When Brendan Flaherty was diagnosed with squamous cell carcinoma of the right tonsil on April 20, 2018, he and his family at least had an idea of what to expect in the weeks and months ahead. The cancer hadn't spread much, and thus the survival rate was high, the outlook positive.
By late June, however, Flaherty's condition had deteriorated. Twice he ended up in the hospital with neutropenic fever - the Mayo Clinic describes neutropenia as occurring "when you have too few neutrophils, a type of white blood cell" crucial to fighting certain infections. On June 27, he again was hospitalized for severe confusion, seizures and high fever, according to family notes.
Two days later, with his immune system already compromised by six rounds of chemotherapy and 29 rounds of radiation, tests revealed that a viral infection known as herpes simplex virus had advanced to Flaherty's brain.
What followed was an agonizing and maddeningly uncertain ordeal that included Flaherty being read his last rites in early August, a nightmare that has robbed him of his short-term memory, his livelihood and his position as Duluth Marshall boys hockey coach.
"It's almost to the point where it's unbelievable that all of this could happen," said Kasey Yoder, Flaherty's stepson. "To know who he was and to watch him go through what he's gone through, and to see things that have been taken away, it's been hard."
Flaherty, 55, and a Duluth Cathedral alumnus who revived what had been a listless program at his alma mater, went from confidently battling cancer to fighting an infection that rarely reaches the brain.
Over lunch recently, Flaherty and his family discussed the events of the past year that led him to officially submit his resignation letter as coach of the Hilltoppers on April 14. At first glance, he resembled the guy who turned Marshall into a perennial state-tournament contender, if not a bit thinner. But his short-term memory isn't what it once was.
While he can recall, for example, leading Duluth Central to state in 1996, a shocking playoff run that featured an upset of defending Class A champ International Falls, current events are foggy. Conversations are easily forgotten.
Flaherty has started to accept that, which, in itself, is a sign of the progress he's made in his rehabilitation, the pace of which offers cautious optimism for a full - or close to full - recovery.
"He's worked so hard and he's come so far," said his wife, Carrie, admitting there are still "so many unknowns."
Flaherty likes to say he's getting good coaching at home.
"These guys are helping me get healthy," he said while picking at a salmon sandwich, his gray hair protruding from beneath a ballcap.
Bracing for cancer
It started with a sore throat and flu-like symptoms in December 2017. Flaherty's Hilltoppers were in the middle of a fast start. Led by George Grannis and Levi Stauber, they were 8-3-1 as the calendar flipped to 2018. Their coach, meanwhile, couldn't seem to shake whatever was slowing him down.
The sore throat turned into a debilitating earache. Flaherty also was experiencing headaches and sleeping more than usual. Finally, he visited an ear, nose and throat specialist at Essentia Health-St. Mary's Medical Center.
"They knew right away it was cancer," said Flaherty's daughter, Morgan.
The ear pain stemmed from a golf ball-sized tumor resting on a nerve.
At the time, Flaherty was asked by a reporter about doing a story. Paraphrasing, he said, "Let's wait until hockey season rolls around. Because I'm going to beat it."
"He tried to tackle it just like any other challenge he's faced in his life," Morgan said. "He was very ready to take it on."
Buoyed by support from family, friends and the hockey community - which is "unlike any other," Morgan said - Flaherty started his treatment on May 7, 2018.
The brain infection changed everything.
Bad to worse
From a timeline provided by the family:
Flaherty went into a medically induced coma on June 30. A collapsed lung on the Fourth of July resulted in a tracheostomy. He came out of the coma and was able to leave the intensive care unit a week later, but the fevers soon returned and Flaherty again became nonverbal. He was transferred on July 23 to the University of Minnesota Medical Center, where "they found worsening lesions in the brain."
Flaherty had a grand mal seizure on Aug. 1 and, shortly after vomiting and aspirating on Aug. 6, he went into respiratory failure. Severely septic and bleeding internally, his levels dropped so precipitously that Flaherty needed six units of blood. It was then that his family was told Flaherty may not make it through the night if the bleeding didn't stop. He was read his last rites.
Another medically induced coma preceded gradual improvements. Flaherty was moved to Miller Dwan in Duluth on Aug. 21. Another grand mal seizure on Aug. 24 sent Flaherty back to the ICU, before he stabilized.
"While working constantly with speech and occupational therapists, it became clear that Brendan had severe issues with memory and cognition," the family wrote.
Flaherty went home on Sept. 16 and started outpatient rehab.
Through it all, few people knew the gravity of Flaherty's predicament. Those close to him obviously did, but the situation was so fluid that it was all but impossible to curb misinformation.
In September, Bill Owens was named interim coach at Marshall. Many still assumed that Flaherty remained sidelined simply because of the cancer. If that was it, Carrie said, he'd have been on the Hilltoppers' bench when the season started in November, the month he was declared cancer-free.
That's where Flaherty always has wanted to be. He loves coaching hockey, which he did at Marshall for 22 years following a stint at Central, where he guided the Trojans to their first state tournament since 1954.
"Coaching meant so much to me," said Flaherty, who also has had to deal with the March death of his brother, Black Woods Group founder Bryan Flaherty. "I just felt it was something in my life I did really, really well."
