Bensalem coach Ron Morris (above, 2020) had a stroke during an outdoor team practice in late August. (Photo: Josh Verlin/CoBL)
Josh Verlin (@jmverlin)
The challenges for Ron Morris’ second offseason as Bensalem’s head coach seemed clear: build on the Owls’ first Suburban One-National title in 28 years, manage the spotlight that comes with an appearance in the District 1 6A semifinals, and continue to develop some talented underclassmen in the program.
That’s plenty for any District 1 head coach to have to worry about, even before the COVID-19 pandemic entered the picture.
One tiny hole only a few millimeters wide and an ill-placed group of cells was enough to change Morris’ offseason, not to mention his entire outlook on life.
“I want other people to know you have to pay attention to these signs. Your body sends you these signals and you really have to listen,” he said. “Life can change at any given moment.”
August 24, a Monday morning, saw a couple dozen players all hoping to make the Owls’ 2020-21 squad getting ready for an outdoor workout. Morris was going over the required COVID symptom checklist with several of his players when the trouble started.
One glance at the page, and Morris realized he had lost the ability to see the words and lines that he’d been reading off the page.
“All of a sudden, everything went blank,” he said. “And I was like ‘whoa, this isn’t good.’”
Though he drank some water, Morris got dizzy. Then he lost his peripheral vision.
“He rarely ever complains about anything,” assistant coach Mike Rongione said. “So when he had to sit down, we knew something was wrong.”
Morris, who’d spent the weekend coaching the Owls and his son’s AAU team, decided to go home for the day, chalking it up to fatigue and maybe some dehydration. But at home, the headaches only got worse.
“It felt like someone would have been hitting me in the head with a bat,” Morris said. “That’s never happened, but if someone was, that’s what it felt like. A severe pain in the front of my head.”
Somehow, Morris managed to fall asleep that night. The next morning, the headache was gone, but something still wasn’t right. After dropping his kids off at a morning hoops workout, he called his doctor, who advised him to go to the emergency room.
At Jefferson-Torresdale hospital, a CAT scan revealed a serious problem.
“I thought they were going to tell me I had a migraine,” Morris said. “I’d never had those. I thought it was a migraine.
“[Instead] they were like, ‘You had a stroke, you’re going to be here for a while.’”
Morris was stunned. Only 41 years old, he was in the best shape of his life. Bensalem’s boys basketball team had taken up a running program over the summer, sharing their results daily through an app and the team’s group chat. Their coach was routinely the top performer, running four miles every other day or so.
But the CAT scan had revealed a clear abnormality, and that meant a round of tests to try and determine what exactly was wrong.
Morris (above, 2020) had a small hole in his heart known as a patent foramen ovale that likely caused his stroke. (Photo: Josh Verlin/CoBL)
“Ultrasounds on my legs, looking for blood clots, ultrasound on my stomach and chest, looking for cancer; they did a spinal tap, looking for MS, [an] ultrasound on my heart,” Morris said. “They did a ‘TEE’ test [transesophageal echocardiography], which is where they go [down] your esophagus with a scope and look at your heart from the inside.”
While he was in the hospital, Morris said, he couldn't stop thinking of his wife, Marie, and their three children, Antonio (15), Noah (14) and Ella (8): “Because of COVID, I couldn’t see my kids. Laying there in the hospital bed, it’s like damn, am I ever going to see my kids again?”
It was the last test that revealed the primary issue: a small hole in his heart known as a patent foramen ovale, or PFO, which connects the left and right atria. During development in the womb, every fetus has this hole, but it typically closes at birth. One in every four people have a PFO when that hole fails to close, though most go their whole lives without knowing it.
PFOs can sometimes result in what’s called a ‘paradoxical embolism,’ when a small clot that forms travels up into the right atrium. In most cases, such a clot would typically get filtered out in the lungs. But in Morris’ case, his clot traveled through his PFO and into the left atrium, which pumps blood into the rest of the body — hence the paradox of a clot ending up where it shouldn’t. The clot made its way up into his brain, where it caused the stroke by temporarily cutting off the oxygen supply to a portion of his brain, causing his symptoms.
Morris spent four days in the hospital undergoing tests, his symptoms lingering a few days beyond that. Though it was difficult for him to watch television and read for another week or two, within a month he was symptom-free.
“He’s both lucky and unlucky,” said Dr. Paul Fiorilli, a cardiovascular specialist at the Penn Heart and Vascular Center and Assistant Professor of Clinical Medicine at Penn’s Perelman School of Medicine.
“He’s unlucky that he happened to have this paradoxical embolism, because the vast majority of people that have PFOs do not have paradoxical emboli events...but he’s lucky in the sense that he ended up having a relatively small event with not much in the way of residual deficits. He’s actually very fortunate on that side of things.”
