As a young graduate assistant at Florida State, Terry Bowden remembers what defensive line/linebackers coach Chuck Amato used to tell players before the Seminoles' infamous mat drills.
"Just remember, gentlemen, the body is a wonderful machine. You will pass out before you die."
That hard-nosed mentality was shared by almost everybody on the team, and Bowden said Amato was no different than most other tough coaches who tried to instill that same quality in their players.
Now, nearly 30 years after he got his coaching start on his father Bobby's staff, Bowden cringes at what he didn't know.
Since then, his father has had a player die. In 2001, FSU linebacker Devaughn Darling collapsed in Tallahassee while participating in those offseason mat drills. Darling's death was later attributed to complications from sickle cell trait, a condition in which red blood cells collapse from their normal round shape and sickle during extreme duress. The warped blood cells become crescent-shaped, sticky and can block blood flow, sometimes causing major organ damage and even death.
Darling is one of nine college football players whose deaths have been tied to sickle cell trait since 2000. That almost all those deaths have come in the offseason is baffling to Terry Bowden and many others.
"We're not training our players to run marathons or enter mortal combat," said Bowden, now the coach at Division II North Alabama. "We're supposed to be getting them ready to play a football game."
Overwhelmingly in the past 11 years, more non-traumatic football deaths have occurred from complications from sickle cell trait than any other cause. It has accounted for nine of the 21 non-traumatic deaths in that time despite the trait existing in just 8 percent of African-Americans. It accounts for an even lesser extent in Hispanics, Caucasians and other ethnicities. And while the trait has been linked to deaths in other sports and at other levels, it has affected a much greater number of college football players.
Those deaths have many in football, athletic training and the medical community wondering what factors turn a generally benign trait into a dangerous, and sometimes fatal, medical condition.
And what role, if any, does football culture play in pushing players past their limits?
The nine deaths related to sickle cell trait make up approximately 42.9 percent of the 21 non-traumatic deaths in college football since 2000, a higher percentage than both heatstroke (28.6 percent) and cardiac issues (19 percent).
Of the 21 deaths, only two came during the football season. Aaron Richardson died in Sept. 2004 on the first day he walked on the team at Bowling Green. Dale Lloyd II died in Sept. 2006 running a conditioning drill the day after a 55-7 Rice loss at Florida State.
Of the other seven, two each happened in February and July and one each in March, May and August.
"None of them have been playing or practicing football. That's an alarming stat to me," said Chris Gillespie, the director of Athletic Training Education at Samford University. Gillespie was a long-time athletic trainer at the school and made changes to Samford's conditioning program after a player survived a sickling episode in the early 1990s.
"That tells me what we're doing in conditioning is what we need to look at," he said.
Most doctors and athletic trainers agree that certain factors that can make offseason conditioning drills dangerous for any player, can be especially risky for those with sickle cell trait.
These factors include:
-- First-day conditioning. Athletes might return from spring or summer break out of shape, making first-day tests more difficult. At least five of the nine deaths occurred on the first day of a training program.