(Dr. Muntz is a team internist for the Houston Texans and serves on the board of the NFL Physicians Society.)
With nearly one million revelers joyously drinking in their team’s first championship, the Astros’ World Series victory parade had wended through the sun-baked streets of downtown Houston to City Hall, where the next phase of the celebration would take place. On stage, the exhilarated Astros were joined by local politicians and a number of luminaries at the start of the official ceremony honoring the team. It was then that Rich Dauer, the club’s first base coach, abruptly began to stagger, almost as if he was drunk. He stepped to the back of the stage with the other coaches as the players were being introduced to the crowd.
Something clearly was not right. Manager A.J. Hinch immediately noticed a difference in Dauer’s color and in his state of mind that was alarming. At that point, even Dauer knew there was a problem. “I don’t really feel too good,” he told the team’s assistant hitting coach Alonzo Powell. Then, suddenly, Dauer became less responsive. Bench coach Alex Cora was anxiously looking on and started shouting to Dauer: “Are you OK? ARE YOU OK?”
Very quickly, and almost entirely out of public view, a drama was unfolding that would determine whether the 65-year-old Dauer would live or die.
Jeremiah Randall, the Astros’ head athletic trainer, had no idea Dauer’s life was in danger when he saw the EMTs descend from the stage, carrying the coach on a stretcher. The stage was so crowded, Randall and his assistant athletic trainers, Scott Barringer and Daniel Roberts, were standing below, off to the side. The three quickly conferred, trying to figure out how to get Dauer through the crowd, to an ambulance. Their initial conclusion was the same as everyone else’s who had noticed Dauer’s sluggishness that day; he was dehydrated, exhausted from the Astros’ long playoff run and exuberant celebration downtown.
The trainers and EMTs found a golf cart and placed the stretcher with Dauer onto the back of the vehicle. Randall sat in the front and called the Astros’ head team physician, Dr. David Lintner. The two discussed whether Randall should take Dauer to a small, local emergency room or a larger facility. Lintner pushed for Houston Methodist, a hospital rated No. 1 in Texas and No. 19 nationally in the 2016-17 rankings by U.S. News and World Report, “just on the outside chance there was something bad going on.”
First, Randall had to locate an ambulance. The nearest one was three blocks away, no easy distance to navigate through jam-packed streets. “There were a million people downtown,” Randall says. “You couldn’t get anywhere. The roads were all blocked off. There was just nowhere to go.” Traffic remained a major problem even as the group reached the ambulance and got Dauer inside. Randall estimates the ambulance did not move for 30 minutes.
The driver made calls, trying to determine the fastest path to Houston Methodist. Randall studied traffic apps on his phone in between giving Dauer’s medical history to the EMTs and talking to Lintner and another team physician, Dr. James Muntz, who were helping prepare the hospital for Dauer’s arrival. The situation was growing more urgent. “If you’re dehydrated and they put an IV in, you respond to the painful stimuli of the needle,” Randall says. “He wasn’t responding.”
Dauer’s wife, Chris, did not attend the parade; she had grown ill, perhaps from food poisoning, and returned to the hotel where she and Rich were staying. Hinch’s wife, Erin, called Chris with the first warning, saying, “I don’t want to worry you, but Rich doesn’t look good.” Randall followed shortly thereafter and said, “We’re taking him to the emergency room.” Chris gathered herself and headed to Houston Methodist.
Trey Hillman, the Astros’ bench coach in 2015 and ‘16, was with his wife, Marie, preparing to watch the sunset from the back porch of their lake house in Burnet, Tex., when he got a text message from Astros hitting coach Dave Hudgens. “Pray for Richie,” Hudgens wrote. “He collapsed and was dehydrated at the parade.”
Hillman, a close friend of Dauer’s who is now the manager of SK Wyverns in South Korea, immediately called Randall, with whom he had worked in 2011 for the Los Angeles Dodgers; Hillman was the team’s bench coach and Randall its physical therapist.
Randall answered on the second ring. “Trey,” he told Hillman, “you need to get down here.”
Trey, accompanied by Marie, rushed out and made the 45-minute drive home to Liberty Hill, Tex., northwest of Austin. They showered and changed, then got back in the car and reached Houston Methodist in approximately three hours.