Few of his former players would disagree.
'He cares very deeply'
When Flaherty took over the Hilltoppers, they were an afterthought. He changed that almost immediately, leading Marshall to the state tournament in 2001, a feat he'd replicate six more times. There were three consecutive Class A runner-up finishes from 2006-08.
"It was never about him. It was always about the players," said Willie Paul, who played goalie for the Hilltoppers from 2006-09. "But he deserves so many kudos."
Meticulously organized, Flaherty always had a plan and every practice - every drill - had a purpose. His attention to even the smallest details extended from the rink to travel plans and meals. Flaherty poured himself into his program and expected the same from players and assistant coaches.
He rewarded them with his faith. Flaherty encouraged his players' creativity; he didn't stymie it. That contributed to their development, Paul said. The coach had his systems, of course, but micromanaging wasn't his style.
Except for music selection. That was Flaherty's domain.
"He crushed '80s tunes in the locker room," said former Marshall defenseman Lane Krenzen, a 2016 graduate who has committed to Denver of the NCHC.
Krenzen alluded to a Flaherty staple - that perfectly kept mane of hair that fell to his shoulders, every strand precisely where it was supposed to be.
Flaherty took immense pride in being a coach, just as he did in his role as executive director at Mars Lakeview Arena, a venue he helped turn into one of the region's best. And he was as competitive as they come. But he also recognized the bigger picture. Give him an honest effort and he could live with the outcome, good or bad.
He liked "using hockey to help develop my players into solid, responsible young men," Flaherty wrote in his resignation letter.
"He taught us about life, he taught us about friendship, he taught us how to be better guys," said Paul, whose three older brothers all played for Flaherty at Marshall. "I appreciate that more and more as I get a little bit older, about the life lessons that I learned from him."
Paul said Flaherty treated every player the same. It didn't matter if it was a superstar like Jack Connolly or Judd Peterson, a fifth defenseman or a backup goalie.
"He expected a lot out of you, but he was certainly fair all the time," Paul said. "He could get stern, he could get worked up a little bit, but at the end of the day he always put his arm around you and had your best interests at heart, whether you were great at hockey or not."
Consequently, Paul added, "Everyone that's been lucky enough to come through that locker room would have run through a brick wall for that guy, and still would."
Peterson, a 2012 graduate, said he neglected his schoolwork when he first arrived at Marshall from Duluth Denfeld. Flaherty wouldn't let that fly and told Peterson if he wanted to play the sport at the NCAA Division I level he'd have to get serious about studying.
"He's the one who kind of got the ball rolling and painted the picture of what I needed to do if I was going to get where I wanted to go," Peterson said. "He's probably had the biggest influence on my life in terms of hockey and turning my academics around."
Flaherty's approach to coaching went beyond wins and losses. It was always about the people. When Paul graduated from Marshall, Flaherty was at the ceremony and the grad party. When Paul got married, Flaherty was there. When Paul was in college at St. John's, or starting a new job, Flaherty would call, just to check in and see how things were going.
Likewise, Peterson went on to flourish at St. Cloud State, and numerous times Flaherty was in the crowd at the Herb Brooks National Hockey Center.
Flaherty's relationships with his players didn't end when their prep careers did.
"He cares very deeply," Paul said. "I hope he knows how much of an impact he made on so many of our lives."
"He was very instrumental in developing me as a person," Krenzen said. "He was inspirational to a lot of people."
When Peterson's ECHL team, the Cincinnati Cyclones, hosted a cancer-awareness night this past season, players were able to put any name they wanted on the backs of their jerseys, someone who'd been impacted by the disease.
The back of Peterson's jersey read "Brendan Flaherty."
"He's the one that made me into the player I am today," Peterson said.
Encouraged by improvements
From where Flaherty was to where he is now, talking and walking and regaining his strength, lifts the family's spirit. That familiar stubbornness is coming back, too.
The old Brendan Flaherty is there, revealed incrementally, layer by layer, small victory by small victory. He walks up to four miles a day. He talks clearly and deliberately, just like he used to after a key Marshall win or a tough loss - though he is apt to unwittingly repeat himself. He keeps a journal, which functions as his short-term memory and jogs his brain.
Because of the memory loss, it's recommended that Flaherty not be left alone.
"It's been a learning experience for all of us," Morgan said.
Krenzen saw Flaherty around Christmastime and had lunch with him a few weeks ago. He said the improvement between those two visits was "dramatic."
"Looking back on the progress he's made, even the last two months, just the change in him and seeing his personality come back through, and little things about him that have come back, is super encouraging," Yoder said. "Our whole family still believes he's going to make a full recovery and that he'll get that short-term memory back and be able to decide what he wants to do with the rest of his life."
Added Morgan: "It's pretty incredible to watch and to see how much progress he's made. It makes me very hopeful for his future."
As he continues to rehab, it's important for Flaherty to get out and re-engage. And remain patient. He's only about six months into recovering from a brain injury. But his family is optimistic he's headed in the right direction.
"He's absolutely a fighter," Yoder said. "It's why he continues to get better. If anybody can come back from this, it's him."