Jackson Jambalaya

Coach O, special assistant for recruiting and defense for LSU Football and former national champion head coach, had been managing a few health challenges heading into preseason. Decades of standing on the sidelines had taken their toll, and he developed chronic venous insufficiency in his legs, a condition in which the veins struggle to return blood to the heart.

Complicating things, he had developed cellulitis, a bacterial skin infection, on his leg. Dr. Michael “Trey” Conners III, a vascular surgeon at Our Lady of the Lake, had treated Coach O’s leg before, but this time the infection was spreading fast.

Then, during a Friday of preseason practice, something shifted. He started limping, and his leg began to swell.

“I just didn’t feel well,” Coach O says.

It was more than tired. It was the kind of unwell that’s hard to put into words. His fellow coaches noticed before he admitted it. They told LSU Head Coach Lane Kiffin that Coach O wasn’t himself, and Kiffin pulled him aside.

“Why don’t you go home?” Kiffin told Coach O. “I’ll send someone with you.”

The Friend Who Wouldn’t Leave

That someone was Dwike Wilson, LSU football’s senior executive director of recruiting and personnel and a newcomer to the program. Coach O told him he’d be fine and urged him to head home. He refused.

He checked on Coach O every hour. Every hour, Coach O got worse. Around midnight, Dwike found Coach on the floor, bleeding and barely able to respond.

The drive to Our Lady of the Lake felt endless. Coach O felt a crushing pinch in his back and thought he was having a heart attack.

“I felt like I was fighting for my life,” he says.

When they arrived, the emergency team was ready for him.

He remembers the stretcher. He remembers screaming. He remembers someone telling him they would place a line in a vein in his neck that would run to his heart. What he didn’t know was that he had become septic.

Hard to Diagnose When It’s Easy to Treat

Sepsis happens when the body’s response to an infection spirals out of control and begins to damage its own organs. It is one of the most commonly misdiagnosed conditions in emergency medicine, and it can begin with something as ordinary as a red spot on the skin.

Dr. Hollis “Bud” O’Neal, a pulmonary and critical care physician and medical director of research at Our Lady of the Lake and an associate professor of medicine at LSU, often points to a description from Niccolò Machiavelli that dates back roughly 500 years. Sepsis, he says, is easy to diagnose when it’s hard to treat, but hard to diagnose when it’s easy to treat.

Coach O’s case showed exactly why. He arrived critically ill and could barely speak. His symptoms could have pointed to a heart problem, a medication issue or something else entirely.

“Our emergency department sees 90,000 to 100,000 patients a year,” Dr. O’Neal says. “Figuring out what’s wrong with a patient in this situation is extraordinarily difficult.”

Dr. Steven Gremillion, a cardiologist and chief medical officer at Our Lady of the Lake, knew Coach O’s heart better than anyone. He has been Coach O’s cardiologist for nearly 10 years.

The team moved fast. They took a picture of his heart, and it looked great. Blood tests ruled out congestive heart failure. Within minutes, IntelliSep gave them the information they needed to act.

“We were able to catch that pretty quickly and get treatment started immediately, which is very important,” Dr. Gremillion says.

Dr. O’Neal compares the process to riding the London Underground. The train station can be chaotic, making it easy to board the wrong train.  If you do, and you notice right away, you can simply turn around. Ride several stops before you realize it, and finding your way back gets much harder. Either way, you have wasted time, and you could miss your destination altogether.

“Sepsis is not much different,” he says. “If you missed the train up front, it can be too late.”

A Test and a Team Built Right Here in Baton Rouge

Coach O’s emergency team had a tool a growing number of hospitals in the world could offer: IntelliSep.

The story of IntelliSep began around 2014, when a small biotech company called Cytovale needed a clinical partner to help test a promising new technology. Dr. O’Neal and his team at Our Lady of the Lake answered the call. Over the next eight years, researchers at the Lake and LSU led a series of studies that helped turn the idea into a first-of-its-kind rapid sepsis test. It earned FDA clearance in December 2022.