Powell, the Astros’ assistant hitting coach, also was far outside Houston when he received word that Dauer’s condition was serious. Powell, who was about to be named the San Francisco Giants’ hitting coach, had left the celebration early and started the 16-hour drive home to Peoria, Az., with his wife, Jana. He needed to fly to San Francisco for a potential news conference that would take place in three days. “I thought the Giants would understand if I was a little late—Richie is a little more important than a news conference,” says Alonzo, who wound up doing a conference call on the appointed day instead.
Jana had been a brain injury rehab nurse before becoming a school nurse about seven years ago, a change she had made to spend more time with Alonzo. She had sat on one side of Dauer during the parade, while Randall had sat on the other. When Jana saw the EMTs take Dauer away on the stretcher, she immediately thought to call Chris Dauer. But Jana’s phone battery had run out of juice after she used it to videotape the parade and celebration; she could not charge it until she and Alonzo got into their truck for the ride home.
As soon as the phone had power, Jana saw a text from Chris asking her to call. “Richie collapsed,” the text said. “I’m on my way to the hospital.” Jana called, told Chris she knew about Richie, and apologized for her inability to phone earlier. At the time, Chris, like most everyone else, thought Rich only was suffering from dehydration. Chris, as Jana remembers, did not seem the least bit concerned. She agreed to keep Jana updated, and about 90 minutes into the Powells’ drive, Jana’s phone rang again. The news was unsettling.
The Powells immediately turned around and headed back to Houston.
Hours earlier, on the fire truck, Jana had noticed Dauer was not himself. He was quiet, wearing sunglasses, holding up his phone as if videotaping the parade. But Jana noticed his phone wasn’t even on. “I could see the signs then, but just shrugged it off, thinking it was exhaustion,” she says.
Recalling the parade ride, Randall also asks himself, “How did I not know something was not right with him?” Randall says his conversations with Dauer on the fire truck were normal, but others later informed him of odd interactions they had with Dauer that day. Yet, even if Randall had been aware of those interactions, he is not sure he would have interpreted them as a sign of a medical issue. Dauer, as an infielder with the Baltimore Orioles from 1976 to ‘85, earned the nickname “Wacko” from Hall of Fame pitcher Jim Palmer. The Astros also knew his quirky, colorful side.
“He’s just kind of this off-the-wall character. It’s just him,” Randall says. “Sometimes you have a weird conversation and you don’t think anything of it. I think that’s what some people thought that day: ‘It’s Richie. It’s Wacko.’ After the fact, we were all like, ‘Dang, we should have seen this.’”
Once Dauer arrived at Houston Methodist, Dr. Muntz—the team physician who specializes in internal bleeding—sprang into action. Muntz did not attend the parade and had raced to Houston Methodist, a five-minute drive from his home, after learning of Dauer’s collapse. The moment Dauer arrived, Muntz sensed trouble. Dauer was wild-eyed. He had gone into respiratory arrest, requiring the insertion of a breathing tube. His body was in a posture that indicated severe brain damage. “He was unresponsive,” Muntz says, “just a disaster.”
Dauer underwent an immediate CAT scan, and the results showed what Muntz feared: “Blood everywhere” around his brain. Adding to the predicament: Due to a heart condition, Dauer was taking Xarelto, a blood thinner that is difficult to reverse. Undaunted, Muntz made a snap decision. “We have some fancy reversal agents, super-expensive,” Muntz says. “I said, ‘Just give them to him.’”
Muntz cut through any delays, at one point snapping at the staff, “No more questions! He goes to the operating room.”
Muntz also called two neurosurgeons and said, “If you can’t get here in five minutes, I’m calling someone else.” One already was at the hospital. The other, Dr. David Cech, arrived within four minutes, with Dauer’s surgery just getting underway. Cech had been across the street, catching up on paperwork in an office building connected to Houston Methodist by a sky bridge. “They called me and said, ‘Listen, we need you to come over here and operate on this guy,” Cech recalls. “I just zoomed across the street on the sky bridge.”
By the time he got there Dauer was in a coma, “almost brain dead,” said Cech.
Cech made a question-mark shaped incision on the side of Dauer’s head, removed a piece of bone, then removed all of the blood. The procedure, lasting about three hours, was especially painstaking due to the time it took for the reversal agents to stop Dauer’s bleeding. His brain had shifted about a centimeter from the right to the left, pushing against the brain stem. Cech and his team relieved the pressure on the stem by pushing the brain back toward the right side.
The Powells arrived at the hospital while Dauer was still in surgery. Jana Powell, drawing on her expertise with brain injuries, spoke with Chris but could provide only so much comfort. “I was trying to be there for Chris, but trying to be realistic—this was not good,” Jana recalls. “I was trying to prepare her for the worst. But she was in shock. She really wasn’t comprehending anything that night.”