How unlikely was Morris’ stroke? Even though 25% of people have a PFO, Fiorilli said, “There’s really not any evidence to say we should be routinely screening everybody for PFOs, because the vast majority of those patients have no issue related to the PFO at all.”
Even after the Jefferson doctors discovered the PFO, it still wasn’t instantly clear that’s what caused Morris’ issues. Morris was released with instructions to get a follow-up MRI three weeks later, to determine whether what they were seeing was the results of a stroke or the beginnings of a glioma, a form of brain cancer.
“People always ask me, ‘During those three weeks, were you nervous?’” Morris said. “And I’m like, ‘No, I wasn’t nervous at all.’ There was nothing to stress about, it was out of my hands. I just prayed about it, and what it was going to be was going to be.”
Morris (center) watches as his Bensalem squad takes on Pennridge in February 2020. (Photo: Josh Verlin/CoBL)
The MRI, and a subsequent second opinion at Penn’s neurology center, confirmed the stroke. While it’s impossible to say for sure that the PFO directly led to a paradoxical embolism which caused the stroke, Fiorilli did say that in the five-to-10 percent of his patients who had a stroke without another clear cause (also known as cryptogenic strokes), “We’ve found [that] many of those patients have PFOs.
“It’s important for younger folks to also be aware of stroke symptoms because this is something that does happen,” Fiorilli added. “The majority of patients that we close PFOs on are usually between 20 and 50 years old. Young, otherwise healthy people.”
Once Morris knew what his diagnosis was, it was time to tell his team. The Owls had generally been in the dark for the few weeks after Morris left practice, Rongione and the rest of the coaching staff diverting questions as best they could. Senior guard James Ashford IV was the first to find out, texting Morris directly after the absence stretched to a couple weeks; Morris told the rest of the team shortly thereafter.
“I was in disbelief,” Ashford IV said. “I was like, ‘Wow, this is crazy.’ He’s young, he’s such a good guy, he’s healthy, he always runs everyday. He was super-athletic and everything.”
Fiorllo recommended that Morris have surgery to repair the hole in his heart, after tests showed Morris was a strong candidate for the procedure. It’s an outpatient procedure known as ‘percutaneous closure,’ where surgeons use minimally invasive incisions in the groin to place a small mesh plug known as a PFO occluder. Morris’ treatment is something he wouldn’t have gotten even five years ago; the FDA only approved its use in similar cases in 2017, after large-scale studies of adults aged 18-60 proved it lowered the risk for future strokes.
Fiorilli performed the procedure on the Bensalem coach on Dec. 29. In between, Morris came down with a moderate case of COVID, the cherry on top of his medical frustrations.
“Having to sit still between the stroke and then with COVID, it was mentally challenging,” he said. “You just pray and rely on your resources, you rely on your support system to help you through. And it brings you out on the other side and you look at life a whole lot differently.”
Assistant coach Mike Rongione (above, in 2020) helped run the Owls' program in Morris' absence. (Photo: Josh Verlin/CoBL)
Though Morris took a few days after the procedure to recover, mostly from the effects of the anesthesia, he was able to get back to the team in time for Bensalem’s season opener Jan. 9 against Holy Ghost Prep. He’d been around for practices in September and October, before he got COVID, but wasn’t quite himself just yet, urged by the doctors to take it easy; the second time back, Morris was under no such restrictions.
“I can’t stress enough, when he came back, it was like nothing changed,” Rongione said. “The first drill, somebody might have been slacking, and he was right on them. It was right back to the same old Ron.”
”Since we’ve started, I’ve felt 100 percent,” Morris said. “I’ve felt ready to go.”
Through six games, the Owls are 2-4, though with a 2-1 record in SOL-Patriot Division play.
Having Morris — a Bensalem alum who spent 15 years as an Owls’ assistant before taking over the program last season — back on the sideline means quite a bit to the players, who know they’ve got a coach as invested as they are. Morris is also a business and technology teacher at the high school, and an advisor to several different clubs, including a mentorship program.
“Everybody loves him,” Ashford IV said. “He treats everybody equally, he motivates everybody. He’s a great coach. He’s like a father figure to us.”
Morris’ stroke journey isn’t completely over just yet. He’s still on several medications, including blood thinners; if follow-up appointments go well in the next few months, it’s possible he’ll be able to stop taking them. There’s a possibility he’ll stay on medication the rest of his life, but he’s more than willing to make that trade to avoid having another stroke.
Morris knows he was lucky. He wants to use his story as a learning lesson for others, especially those who might never think ‘stroke’ when things don’t feel right.
“Strokes happen to people of all ages,” he said. “I felt healthy, but if these signs are coming your way, you’ve really got to get checked out.”