In the worst of times, when horrific headaches drive him to a darkened bedroom for days, Greg Giovanazzi struggles toward the light.
Brow knitted, eyes clenched, he wades through the pain to think of stuff that matters - family, friends and job. It helps him ride out the migraines that have hounded him for decades, said Giovanazzi, the volleyball coach at Johns Hopkins.
"Coaching motivates me to get out of bed, manage my depression and start the healing process," he said. "It gives me reason to continue. That might sound dramatic, but ... I don't want to miss time with my players. I want them to have the opportunity to be the best they can be."
Giovanazzi suffers from chronic migraines, the relentless, debilitating daily headaches that haunt 3.3 million Americans. It is a condition, experts say, for which there is no cure yet.
"Our arsenal of medications against migraines is fairly primitive," said Dr. Jason Rosenberg, head of the Johns Hopkins Headache Center. "Most people have annoying tension headaches. They take Tylenol and get on with their lives. About 12 percent of the U.S. adult population - 20 million people - suffer from migraines, mostly intermittent.
"But 2 percent of adults have chronic migraines, these smoldering headaches that [routinely] become full-blown and disabling. These people are scattered out there and suffering miserably from pain, nausea and depression. Imagine having a horrible hangover every single day."
Imagine? Giovanazzi lives that life. Once he was laid up for a week, shades drawn. Another time, the migraines triggered nausea so intense that he vomited 23 times in 12 hours. Keeping count took his mind off the pain.
Seeking help, he has run gantlets of tests. He has been poked and prodded, X-rayed and CT-scanned. He has seen neurologists and therapists, hypnotists and herbalists. He takes six medications daily but is never pain-free. Fifty times, he has gone to the emergency room. The headaches keep coming.
Giovanazzi, 50, soldiers on, leading Hopkins to a 19-5 mark entering today's match at McDaniel College. Victories there and against Ursinus on Saturday would put Hopkins in a three-way tie for the Centennial Conference championship.
"It [the disability] is part of my every day, but I'm not dying from it," he said. "I'm doing what I can do, when I can do it."
Though their coach has missed some practices, the Blue Jays say his absence is trifling compared to his stellar credentials and the savvy he imparts to a Division III team.
Giovanazzi starred on UCLA's national championship team in 1976, then played pro volleyball in Europe. He helped coach the U.S. women to a bronze medal in the 1992 Olympics. He spent seven years as head coach at Michigan until the disease that has bothered him since college forced him to step down.
Seeking better medical care, Giovanazzi moved to Baltimore with his wife and daughter. Now on disability, he served as a volunteer coach at Loyola College for one year and at UMBC for two. Both times, headaches triggered his departure.
Desperate for a coach when his predecessor resigned in August, Hopkins took a flier on Giovanazzi. The chemistry worked. Players swear by their soft-spoken, balding, bespectacled coach whose laid-back demeanor belies the turmoil within.
"He's a cool, humble guy who has had an awesome life," said Allison Cappelaere, a junior from Centennial. "We can only aspire to be as good as the players he has coached."
During matches, Hopkins players hang on their coach's every word, athletic director Tom Calder said.
"I've watched this team during timeouts, and nobody looks into the stands, like on other teams. Everyone pays attention to Greg," Calder said.
Giovanazzi was born to coach volleyball, colleagues say. As a mainstay on UCLA's 1976 title team, "Greg was the calming influence on a group filled with fire," said Al Scates, the Bruins' coach for 46 years. Impressed, Scates hired him as his assistant in 1984, and UCLA finished 38-0. That same year, Giovanazzi helped coach the UCLA women. That team won the NCAA title, too.
"Greg has a gift for dealing with people, especially women," said Terry Liskevych, former U.S. Olympic coach. He made Giovanazzi his assistant in 1992 when the upstart Americans took third in Barcelona.
It was while coaching at Michigan (1992-1998) that the headaches nagging Giovanazzi since childhood overran his life. As a youth, he had suffered a number of concussions in football and in car accidents. Moreover, he has a family history of migraines.
"I'd heard of my great-grandfather beating his head against the wall to get the pain out," he said.
The pressure of coaching a major college team worsened the pain. After big matches, Giovanazzi would "crash" - typical of the affliction, experts say.
"It's not the stress that causes migraines, but the letdown after stress," Rosenberg said. "People get crushed once they finish a big project or final exams.
"There are new drugs for migraines on the horizon. But this is a horribly underrecognized disease. The World Health Organization ranks a day with migraines as disabling as a day with quadriplegia." Giovanazzi has not given up. Before hiring him, Hopkins officials phoned his longtime friend, Russ Rose, coach of Penn State's 2007 national champions.
"Hopkins was thinking he had fallen from heaven," Rose said. "I said, 'That's a pretty fair statement.' "
Never mind that the migraines have whittled Giovanazzi down from coaching in the glitzy Big Ten to the Centennial Conference.
"The beauty of Greg is that he doesn't live in the past," Rose said. "Every time we talk, he says, 'I'm coaching the greatest kids in the world right now.' "
Hopkins players rally around Giovanazzi, aware of the hints that a migraine is brewing: the slurred speech, droopy eyes and tingling in his arms.
"Caffeine helps for a while so, during a match, a player or parent will run out for coffee or a Mountain Dew," the coach said. "That helps me stay focused and keeps me from throwing up. But if my reasoning skills falter, my assistant knows to tap my shoulder and I'll back off."
Unlike years past, when he coached elsewhere, Giovanazzi has not missed one match. As the season winds down, he hopes to maintain that streak - a small victory in his war on nerves.
" 'Gio' was real excited about this opportunity at Hopkins," said Reed Sunahara, University of Cincinnati coach and a friend for 30 years. "His knowledge of the game is among the best in the country.
"I can't imagine the pain he goes through, but I do know he missed being in the gym. He still has a passion to coach."