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THE FACE OF PAIN

The scream of Billy Cunningham as his knee tore and his season—perhaps even his career—ended, bespoke the savage hurt that can come with sport, the pangs and throbbing and enduring ache that athletes live with, scheme against and, at times, are beaten by. The irony is, fans seldom notice...

Like a bullet, the puck zipped toward Stan Mikita's eye. He tried to duck, turned his head, but the puck sliced his right ear almost in half, leaving the lobe dangling by a thread of flesh. He took 20 stitches.

The next day Mikita reported to the stadium. He did not intend to play, but then again.... He told the trainer to get a steel cup from a jockstrap, and they rigged up a protective device for the ear, attaching it to the helmet. He went to Coach Billy Reay.

"Billy," he said, "if I wear this thing, I think I can play tonight."

"I don't know. What if you get hit in the same place?"

"Well," said Mikita, "they can sew it up again."

JERRY WEST: There I was...holding two teeth in my hand.

The French call it peine, the Germans know it as Pein, and in Italian it is pena. Pain as a word is as common, as familiar, as elemental as existence itself. The word rolls over lips, passes before our eyes daily in print and endlessly marches into our ears. But unless it is broken down, described in repellent detail, it seems to convey nothing. It is not, for all the fear it triggers, a feeling word. The irony is that nations and ideologies are built on it and, most of all, the individual human being spends much of his lifetime suffering it or inflicting it, but as a simple word, there may be none more remote. Pain must live, it is a visual thing, a hearing thing. In those circumstances, none but the catatonic or moronic are not touched by the face of pain.

Consider a fighter's face, a dolorous example such as the rutted hemisphere of heavyweight Chuck Wepner. If it is reported that Wepner took 120 stitches in his face after a bout with Sonny Liston—bringing his career total close to 300—the response of readers or listeners is predictable. The number of stitches will be noted, but in an easy chair a stitch is a stitch is a stitch. An observation might also be made mentally that Mr. Wepner has an unfortunate calling. The stitches have become only a fact. Had the person in the easy chair been in the dressing room, or later at the hospital watched Wepner take all that catgut without any pain-killer, watched the long needle make its stinging passage, he might have turned his eyes away, or been caught in a swell of revulsion or nausea. Put him at ringside and his reaction is usually different; pain being given or taken mesmerizes. But that is just one contradiction of pain: it sickens yet fascinates.

After millions of years, pain is still a puzzle, a labyrinthine paradox. It is life. It is death. It is survival. "Despite our amazing technology," says Dr. Arthur S. Freese, internationally known in the field of pain, "we have yet to attain the stage of knowledge and understanding of pain that the Wright brothers had of powered flight when they first flew. We find new ways to relieve pain, but we still don't understand how we hurt or why." No two people mean the same thing when they say, "I know what pain is." They only agree that something hurts, and the human race has been hurting from the time early man looked upon pain as the work of hostile spirits, to the present when it has become a test of faith for the religious, a "passion of the soul" for the philosopher, a symptom for the physician.

How does an athlete look at pain, what does it mean to him, how does he live so constantly within its walls, is there a psychological link between athletes and the crazed Marquis de Sade (sadism), or Leopold von Sacher-Masoch (masochism)? Look into an athletic training room, the little room where the ego thrashes furiously against the villain of pain, and there you will see why the athlete is paid so much, why he remains special despite the often proper cynicism that now accompanies him in these, his salad days. Loneliness, desperation, frustration—all ordinary emotions—are trebled in a training room. They cannot always be seen, sometimes only sensed, as the athlete confronts that most unordinary equation: pain and play.

All people suffer in some form, whether from a finger caught in a door or a chronic, debilitating condition. But the athlete is different: at times he suffers almost unendurably—and still must play. Linebacker Tommy Nobis of Atlanta has played with broken hands, shoving and using them as if they were forged of steel; his teammate Paul Flatley, a wide receiver, caught hard-thrown balls with fractures near each wrist; Earl Monroe, of the Knicks, plays with an arthritic condition and at its worst was averaging 22 points; Muhammad Ali has fought most of his career with hands that ache and throb perpetually in the ring; Gene Fullmer and Carmen Basilio fought successfully, looking most of the time as if they had passed through a shredding machine.

