The way Mark O’Brien saw it, he had two things to save when he went under the knife for open heart surgery as a 16-year-old.
First was his burgeoning football career at Derby County and second was his life, which is why he opted for his two heart operations to rectify a leaking aortic valve in the order he did. Pig-skin valve first, then metallic valve 11 years later — two hearts to bookend his career in football.
Few gave him a chance of being able to play professional football after the first operation and the more generous consultants said he would manage five years at most. He is thankful he managed more than double that and so too are Newport County fans, who were spared relegation to the National League in 2016-17 in part because of one of his five career goals before he retired aged 27.
“When I speak with my family about it now, my mum has said she would have wanted me to take the metal valve then and stop playing football,” O’Brien says. “But, at the time, my family and everybody knew how much football meant to me and that the decision was mine, even though I was 16. I’d had a routine heart scan after making my debut (for Derby in the Championship ** ** in 2009) in the season previous to that and I never had a single symptom. I was told I was lucky because, in the space of that year, if I hadn’t had that scan, they said I would have died. To go from your debut to being told you would have been dead within the next year was surreal.
“Once I had that taste of professional football, I was going to do everything in my power to play. If that meant having one year or, as the doctors thought, five years, I was going to give it the best five years I could. At 16, I knew if I didn’t do it, I would regret it and I wouldn’t have been able to live with that regret. The reason I retired after my second operation was because I always said I’d give one operation for my football career, however long that would be, and the next operation was always going to be for life.”
O’Brien playing for Derby in 2011 (Ben Hoskins/Getty Images)
O’Brien is now 30 and has had three years of his retirement to reflect on the challenges of his life and career since everything changed for him as a teenager living away from home after moving to Derby from Dublin. He has undergone a second heart valve surgery and a gruelling recovery, which he says was physically and mentally taxing. Some days, he needed to use two hands to open a door at home while on others he was so low while suffering from anxiety and depression that he did not feel able to get out of bed and go into Newport’s training ground, where he has been working as an ambassador since calling time on a career that spanned 204 appearances from League Two to the Championship.
But time has been healing and O’Brien has written a book, Game of Two Hearts, which has helped him make peace with having a career cut short in order to give him a healthy life.
“My career was on a timescale and I never knew when it was going to finish,” he says. “I had a heart scan every season to see which year would be my last and that’s how I handled my career. It made me appreciate and play every year like it was going to be my last because there was that chance. When I came across from Ireland at 15, football matured me beyond my years because I had to stand on my own two feet. Then being hit with news that my heart was three times the size it should have been and I could be dead within a year made me grow up even more, but I was still really naive because all I kept asking was whether I could still play football.
“I look at my career and I’ve always been really proud of it, but three years later I’m calmer and more understanding of my situation and that’s after years of working stuff out. Like a typical footballer, I wanted things done with a click of my fingers and I expected that when I retired. I knew it was going to come but I was never fully prepared for it, so when I got told, I burst into tears and cried my heart out.”
After his first operation at 16, O’Brien was able to defy doctors’ expectations and return to make 35 appearances at Derby while playing under Nigel Clough. Each season he underwent scans to determine if the pig-skin valve was still functioning properly — any sign of a leak would be the end of his career. A pig-skin valve usually wears out over a period of time, while a metallic valve can last for life but is more likely to cause clots, meaning O’Brien now has to take blood-thinning medication that makes contact sport dangerous.
After leaving Derby in 2015, he had spells at Luton Town and Southport in non-League before ending his career with a four-year stint at Newport, where his winner against Notts County on the final day of the 2016-17 season will always be fondly remembered as the start of a new chapter for the League Two club by securing their EFL status.
The former Republic of Ireland Under-19 international is frank when he says that Derby and Newport “saved my life” and have been his home away from home.
“Derby stood by me and it was the first place I’d moved to on my own. At Newport, I was able to play to the best of my abilities and captain that great club, score the only goals I’ve ever scored in my career and play with a smile on my face.
“I’ve made a life for myself in Newport where I can work and be around every day working in football. It’s another club that stuck by me at another really extreme time in my life after the second open heart surgery. Clubs like that are few and far between, so the fact I’ve got two of them means a lot.
“Everywhere I played, I got treated the same as everyone else. When I retired and I was telling people about having a heart scan every year, I had Stuart McCall who signed me at Motherwell on loan saying he didn’t know I had to go through that and it was a great achievement. I never brought attention to the fact that sometimes I did struggle mentally as well. The physical toll it took on me was my general fitness. So if I was asked to run 10k there would be no chance I could do that and I was the slowest of the slow in pre-season. But, in a match, I could play 90 minutes and train every day.”
Football acted as a distraction for the centre-back, despite constant worries over symptoms like a sore chest caused by training during cold weather being related to his heart. O’Brien says he rarely discussed his heart condition with team-mates unless they asked about his scar, which runs down his sternum as a result of surgeons sawing through his chest bone to reach his heart and replace the valve.
O’Brien’s scar from his second operation (Mark O’Brien)
“Having my scar at the beginning, I didn’t like it,” he says. “I didn’t want people to see it and I didn’t want to have it. It would always be a reminder of having the surgery. I didn’t want managers to see it because, once or twice, if a new manager came into the building, I didn’t want them to look at it and judge me immediately.
“That might have all been in my head overthinking things. I grew to forget it because it was just part of my life. But for the cover of my book, I wanted people to see it in the rawest way possible, so the picture on there is a couple of days after the operation for my second open heart surgery. I want people to see that it’s not a scar that I need to be ashamed of, I can be proud of it and it’s real life. It saved my life.”
There are things O’Brien has learned to live with as well as his scar. The months-long recovery this time around meant plenty of time resting and listening to the click of the metallic valve inside his chest that keeps him alive. It has taken some getting used to compared to the quieter pig-skin valve and is one of many topics that he has discussed with his fellow Newport centre-back partner Fraser Franks, who has undergone the same operation this year after also having to retire early due to having a bicuspid aortic valve since birth. Though O’Brien knew the physical challenges awaiting him and Franks in recovery, his mental health recovery was different because he had stopped playing.
“I still have days where I miss football a lot or where I’m struggling with the sound of the clicking of the valve,” says O’Brien. “That was all more extreme at the beginning. When I retired, all the distraction of football came to an end and depression kicked in, anxiety, too. I never knew what anything like health anxiety was before but I had to figure it out, get counselling and understand why I couldn’t get out of bed and why that was nothing to do with my heart.
“Or why symptoms I was feeling that I thought were a heart attack and made me call an ambulance were a panic attack. Health anxiety made me worry constantly about everything, I wasn’t believing doctors and that was when I knew I was struggling. I added it all up and I had seven doctors telling me I was OK, but I still thought they were missing something. I’m a lot more relaxed and calm about things now but I’m not 100 per cent fixed. I just know if I say it out loud, then at least people are aware of it rather than keeping it inside.”
O’Brien hopes speaking out about heart and mental health will help others and give him a sense of purpose in retirement. A new chapter awaits in his work with Newport and, thanks to his new valve, he can look ahead to the rest of his life while feeling proud of the time football gave him.
“I’ve had plenty of messages through social media from people with existing heart conditions and people who have had open heart surgeries or people who have struggled with their mental health,” says O’Brien. “You want to be that example to show the human side to footballers that people at some stage forget about. It brings that realisation to say if it can happen to a footballer, it can happen to me in day-to-day life.
“It might be worth going and getting that screening or the check, even if you think you’re OK.”
_Mark has worked withCalon Hearts in south Wales and the British Heart Foundation to encourage people to have regular heart screenings. _
(Top photo: Nathan Stirk/Getty Images)
