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"Don't let this drive you crazy," Richard told Carolyn.
"What's it doing to you?" she asked.
"I'm fine," he said.
On July 16, Richard went on the disabled list, and the next day the team physician, Dr. Harold Brelsford, gave him a physical examination. He says he found that the circulation in Richard's pitching arm was excellent. He determined that by pressing down on Richard's fingernail beds, then relieving the pressure and watching how quickly they reddened again. Dr. Brelsford didn't X-ray Richard's arteries because, he explains, "You do it only if you have a pretty good reason." A few days later, Richard went home to Louisiana for a rest.
He and an old friend, former major-leaguer Ralph Garr, fished together. Garr is from Ruston, just four miles from Richard's childhood home in Vienna. "He was really tense, acting like he was really depressed and tired," Garr says. "I asked him about his arm. He said, 'Hey, man. I been pitching a lot. My arm's tired.' He didn't want to discuss it."
After returning to Houston, Richard checked into Methodist Hospital on July 23 for three days of testing. Arteriography, a process in which an opaque dye is injected into the bloodstream, revealed the occlusion of the distal subclavian and axillary arteries leading into his arm. It also showed the development of the collateral artery system.
So that was it. The discovery of the clot explained the mystery of the tired arm and reduced many of his critics to pained, embarrassed silence. McCollum and Brelsford agreed not to operate. The clot wasn't likely to move. And they feared that an operation might diminish Richard's pitching ability. They thought he might be able to continue pitching this year, though for shorter intervals, if the collateral system kept improving. It was decided that Richard could work out under close observation. Ewell was the observer on the morning Richard collapsed in the Dome.
Richard's ambulance arrived at the Methodist Hospital emergency room at 12:20 p.m. His condition was unstable, his heartbeat irregular. In intensive care his condition stabilized, but then it was discovered that he had no pulse in the right carotid artery leading to the brain. His nail beds were turning blue. He underwent emergency tests. One of them, an arteriogram, revealed something that both surprised and baffled McCollum. The clot had increased in size. Now it was cutting off the flow of blood to the proximal subclavian artery from which the collateral system had developed. This explained the blue fingernails. The clot also blocked off the innominate artery, which leads from the aorta, and above that the common carotid. It was this blockage that caused the stroke.
"We don't know what caused the blockage," McCollum says. "Even after all this time we still don't know. We really don't know what happened or why it happened. We've been over all the various possibilities."
Two of the three possibilities considered were rejected because tests suggested otherwise. The third possibility was that Richard suffered from a retrograde thrombosis, an extremely rare occurrence in which a clot moves counter to the flow of blood. "It doesn't make sense," McCollum says.