Despite other successful cases, Bosh's return remains murky

What happens with Chris Bosh now?

Who knows what the next step is for Bosh and the Heat, who announced Friday that Bosh had failed his physical. The South Florida Sun Sentinel reported that the 31-year-old Bosh had suffered a recurrence of the blood clotting that had ended each of his last two seasons prematurely, and that NBA physicians had confirmed the diagnosis of the Heat’s doctors.

In light of Bosh failing the physical, Heat president Pat Riley said Monday morning at Miami’s media day that Bosh’s career with the Heat is “probably over” and that the team is no longer working toward his return.

The uncertainty both about Bosh’s and the Heat’s future is a sad denouement to the SuperFriends. LeBron James famously went home to Cleveland two years ago. Dwyane Wade, shockingly, is gone to Chicago. And now, Bosh is in limbo, just when the Heat were finally going to be his team, in temperament and planning.

Bosh had been symptom-free for the past several months. But the salient issue has less to do with Bosh’s physical condition, and more to do with the rights of an individual rather than the team to determine how much risk is too much.

Bosh knows he has, or has had, episodes of clotting. But he believes that he can continue playing, with some adjustments, having found players in other sports whose careers continued despite being diagnosed with clots. He is saying, basically: it’s my life, and I want to keep playing. Which is an understandable position to take.

“Little setbacks happen,” Bosh said in an Instagram post on Friday. “But that doesn’t change my intentions, and what I want to accomplish…It’s a down moment now, but everything’s gonna be all right.”

The Heat have said next to nothing publicly during the last year-plus regarding Bosh’s health, citing the Collective Bargaining Agreement prohibition that prohibits a team from discussing a player’s medical condition without his consent on Friday. But their position seems clear: blood clots are serious, serious stuff. They can, and do, kill people. And we’re not going to leave ourselves liable if he collapses and dies on the court, or on a plane. Which is an understandable position to take.

And that’s the problem. I get where Bosh is coming from. I get where the Heat are coming from. I don’t think there’s a villain here.

“The ethical issues in making return to sport decisions might not seem that prominent in many cases,” physiotherapy doctor Theresa Burgess wrote in the South African Journal of Sports Medicine in 2011. “However, one of the main ethical issues that have been identified by healthcare professionals working with athletes and sports teams is the tension between the long-term welfare of an athlete and premature demands to return an athlete to sport.”

The irony in Bosh’s case is that the usual roles mentioned by Burgess are reversed. In this case, it is the athlete pushing to get back on the court as soon as possible, with the team expressing reservations.

Though he and the team have worked together to try and find common ground, Bosh has pushed back against the Heat’s doctors’ diagnoses during much of the process.

“The team doctors, they told me (last spring) that my season’s over, my career’s probably over,” Bosh said in his own digital series, Uninterrupted. “And, yeah, this just happens, this is just how it is. I felt right away that I was just written off.”

There is also the not-insignificant matter of the remaining $75 million on Bosh’s max contract. If Bosh doesn’t play for a year, the Heat can excise the rest of his contract from its books as soon as next February, a bit of financial bookkeeping that would obviously have major repercussions. If Bosh’s $25 million salary for 2017-18 were removed, Miami would have less than $47 million in guaranteed money on its cap next summer, leaving the Heat able to sign two max salaried players to pair with Hassan Whiteside, Goran Dragic and Justise Winslow.

But first and foremost is the danger of clots. This isn’t a ligament tear we’re talking about; clots kill. The Centers for Disease Control says a precise number is unknown, but it estimates that up to 900,000 people per year in the United States could be affected by deep vein thrombosis and pulmonary embolism.

The National Blood Clot Alliance estimates 274 people die every day from blood clots. It estimates between 100,000 and 300,000 deaths per year are due to clots, which it says is more than the total number of people who die annually from AIDS, breast cancer and car crashes combined. CDC says that a quarter of those who die from clots do so immediately; 10 to 30 percent die within a month of diagnosis. One-third of those diagnosed with DVT/PE have a recurrence of it within a decade.