"The pain threshold," says Dr. Robert Kerlan, sports' renowned orthopedist, "is high among superstars or high-level athletes. I think this is most true in the contact sports. I don't know if these athletes can accept more, but they definitely don't feel pain as much. Whether this is acceptance, or the way they're put together, we don't know. I think it has much to do with the way an athlete is put together. You have to have a high pain threshold to play football, hockey, definitely for boxing. In the more skilled sports the pain threshold might be a little lower, although basketball demands heavy contact, and there the level is high. When you try to compare thresholds of football and baseball players, it's not really fair. A football player can play with a broken hand. It's hard for a baseball player even to play with a blister on the end of his finger."

The extremes in types run from Gus Johnson, the former Bullet, and Jerry West, to the implacable Jim Brown. Johnson and West (10 broken noses for West) played their whole careers in pain. "West on one leg is better than most with two legs," the saying used to go. Talking of Brown, Dr. Vic Ippolito of Cleveland says, "No. 32 was impervious to pain. He missed only one part of a quarter in all the time he played. I don't think he was even in the training room for his first six years." A Jim Brown, a Jerry West, a John Unitas, these are extreme examples of players who insist on enduring. With other players there comes a time when the ego drops a few notches, when they start to think of how brittle they and their careers are, when the equation no longer seems workable, and then they slowly slide into that gray area peopled by hypochondriacs, malingerers and the "no-risk" takers.

To play at all, to compete at all against another body, to be physical to the highest pitch, is a risk few have to take as part of their daily employment. Football players now damage ligaments and cartilage in their knees to an extent unknown before; if they take a "spear," there is the possibility of a broken neck or paralysis from dislocated vertebrae. Tennis players can snap a tissue called the rotator cuff while serving too hard. A missed swing can chip an arm bone in a baseball batter, and an outfielder can break an arm by snapping a hard throw to home plate. Jockeys fall, and the results often are collapsed lungs. Fractures of heels and toes dog runners and ice skaters, while soccer players and hurdlers must contend with injuries to the pelvis. Skiers are prone to boot-top fractures. As if pain were an old enemy, athletes scheme against it, use it, or get beaten by it throughout their days.

Take the cases of Merlin Olsen, the great tackle of the Rams, and Taz Anderson, a former tight end with the Cardinals and Falcons. Pain to Olsen is "minor"—even when it keeps him awake at night. But Anderson seems to be locked in an awful struggle, a constant self-interrogation of whether or not it was worth it. Anderson is 36, and he estimates he has had 10 operations on his knees, his feet and toes. He cannot remember precisely. "And I'm not finished," he says. "I am just buying time hoping medical science will come up with something to help. I've been told by doctors I'll be in a wheelchair by the time I'm 55. I can still see my doctor looking at my X rays and shaking his head." Before reporting to the Cardinals as a rookie in 1961, Anderson had cartilage removed from a knee, but he says he entered pro football "in the best shape of my life."

Starting with his third game in 1963, Anderson's pain has been relentless. "I went over the middle to catch a pass," he says, "and the safety's headgear hit my right knee. It felt like nothing I could ever explain. The pain was like what it must feel to have your leg amputated. It was just like somebody had cut my leg off at the knee. I tried to play the next games with cortisone and Novocain and had the knee drained. But then one day I collapsed getting out of bed." His career ended in the middle of the 1967 season when he was with the Falcons. "While trying to play with one bad leg, I messed up the other," he says. "I couldn't begin to give the sequence of operations. Just too many. I've had a tendon reattached in my left foot. Because of favoring my right side so much, the tendon came away from my arch. I've had bone chips taken from my left ankle, and even a joint in my second toe has been removed. I've had tendons on my toes cut and lengthened. Last year, eight years after I left the game, I had to have my left knee operated on twice."

Anderson says his knees hurt constantly. He takes 12 Excedrin a day, and he is always stiff and sore, and when cool, rainy days come he says he nearly goes out of his mind. "Besides the pain, I have had to lose time from work for operations," he says. "Then there is the cost of treatment, and even the fluoroscope exams hurt so much. They blow your knee up with air, then force the dye into it. There's just no way a knee can stand that cutting and repair work. It doesn't have a zipper on it.

