University of North Carolina Athletics
THM: Pepper Writes Another Carolina Comeback Story
August 30, 2004 | General
Aug. 30, 2004
By Mick Mixon, Tar Heel Monthly Sweaty but not tired, 45-year-old Mike Pepper stepped to the foul line, spun the basketball in his hands, took a deep breath and trained his ice blue eyes on the front of the rim. If he made this free throw at 9:20 PM on Wednesday, December 17th, 2003 in McLean, Virginia, his team would keep the Langley High School gymnasium court for another game. If he missed, his squad would suffer the pickup ball indignity of sitting out. Still trim and muscular from a lifetime of athletics and good health habits, he went through the same pre-shot routine he used during his playing career at UNC. As a starting guard on Carolina's 1981 Final Four team, "Pep" was accustomed to attempting meaningful free throws but he had no way of knowing just how significant this one would become. He bent at the knees, straightened and confidently released the ball. At that instant, a medical emergency began on the right side of Mike's brain. A weak area in the wall of his middle cerebral artery, a defect he could have had since childhood, started to leak blood into his skull. This event, a ruptured sub-arachnoid aneurysm, kills 50 percent of its victims and leaves half of the survivors permanently disabled. "When the ball left my hand, I felt an uneasy feeling come over my head," Pepper said. "It was like a slow moving brain rush from the front of my head to the back, and it caused me to step back and then go sit down. It was just a very awkward feeling and it stayed with me. "I wasn't sure what was happening but I knew something wasn't right. Headaches came over my body. The pain was pretty intense. That first night was one long night. I remember sitting on the edge of my bed for hours. I'd never been sick a day in my life...I didn't even have a doctor! I just thought I could take some Advil and get some rest and I'd feel better in the morning." Pepper was going to do what he always did. Tough it out. Fight through it. Keep on going. But the headaches were unrelenting. Still, he went to work on Thursday and later that day he drove more than five hours to Fayetteville to visit his girlfriend, Dr. Lynette McDonald, a 1986 graduate of UNC's School of Dentistry. "He came down to go to some Christmas parties with me, one on Friday night and one on Saturday night," said Dr. McDonald. "I could tell he wasn't himself. By then the headaches had moved down his back, but he was out there dancing...I'll bet he danced with half the women there, but if you look at pictures from that weekend, his color wasn`t very good. He was kind of pasty. He drove back on Sunday directly to coach his son`s AAU basketball game and basically never made it home from there." Pepper had planned on going to his house in Vienna, Virginia right after his 10-year-old son, Dane, finished playing basketball, but at the game he took one of his fellow coaches, Joe Robinson, into his confidence. "When he showed up for the game that Sunday night he told me he had had a splitting headache for five days," Joe said. "A steady, pounding headache. I said, `Did you go to the doctor?' and he said, `No, I don't have one.' Well, I had a friend that, a year earlier, the same thing (a brain aneurysm) had happened to. I told Mike the story of the other guy. I didn't realize how bad I scared Mike. His girlfriend had been telling him to go see a doctor, his sister had been telling him, several women had told him, but he wasn't listening. I guess it took a man to tell him." "Joe is a great friend," said Mike. "He told me, `You have to get checked out,' but I didn't know where to go." From the AAU game, Pepper and his son drove to a nearby clinic, Inova Urgent Care in Vienna, where Mike explained some of his symptoms to the physician on duty. "The doctor told me, `Pick a hospital, Reston or Fairfax. You're going in,'" Mike said. "I drove myself to Reston Hospital. They were waiting for me there because the urgent care doctor had called ahead." A computerized topography, or "CAT scan," of Mike's brain at Reston Hospital revealed no abnormalities, a good sign but inconclusive. "Dad, I saw them take a picture of your brain," Dane remarked. Next, Reston doctors decided to perform a lumbar puncture, where a long needle is inserted between two vertebra to extract a sample of the cerebrospinal fluid. In a healthy person, it should be clear, like water. Mike's was crimson red. Now the doctors knew what they had suspected and feared all along. Pepper was bleeding from a ruptured artery in his brain. His life was in danger. Less than two minutes from the results of the lumbar puncture, an ambulance pulled up in front of Reston Hospital. Fairfax Hospital was better equipped to deal with Mike's case. Dane's biological mother, Lily, (she and Mike divorced eight years ago), was called to come pick up Dane. Then, alone with only his thoughts and a team of paramedics, Mike Pepper boarded the ambulance. "I was very nervous," Pepper said. "I had no friends or family members with me but I was able to convince a paramedic to make a few cell phone calls for me. He called my sister, Julie (Pepper has six sisters), and left a message that her brother was being taken to the hospital for treatment of a possible aneurysm. He called my friend, Jeff Roman, and left word with Jeff's wife." "We were just sitting down to a holiday dinner when the paramedic call came in," Jeff said. "I immediately called Fairfax Hospital but they couldn't disclose any more information. `Is there anybody with him?' I asked. `No,' they said. `Should there be?' I asked. `Yes,' they said. So I got in my car, went over there and spent three or four hours with him while he got tested. We had long conversations, obviously he was very upset about the whole thing. He knew it was life-threatening and it hit him about his kids and the potential impact of what he was facing." In addition to son Dane, Pepper also has a daughter, Sara (13). After the divorce, he became their primary caretaker. "Time is a great healer," Pepper said. "Their mother is still very involved in their lives." At Fairfax Hospital, an arteriogram was performed. Dye was injected through the neck into his circulatory system so that neurosurgeon Dr. James Melisi could get a good picture of the brain. Bingo. The arteriogram revealed the cause of the bleeding and Mike was immediately placed on the surgical schedule for the dangerous operation that was his only hope of survival. "The aneurysm was