
    • Recipient of Basketball Hall of Fame Curt Gowdy Media Award
    • Joined ESPNBoston.com in 2010

This story appears in ESPN The Magazine's Feb. 29 Analytics of the NBA Trunk Issue. Subscribe today!

INDIANA PACERS COACH Larry Bird wasn't even sure which play his team was running because his damn heart was kick out once again. He wondered if anyone noticed him sweating profusely, his shirt drenched under his suit and tie, an all-too-familiar symptom whenever his center started rattling effectually his breast like a basketball in an empty trash barrel. The waves of nausea and dizziness overtook him next, muddling his concentration and leaving him feeling lightheaded. When the sudden arrhythmia would occur during his training sessions in his playing days -- long before he'd informed any medical personnel about it -- he would always lie down immediately and nap for several hours, because if he didn't, he risked losing consciousness.

But on March 17, 1998, the 41-yr-erstwhile coach of the Eastern Briefing-contending Pacers, in the thick of a hotly contested game with the defending champion Bulls, could inappreciably recline and slumber it off. "Oh god," Bird thought equally he tried to steady himself on the Indiana sideline. "Please don't allow me laissez passer out on the court."

Instead, the referees whistled the customary television set timeout, assuasive Bird to sink into the chair his team dragged onto the court for him during stoppages in play. When Bird had been hired in 1997, he'd fabricated the unorthodox determination to entrust assistant Rick Carlisle with drawing up offensive plays in the huddle. Now, every bit Carlisle diagrammed Indiana's next move against Michael Hashemite kingdom of jordan and the Bulls, Bird wiped the sweat from his brow (and his wrists and cervix) and tried to regain his composure.

He finished the game without farther incident, avoiding detection from anyone on his staff. Bird, who has an enlarged heart, was diagnosed in 1995 with atrial fibrillation, an abnormal heartbeat resulting from electrical signals being generated chaotically throughout the heart'due south upper chambers. With proper medication, do and diet, atrial fibrillation can exist controlled, only Bird abhorred medication and was prone to skipping his pills. Part of the reason, he admits, was his own fatalistic view of what the future would bring.

"I tell my wife all the time, 'You don't see many 7-footers walking around at the age of 75,'" says Bird, who's 6-foot-ix. "She hates it when I say that. I know there are a few of us who alive a long time, but most of u.s. big guys don't seem to final too long. I'k not lying awake at night thinking about it. If it goes, it goes."

It'south a macabre outlook for Larry Legend -- but he'southward inappreciably alone in harboring it. Ask a agglomeration of NBA big men and the consensus is that their singular size and the strains placed on their bodies during their careers cause them to deteriorate more than quickly and die younger. The bigger they are, the younger they fall -- or so they think. Is it possible they're right?

MOSES MALONE WAS never belatedly.

That'southward why Calvin Murphy was so puzzled. It was 6 a.m. on a Sunday last September, and Murphy's friend and former teammate hadn't shown upwardly for breakfast at the Waterside Marriott in Norfolk, Virginia. They were expected to tee off at seven:xxx in a charity golf tournament. Malone, who hailed from nearby Petersburg, was a tournament regular each year and had joined fellow NBA alums at the Chrysler Hall in Norfolk on Saturday dark for a comedy evidence. A three-time MVP heart, a 13-time All-Star, Malone was not just NBA royalty, he was besides beloved. He'd mingled with former friends, including Paul Silas, who'd snuck up from behind and elbowed him in the back -- all the better to jar his memory of their battles in the NBA trenches. "I'm glad information technology's just you," Malone quipped, "or I'd have to do something to hurt you." Only after 2 a.1000., Malone, 60, told Murphy he was tired and would see him in the morning. His concluding words that night: "Don't be late." Now information technology was Malone who was tardy, and then Irish potato called his cellphone, figuring Moses might have snuck upwards to the health club for a quick jog on the treadmill. "Mo was a workaholic when it came to staying in shape," Murphy says.