"I don't know why I continued to play for so long. I don't know if I would go through it again. I know one thing. I wouldn't want my son to play pro ball. I guess I must have had my knees injected and drained 70 times after I got hurt. We'd be in a restaurant eating as a team, and they'd have me up on a table working on my knee, shooting it up. It got to the point where the shots started wearing off in the middle of the first quarter. I'd run one-legged the rest of the game. I couldn't even go out for warmups. I knew I had only so many steps. I didn't want to waste any. I was never forced to play hurt after my first serious injury. I should have gotten out then, and maybe I'd be whole today.

"I was watching the Redskins on television one night last season. Larry Brown is pitiful. Somebody should tell him right now: 'Stop! Get out before it's too late.' Those guys who get hurt, the ones who aren't making those big salaries, should really consider if it's worth it. The way it is, I can hardly get around to sell real estate now. I go out and try to show customers property, and I've got to keep my mind on where I'm walking every minute. If the ground is the least bit uneven, I have a terrible time because I have to walk so stiff-legged."

Merlin Olsen has been under a surgeon's knife only once in his 14-year career. "I've only missed two games in all those years, and they were in my first two seasons," says Olsen. "I was kicked in the groin and had to spend a few days in the hospital. Pain is an interesting thing. The second injury that I had—a hyperextension—was when I got hit as I was trying to jump over an offensive center. A guard or a tackle dove and hit right on the kneecap of the leg that was planted. That drove the kneecap 12 to 14 inches straight back, which caused a massive trauma of the knee area. It seemed like I was in slow motion. I felt the tearing of the muscles. I felt blood vessels popping. I kept saying to myself, 'Get those damned cleats out, get those cleats out of the ground.' It didn't last as long as it takes to snap your finger, but that instant seemed like forever. Then I went to the ground, and I felt the most intense pain in my life."

Olsen chooses to ignore pain, to adjust to it and then go on his way. "Man is an adaptable creature," he says, "and one finds out what you can or cannot do. It's like walking into a barnyard. The first thing you smell is manure. Stand there for about five minutes and you don't smell it anymore. The same thing is true of a knee. You hurt that knee. You're conscious of it. But then you start to play at a different level. You change your run a little bit. Or you drive off a different leg. Maybe you alter your stance."

Olsen says you have to battle pain week after week after week, that a player is placed on an emotional rack and the price is always there to be paid in full. "I remember that year after surgery on my knee," he says. "I had to have the fluid drained weekly. Finally, the membrane got so thick they almost had to drive the needle in with a hammer. I got to the point where I just said, 'Damn it, get the needle in there, and get that stuff out.' "

Olsen and Anderson cannot be directly compared. They are only case examples used to illustrate pain, to show how two men look at it and are affected by it: Anderson, long out of the game, suffering and somewhat confused, even slightly bitter but blaming no one; and Olsen, still playing, who looks upon pain as an interesting companion, as something which arouses his contempt and inexhaustible taste for pragmatism. Olsen seems to have the perfect attitude for his savage sport, a way of life that is pain more than most others, one that is best underlined by Eddie Block, the creative trainer of the Colts. "John Unitas was recovering from broken ribs in the championship game of 1958," Block recalls. "So we made a glorious protective device for him, and the thing weighed 9½ pounds. It was made out of hammered aluminum. He wore it in that game, and afterward it was so bent the equipment manager pulled from the front and I put a knee in John's back and pulled from behind, just to get it somewhere near its original shape so that he could get it off." (Times change, needs don't. Last year the Colts wrapped the bruised ribs of their latest stellar quarterback, Bert Jones, in a three-pound plastic shield.)

The pain from injury is one thing, yet often not nearly as debilitating to athletes as operations and rehabilitation. Operations seem to take a lot out of them. "It's more of a mental thing," says Austin Carr, of the Cleveland Cavaliers. "And the exercise, weight lifting and all that other stuff after an operation is punishing." Angel Pitcher Bill Singer, who has undergone several operations, says, "The thought of going through another one is too much. The last one got to me. I don't think I want another. If it's a baseball injury that could cost me my career, I pass. I've had enough."

After an operation, the recovery process is tedious and costly to a player. "Most don't realize how tough it is," says Dr. Kerlan. "Not many ordinary people could meet the sacrifice. Take Wilt Chamberlain when he had knee surgery. Wilt lived in Bel Air, and my office was about 13 miles away. When Wilt was getting to the midpoint of his recovery he didn't drive to my office. He ran to my office. He ran 13 miles down here and then 13 miles back. He might jog a bit, or walk some, but mainly he ran that distance. That's a tremendous price. Then he would go down to the beach and run for miles in the heavy sand with heavy shoes on."

