KNOXVILLE, Tenn. – Three months ago, Pat Summitt, 59, the University of Tennessee women's basketball coach, visited the Mayo Clinic in Rochester, Minn., seeking an explanation for a troubling series of memory lapses over the past year.
They were small, baffling glitches: a woman who was always highly organized had to ask repeatedly what time a team meeting was scheduled for.
"She lost her keys three times a day instead of once," her son Tyler says. She was late to practice. On occasion, she simply stayed in bed.
"Are you having trouble with your memory?" friends began asking, puzzled.
"Sometimes I draw blanks," Summitt finally admitted.
The diagnosis: early-onset Alzheimer's disease.
Her first clue that something was badly wrong came last season, when Summitt – who holds the NCAA career record for victories, men or women – drew a blank on what offensive set to call in the heat of a game.
"I just felt something was different," she says. "And at the time I didn't know what I was dealing with. Until I went to Mayo, I couldn't know for sure. But I can remember trying to coach and trying to figure out schemes and whatever and it just wasn't coming to me…"
Summitt believed her symptoms were the side effects of a powerful medication she was taking for rheumatoid arthritis, which she has quietly suffered with since 2006.
Instead, when Summitt received her test results from the Mayo Clinic at the end of May, they confirmed a shocking worst-case scenario: she showed mild but distinct signs of early-onset dementia, Alzheimer's type, the irreversible brain disease that destroys recall and cognitive abilities over time and that afflicts an estimated 5 million Americans.
Last week, Washington, D.C., attorney Robert Barnett flew to Knoxville to meet with his longtime friend and client, half expecting her to step down after 38 years as Tennessee's coach. With him, he brought a copy of the statement with which former President Ronald Reagan announced in 1994 that he had Alzheimer's.
But Summitt told Barnett that she did not believe her symptoms were severe enough yet to warrant retirement and that she would like to coach at least three more years if possible.
"It is what it is," she said. "I've got to face it."
Last Thursday, Summitt, Barnett and her 20-year-old son, Tyler, who is a junior at the University of Tennessee, met with Chancellor Jimmy Cheek and Athletic Director Joan Cronan to inform them of her condition. Barnett had warned Summitt that contractually, school administrators had the right to remove her as head coach immediately.
Instead, Cheek and Cronan listened to Summitt's disclosure with tears streaming down their faces.
"You are now and will always be our coach," Cheek told her. With the blessing of her university, she will continue to work for as long as she is able.
Tennessee will be in uncharted territory, as will Summitt herself. The school's concerns over leaving her in place include potential embarrassment; a decline in Summitt's health; and the possibility that players could feel shortchanged or that the team is more about Pat than them.
Cronan believes the exchange is worth it.
"Think about the difference she's made, and the difference she can make going forward," Cronan says.
Summitt has agreed to a significant redistribution of her duties. In consultation with Cronan and her staff, her role will be redefined to give her colleagues more formal responsibility, such as calling plays during games.
Summitt will continue to do what she has always done best: teach and lead.
"I've got a great staff and great support system, and I'm going to stick my neck out and do what I always do," Summitt says.
On Tuesday afternoon, she walked into the Tennessee locker room to inform her current team of her condition.
"I just want them to understand that this is what I'm going through, but you don't quit living," she says. "You keep going."
Long denial period
After several instances of forgetfulness last season, Summitt became increasingly hesitant, and withdrawn. She avoided meeting with players one on one, afraid she might say something wrong.
There were days – not many, but a few – when she couldn't bring herself go to the office at all, and stayed home, "just to be around the house and be in a safe place."
"Pat, you need to be here, need to be here for this team. What is going on with you?" DeMoss asked.
"I don't know," she said. "I don't know."
Finally, when the season ended, Summitt decided to visit the Mayo Clinic for a full examination.
For three days, she underwent a battery of tests, an MRI, a PET scan, a neuropsychological evaluation, and a spinal tap.
Dr. Ronald C. Petersen, director of Mayo's Alzheimer's Disease Research Center, rendered his opinion: She appeared to have signs of the disease, though she would have to wait for the lab results to be sure.
Summitt was so highly functioning that it actually delayed her acceptance of the diagnosis. Immediately after her stay at Mayo, she rushed to the Southeast Conference annual meetings in Destin, Fla., then back to Knoxville to run a series of summer camps, and then hit the road again for a series of basketball tournaments to evaluate potential recruits.
It wasn't until this month that the reality of her condition hit home.
"There was a pretty long denial period," Tyler says. "At first she was like, 'I'm fine.' "
When the blow finally fell, it was heavy. Summitt had always been the caregiver: Friends, family and former players struggling physically or emotionally have always come to her house for comfort, a hot meal and soothing advice in that honeyed southern voice.
"I want to go see Pat" is a common refrain. It wasn't easy to reverse the role and to admit that she would need care. In September 2006, not long after the death of her father, she separated from R.B. Summitt, her husband of 26 years. Some months later, she found herself immobilized by physical pain, and was diagnosed with rheumatoid arthritis.
"Everyone has always wanted to know what Pat's really like," DeMoss said. "The word I've always used is 'resolve.' Pat has more resolve than any one I've ever known. She has a deep, deep inner strength."
Her intention is to remain as sharp and strong as possible over the next few years, with the hope that researchers are racing toward new therapies or a cure.
"There's not going to be any pity party and I'll make sure of that," she says.