After the surgery, Chris asked Jana to join her in speaking with Cech. The conversation, as Jana recalls, was chilling. “He was trying to explain to her that this was really bad, that if he made it through the night, he wouldn’t be the same—he said he’ll never be the same,” Jana says. “He said he wouldn’t know the extent of the brain damage until Richie woke up. All Chris said to the doctor was, ‘Is he going to be OK? All I want to know is if he is going to be OK.’”
Says Chris: “I was kind of numb. I prayed. I said, ‘God, please don’t take my husband now.’ I went into the bathroom stall and prayed. But I felt I needed to be really strong through the whole thing. There was a part of me that thought, Maybe he’s not going to make it. But another part thought, No, he’s going to make it.”
The chances of significant brain damage were indeed high—“most of these people end up vegetative, in a nursing home,” Cech says. But Cech also recalls telling Chris he was cautiously optimistic because the surgery had gone well. Dauer underwent a second CAT scan about an hour after the surgery to make sure the blood was gone and his brain was back in the proper position. The scan looked good. The pressure on Dauer’s brain stem had eased.
Cech returned to the waiting room and found two security guards outside, allowing privacy for the growing contingent of Astros personnel—Hinch, his coaches and team staff members, along with some of their wives and Hinch’s daughters, Haley and Kaitlin. The bond between Hinch and Dauer dated to 2001 when Hinch was a Kansas City Royals catcher and Dauer was the team’s third base coach. Hinch, as the San Diego Padres’ assistant GM, had helped hire Dauer as the team’s Double A manager in 2013, then added him to his coaching staff after becoming Astros manager entering ‘15. Game 7 of the World Series was perhaps the culmination of their friendship. Two days later, Hinch found himself at Houston Methodist, not sure Dauer would survive. “I just couldn’t believe what was happening,” Hinch says. “I couldn’t comprehend it.”
Randall, who was part of the contingent in the waiting room, had Dauer’s belongings, including his cell phone. Few outside of the Astros’ family knew Dauer’s life was in jeopardy, but everyone connected to him knew the Astros had just won the Series. In those terrifying moments when Dauer laid unconscious, about to undergo surgery, Randall gained a greater appreciation of the longtime coach’s popularity within the baseball world. “His phone just lit up,” Randall recalls, “all these people reaching out to Richie to say congrats.”
The doctors advised Chris to have family members get to the hospital as quickly as possible. One of the Dauers’ daughters, Casey, arrived in Houston from Atlanta before Rich was out of surgery. Two others, Kelsey and Katie, arrived the next morning from Cincinnati. By that time, their father already was defying the odds. Dauer was responsive, stunning Chris, Casey and Trey and Marie Hillman, all of whom were by his side.
In a group text shared among baseball people, Randall called Dauer’s progress, “nothing short of a miracle.” Dauer followed nurses’ commands, moving his left arm and leg. His right side was more problematic initially, but he gave a nurse a thumbs-up with his left hand as she explained where he was, what had happened.
The doctors gave Dauer a “sedation vacation,” allowing his system to slowly awaken so they could check his responsiveness, get his limbs moving. They also removed Dauer’s breathing tube three days following surgery after initially saying he might need it for a week or more. “The magnitude of what he had wrong was intimidating, astonishing,” says Lintner, the Astros’ head physician. “The pace of his recovery was just as astonishing.”
During her time as a brain injury rehab nurse, Jana Powell had seen hundreds of similar cases, but never a recovery quite like Dauer’s. She remembers thinking, There is no way this is possible. Yes, people recover, but they have developmental issues, mental issues.
Dauer, though, was completely alert. “I never repeated my name and the date so many times in my life,” he says. “Every question was, ‘What’s your name? Where are you? Who is the president?’ I knew all that. There was never any time when I was out of it, never any time I couldn’t function. If it was up to me, I would have left (the hospital) as soon as I opened my eyes.”
He wasn’t kidding. Lintner recalls Dauer, with his wife and daughters present, “fussing about” two days after surgery, saying he needed to get up and walk around, go home.
“Do I hear complaining? Are you really giving these people a hard time?” Lintner asked.
“What? I feel great,” Dauer replied.
Lintner then asked Dauer if he knew how close he had come to dying.
“He really didn’t,” Lintner says. “He has always been healthy and active. The whole concept of a brush with death was completely foreign to him. I got one of his daughters to take a picture of the back of his head where he had the procedure. There were still monitors going under his scalp, into his skull. He saw those and quieted down a bit.”