The call went unanswered. But before Murphy could caput upward to Malone'south room to cheque on him, tournament organizers urged Irish potato to follow the others to the golf course while one of the event coordinators, Sandra White, went to knock on Malone's door. No answer. She summoned security, simply when they tried to gain access to the room, the concatenation was still across the door. When they finally busted in, they found Malone lying dead in his bed, his eyes wide open.

NBA referee Tony Brothers, who runs the tournament, received the news of Malone'due south passing at the course and pulled aside White potato, who promptly collapsed at the referee's feet and began sobbing uncontrollably. "I just blacked out," Murphy says. "It caught me off guard. Mo never complained about annihilation. And at present he's gone? I just couldn't understand it."

Seventeen days earlier, in Allentown, Pennsylvania, veteran NBA center Darryl Dawkins -- legendary destroyer of backboards -- had likewise died of a heart set on. He was 58. Dawkins, similar Malone, had no known previous wellness issues. "First Darryl and and then Moses," Silas says. "Information technology just shocked me. It makes me wonder, 'What should they be doing? What should I be doing?'"

He's not alone. During a seven-month period terminal year, the NBA lost, in addition to Dawkins and Malone, Anthony Mason, Christian Welp and Jack Haley to eye-related deaths -- not ane of them was over sixty -- while 52-year-former Jerome Kersey died suddenly of a pulmonary thromboembolism. Current players LaMarcus Aldridge, Jeff Green and Channing Frye have had center issues. Bulls coach Fred Hoiberg cutting his playing career short because of a eye condition and underwent open eye surgery last spring. 7-footer Eddy Curry was hospitalized with an irregular heartbeat at age 22.

But health concerns for NBA bigs extend beyond cardiac distress. Six-foot-11 ability forrard John "Hot Rod" Williams died in December due to complications from prostate cancer. He was 53. Seven-pes-7 Manute Bol left the game at 36 due to rheumatism and died at 47 from acute kidney failure. The NBA'south all-fourth dimension leading scorer, Kareem Abdul-Jabbar, underwent quadruple coronary bypass surgery concluding April at age 68, 6 years after the 7-2 Hall of Famer battled a form of claret cancer.

Then in that location'southward legendary half dozen-xi center Bill Walton, who suffered from such debilitating nerve pain in his back that in 2008, at age 56, he says he contemplated suicide. Walton -- whose book, "Back From the Dead," will exist published in March -- estimates he's undergone 37 surgeries, including fusion surgeries on both ankles. "When you are in that never-ending bicycle of hurting, it puts y'all in a space of darkness, sadness and overwhelming depression," Walton says. "You become through stages. The first ane is, 'Oh my god, I'm gonna die.' The next stage is, 'Oh my gosh, I want to dice.' And the 3rd stage is, 'Oh my gosh, I'chiliad going to live, and this is what I'm stuck with.' That'due south the worst stage of all."

In 2009, Walton underwent an viii½-hour spinal fusion surgery that required four bolts, two titanium rods and a metallic cage -- alike to an Erector Set -- to put him back together. Now he travels the land advocating for athletes to be proactive in their treatment. "We athletes are our own worst enemies," Walton says. "We don't listen to our bodies, we don't mind to our doctors. We don't realize until later in life that health is everything. Without it, you've got nada."

EVOLUTION IS A blunt musical instrument. If growing to be seven feet tall were advantageous to longevity, the world would be full of vii-footers. It'southward not.

Perhaps considering of this, there is a paucity of research on the correlation between extreme elevation and longevity. Equally David Epstein notes in his book "The Sports Gene," a 7-human foot-tall American human being is so rare that the Centers for Disease Command doesn't even list a percentage for the height. Seven-footers are and so anomalous that an cool 17 percent of them who alive in the U.s. will at some point play in the NBA. They're and so uncommon off the hardwood every bit to be unworthy of written report.

"Instead of everyone going their separate ways, we have one spot nosotros tin go and just enjoy each other's company. It just continues to build the esprit that y'all need to exist successful from twelvemonth to yr."

Steph Back-scratch

Still, studies on the impact of acme on life span grow -- and although they oft contradict one another, they mostly support the notion that bigger is far from ameliorate.