In August 2023, Our Lady of the Lake became the first hospital in the country to use IntelliSep in everyday clinical care. That work was made possible through the Championship Health Partnership, which unites FMOL Health and LSU in advancing care, education and research. IntelliSep is now available in all emergency departments across FMOL Health.

When Coach O came through the doors around 1 a.m., his care team ran the test. The results indicated the highest probability of sepsis, and treatment began immediately.

The high-risk result set a well-practiced plan in motion. Our Lady of the Lake teams follow sepsis protocols built around three steps, and each one is on the clock.

“Start your fluids early, start your antibiotics early, get the cultures to find out what the bug is,” Dr. Gremillion says. “When you do those things, you decrease mortality and increase survival.”

When it comes to sepsis, speed matters.

“Coach O came in, got quick, team-based care, and it really saved his life,” Dr. Gremillion says.

Dr. Conners sees that focus across the hospital.

“We have a focus on sepsis where we’re able to identify it as soon as you come in the door and put measures in place to gain control of it,” he says. For Coach O, it made all the difference.

“It saved his life,” Dr. O’Neal says. “The actions of the emergency department, getting him on the right track early in the course of his illness, really saved his life.”

For Dr. O’Neal, caring for one of LSU’s most beloved figures with a test built through that very partnership was deeply meaningful.

“It really was a full circle moment for us,” he says. “And it was very special.”

Seven Days in the ICU

Coach O remembers little of that first night. He remembers waking up the next day to a room full of physicians who had been working to keep him alive. For the first two days, he says, it was touch-and-go.

He spent seven days in the intensive care unit. The LSU Health Critical Care team directed his ICU care, working alongside Dr. Catherine “Katie” O’Neal, MD, FMOL Health senior vice president, chief academic officer and infectious disease physician. Dr. Gremillion kept watch over his heart. Dr. Conners continued to treat the leg where it all began. Nurses, residents and specialists filled in every gap, day and night.

Each day, that team gathered at his bedside. Dr. Gremillion says multidisciplinary rounds are now the standard for critically ill patients. Physicians, therapists, pharmacists and other specialists all collaborate.

Coach O had no idea how sick he was. He didn’t even look at the monitors for three days. He only learned later how close he had come.

“I never thought I was going to die. I wasn’t going to let that into my mind,” he says. “But I found out later how close I was.”

Because Our Lady of the Lake is a teaching hospital, residents were part of Coach O’s care team too. Dr. Bud O’Neal sees that as a strength.

“They ask us good questions. They make sure that we know our stuff,” he says. “It’s another set of eyes looking at the patients, and everybody learns.”

He is quick to credit the nurses most of all.

“The ICU is not an ICU because of the doctors that are there,” Dr. Bud O’Neal says. “The ICU is an ICU because of the nurses that are there.”

‘One Team, One Heartbeat’

Coach O knows a great team when he sees one. In 2019, he led LSU to a perfect 15-0 season and a national championship with a rallying cry that still echoes across Baton Rouge: “One team, one heartbeat.”

He sees that same spirit in the people who cared for him.

“That team, we had no superstars. Everybody pulled for each other,” he says. “And this team at Our Lady of the Lake, from what I’ve seen, is the same way. They are all experts at what they do, and they put all their ideas together to save my life.”

Care That Followed Him Home

Leaving the hospital was not the finish line. Coach O came home 28 pounds heavier from fluid, with a swollen leg and a long road ahead.

His care team stayed with him every step of the way. Several team members, including Dr. Bud O’Neal, Dr. Katie O’Neal and Dr. Conners, went out of their way to check on him and ensure he was healing properly.

“The doctors were always available to me,” Coach O says. “I consider them like my family. It wasn’t just another doctor visit.”

Dr. Bud O’Neal says the goal was never just survival.

