Karl Nelson, an offensive tackle for the New York Giants, detested having his chest X-rayed. During physical exams at two consecutive May minicamps, in 1986 and '87, a tiny spot had appeared on his X-rays, but each time further tests had come back negative. Understandably, when Nelson checked into New York's Hospital for Special Surgery last August for arthroscopic surgery on his left shoulder, he balked at the idea of having another picture taken of his chest.
"I don't need the hassle," Nelson told Dr. Russ Warren, the Giants' physician.
But Warren insisted because a chest X-ray before surgery is standard procedure. When the X-ray looked suspicious, Nelson was given a CAT scan—a computerized X-ray. It revealed that the tiny spot in his upper chest had developed into a mass some six centimeters (2‚Äö√Ñ√∂‚àö√±‚àö¬® inches) in diameter.
The shoulder surgery was postponed, and two days later, Dr. Arthur Okinaka removed tissue from Nelson's sternum for a biopsy. To reach the mass, the tackle's right lung was collapsed and five inches of his bottom right rib were removed.
July 10, 1988
That evening Warren phoned Heidi Nelson, Karl's wife, at their Montvale, N.J., home with the diagnosis: Her husband had cancer, though the exact form of the disease was still in question. Heidi became hysterical. She started crying uncontrollably, fearful that Karl was going to die. She jumped into her Blazer and raced 65 mph through the residential streets, smoking one cigarette after another. She thought she was headed in the direction of her best friend's house, but instead she ended up on the street in nearby Woodcliff Lake, where she and Karl had owned their first home. That was two miles from her intended destination.
"I really have no idea why I went there," Heidi says now.
A few days later she had a better grip on the situation. Karl's illness had been diagnosed as Hodgkin's disease, a cancer of the immune system. At one point his small hospital room was loaded with dozens of floral arrangements and packed with family, including his parents, Jan and Bill, who had flown in from DeKalb, Ill., and friends, among them Giants right guard Chris Godfrey. The loud, nonstop sports chatter ran the gamut from Godfrey's memories of his days in the USFL to the Giants' opener in Chicago on Sept. 14.
"Nobody was addressing Karl's cancer," Heidi remembers. "It was as though everybody had just dropped by the house for a friendly visit."
When Karl declared that 42 radiation treatments would enable him to return to the team by midseason, Heidi exploded. "Damn it, all of you!" she screamed. "Stop denying that this is cancer. We're talking about Karl's life. Who gives a damn about football?"
Only a handful of men have resumed NFL careers after bouts with cancer. But Nelson, a hearty 6'6", 273 pounds, has apparently overcome his, and according to Dr. David Wolf, one of Nelson's doctors, it is now in remission. Since mid-February, Nelson has sequestered himself four days a week in the basement of Giants Stadium, enduring five monotonous hours of physical therapy, strength training and cardiovascular conditioning.
For the next five years he must undergo a semiannual CAT scan. According to current research by the National Cancer Institute, there is a 40% chance that the Hodgkin's disease will recur in that period. If it doesn't, Nelson will be pronounced cured.
"The irony is that the cancer may have added another year to my football career," says Nelson, 28, laughing. "It meant an entire season that my knees didn't take a pounding on AstroTurf."
In January, Nelson underwent innovative, intricate shoulder surgery that also may have helped to extend his career. The head of Nelson's left humerus bone had popped out the back of his shoulder joint, an uncommon dislocation. Warren, a leading shoulder specialist, performed a posterior shoulder stabilization, in which he tightened the joint in Nelson's upper back by repairing the soft tissue of the shoulder and grafting the tissue onto the muscle of his upper back. Warren also removed a piece of shoulder blade that had broken off.
Shoulder stabilizations are tricky procedures. If the joint is tightened too much, the patient loses his range of motion. For example, he wouldn't be able to extend his arm overhead or across his chest. Moreover, few if any patients have had their shoulders subjected to the violent charges of defensive linemen or swift, powerful linebackers. "Because an offensive lineman uses his arms to block, enormous forces are placed on the back of his shoulders, play after play," Warren says. "That's exactly where Karl's graft is."
Normally the recovery period from such a procedure lasts from eight months to a year. The short end of the scale would put Nelson back on the field Sept.5 for the Giants' opener against the Super Bowl champion Washington Redskins in the Meadowlands. At the long end, however, he wouldn't be back in action until the end of the season.
