CHICAGO – Billy Garrett Jr., by all guesses the nation’s only college basketball player with sickle cell disease, can recount in detail each painful crisis triggered by his condition.
There was the dehydration during a summer camp in a broiling gym that left him in need of a blood transfusion. There was a less serious episode during his freshman year at Morgan Park High School, after his mother’s birthday and before a game against powerhouse Simeon High, prompted by overexertion. And in January, there was the telltale ache in one knee after a DePaul practice that became stabbing pain in both legs just as a road trip began. It led to vomiting from over-medication, the loss of 10 pounds and an extended stay in New Jersey as Garrett Jr. recovered for days in a Newark hospital.
He missed two games and then had to rebuild the strength in his legs. It was the cost of pursuing a passion that tests his disease daily, with a near-constant risk of dehydration and exhaustion and stress that can trigger terrible pain. The freshman point guard and former top 100 prospect bears the load of leading the Blue Demons program, but that burden barely compares to opening himself to crises few can conceive.
“Doctors have told me basketball probably isn’t the best thing for me to do, that I should try other things that aren’t as strenuous,” Garrett Jr. said. “But I’ve been able to handle it. It’s worked out for me. I’ve been playing for so long I never really thought about not playing basketball. I’ve never really thought about, ‘I can’t do this because of the sickle cell.’ It hasn’t been easy, but I really didn’t want anybody to tell me I couldn’t do it.”
He has been mostly right. The Blue Demons (11-8, 3-14 in the Big East) close their season Thursday, but Garrett Jr. exceeded even his coach’s expectations by averaging 12.4 points and 3.2 assists. He has stated a case for Big East Rookie of the Year despite his disease and the games he has missed because of it.
The 6-foot-5 Chicago native has the “SC” form of sickle cell disease, statistically milder than the “SS” form. It is different from sickle cell trait, which can cause muscle breakdown during intense exercise. Garrett Jr.’s condition, in short: Red blood cells mutate into a “sickle” shape to clog vessels and limit blood flow. This can cause extreme pain emanating from joints or, worse, damage to organs. Each of these episodes is called a crisis. Triggers include stress, a lack of rest, cold temperatures (that constrict blood vessels) and dehydration -- all of which describe the daily working conditions of a teenager playing high-level basketball at a Midwest school.
For 20 years, Dr. Lewis Hsu has treated and counseled children and adolescents with sickle cell disease. The pediatric director of the Sickle Cell Center at the University of Illinois-Chicago, Hsu counts Garrett Jr. among his patients. He has never seen anyone attempt to do this.
“He is taking some risks,” Hsu said. “Our hats are off to him for being both brave enough to do this, but also being wise enough to pay attention to his body. The thing that he knows is how sickle cell pain is. To put that in context: Women who have both delivered a baby and had sickle cell pain crisis said they would take delivering the baby, labor pains, any day. This is pain that is 10 on a scale of 10, pain that doubles people up and makes them pretty much incapacitated. That’s the pain he’s trying to avoid, and that’s the pain that sometimes still hits him.”
Still, all it took for Garrett Jr. to play for DePaul was his desire to do so and Hsu signing off on the plan after a standard player physical. Per Hsu, better treatment and awareness over the past two decades – even in the 1960s and 1970s, he said, life expectancy fell short of adulthood – has broadened perspective on what sickle cell patients can do.
Not that such optimism existed when Garrett Jr. was diagnosed. Doctors informed his parents he should avoid sports due to the disease. Billy Garrett Sr., is a former football player at Illinois State and currently a DePaul assistant coach after previous stops at Iowa, Seton Hall and Siena. When he heard the doctors’ opinion, Garrett Sr. thought: We’ll see.
That attitude is as genetic as sickle cell itself. “You can’t just brush it off to the side and say, I can do whatever, I’m fine, because it can come back to haunt you,” Garrett Jr. said. “But I kind of use it as motivation to play harder and play better. It just reminds me not everybody gets this chance to play major Division I basketball. There are people that have my condition and they don’t get the chance to do this. I’m blessed enough to have this opportunity, so I have to make the most of it.”
Thus Garrett Jr. played baseball and basketball and football and did all the things the doctors said he couldn’t do. Enlarged spleens are a danger for those with sickle cell disease, so for football, he wore a pad designed to protect that area. He was in only limited athletically by his mother, Annissa, who cautioned him to take it easy. “But I’d be like, play as hard as you can for as long as you can and then get a rest,” Garrett Sr. said.
Treatment of his sickle cell disease consisted of daily doses of penicillin as a small child – Garrett Jr.’s mouth still purses at the memory of its caustic taste -- and then folic acid supplements through adulthood. (Garrett Jr. admits forgetting about the latter too often.)
Now it is a program of self-awareness. Garrett Jr. cannot push himself in conditioning drills for as long as teammates do. He must have adequate hydration and rest. So at any DePaul practice, trainer Jeff Carrico constantly hands the Blue Demons’ first-year floor leader water or Gatorade. He also probes Garrett Jr. about his fatigue or the smallest aches and pains.
“Every once in a while I have to get him on a lie detector test,” Carrico said. “He’s a competitive kid. For his age and his maturity level, he’s handled it very well. I told him I don’t get an extra $5 for keeping him out of games.”
DePaul coach Oliver Purnell likewise adjusted. He, Carrico and the elder Garrett met before the season to discuss the parameters of managing Garrett Jr.’s disease. The result was a more deliberate, watchful approach.
“A lot of times with a player who doesn’t have (sickle cell disease), you push him past that point of exhaustion, you push him a little bit more so the next time he can go a little bit farther,” Purnell said. “With him, it’s not that way.”