Former Blazers great Jerome Kersey died at 52 in 2015 from a pulmonary thromboembolism likely caused by a clot in his leg. NBC News correspondent David Bloom died at 39 from a fatal pulmonary embolism in 2003 caused by a clot that traveled from his leg to an artery in his lungs.

Before the team announced he’d failed the physical, Bosh had taken control of the narrative, along with his wife, Adrienne. They had taken to social media all summer, through Uninterrupted, a LeBron James/Maverick Carter vehicle. Bosh produced a digital series of his work, entitled “Rebuilt”, and posted videos of his workouts during the summer, showing that he felt ready to go.

During an Uninterrupted podcast last week (“we’re kind of filming this, kind of project, I guess,” Bosh said at the start of the podcast), Bosh indicated that he’d spent the past several months meticulously researching the science of blood clots and the ability of professional athletes to continue with their careers despite having them. He found doctors who told him he could continue with his career, on a program of blood thinners.

“It’s just a matter of time,” Bosh said in the podcast. “I’m not the first — and that’s the best part about this — I’m not the first athlete to do this regimen. My wife and I went out and we found doctors ourselves. We worked with guys. We end up finding a guy by the name of Tomas Fleischmann. He used to play with the (NHL’s) Florida Panthers. Same problem I had, actually the second time. And this was five years before, six years before. And he’s been playing for four or five years now…this is nothing that’s new. It’s not groundbreaking. We’re not re-inventing the wheel here…for anybody to have worries, there is a guy — guys — playing basketball and hockey and football.”

But Bosh acknowledged that the summer has been a “struggle,” not just gathering information and doing research and seeing doctors.

“If you’re an athlete in this game, you have to protect your own interests,” he said. “And you have to protect your body and your family. Nobody is going to feel more important about you than you, right?”

The record on pro athletes playing with blood clots is murky.

Fleischmann was first diagnosed with a blood clot at the start of the 2009-10 season, while playing with the Washington Capitals. He returned to play 69 games that season, and 45 the next season. But in January, 2011, he developed clots in both lungs while playing for the Colorado Avalanche and missed the second half of the season.

Fleischmann went on blood thinners, signed with the Panthers in 2011, and played in all 82 games that year, going on a program of treatment after practices and taking injections during the season. He played most of the next three seasons as well. But just last Friday, he flunked a team physical for his new team, the Minnesota Wild.

The NHL’s Pascal Dupuis first developed a blood clot — a pulmonary embolism in his lung, that started in his calf — after a December 2013 collision with Penguins teammate Sidney Crosby that tore Dupuis’s ACL, MCL and PCL.

Dupuis was put on blood thinners for six months while he rehabbed the knee injury, and returned to the ice for the start of the 2014-15 season. But early that season, he developed another embolism in his lung. He went back on blood thinners and missed the rest of that season.

At 36, Dupuis came back for one more run with the Penguins last season, but felt chest pain during a Dec. 1 game, and was again shut down for the season. He stayed with the team as a unofficial coach, and was on his skates when Pittsburgh won the Stanley Cup in June.

Tennis legend Serena Williams was out for much of 2011 after being rushed to a hospital to treat multiple embolisms in her lungs. But Williams has come back, winning nine more major titles in the last five years to tie Steffi Graf for the most major wins in the Open era, 22 — including this past year’s Wimbledon championship.

Numerous baseball players in recent years have suffered from clots. Some have returned to action; some have not. The Warriors’ Anderson Varejao has come back to play in two of the last three seasons after being shut down in 2013 with a blood clot in his lung.

But none of those other cases will have bearing on what happens to Bosh.

“I have full confidence,” Bosh said in the podcast, before he was flunked on the physical. “Yeah, I’ll be there. Will I be cleared? I don’t know. But that’s out of my hands. But I will play basketball in the NBA. I’m confident.”