The Giants desperately need a healthy Nelson at right tackle. He is one of the NFL's best at run blocking. Until his illness he had started 55 consecutive games, had missed only two practices in three seasons and had blasted more holes for running back Joe Morris than any other Giants lineman.
In 1986 Morris rushed for 1,516 yards and 14 touchdowns, and most of those yards were gained on plays called to Nelson's side of the field. Last season—with William Roberts playing right tackle and Godfrey, who was hampered by a bruised left knee, at right guard—Morris rushed for a mere 658 yards and three touchdowns.
So far Nelson's shoulder has been mending more quickly than Warren had anticipated. The doctor hopes to have his patient ready for training camp on July 18. The patient is obsessed with regaining his starting job and achieving his ultimate goal—the 1989 Pro Bowl.
"An offensive lineman either plays or he doesn't," Nelson says. "The coach doesn't work you in for a couple of plays, the way he does with a running back or a wide receiver coming off injured reserve. An offensive line needs to play as a unit. I need to be ready for the opener, not the 10th game of the season. That ain't how it works in this business."
The various operations to control the Hodgkin's disease have turned Nelson's chest into a map of long, thick pink scars. An 11-inch scar wraps around the right side of his ribs to his spine. A 12-inch stripe divides his chest in half, from the breastbone through the navel. His torso looks like a connect-the-dots puzzle, with 16 black-dye pinpoints strategically tattooed across his chest and back. The dots are permanent. They were used to direct the radiation to key points in his body.
"Simms!" Nelson shouted across the Giants' weight room recently as quarterback Phil Simms was hoisting heavy metal. "You have such a bad body!"
"Don't get into a war of words, Nelson," Simms retorted. "You look as if you have been run over by a freight train."
Nelson says he felt like a human pincushion after his cancer was diagnosed—poked and prodded, examined and reexamined. Following the original biopsy, he underwent a week's worth of tests to determine the extent of the Hodgkin's disease. First, there were CAT scans to locate the diseased areas and magnetic resonance imagings (MRIs) to determine whether the cancer was active or inactive. Nelson was too large for a single CAT scan machine, so technicians squeezed him into two, one to scan the upper half of his frame and the other to scan the lower. The MRI machine, a chutelike apparatus in which the patient is placed, also proved to be a challenge. Because of Nelson's size, he became wedged in the narrow machine, and two technicians had to yank him out by the feet.
Next he underwent a painful bone-marrow biopsy. Nelson lay on his stomach, his hips numbed by Novocain, his hands gripping the head frame of the hospital bed. Wolf then thrust a long needle into each side of his pelvic bone. "My worst 10 minutes in the hospital," Nelson says of the procedure. "Dr. Wolf was trying to drive the needle into me. He was yelling, 'Boy you have hard bones!' I was sweating bullets."
After that, Nelson was given a lymph-angiogram, in which dye is injected into the lymph system through the tops of the feet. The dye works its way up through the system, and 48 hours later X-rays reveal the path and extent of the disease.
Finally, Nelson underwent a laparotomy, in which a piece of his liver was removed for biopsy, and a splenectomy, in which his spleen was taken out. For the two procedures, doctors made an incision down the middle of his abdomen, rather than across the abdominal wall, which is standard procedure, to avoid damaging Nelson's stomach muscles.
After all these tests Nelson's Hodgkin's disease was determined to be in stage I, meaning the cancer was localized in a single lymph-node region and hadn't spread. He was given a 95% chance for a full recovery.
Two days after his release from the hospital, in early September, Nelson went to Giants Stadium to visit his teammates. He had lost 25 pounds, and he was pale and extremely weak. When he coughed he placed towels over the chest incision to lessen the discomfort. "I was in so much pain, I probably shouldn't have gone," Nelson says. "But I wanted to let everybody see I was O.K."
Seeing Nelson in that condition, wasn't exactly comforting. "It was very frightening to the team," recalls Ronnie Barnes, the Giants' head trainer. "It hit the offensive linemen hard, harder than anyone. It was a shock. Three weeks before Karl had seemed so healthy. He was one of them."
Barnes and Giants coach Bill Parcells later met privately with players who were having difficulty coping with Nelson's illness. Several Giants demanded CAT scans for themselves, because Hodgkin's disease commonly affects men in their mid-to late 20's. Linebacker Harry Carson, who during his 12 seasons with the Giants has seen three other teammates diagnosed with cancer—running back Doug Kotar, who died in 1983 of a brain tumor; running back John Tuggle, who died in 1986 of liver cancer; and linebacker Dan Lloyd, who is coaching high school football in San Jose, Calif., after having recovered from lymph cancer discovered in 1980—charged that playing in the Meadowlands was hazardous.
