Two years ago, Charlotte Hornets coach Steve Clifford turned to the team's medical staff, searching for something to dull his periodic headaches. They gave him medication to manage the pain, and Clifford marched the franchise into the 2016 playoffs. Time passed, but the headaches only worsened. Doctors ran him through a battery of exams during the 2017 All-Star break, and Clifford kept going.
That's all he knew, all he has ever done. That's how a kid who grew up in the far reaches of Maine, played Division III ball and started as a high school coach gets to become a respected NBA coach -- outworking everyone, outsizing the opportunities of his lifetime.
Eventually this season, Clifford was struggling to sleep at all. The pain had become prodigious. All the angst over the winning and losing, all the hours watching video, all those 3 a.m. hotel arrivals off back-to-back games, and finally, Clifford sat inside his practice-facility office on an early December game-day morning and the truth washed over him: I can't live this way anymore.
Four years ago, in November 2013, Clifford had two stents inserted into his heart and coached three nights later against the Atlanta Hawks. After that, there was a road game in Boston. Charlotte's team physician, Joseph Garcia, suggested that Clifford sit out the charter flight to New England.
"But there was no way I wasn't going on that trip," Clifford told ESPN by phone on Friday morning. "But this issue now, the headaches, was not even close to the heart. That week before I stepped away, and that morning in the office, it scared me. It was much more significant than the heart was, and I've never had anything physically that concerned me as much as this did.
"The doctors, all of us, agreed that there was no way I was in a place where I could coach. Whatever I needed to do, I needed to feel better."
Clifford is 56 years old, in his fifth season as Charlotte's head coach, and he had to come to understand what his body had finally told him: No more. Clifford wasn't the 20-something driving back to New Hampshire all night from a recruiting trip to Jersey, or the 30-something Division II college head coach in New York, or the 40-something assistant on Jeff and Stan Van Gundy's staffs in New York and Orlando.
How Clifford had always lived and grinded on the job -- a bachelor with no kids living out of a Spartan condo near the office -- offered him an around-the-clock dedication to his craft. In many ways, though, Clifford had tilted the imbalances too far. He had to change -- or risk losing everything.
"For the most part, the diagnosis was sleep deprivation," Clifford told ESPN. "The headaches and the cause of the headaches were a lack of regular sleep and the stress that goes along with coaching. There were two ways to treat it: stronger medication or stepping away from coaching, stopping the travel, getting regular sleep, diet and exercise.
"But getting on medication would only be a Band-Aid. It could get me through another day, a week, a month, but here was my decision: long-term health versus coaching right now. The doctor told me, 'You may get through this season, but you're going to have migraines soon, and that's going to become a much bigger problem for you.'"
After 35 years of coaching, including 17 in the NBA, Clifford stepped away on Dec. 4. His top assistant, Stephen Silas, moved into the interim job, and Clifford huddled with Garcia and Charlotte neurologist Ki Jung on how to get well -- and stay well. The headaches lingered for weeks, but he found ways to sleep through the night, and do something else he had never taken time to do: nap in the daytime.
His parents and brother visited from New England, his sister from Texas, his agent Spencer Breecker from California. They'd sit and talk and visit in ways that he never had during a basketball season. "Everyone had plenty of advice for me, especially my mom and sister," Clifford said.
For the first two weeks, the headaches forced him to doubt his ability to return to the Hornets this season. In his mind that barely mattered. "I could not live this way," Clifford told ESPN. "Other than watching our games, I didn't think about basketball at all."
As the doctors targeted sleep as the primary issue, Clifford underwent tests upon tests to rule out something more complex. As time passed, as seven hours of sleep each night became the norm, the headaches subsided.
He visited Garcia and Jung on Tuesday in Charlotte, and they could see a stark difference in him: how he looked, how he felt and what they believed he could handle. They gave him clearance to return to coaching, and a meeting was set with owner Michael Jordan and a couple members of senior leadership on Thursday evening. Ownership had been supportive of Clifford taking the time away, allowing him to put his health first, and now, understandably, Jordan wanted to know: How can we be confident you won't have to step away again?
Clifford understood the question because he asked it of the doctors himself.
"I never, ever want to go through that again, feel that way again, and I don't believe I'll ever have to," Clifford told ESPN. "What doctors have done for me is not only given me a plan to help me feel better physically, but they've educated me on how headaches work. In my case, it's not just how I did the coaching thing, it's how I lived.
"I have to sleep more, and I have to train my body to sleep more. As the doctor told me, 56 is a little different than 50. The things I did when I was younger, well, the body is telling me I can't do that anymore."
Clifford was on the phone Friday morning, about to drive downtown to the office and see his players and coaches, the trainers and PR staff. He'll run a practice on Tuesday, coach against the Washington Wizards on Wednesday, and he'll try to get past all these injuries and get Charlotte to the Eastern Conference playoffs for the third time in five seasons on the job. The Hornets have a better schedule coming and their coach back to take them through it.
"As much as anything, I missed the daily interaction with everyone there," Clifford said. "I've coached most of these guys for a long time. The base is already in place, and we will just need to get the details into the right place for the next game. I don't need to reinvent anything or give a big motivational speech. I just want to get back to work, get back to our team.
"I'm better now, and I'm going to be better in the long run. And I've missed it."