The bad knee is like the common cold in sports, and there the similarity ends, for a knee problem can reduce a career to cold ashes. This is the most feared injury in sports. "Have you ever had a tooth broken off so the nerve ends are exposed?" says Bob Lilly, who until recently played defensive tackle for Dallas. "If you have, then you know what a knee injury is like. It feels like there are four teeth broken off inside your knee." Ben Scotti, former defensive back for the Eagles and Redskins, used to say, "Bad knees? You wanna know about knees? They've busted more players than booze. Give an average player a couple of good knees and he can stay in this league forever." It is a frightful moment when the knee goes. Olsen heard that pop, and there was a strange feeling within him. Jerry West's ligaments ripped—much worse than a torn cartilage—in a game in March, 1971 and he remembers thinking his career was over instantly. With all his other ailments and injuries, this is the one that West cites when asked about pain, the hurt he recalls most vividly.

"A very frightening experience," says Dr. Kerlan, pointing out that a long stream of mental problems can be loosed.

The mind of an athlete? To some, it is the butt of fraternity-house humor. To others, it does not exist at all; he is purely arms and legs, a confluence of muscles that move with more speed, greater force than the rest of us; his body says everything that has to be known, speaks of what he is or is not. But attitude, will, desire are of the mind. Coaches frequently talk about such things, often knowing less about their source than the players themselves; how many careers have been ruined (mostly early) because a coach could not or would not try to understand a kid's head? The coach sees, understands what is in front of him: a block, a cut, a touch, a swing. The player thinks about his mind much more. Winning games, excellence, he knows, is first a matter of the mind. More troubled than ever before, more aware of the ravages of his sport, shot up and shot down with all sorts of drugs, the modern athlete often—and understandably—turns inward.

When they cannot play or practice, some players begin to feel like strangers. Their pain has become a barrier between them and the rest of the team. Once taken in the spirit of things, laughs suddenly seem to become pointed ridicule. The vacant remark becomes loaded with significance or accusation. The team has become an immense and quick eye, recording every trip the athlete makes to the training room, every nuance of his presence. Some of this, of course, is paranoia evolving out of an inner guilt of not contributing, but often the player is right in what he feels. Healthy players can be hostile, and coaches sometimes are cool to those who cannot perform; debilitating pain is a threat to their security—an enemy. Consider the experience of Rayfield Wright, the All-NFL tackle for the Dallas Cowboys.

In the 1973 season Wright suffered cartilage damage to his knee. A good example of a player who will not sit out for a variety of fears—sometimes their jobs, their egos, or the bullwhip of the organization—Wright played in pain the rest of '73 and then through all of 1974. Finally, the Cowboys concluded he needed an operation. "By this time," says Wright, "the cartilage was crushed into bits. If I had had the surgery when I was first injured, it would have been much simpler. They had to pick the stuff out with tweezers." Came 1975 training camp, and Wright was sure the knee was not ready, so he declined to do calisthenics or any of the rough work. "Suddenly," he says, "I began to feel the pressure. Word got to me they were wondering why I wasn't doing the drills, that I was taking it too easy on myself." Coach Tom Landry said there was concern that Wright was coming along too slowly. Wright said he would not do anything until the knee could take it, and he refused to play until the third exhibition game. His assessment of the situation was correct. He did not miss a down after that.

The mental aspect of pain is sometimes even worse than the physical hurt. There is gnawing self-doubt, anxiety over the future, the dread of an operation. Always an optimist, Billy Cunningham of the 76ers fought back from two major kidney operations, but when his knee was severely hurt in a game last December it was obvious he was hanging on an emotional precipice. "He was very upset, very emotional," says Philadelphia trainer Al Domenico. "He had had those terrible kidney operations. Now he knew another operation was coming up." A photographer recalls the moment: "Cunningham yelled, 'It's broken, it's broken.' I saw the bone in his knee move...I mean, it just moved to one side. He screamed." A teammate, Steve Mix, says, "It was black-and-blue before they got to him. I've seen guys go down. I've never seen an injury like that." Cunningham himself says it felt like someone had a hand on his foot, and another person had a hand on his hip "and they just pulled my knee completely out of the socket."