"The players wondered if Karl was going to die," Barnes says. "And they were worried they were going to get cancer."
As a result, the New Jersey Sports and Exposition Authority commissioned, at a cost of $200,000, an extensive epidemiological study of the Meadowlands area. The medical records of everyone ever employed at the sports complex—almost 10,000 people—are currently being analyzed. The air, soil and drinking water at the Meadowlands are also being tested. The study is expected to be completed by September.
Throughout Nelson's illness, Parcells maintained his tough-guy image. But when he was out of the players' sight, he often was upset. "Bill had nothing but tears," Barnes remembers. "Every night he wanted an update on Karl's health, wanted to know if he'd had a good day or a bad day. Whenever he talked about Karl, his eyes filled up."
Nelson had more good days than bad during the radiation therapy that began at New York's Memorial Sloan-Kettering Cancer Center in the second week of October. He had a 9:45 a.m. appointment, five days a week for six weeks. The sessions lasted only a minute or so.
"I tried to see the treatments as a job I had to do," Nelson says. "Every morning it was, 'I'm off to work, honey.'
"I never sat around and dwelled on the subject of cancer. I figured if I ever asked, Why me? I'd be afraid. And I never wanted to be afraid."
Morning after morning Nelson sat in the back corner of the hospital waiting room, and he never wore a blue hospital gown. "The blue gowns meant 'cancer,' " Nelson says. "I didn't want to feel sick." During his treatments he became friends with two fellow patients, a loan officer at a Manhattan bank and a Brooklyn policeman. The three of them formed a make-believe club, promising to share anxieties and motivate one another.
"To get through the treatments we'd make light of them," Nelson says. "I'd say, 'Tony, how bad are they frying you?' And he'd say, 'Karl, where are you getting zapped today?' "
Twice a week on the way home to New Jersey from Sloan-Kettering, Nelson stopped to lift weights at the stadium. On Sundays he worked Giants games as an analyst for WNEW-AM radio. When those tasks seemed too draining, he would think about his friends and the rest of the patients at Sloan-Kettering. They inspired him to go on.
"I easily was the healthiest person in that waiting room," he says. "Yet everybody made a fuss over me because I was an athlete and a New York Giant. That was hard.
"I knew people whose skin was crusty from the radiation. I met folks who wore handkerchiefs across their necks to cover holes in their throats. They were dressed in blue hospital gowns, trying to deal with cancer, yet they remained very dignified.
"Everybody thought I was so courageous to fight cancer. Well, it never really took that much courage. They were the brave ones. I was just doing what I had to do."
The experience with cancer caused Nelson to reexamine his life. A quiet man with a tendency to internalize his problems, Nelson believes he now communicates better with Heidi. He also spends more time with his 2½-year-old daughter, Brittany—reading her stories as she sits in his lap and then letting her slide down his legs to the floor—and he's more conscious of the little changes in her as she grows. Because he realizes that football won't last forever, he's developing a new career. Though he has an industrial engineering degree from Iowa State, he is working in the investment field.
"Cancer made me see football differently," he says. "I won't ever let any job be so all-important."
The off-season conditioning and therapy sessions tend to be consuming, however. Since the shoulder surgery, Nelson has been following two separate upper-body training programs, each taking two hours a day. In one, he uses a 110-pound dumbbell to strengthen the right side of his torso. In the other, he does range-of-motion work on his left shoulder, using a thick rubber band, ceiling and wall pulleys and a Cybex, a computerized resistance machine for building strength.
Whenever Nelson is working out in Giants Stadium, Parcells stops by to offer encouragement and to joke a little. "You're not benching enough!" he'll say, laughing. The morning the NFL announced the Giants' 1988 regular-season schedule, Parcells phoned Nelson in the weight room. The tackle had beat him to the punch.
"I've already heard," Nelson said. "We open with Washington."
"That's right," Parcells chuckled. "Monday night. National TV. Fifty million fans. It'll be billed as The Karl Nelson Comeback."
Nelson had to laugh. "Yeah, if I screw up," he said, "everyone will know it."
Parcells tried to be reassuring. "Nah," he said, "after the first sack, it will seem like you never left."