AT 16, IRISH defender Mark O’Brien’s career appeared to be hanging in the balance.
Having made the move from Cherry Orchard to Derby County, the promising youngster, who had already made his senior debut for the Championship club, was diagnosed with a heart problem.
They found a minor leak in the aorta valve that was initially thought not to be too serious.
Players’ heart rates were regularly measured at Derby and when it was discovered that O’Brien’s maximum heart rate was abnormally high, he went for an MRI and discovered the leak was escalating.
“Suddenly, I was told I needed an operation within the next two weeks, otherwise I could drop dead on the pitch,” he recalled in an interview with The42 back in 2016.
The issue did not prevent O’Brien having a career in the game. Just seven months after the operation, the Ballyfermot native was back with the Derby first team, making the bench for their final match of the 2009-10 season.
He would ultimately spend seven years with the Rams, making 35 appearances. The stop-start nature of his time there was more to do with a series of unfortunate injuries as opposed to the heart problems, with knee and cruciate issues primarily responsible for hindering his progress.
He made 19 appearances on loan at Motherwell in the Scottish Premiership, before joining Luton Town on a two-year permanent deal. But the latter move didn’t work out, as he made just six appearances in total for the club, with another knee injury exacerbating his woes.
It was not until O’Brien joined Newport County in January 2017 that he found a place that felt like home.
The defender endeared himself to the club’s fanbase not long after signing. With 12 matches remaining, they were 11 points from safety and looked dead certs for relegation.
Yet a couple of crucial wins left them with a chance of survival on the final day. And it was a last-gasp goal from O’Brien — just his second at senior level amid a 2-1 victory over Notts County — that ensured they avoided demotion to non-league football
Having made just 77 senior appearances in his career prior to joining Newport amid doubts surrounding his long-term fitness, he made 127 appearances in four largely uninterrupted seasons with the Wales-based side.
There were plenty of highs, particularly that Notts County goal, as well as FA Cup upset victories over Leicester City and Middlesbrough. He also started in the 2019 League Two play-off final at Wembley Stadium, though he was sent off in the 89th minute of the 1-0 loss to Tranmere.
Just over one year later, O’Brien announced his retirement from the game at the age of 27, amid news he would need to undergo further heart surgery.
It’s just got to the stage where I have pushed this valve as far as it can go,” he said at the time.
A couple of months on from the heart surgery and the retirement news, O’Brien is gradually beginning to feel better.
He recently had his first jog in almost a year, having played professional football for the last time in January 2020, picking up an injury shortly before the pandemic brought a halt to sport across the world.
The Dubliner had no idea at the time an otherwise forgettable 2-1 loss against Leyton Orient would be his last game, and although he knew the day of his retirement would eventually come, the news that he would have to hang up his boots prematurely came as a “massive shock”.
The heart surgery at 16 had taught him to savour every moment in the sport though, and it was not something he could ever take lightly.
“After every single season, I would get a routine heart scan that would tell me if I could play the following season or not,” he explains. “I always knew that one of those heart scans would be the time where they’d tell me: ‘You have to retire.’ I was kind of half-ready for the decision.”
The fact that football had been going well, with O’Brien having been appointed club captain ahead of the 2019-20 campaign, made the bad news all the more difficult to accept.
“I remember breaking into tears and it was a decision I didn’t want to make,” he says.
Yet the problems didn’t end there. After retiring, O’Brien started to suffer from panic attacks.
When the first one happened, my first thoughts were: ‘There’s something wrong with my heart, my valve is beating out of my chest and I don’t know what’s going wrong.’ I’d never experienced anything like it before,” he recalls.
“I’ve always been an anxious kind of person, but that was down to football — worrying about my performance, or about the next game coming up.
“But once you go out and play a 90-minute game, it’s all forgotten about and you’re in matchday mode.”
O’Brien still has good and bad days, but he has found speaking openly about his problems to be hugely beneficial.
“I’ve sat and cried in front of our club doctor, Daniel Vaughan, he’s been amazing to me. I’ve sat and opened up to coaching staff and family friends. I’ve asked more questions than I ever thought I’d needed to know just to put my own mind at ease. It’s helped me so much more.