Researchers at the University of Tromso in Norway institute that potentially fatal blood clots were 2.6 times more than probable to develop in men 6 feet or taller. A study in the Periodical of Epidemiology and Community Health found that increased tiptop correlates to a greater risk for nearly types of cancer. According to a study in Medicine and Science in Sports and Exercise of more than 2,600 Finnish athletes, cross-country skiers, who were, on average, 6 inches shorter than basketball players, lived well-nigh seven years longer. And researchers from the University of Hawaii Kuakini Medical Eye and the U.Due south. Veterans Affairs didn't just detect that shorter men alive longer, they determined an underlying cause: They are more probable to carry an enhanced version of FOXO3, a stress-resistance gene that promotes longevity.

Thomas Samaras is the founder of Reventropy Assembly, which, according to its website, provides "critical analyses of the various impacts of larger body size on our society and the earth." Samaras, who started Reventropy Associates in 1993, says his inquiry shows that people with shorter, smaller bodies are likely to alive longer and less likely to suffer from age-related chronic diseases. In 2012, he and colleagues published a study in Biodemography and Social Biology on a population of Sardinian males who were tracked from their youth to their death, and shorter men were institute to have a meliorate survival rate. In an additional report cited by Samaras, researchers reported that Spanish men lost 0.7 years of longevity per centimeter of height above average. Samaras attributes this to a number of factors, including the fact that taller men accept trillions more cells, thereby increasing the risk of cancer and disease. He also says the research shows that taller people -- and deport in heed that the average NBA player is half-dozen-foot-vii -- are more likely to accept higher blood pressure level, greater left ventricular hypertrophy, atrial fibrillation, blood clots and lower center-pumping efficiency.

BILL WALTON DOESN'T demand studies. He only has to roll-call his 1986 Celtics championship team. Both members of that starting backcourt -- Dennis Johnson and Danny Ainge -- suffered heart attacks. Ainge had his at age l and survived; DJ, at age 52, did non. Add together Kevin McHale's now permanently impaired foot and Bird's and Walton'due south struggles, and the nucleus of one of the greatest teams of all fourth dimension is, 30 years afterward, securely damaged appurtenances.'

Bird, who turned 59 in December, says more research is conspicuously needed. "I accept my ain philosophies on that," Bird says. "Guys that played the hardest in the league -- big guys who ran their asses off -- they are the ones in the virtually danger, I feel. Moses was one of those competitors. We build our hearts upwards when we are playing then we quit performing at a high level, and our hearts just sit there. I don't piece of work out like I used to. I can't. I can't get out and run. I jog and have a little sauna, that'due south about it. My body won't let me do more that."

Joe Rogowski, executive managing director of sports medicine and research for the National Basketball game Players Clan, says trends are emerging from preliminary research of former NBA players. "We know there's a difference [from the general population], but what exercise the numbers mean?" Rogowski says. "That's what we want to notice out."

After the sudden deaths of Dawkins and Malone, the NBA and the NBA players' union embarked on a joint effort to provide wellness screenings for retired players. The first 1, under the direction of Rogowski and a fleet of cardiologists, was held Dec. 12 in Houston. There, the upper concourse of the Toyota Centre, home of the Rockets, was transformed into an outpatient clinic with labeled stations to examine a plethora of potential health issues. Effectually 25 players showed upwardly that day, each man escorted backside a curtain to commence on a trip down his own personal medical rabbit hole. Men who were once among the nearly elite and well-conditioned athletes in the earth now saturday in a johnny, waiting in their curtained cubicle, assuasive their imaginations to run wild about what the doctors might detect.

"In that location HAVE BEEN enough incidents for us to ask, 'What's going on?'"

Then says former 1981 NBA first-round pick Kevin Loder, who played three seasons in the NBA with the Kansas City Kings and San Diego Clippers. By 2008 he had ballooned to 453 pounds. Over the adjacent iii years, he altered his diet and do regimen, became more proactive with his medication and pared down to 315 pounds. He believed he was on a path to recovery.