His wife Sondra reflects on all the pain of the last several years, all of the hard mental sweat. "The first time he had the kidney operation," she says, "they told him he'd be back on the court. It didn't happen. He had to go through another. I felt so sorry for him. He'd take our oldest daughter out for a walk. He'd barely get down the driveway before he was so tired he'd have to come back. He would just about make it up the staircase to the bedroom. I remember he started working out on the day they pulled the tubes out of him. He rushed to the Philadelphia Athletic Club and started running around. He ran and he ran. And then he sat down. And he was so tired he fell asleep, right there on the bench."

Tony Roche has managed only 1½ years of tennis in the past six years. To the Australian Roche, once one of the game's most luminous talents and ranked No. 2 in the world, pain has meant half a million dollars or so, three operations and endless anxiety. At one point he was filled with so much cortisone that the drug was no longer effective. Two of the operations were on his left elbow, another on his Achilles tendon. "At first," he says, "I started to get a constant pain like a toothache in my playing elbow. It hurt to grip a racket. It was there all the time, and I played with it for nine months. I took four months off, came back, and the pain was worse than before. It had shifted to the bone. I worried when I played. I couldn't practice because I had to save myself for actual matches. There are so many things added to the pain, the lack of confidence, the frustration. Away from the court, every time I would grasp something it would hurt. If I was on the telephone with my arm in one position for any length of time I would have difficulty straightening it out when I hung up. I then had two operations, and my arm was as bad as ever. I was serving so softly it might as well have been underarm. After a while you begin to wonder if it's worth it. It is especially true when you have just lost to somebody you know you could beat in the past. It was a long, hard battle to get to No. 2 in the world. Once is enough to battle up that ladder."

Pain of the mind, pain of the body, it is seen, or heard, and then felt, but often it is not remembered. In games played for money, where man times speed equals injury, where ego is involved, where the law of natural selection is rarely more obvious, the canvas is smeared with pain. You look, and then move away, never looking back. You think athletes are like certain birds, that can go so far, so long. Some can go only a little way, some are like the blue geese that migrate nonstop from Hudson Bay to Louisiana, and then there are those few, like the Sooty tern, which can fly for three years or more before alighting. That is the way of athletes; Leopold von Sacher-Masoch has nothing to do with it.

Everyone has his own private picture of an athlete in pain—Joe Namath laboring to get out of a taxi, his face contorted while placing his leg down as if he were about to walk barefoot on nails; Ben Hogan, bandaged from his foot to his crotch. For me, my last look at Dick Tiger will always stick. Toward the end of his career, the last four years or so, pain followed Tiger like another man's shadow. It got up with him in the morning, it ate with him, and it sat alone with him in the shabby hotel rooms in which he used to kill the long Manhattan nights. Once, watching him walk down sticky and stained Eighth Avenue on a winter afternoon, it seemed that the gray sky had opened up and poured all its sorrow on him. But that was only the way he looked, mostly because of his old man's shuffle, his weathered Homburg and tattered overcoat that trailed the ground. For Tiger, eye to eye, was a man of strength, of a dignity that threw out a wide light, and few athletes ever suffered more to the day he died—so quietly and too young.

At 41, Tiger had not been a memorable fighter or champion, but he had produced moments that you reach back for over and over, and then try to hold like some stone or other keepsake; he made you feel better for having watched him work. By all accounts, he was through by age 37, though he hung on gloriously, crouching and weaving until cancer found him. By then he had no hope, no money (once he was wealthy) and no country. The Nigerian civil war, with its drawn-out horror, had left him that way. The stress of trying to fight on, of trying to find a way to help his country and family, finally cut out his heart.

One afternoon one of his trainers and I stopped by to see him in a little West Side hotel room. Tiger just sat there in a worn robe in the half-dark, saying nothing, his hands joined solemnly over his nose.

"Well, Dick, we'll stop back later," said the trainer. "We were just wonder-in' 'bout ya. How ya were doin'. You know. That sort of thing."

"Yes," he said, in his accented English. "Come back, please, in a little while. I don't want to talk now, gentlemon."

"That goddam war broke him in two," said his trainer, leaving and closing the door. Then the trainer stopped and said, his eyes widening, "Shhh. Listen. Can ya hear him? Tiger, Dick Tiger cryin'? Yeah, he's cryin'!"

Dick Tiger was dead one year later. The face of his pain remains.

THREE PHOTO ILLUSTRATIONS

GEOFFREY GOVE