“At the beginning, when I was holding a lot in, it wasn’t just because of the heart operation that I had the panic attack. I had to deal with not doing the job I love anymore, having to retire from football, not being able to train every day.
“Having to deal with the bloods and the warfarin tablets that I’m on, the different foods I have to eat, everything seemed to get on top of me. I kept it in a lot more than I probably should have. But at the same time, it was a learning curve to know if I do take those dips, I can speak to a lot more people and get it off my chest.”
While more people both in football and society in general are showing a willingness to speak about these types of issues that might have been perceived as taboo not long ago, O’Brien also feels more could be done to encourage such openness.
“I still think that football is an industry that can discourage it to an extent from the outside looking in, from a fanbase or people in the general public. They look at footballers and ask: ‘What do they have to worry about? He’s on thousands of pounds a week, he’s doing the job he loves, why would he get anxiety?’
“You don’t want people to perceive you in that way, that you’re just ‘looking for attention’. You might have a nice house, a nice car, but the minute somebody hears that you play football, they automatically think you’re on a £100,000 a week. Whereas when you drop down the leagues, you’re in League One, League Two, everybody is playing for a wage, just like the general public work for their wage. This is our job.
“I never really spoke about my heart issues from 16 onwards, because I always saw it as ‘if I speak about it too much, people will think I’m looking for sympathy,’ and that’s something I never wanted.
“But in this day and age, people are finding it a lot easier. Obviously with social media, there are a lot more support groups and people are coming out a lot more to speak out.
Those anxieties you’re probably able to hide away in football, because in the 90 minutes, you go out and forget everything that’s happened in your life and you forget about everything that’s going on, you’re there for the enjoyment and loving every minute of it.
“But then when you don’t have that release of going out training every day for a 90-minute game, that’s when it all starts building up and that’s when you start realising [the need] to talk that bit more, because when it all does build up, it builds like a volcano and it just erupts.
“You don’t know what’s going on or happening, that’s what happened to me, and luckily, I have the people around me that have been amazing to me.”
One of the big challenges O’Brien has faced is simply rediscovering a sense of purpose. Since childhood, his life has been dominated by football. Training, dieting and obsessing about the next game is a relentless cycle. Christmases, birthdays and New Year’s parties were constantly missed because of his dedication to the sport. When that life is suddenly taken away, adjusting is no mean feat.
“Normally in football, you get a weekly or monthly plan. You know what or when you’re doing it, the times you’re doing it at and you’re able to structure your life from that. So when you come away from that and you don’t have that structure of knowing what you’re doing Monday to Friday, it kind of messes up your body clock to an extent, because you’re looking for that structure and purpose again, you’re looking for that outlet of: ‘What am I going to do with myself?’
“You find a lot of people struggle, because most people’s outlets when they are in football is going out and you’re amongst all the lads in the changing room, having a laugh, having a joke, you’re training hard each day, you’ve got a game on a Saturday to work and build towards.
“When you dedicate your life to your sport and the job that you love, when you come away from it, you start realising that that’s all you know. You go into a bit of a panic, because you have to try to fill that void, which I’ve been trying to do.”
For some footballers, there is no obvious next step, and many encounter problems. As The Secret Footballer has noted: “Remember the stats for former footballers — one in three will get divorced, one in three will suffer a mental illness, and one in three will be declared bankrupt.”
O’Brien feels fortunate that Newport have continued to show him support since his retirement. He still works for the club, doing commentary on matchdays and helping out with the training.
“That’s why football still being on right now [during the pandemic] has helped me so much more,” he adds. “Having that structure, going into the training ground each day, commentary on a matchday, still feeling as though I’ve got a certain purpose. Whereas when I first came out of the operation, I hadn’t a clue what I was going to be doing.
Football is a massive outlet and I’ve realised that so many times, but even more so now that it is needed. If football wasn’t to continue, or we didn’t have the support [financially], not just me but you see with a lot of people, even the lads who are still fit and well to play, they don’t know what to do with themselves, because they don’t have the training regime, they don’t have the routine every single day.