at the base of the brain," said Dr. Melisi, recently named one of the DC area's top neurosurgeons by the Washingtonian. "It was in a very difficult place to get to operatively. To repair it, we had to separate frontal lobe of brain from temporal lobes using microsurgical techniques. It was a technically challenging operation as the aneurysm could rupture further during surgery. If that happened, the results could be catastrophic." During the lengthy and delicate procedure, Dr. Melisi and his team placed a titanium clip over the weakened arterial wall. The operation was termed a success. But on day three of Mike's recovery, major complications occurred. "He was doing fine post-operatively," said Dr. Melisi. "But then some of the blood vessels in his brain started to spasm. This causes pressure to build up, kind of like a kink in a garden hose with the water turned on. We had to remove the bone flap to relieve the swelling of the brain and we left that off until his condition improved." "Half of his skull was in a refrigerator for a month," explained Dr. Mark Vacilitis, a primary care physician who has been instrumental in Pepper's treatment and recovery. "His brain was exposed. He could easily have died from the vasospastic swelling." Pepper nearly did. The swelling caused what is known as a mid-line brain shift, a condition associated with a high mortality rate. He spent one week in a coma. "His head was the size of a volleyball," said Joe Robinson. "It shocked me to see that. I didn't think he was gonna come back out of that." "I was by his bedside quite a bit," said Jeff Roman. "I took a lot of the calls from people checking on Mike. Coach Smith would call his room, Kay Thomas, Linda Woods, Phil Ford, Larry Brown, all the Detroit guys, and so many others. I'd always heard about how close knit that (Carolina) group was and it was neat to see it. "I'd talk to the nurse and ask how things were going and she'd say he hadn't moved at all. I just started talking to Mike, telling him about all the people who had called to check on him. When I told him, `Coach Smith called for you,' he started moving around a lot! The nurse said, `Whatever you just told him had a big impact!'" Michael Bradford Pepper camouflages his substantial athletic gifts with a warm, gracious, quiet demeanor, but beneath his self-deprecating exterior beats a champion's heart. Competitive, proud and in excellent condition prior to surgery, his mind and body fought tenaciously to get well. Miraculously, he won that fight. The brain swelling gradually subsided. The skull flap was replaced. His severely blurred vision slowly cleared. Today, Pepper is a member of a small, exclusive club: those who have recovered completely from a cerebral hemorrhage. "There is no doubt that his physical conditioning and his competitive spirit helped him get through this," said Dr. Vascilitis. "There is ample evidence to suggest that his fitness helped his chances," said Dr. Melisi. "His heart was just so strong," said Dr. McDonald. "If he had had any other underlying condition, high blood pressure, if he was overweight, anything...he would not have survived this." When was Pepper the most afraid? "There were two times, really. The first was the hospital ride (in the ambulance to Fairfax). I had..." At this point, the words stop, his chin wrinkles and his eyes fill with tears. He gazes off for a few moments to compose himself. "I'm sorry," he says. "It is still tough to talk about. The ambulance ride, I had no friends or family with me and I was pretty nervous because I knew it was serious. The other time was the morning of the first surgery. The doctors explained everything to me and I knew what was about to occur. My family was there, my kids, and they were noticeably concerned." A devoted parent and a successful commercial real estate broker, Pepper really didn't need to have his perspective on life refined by a near death experience. Nonetheless, the 30 days he spent flat on his back have caused him to view the world even more enthusiastically. "I'm incredibly thankful. I hug my kids every day," he said, his voice quivering with emotion. "I appreciate getting up in the morning, I don't take important things for granted, I reflect more every day. I also wonder why things turned out so well for me. I think about it, pray about it. It's one thing to recover, but another to have no real setbacks. Speech, memory, motor skills, not one of those (complications) happened to me. The good Lord just looked after me." "Mike is a good golfer," said Roman. "He could shoot in the low to mid 70's before the surgery. Now's he's almost back to that. We call him `Miracle Man.'" Pepper was able to make it back for the big Carolina reunion bash on February 20th, 2004, in Chapel Hill. "Woody made an effort," Pepper said. "He reached out to me and kept reminding me of the date and that it would mean a lot to see me there. Kay Thomas, too. She got Jeff (Roman) a ticket. I couldn't drive and Jeff was going to drive me. Then, Paul Lawing (a big UNC supporter) gets wind of the story and offers to send a jet plane to pick me up at Dulles. I had fresh wounds, my head was all wrapped up in bandages, I'm sure I stuck out like a sore thumb. But it was great to see all the guys from the different classes, and when Woody recognized me at the banquet that night, that was emotional for me." "We told him, `Get healthy and get here for the reunion,'" said Carolina head coach Roy Williams. "As a player, Mike always worked hard. He did the little things well. I always knew he'd be successful in whatever area he chose. He's as tough as can be." "I had incredible support" Pepper said. "My friends, co-workers, family, the whole UNC thing, the endless calls and cards, trips people made to see me. People I never met..." Again, Mike's voice must stop for a time out. The emotion of talking about this in such detail for the first time is too much. "In a way, the easy part was what I experienced. I'm sure this was much harder on my loved ones in the waiting room. I was really touched. It is something you have to experience yourself to understand, but it does make a difference. You feel it, the power of prayer. It absolutely impacted my recovery." Typical of a Carolina basketball player, isn't it? Undeniably central to this remarkable human story and medical miracle, he still wants to make sure he points, the Tar Heels' universal, silent sign of thanks, to the vast support network that gave him life's ultimate assist, their love. To subscribe to Tar Heel Monthly, click here.