…AND NOBODY ASKED YOU, EITHER

A New Day Dawns in the 405. From Isaiah Claman:

As a Thunder fan, I’m pretty devastated losing KD, but after seeing media day, the group looked happy, Russ was looking like he could lead them, Adams looked huge and Oladipo was hilarious. What are the chances for my Thunder to make noise in the playoffs and what do you think the starting lineup should be?

If you define making noise as anything other than making the first round, I don’t like their chances very much, Isaiah. It’s true that Golden State looks to be the top team in the west, but it’s hard to put OKC ahead of the Clippers or Spurs right now, either. The Blazers are going to be tough. So is Memphis. I wouldn’t write off Houston and Dallas, either, and Utah and Denver and Minnesota and Phoenix will all be a lot better. There’s still a lot of talent there and ultimately, the Thunder will get Durant out of their system, but there has to be some transition time for the franchise.

Roger Murdock, GOAT. From Steve Abrams:

I’m a longtime basketball fan.

I grew up in Los Angeles and went to UCLA at the same time as Kareem.

I was always a Laker fan, except for the time Kareem played in Milwaukee.

I’m now a Warriors fan, as I live in the Bay Area, and I think they play the game how it should be played, with finesse, teamwork, defense, outside shooting, etc.

I’m writing to you because it continues to bother me how much he seems to be overlooked when there is talk about the “greatest” players. It happens time after time.

The most prolific scorer, unstoppable sky hook, 6 titles, MVP awards, scoring titles, all-star selections, amazing longevity, it goes on and on, and all done with ultimate style and integrity.

So why is this? It’s always Michael, Magic and Larry.

My feeling is that it might be because of his soft-spoken introspective demeanor, his distance from the press and public in general (which I totally support), and his heartfelt and very well-expressed views on society.

I think he must be always considered in the top three to five of all-time, if not the very top.

Agree on all counts, Steve. To me, Kareem’s standoffishness toward the media for much of his career is the clear and chief reason he isn’t cited more often as one of the top players of all time. It’s not that print and broadcast people willfully exclude him; it’s that he never built a meaningful relationship with anyone in the media who could now champion his cause. (Frankly, I don’t think he cares much. He knows what he did on the floor.) I came in almost at the end of Kareem’s playing career, and in those brief encounters I certainly didn’t establish any kind of relationship with him. In the times I’ve interviewed and spoken with him since, I’ve found him engaging and willing to discuss things. But I know that wasn’t the case with most who covered the league during his prime.

Wither Vansterdam? From John Aldridge:

Long time reader/fan of your column in particular; first time responder. I was pleased to hear that the league is going to relocate the All-Star game to another city. There really is no place anymore for Discrimination/Bigotry/Hatred/Exclusion/etc. We can not evolve as human beings if we continue to accept or allow this It is intolerable. As far as I’m concerned, you can be any colour, follow any religion, vote for any political party, be in any position of power, live in any hut with the tribe of your choice. You treat me like a human being and I’ll treat you the same. I happen to be hopelessly and helplessly heterosexual. I love people, especially those empowered to be who they are, and as a consequence, the best they can be. If we all just did that (like a lot of the books tell us to), would we not just all be a little better for it? C’mon people…enough already…it’s time. It’s long past time.

Back to the relocation of the event that is All-Star; might I suggest either Vancouver or Seattle? Two cities that lost their franchises which are sorely missed. I would love to be greedy and say Vancouver as I am just a ferry ride away. They had glimpses of promise during their limited run (Rahim, Dickerson, Bibby, Raouf etc). It’s unfortunate that it did not work out and I won’t opine on my thoughts concerning that franchise. Seattle was an exceptional team for a very long run and incredibly exciting to watch. They have a lasting basketball fan-base. The Sixth Man hosts stuff there every summer, year after year. Also, Bill Russell is in that neck of the woods, isn’t he? Didn’t they name some sort of trophy after him? Please consider my plea NBA, the pacific northwest misses its live ball.