“Our goal wasn’t just that he survives and gets out of the ICU,” he says. “Our goal was to get him back on the sideline and see him yell ‘Geaux Tigers’ at those players.”

The Two Women Who Wouldn’t Let Him Quit

Recovery tested Coach O in ways no opponent ever had. There were days he didn’t think he could make it through.

His wife, Brandy, rushed home from Nashville. Coach O had never seen her cry until she arrived and saw how serious things were. She stayed by his side through the hardest nights, and she stayed in his corner long after he came home.

When he told her he couldn’t do it anymore, she wouldn’t hear it.

“She goes, ‘You’re not a quitter. You can’t quit,’” he says. “It was the first time Brandy talked to me that way.”

That same day, Dr. Katie O’Neal pushed him, too. On a miserable day, she urged him to go to a check-up. He pushed back. She didn’t budge.

“That lady stood up to me, and I loved it,” Coach O says. “She motivated me to go to that appointment and made me feel better.”

Brandy also took charge of his medications, sorting a week’s worth of pills into boxes for morning, midday and night. For a man who always insisted on seeing the label, that meant something.

“She is the first person that I ever trusted to put pills in a box, and I’ll take it,” he says.

His physicians noticed her dedication.

“I feel like she probably has a nursing degree at this point,” says Dr. Oscar Shoenfelt. “She has been a rock for him.”

A Coach for Coach O

During his hospital stay, Coach O connected with Dr. Shoenfelt, a family medicine physician at Lake Men’s Health. He became Coach O’s primary care physician and took on a role every complex recovery needs: coordinating the whole team.

“We were trying to help give him a healthcare home, so to speak,” Dr. Shoenfelt says. “To make sure everybody taking care of him knew what everyone else was doing, so nothing slipped through the cracks.”

He also had to manage the toughest patient of all: a coach who wanted to be back to full speed the next week. A common rule of thumb in critical care says each day in the ICU can take about a week of recovery.

“To him, it wasn’t good enough,” Dr. Shoenfelt says. “He wanted to be at that championship level right away.”

Through rehab, physical therapy and steady follow-up care, Coach O has kept climbing. He’s back traveling with the team and making recruiting trips again.

‘The Advantage the Lake Gives Us, No Other School Has’

Coach O spent time coaching elsewhere before returning to Baton Rouge, and he knows the difference being home makes.

“I come to the Lake, and I get treated like family and get first-class treatment,” he says. “Thank God I was here working for LSU when this happened.”

Today, he brings that experience into living rooms on the recruiting trail. When he tells families why LSU stands apart, the care at Our Lady of the Lake is part of the pitch.

“The advantage the Lake gives us, no other school has,” he says.

He puts it in the same category as the program’s legends.

“This school is elite. It’s only the best,” he says. “We want Joe Burrow, Justin Jefferson … Dr. Katie, Dr. Bud, Our Lady of the Lake. That’s what we want here. The very, very best. And we got it.”

Coach O’s Message: Don’t Power Through It

Coach O was in the hospital during Sepsis Awareness Month in September. Before last August, he says, he didn’t even know he could become septic.

Now he wants everyone to know what he didn’t.

“Whenever you get a sore, whenever you get anything, go to your doctor,” he says. “Make sure that you get the proper care.”

Dr. Bud O’Neal agrees. Many people have had a red spot on their skin that went away on its own. That’s what makes sepsis so dangerous.

“It can turn from a relatively mild infection to a life-threatening disease in just a little bit of time,” he says.

If you have a wound or sore that isn’t healing, looks red or swollen, or comes with fever, chills or a sense that something is just off, don’t wait it out. Toughness is a gift on the football field. With sepsis, the strongest move you can make is getting help early.

A Comeback Rooted in Faith and Teamwork

Coach O believes his story was shaped by something bigger than himself.

“God had a plan,” he says. “It wouldn’t have happened without Him and everybody together.”

To the people who cared for him, Coach O put it simply: “Y’all made the right decisions at the right time. I will never, ever forget that.”