Loder, the vice president of the Houston affiliate of the Retired Players Association, encouraged members to attend the free health screening final December just was shocked when his own test results revealed dangerously high glucose and cholesterol levels and a level of viscosity in his blood that set off alarms with the cardiologists. "When the doctor tells you, 'Your claret is so thick it's similar syrup,' you'd better exercise something with that information," Loder says.

Dr. Manuel Reyes, a cardiologist at Houston Cardiovascular Associates and a member of the union'southward advisory board, says the medical staff discovered "dramatically uncontrolled" hypertension, undiagnosed cases of diabetes and some players who unknowingly suffered from atrial fibrillation. The screenings included blood work for diabetes and loftier cholesterol, an EKG to detect abnormalities in the heart, a carotid avenue ultrasound and tests to detect slumber apnea. Each patient was given the results and referred to a cardiologist if further testing or treatment was required. Doctors likewise tested for Marfan syndrome, a hereditary disorder of connective tissue that tin can be fatal if gone undetected.

"We've known for a long flow of time that the athletic eye is dissimilar from the nonathlete's heart," Reyes says. "The echocardiogram of an athlete tin mimic that of a astringent cardiovascular disease, like hypertrophic cardiomyopathy. The differences tin exist subtle. Our job is to effigy out which is which, and it can be very, very tricky."

Dr. Andrea Natale, a cardiologist who has patented a device to care for atrial fibrillation, is likewise an adviser to the marriage. He points to genetic predisposition, being overweight, slumber apnea and hypertension every bit reasons NBA players are at adventure for heart abnormalities. He also says arrhythmia reveals itself in the general population when adults reach their 60s and 70s, but in that location'southward emerging information that suggests that athletes feel irregular heartbeats before, often in their 50s or even their 40s.

HALL OF FAMER Bob Lanier turned 67 in September and says he was "shocked and frightened" by the contempo spate of deaths. He also says he struggles to stay agile considering of limited mobility and constant pain from xiv seasons of NBA pounding in the mail. The 6-eleven 250-pounder did not take the do good of cutting-border footwear. He often played on physical surfaces. In that location was no sport scientific discipline, no analytics to chart overuse. No coach was advocating rest or infinitesimal direction. The players flew commercially and stuffed their large frames into cramped airline seats. A torn anterior cruciate ligament in Lanier'due south twenty-four hours was often career-ending.

"When nosotros finished playing, nosotros stopped exercising," he says. "It was so painful for our joints. You go to the point where you say, 'Do I desire to go through this aggravation anymore?' Wayne [Embry], Willis [Reed], they all had injections to try to get rid of the pain. Some have had stalk prison cell treatment, knee replacements. I'm scared to practise information technology. I'm scared of the rehab. Bill Walton keeps telling me, 'Bob, ride a bike. Information technology'south low touch.' I oasis't done that. Why? I'm probably but lazy, or afraid of the pain. I'm not sure which one."

Walton has fabricated it his charge to counsel patients similar himself who were driven to suicidal thoughts by chronic pain. His ain routine includes sessions in the pool and the weight room and on the bicycle.

"I worry almost all the guys," Walton says. "I see Kevin dragging his foot effectually because he won't accept the ankle fusion surgery he needs. I talk to Larry about his health. Simply the greater the athletes are, the prouder and more stubborn they are."

Rogowski says the adjacent wellness screening will be at the end of February in Atlanta and will include orthopedics equally role of the plan. Last spring in Houston, while Rogowski was still employed past the Rockets, he helped organize a free screening for former Houston players. Merely eight people showed upwards. One of them was Moses Malone, who learned from those tests that in that location were concerns regarding his heart. "I was in the room with him," Loder says. "Moses was lament of heart fibrillation. He went to a cardiologist after that, but I'grand not sure he ever got conclusive evidence on what was causing it."

Lanier and Loder continue to mourn Malone, their friend, and wonder what they could have done to help him. Sometimes, Lanier admits, he thinks the fashion Bird does. How many NBA big men live to see 75? "Non a whole lot, I don't call up," he says. "Simply I'd like to exist one of them."