Alas, John, the 2017 game has been awarded to New Orleans, not that there’s anything wrong with New Orleans. I would have loved to take another trip to the Pacific Northwest to either Vancouver or Seattle for an All-Star Game, but I doubt the league would want to re-litigate the issues involved in those cities’ losses of their respective NBA teams by playing there. We (and by “we” I mean all right-thinking humans) can only continue to hope that somehow, someday, the NBA returns to one if not both of those great markets. (Aside: as far as John and I know, we’re not related.)

Send your questions, comments, criticisms and detailed plans to flee your own minimum security prisons for next week’s Morning Tip to [email protected]. If your e-mail is funny, thought-provoking or snarky, we just might publish it!

I’M FEELIN’ …

1) Many thanks to Paul Shirley, Etan Thomas, Mark Eaton for Guest Morning Tip columns while I was on vacation, along with all the fans who submitted Fan Tipper columns. The winning column will be part of next week’s regular Tip.

2) Continued congratulations and respect to our Turner colleague and Hall of Famer Isiah Thomas for his work in keeping the annual Peace Game going in his native Chicago. Thomas’s fifth annual tournament, which brought together young Chicagoans, including gang members, for a day of basketball and brotherhood this past weekend, is a retort to the cynics who say African-Americans never do or say anything about black-on-black crime. Players have to sign a pledge promising to try and end violence in their communities when they return home.

3) Very glad to hear the Board of Governors will vote next month on a proposal that would have the Replay Official in Secaucus responsible next season for all rulings on reviewed plays, other than flagrant fouls and fights, which would still be handled by game officials. Streamlining the process — the vote is likely to pass — will increase game flow and make more reviews be adjudicated quicker. Whatever gets Joe Borgia more air time, we’re for.

4) I went to DeMatha High School. I know great high school basketball.This was the best high school basketball team I ever saw. It was better than a lot of college basketball teams I’ve seen.

5) All one can do as Vin Scully’s broadcasting days with the Dodgers dwindle to a precious few is thank him for his decades of excellence behind the microphone. What an incredible career, one that has shown absolutely no signs of deteriorating, as Scully passed his 88th birthday.

NOT FEELIN’ …

1) An awful, terrible year was made worse Sunday with the deaths of two wondrous talents at different ends of the athletic spectrum. Jose Fernandez, the Miami Marlins’ All-Star pitcher, was just starting to touch his potential, at 24, when he was killed early Sunday in a boating accident that claimed the lives of two others in Florida. It was a joy to watch him pitch and touch greatness with his repertoire of pitches. Arnold Palmer, the Hall of Fame golfer, was 87, his best days long past him. But Palmer’s impact on the game is still felt. He was golf’s first major star in the television era, playing a swashbuckling style that endeared him to galleries around the world. And he became a marketing behemoth, selling cars and pants and seemingly everything else for decades, well into his 80s. May both of these great talents rest in peace.

2) It’s hard to contemplate the dawn of a new NBA season without Kobe Bryant, Tim Duncan and Kevin Garnett on the hardwood. But, here we are, and there they are not. On the other hand, those three, plus Tamika Catchings and Swin Cash, all going into Naismith in 2021? Wow.

3) Among the worst things teams have to absorb: the just-before-camp-opens significant injuries to key personnel, which this season have struckMilwaukee, Phoenix and Miami. Losing Middleton, the only consistent perimeter shooter in the starting lineup, is an especially brutal blow to the Bucks, looking to move up in the east this season.

4) I’m sure J.R. Smith is going to sign any moment now and report to Cavs’ camp. Right? Right?