“Keeping the clubs open has given me that opportunity to be able to progress, find out new avenues to go down and new things to speak about and adventures to go on.
“Whereas if it wasn’t for football and we weren’t getting the help, I’d still probably be sitting around struggling and not knowing what to be doing.”
And while some people may consider O’Brien unfortunate having to retire so young, he takes a different view.
“I got 10 years longer than any doctor or hospital gave me from the beginning, so if anything, I see myself more as lucky rather than unlucky,” he says.
“When I got told [about my heart problems] at 16, my only question to the doctor when I got the news was: ‘Can I play football?’
“All I ever wanted to do was play professional football and I had a taste of being in the first team the season before when I made my debut, so I knew that this was exactly what I wanted to do.
“The hospital gave me a slight chance, saying ‘there’s potential you can get back fit, but we’re not going to guarantee that you’ll play professionally again, we’re not sure. The valve could last you one year, or a maximum of five years.’
“So they never gave me the full blessing of ‘it’s definitely going to happen,’ but they gave me that glimmer of hope.
“Once I had that glimmer, once I had that small chance, I just gave everything to each year of playing.”
O’Brien is also grateful his heart problems were diagnosed early on and that he did not suffer the same fate as other footballers who have tragically died, owing to undetected issues.
“Sometimes it’s the ‘what ifs’ that give me the up-and-down days,” he says. “At the end of it all, sometimes I don’t even concentrate on what may have happened if it was another era [with less knowledge in football about potential heart problems].
“The way I look at it is: ‘If it wasn’t for Nigel Clough as a manager, I may not have had a career in football.’ I was lucky enough that he gave me an opportunity to play in the first team at 16. I was rewarded with a three-and-a-half year deal straight after that. And he backed me through all of the heart and injury problems I had at Derby. He backed me through every last one of them, whereas if I was at a different club under different circumstances, they might have just washed their hands of me at the first sign of trouble and I probably never would have had a career.”
On a similar note, he continues: “Newport for me obviously have been amazing. I couldn’t have asked for any more off them for how they’ve stuck by me through all this. If there’s anything that I needed, or they wanted me to do anything, it was always open and they were coming up with ideas for me, to keep me busy and know that I need to keep my head in football.”
O’Brien has already opened up about his issues with panic attacks and other problems post-retirement in a piece with ITV News, and he has been overwhelmed by people’s response to his honesty.
When I got approached to speak about myself and my problems, I found that more difficult to do, because I’ve always been a private person where whatever happened away from football were my problems. ‘I don’t have to burden anyone else with them,’ is the way that I looked at it, because I didn’t want anyone to have sympathy and I’ve never looked for anyone to have pity for me.
“But when I opened up and spoke publicly about it, the response was the opposite to what I would have expected, thinking people wouldn’t respond well to it. I was thrown by the amount of people that spoke to me, who either had to retire from football from an early age, or that have just gone through a heart operation and see me as an inspiration to be able to get themselves back to feeling normal.
“Loads of people were saying how amazing it was that I spoke out, that it’s helping so many other people and that was just me being honest about the life that I’ve had to live.
“There weren’t any thrills or spills, or me adding arms and legs to a story, it was just me being me for the very first time. It was a great response, and not just from a general public perspective. I’ve had other footballers speak to me about the career I’ve had, my team-mates not knowing that all of this was going on. I had former managers messaging me saying it was brave of me to speak out and they didn’t know that I would have had those troubles through my whole career — these are managers I’ve played under.
“On one hand, I was proud that I was able to say: ‘Do you know what? I was able to have a football career and not have anyone pity me for anything.’ But also, this is me now. I can speak about how I was, because it won’t hinder me in my career anymore. Whereas before, I thought: ‘If I speak about my heart problems, no manager will want to sign me, because they’ll see me as someone who ‘we can’t really trust that we’re going to get a couple of years out of him, because he’s got heart troubles’. It was something where it felt good to get it off my shoulders and get a response for it, rather than just keeping it all bunched in.”