KNOXVILLE, Tenn. - The first thing you notice is how still she is.
Pat Summitt doesn't run down in front of the scorer's table anymore, screaming at officials and manically gesturing at her players to get back on defense.
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Occasionally, Summitt will bark out an order the way she used to, but for the most part, she stands almost frozen at the end of the bench, watching the action unfold in front of her.
"She's not as animated. She's more of an observer now," said longtime Tennessee assistant coach Mickie DeMoss. "But that's OK. She's still the same Pat. She still has more courage than anyone I know. The disease hasn't taken that away."
The disease is early-onset dementia, Alzheimer's type. In August, Summitt, 59, stunned the sports world when she announced that she had been diagnosed with Alzheimer's and, with the blessing of the school's administration, planned to keep coaching.
Summitt, who has won an Olympic gold medal, eight NCAA championships and 1,075 games entering Sunday's game against DePaul, is the winningest coach in college basketball history. Now she is in the middle of a battle she is destined to lose. But she is fighting to redefine the perception of a debilitating and stigmatizing disease.
It is the sixth-leading cause of death in the United States, and an estimated 5.4 million Americans, including more than 55,000 people on Long Island, have been diagnosed with the disease, according to the Chicago-based Alzheimer's Association.
When she first went public with her diagnosis, Summitt said she had a grandmother who suffered from "severe dementia."
For many of those with Alzheimer's and their caregivers, Summitt's announcement was a seminal moment, much as Magic Johnson's announcement that he was HIV-positive was for AIDS patients in 1991.
Angela Geiger, the chief strategy officer for the Alzheimer's Association, said she and her staff received more phone calls, emails and texts when Summitt revealed her diagnosis than they had for any other news story relating to the disease.
"Her impact is huge," Geiger said. "She's a very public figure that many people admire. The way she announced it was very honest and empowering for other people. It helped destigmafy it. It's only recently that we've had people who are in the early process of this disease come out and talk about it."
Summitt's staff and her close friends began noticing things last season. Normally quick-witted and disciplined, Summitt suddenly was late for practices or would hesitate when calling a play or simply would not get out of bed in the morning.
"She lost her keys three times in a day instead of once," said her 21-year-old son, Tyler, a walk-on on the Tennessee men's basketball team. "She was the one who was always five steps ahead of us. Suddenly she was right there next to us and we knew something was amiss."
Summitt had suffered from rheumatoid arthritis for years, and she thought there might be a problem with her medication. A battery of tests at the Mayo Clinic in the spring, however, revealed she was in the early stages of the irreversible disease.
It was shocking news for a woman who had never met an opponent she didn't think she could beat. In 37 seasons, Summitt had built the Tennessee women's program from one in which she drove the team van and did its laundry to a multimillion-dollar enterprise that drew an average of 12,999 fans per game last season.
She also has managed to have a family, going into labor with Tyler on a 1990 recruiting trip and bringing him to nearly every practice and game after that.
Tyler, who is very close to his divorced mother, is now the point man on her support team. Initially, he was one of the few people who knew of her diagnosis as she went through several months of denial.
"Of course we asked, 'Why is this happening to us?' " he said. "It was hard to even think about. Then we talked about it and decided there had to be a higher purpose. My mom has always been about helping people. God is giving her something to do on a higher platform than just the world of basketball."
Staying on the job
Summitt knew she wanted to keep coaching as long as she could. What she didn't know was how the university, the fans, her players and her coaching staff were going to react to this decision. The Summitts talked to a lawyer and knew that the university had the legal right to immediately remove her from her position. Instead, when they broke the news to chancellor Jimmy Cheek and athletic director Joan Cronan, the two began tearing up and pledged their full support.
"This is uncharted waters for all of us," Cronan said. "But if you're going to be in uncharted waters, wouldn't you want someone like Pat to be the captain of the ship?"
The captain of the ship has had to learn to delegate, which is exactly why the ship is sailing as smoothly as it is heading into Madison Square Garden, where the No. 9 Lady Vols will play No. 20 DePaul in the Maggie Dixon Classic on Sunday.
Summitt's assistants do the heavy lifting now. Associate head coach Holly Warlick runs the huddle and conducts the postgame news conferences. DeMoss helps Summitt with the offense. Dean Lockwood, another longtime assistant, is in charge of the defense along with Warlick.
Summitt is never alone. Her staff is with her during the day. And Tyler, who has an apartment on campus, now spends most of his nights in the family's sprawling riverfront home in Knoxville. He helps her stay sharp by downloading new puzzles and games to her iPad every few days.
Summitt's access to the media is limited. With DeMoss' help, she still does her postgame radio show and issues a written statement after each game. She no longer does one-on-one interviews.
"This program will always be Pat Summitt's basketball program," Warlick said. "I'm just the messenger for her right now. Pat is still coaching games, she's still at practice and she's still very involved in recruiting. We've just tried to lighten the load so she doesn't have to come in the office every day. There's going to be bad days."
After getting over the initial shock of hearing the diagnosis, her players say not much has changed on the team.
"We were worried about the first practice, and we weren't sure what to expect," senior Vicky Baugh said. "But then she started yelling at us like she always does. It kind of [stunk], but there was also a sigh of relief that she was still Pat, she's still here and she's still our coach."
She's also still the coach to the thousands of die-hard Lady Volunteer fans who scream when she is introduced at the start of a game as if she were some kind of visiting rock star.
More than 35,000 of them have bought bright orange "We Back Pat" T-shirts, the funds of which will go to the newly launched Pat Summitt Foundation. Summitt started the foundation shortly after going public with the goal of raising awareness, providing advocacy and helping fund research for Alzheimer's.
The big question that remains in Knoxville is how much longer Summitt can continue doing all this. DeMoss, who joined Summitt's staff in 1985, believes her friend will know when it's time to go. The Tennessee administration seems to be taking a wait-and-see approach. "Nobody has a crystal ball," Cronan said. "We're just going to take one day at a time and make the right decision that day."
Perhaps the most important decision already has been made. By deciding to go public with her situation, Summitt has extended her legacy beyond the basketball court. She's made it easier to talk about something no one was talking about. Said DeMoss: "I think something great is going to come out of this. It's going to help millions of people."