5) I mean this sincerely: I hope the Seattle Mariners don’t waive catcher Steve Clevenger for his two Tweets last week that were harshly critical of both President Obama and the Black Lives Matter movement. The Ms suspended him without pay for the rest of the season on Friday. It would be easy for the team to cut ties with the 30-year-old — he hit .221 this year, he’s hardly a major piece of the team’s future and who needs that kind of headache these days? But it would be wrong. Not because I agree with what Clevenger said — I don’t. It would be wrong because we can’t ask for ourselves what we would deny to others. If I support Colin Kaepernick’s right to take a knee during the national anthem to protest police brutality, I must also support Clevenger’s right to speak his mind on his Twitter account. This is a great opportunity for Clevenger and all of his teammates — not just his African-American teammates — to have a frank and open discussion about race and class and politics. No one should expect consensus. But clipping off debate because someone has a position different than yours makes finding any common ground impossible.

BY THE NUMBERS

7: Remaining players drafted in the 90s in the NBA after Kevin Garnett’s retirement last week. The list: Elton Brand, Jason Terry, Metta World Peace andManu Ginobili (all taken in the 1999 Draft), and Dirk Nowitzki, Vince Carter andPaul Pierce (1998). Andre Miller (1999) and Nazr Mohammed (1998), who played last season, have not yet been signed as free agents for this season.

271: Career games in Minnesota for Nikola Pekovic, the former second-round pick who the team officially announced Sunday would miss the entire 2016-17 season with ankle problems. It is not likely the 30 year old will play again for Minnesota; he’s still owed the final $23 million of the five-year, $60 million deal he got in 2013.

7,483: Days, as of their first regular season game (Oct. 26), since the Lakers last played a regular season game without Kobe Bryant in the lineup. The last non-Bryant game was L.A.’s Game 4 loss to the Rockets in the first round of the 1996 playoffs. The Lakers maneuvered to acquire the Draft rights to Bryant in the 1996 Draft a little more than a month later. (In case you’re wondering: it will be 7,128 days when the Spurs play their first game this season (Oct. 25) since they’ve played a game without Tim Duncan in the lineup. Their last non-Duncan game was April 20, 1997, the final game in a 20-62 season. Improbably, San Antonio then won the Draft Lottery and took Duncan with the first pick of the ’97 Draft.

TWEET OF THE WEEK

I loved every minute I competed against you. A true warrior #ticket #KG

— Kobe Bryant (@kobebryant) September 24, 2016

— Kobe Bryant (@kobebryant), Saturday, 2:30 p.m., paying tribute to the career of Kevin Garnett.

THEY SAID IT

“I know he don’t want to talk about it all year and I don’t either. We want Paul here and we know what it’s going to cost and what it’s going to take. If Paul wants to get a deal done, we will. It’s a max deal. There’s no others, so there’s no use talking about it. If he wants it, he’s got it.”

— Larry Bird, to the Indianapolis Star, on the likelihood of a max contract extension for Paul George this year. With two years remaining on his current deal, George is eligible for a four-year extension.

“He is in a better place and hopefully he is in a perfect place at some point. I think he’s working toward that but I have no doubt that he’s ready for camp and ready to go for the season. Last year, he wasn’t, he just wasn’t ready. It wasn’t really a possibility. This year, he’s absolutely doing it, so that’s a good improvement. He is trending in the right direction.”

— Warriors GM Bob Myers, to The Associated Press, on the improved health of his coach, Steve Kerr, going into this season. Kerr missed Golden State’s first 43 games last season after suffering complications from offseason back surgeries.

“Being in the headlines in 2016 is…well, it’s interesting. To this day, I’ll tweet out something like, “So good to be back home.” And the first 10 replies are like, “Make sure you don’t punch anybody.” Dang. That’s fair, Twitter. Tough, but fair.”

— Blake Griffin, doing the mea culpa tour in The Players’ Tribune last week for the fight he got into with a now-former Clippers’ employee that broke his hand and cost him much of the second half of the season.

MORE MORNING TIP: NBA, players weighing options for athlete activism |Reflecting on career of Kevin Garnett

Longtime NBA reporter and columnist David Aldridge is an analyst for TNT. You can e-mail him here and follow him on Twitter.

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