Purnell expected his top recruit to offer 15 to 20 minutes a game, given the disease’s effects. Garrett Jr. averages 29.3 on the year. He worked out two or three times a day during the offseason and does extra running or cardiovascular work after in-season practices. Whenever he feels weary during a workout, he backs off and saves it for later. “You have to listen to your body,” Garrett Jr. said.
Crises can still sometimes occur. At that summer camp in Iowa, a preteen Garrett Jr. was determined to prove his mettle after moving to town only days earlier, forgetting to mind his own wellbeing. The same mentality sparked the episode years later at Morgan Park High. And several circumstances conspired for the most recent crisis, a detour in a promising season – one that underscored just how rigorous a path Garrett Jr. has chosen to take.
After DePaul finished a practice and prepared to travel for a Jan. 25 game against Seton Hall, Garrett Jr. felt the ache in his knee. He figured it was post-workout soreness. By the time the team was on the bus to the airport, the pain increased. He took an aspirin. It didn’t work. By the time he was on the team plane, the pain migrated to the other knee as well, and Garrett Jr. knew it was serious.
Often, crises last a few hours, endured with the help of standard medication. But this was a constant distress, like back spasms in his knees. The altitude of the flight compounded the blood-flow issues and Garrett Jr. had to take oxygen from a machine he brings with him on every trip. Still, even as his father massaged his legs to help ease the discomfort, Garrett Jr. insisted he would play the next day.
When DePaul finally reached its hotel near the Prudential Center in Newark, Garrett Jr. deemed the pain “unbearable.” He plunged into a hot bath.
“As soon as I got out of the bath,” he said, snapping his fingers, “it came right back.”
Both Garretts and Carrico traveled to an emergency room for more treatment. Normally, sickle cell crisis patients remain at a facility until they can manage the pain on their own. But not all outlets are well-versed in the best course of treatment, and many sickle cell patients become addicted to the pain medications, revisiting facilities just to get a fix. So even with a trainer and father on hand and physicians on the phone from Chicago, doctors gave Garrett Jr. his pain dosage and hustled him out. It was a fatefully hasty decision.
Instead of morphine, Garrett Jr. received Dilaudid, a stronger drug.
And he received a double dose.
According to Garrett Jr. it was seven times more medicine than he needed.
Back at the hotel, Garrett Jr. vomited from the excess, which only exacerbated his dehydration. He returned to that same emergency room, received morphine and more intravenous fluid, and then was shuffled off again. He lasted in the hotel from about 6 a.m. until the middle of the afternoon, when his mother, Annissa, arrived.
She brought her son to Beth Israel Hospital in Newark, the facility the family used when Garrett Sr. worked for Seton Hall. That is where Garrett Jr. spent his next few days recovering while his father and his team played on, until he needed only aspirin and a heating pad to dull the pain.
The damage, though, was done.
“It was scary for me,” Garrett Sr., said. “When I got to the hospital, he looked like he was on his death bed. But he helped me through it, because he wasn’t worried. It was like role-reversal.”
The entire program knew Garrett Jr. managed sickle cell disease on a daily basis. But neither coaches nor players had this stark a picture of the challenge until then. Hsu lamented that Garrett Jr. did not call him for advice until two days into the entire ordeal, and the two have had a stern conversation about that since. Likewise, DePaul now has created a list of facilities that specialize in sickle cell care for every road destination.
“It was an eye-opener for everyone,” Carrico said.
Before the crisis, Garrett Jr. had become a reliable starter for DePaul as it scraped through the new Big East, averaging 13.5 points in 15 outings. But he would miss the Seton Hall game and the Providence game after that, then work to restore his strength and conditioning when he returned. “I had been playing decent until that time, and then having to get back in shape and take a couple steps back – that probably was the hardest part about it,” Garrett Jr. said.
As he recovered from the crisis, DePaul plunged into a 10-game losing streak to vaporize any hope for a turnaround. Part of that was the loss of Cleveland Melvin, who was suspended for a violation of team rules and who ultimately would leave the school.
But a crisis for Garrett Jr. contributed to the problem at large.
“He was a steadying influence on our team at the point guard position, and now all of a sudden he’s not there,” Purnell said. “It’s very frustrating, because we’re struggling as a team, trying to get it going, trying to catch fire down the stretch, and now one of your vital cogs is not there. And then I know he feels bad, because he worked so hard to get to that point. And now he’s in a position to help us catch fire, and he can’t do it.”
The mismanaged treatment in New Jersey amplified a bad situation, but it didn’t cause Garrett Jr. to doubt his decision to play basketball. Per Hsu, the issues shouldn’t rise to life-threatening levels without additional, somewhat unrelated factors being introduced.
Still, what Garrett Jr. is attempting is not normal. “It’s pretty extraordinary,” Hsu said.
Some vigilance is also necessary, requiring Garrett Jr. to know what he can and must control. His father’s suspicion is that a lack of quality sleep sparked the January crisis, but everyone involved is confident Garrett Jr. will learn and minimize future risks. “That’s how he’s always done things,” Garrett Sr. said. “He looks at things, cautiously tries to figure them out, and then he’s better the second time around.”
Garrett Jr. now also feels comfortable enough to use this platform to assure others with sickle cell disease that they are capable of more than some might suggest. He has spoken to groups about this and Carrico suggested that, next season, DePaul might host sickle cell awareness events. Hsu noted that funding is still needed to research the disease and raise awareness even within the medical community, let alone the population at large.
“I feel like I’m not the only one that’s been told you can’t play sports, you can’t do this, you can’t do that,” Garrett Jr. said. “If I’m an example, and if I can inspire one person to go out there and chase a dream they have despite having sickle cell and despite what doctors have told them, then I’ll be happy.”