Says Hillman, “Even in talking to Richie now, I know he knows what happened. But I’m not sure he can fully grasp the severity of it. We were seeing things he wasn’t seeing. In his mind it was, ‘Hey, I’m OK, get this tube out of my throat. I’ll just be fine. I need to tell you guys what is going on here.’ It was very typical Richie.”
Days after surgery Dauer was out of bed and enjoying visits from Astros players George Springer, Jose Altuve, Carlos Correa and many others. At one point, he texted friends a video of himself walking around the hospital, saying, “I’m already up to 50 percent of my jogging to first-base speed.” Eight days after surgery, in another text, he said, “I get my last drain out of my head today. Who would have thought my brain needed drains?”
Fluid in Dauer’s lungs lengthened his stay, but he was released on Nov. 15, exactly two weeks after the Astros completed their Series triumph and 12 days after he entered the hospital. Jake Kucherka, one of the team’s clubhouse attendants, helped Dauer get to his offseason home in Atlanta, sharing driving responsibilities with Chris on the two-day ride. Once home, Dauer visited a neurosurgeon, Dr. Daniel Barrow, who told him, “I’m amazed I’m even talking to you.” Barrow told Dauer he could resume his normal workouts. Dauer will continue to receive periodic checkups, but says his brain is “perfectly fine.”
His sense of humor certainly is intact. Lintner chuckles about a video Dauer sent of himself doing housework with the caption, “Get me out of here!” Muntz cherishes a text Dauer sent him on Dec. 5, barely more than a month after undergoing surgery: “Hey Dr. Muntz, we’re doing well. My workouts are up to 50 minutes on elliptical and treadmill. I lifted light weights today and just left Taco Bell with a seven-layer burrito! Life is good!” To which Muntz replied, jokingly, “If the subdural didn’t kill you, the burrito will.”
Dauer even offers a punchline in his story about asking Chris what God had in store for him. “I figured it out,” he says. “Fortunately for the fans of New York, I didn’t get the Yankees’ managing job.” But he and Chris, both Christian believers, talk about the role of divine intervention in his recovery. Hillman echoes their thoughts, attributing Dauer’s healing to “the miracle of medicine and the miracle of God’s grace.”
Chris refers to Deuteronomy 31:8: “The Lord himself goes before you and will be with you; he will never leave nor forsake you.” She mentions the good fortune of Randall standing nearby at City Hall to help Rich immediately, Muntz making the necessary snap decisions at Houston Methodist, Cech doing paperwork across the street on a day he otherwise might not have been at the hospital, Hillman making the three-hour drive to Houston and helping in any way he could. “I think you could see God before us,” Chris says.
Dauer, who had already decided to retire, recalls nothing about what happened on stage; his last memory is of riding on a fire truck in the parade. Hinch later informed him of an exchange they had just before Dauer began deteriorating. “A.J. said he turned to me and said, ‘You don’t look good. Are you OK?’” Dauer says. “Apparently, I said I was fine, like all old-school baseball players do.”
Clearly, he was not fine. The night before, he had slipped on a wet floor and hit the side of his head. He never thought he was seriously injured, never had a headache, never considered missing the parade. But Dauer had suffered an acute subdural hematoma, a collection of blood outside the brain. Before undergoing surgery, his chances of survival—according to what doctors told Chris and friends gathered at Houston Methodist—were 3 percent. And even if he survived, his chances of avoiding significant brain damage were slim.
Dauer, grateful to all who helped him, frequently calls Randall for the names of people he does not recall meeting but wants to thank. It bothers him that his trauma perhaps diminished the Astros’ joy as the franchise celebrated its first World Series title. But Alonzo Powell, the team’s former assistant hitting coach, says the way the Astros responded to Dauer typified their season. The team started out close, grew closer after Hurricane Harvey ravaged Houston and rallied one last time around Dauer.
Muntz calls Dauer’s case the most fascinating he has seen in his 30 years in sports; every second counted, every step of the way. Randall credits the ambulance driver for skillfully shaving minutes off the trip to Houston Methodist. Rich, like Chris, marvels at how “all the miracles lined up” at the hospital. Lintner says, “If any of the dominos had fallen differently, we’d be having a very different conversation.”
Not to worry. One last time, in the year of the Astros, the dominos fell just right.
(Top photo illustration: Cal Sport Media via AP Images; Tim Warner/Getty Images)