An NBA referee’s new mission: post-traumatic stress for health care workers

Jonathan Feigen
Houston Chronicle Staff writer
June 21, 2022

The signs and banners hanging at the front doors of clinics and hospitals were so ubiquitous at the time that most barely gave them a thought. If they did consider those three words, they saw nothing wrong in a shoutout of praise.
“Heroes work here.”

Bob Delaney saw them, too, but he had spent decades noticing and evaluating details. He had been a New Jersey state trooper going undercover to infiltrate the mob. He had been an NBA official for 25 years, rising to the top of his second profession to work nine NBA Finals.
Through 10 years since he put away his whistle, he had continued to work with officials in the NBA and NCAA’s Southeastern Conference. But much of his focus had been devoted to working with service members in recognizing and treating the sort of post-traumatic stress he felt when he was undercover and in the years that followed.

When he saw those banners, he knew the work he had done with police, firefighters and soldiers was needed again.

“When people would call me a hero because of the work or would refer to me as a tough guy because I did that undercover job for three years, I didn’t see myself as that,” Delaney said. “I talked to so many soldiers and military (members); those that are given the title of hero don’t like it. They don’t see themselves as that.

“I thought the same thing as I drove by these hospitals. We’re putting these signs out front of hospitals and health care facilities to make ourselves feel better. We’re looking for heroes to solve our problems and make things all better. That’s a heavy crown to lay on somebody’s head. To have those expectations on people, that’s an added stressor, on top of that, they are doing work and feeling they are not being successful because people are dying.

All of that drove me to becoming more knowledgeable about what their experience was. The more I dug into it, the more I saw parallels with the conversations I had with those in the military in Iraq and Afghanistan.”

Delaney, who drew nearly as much acclaim when he told the story of his work infiltrating the mob as “Bobby Covert” as when he became one of the NBA’s top officials, had spoken to police, firefighters and military members about dealing with the “emotional shrapnel” they cannot dodge.

He had been to Iraq and Afghanistan, embedded with troops to better understand not just their mission but the toll it takes.

As the COVID pandemic raged, he found dangerous similarities between the front lines of very different wars, with health care workers facing the sorts of threats he had spent decades understanding.

Those battles are the topic of Delaney’s talks with health care workers, including a visit to Baylor Scott & White Medical Center in College Station, and his hopes to work with groups in the enormous Houston medical community. It is the subject of his third book, “Heroes are human,” written with Dave Scheiber, set to be published in September.

“Military goes to where trauma is,” Delaney said. “Law enforcement goes to trauma. Firefighters go. First responders. Then it came to mind every time I drove by a hospital, I was seeing ‘heroes work here.’ I was realizing trauma comes to them. It walks in the front door. They’re getting hit with the emotional shrapnel of other folks that gets placed onto them. Then it was compounded by the fact that with COVID, family members could not be in hospitals.”

This is part of the burden carried by health care workers, but COVID made it even greater. The danger of treating a highly communicable disease compounded risk assumed not just by workers but their families, adding a fear of bringing that risk home. And because patients’ families could not be in hospitals, the need to comfort the dying forced health care workers to live in an increased and inescapable period of mourning.

“Nurses and doctors were taking on additional roles of being comforters, holding hands, setting up phone calls and Zoom calls for people to say their goodbyes,” Delaney said. “They were additional responsibilities thrust upon health care workers.”

Firefighters have long been thought of as heroes, with the public understanding that when they run into a fire, they can be burned.

Health care workers labeled as heroes through the COVID crisis have not been viewed as in danger beyond their exposure to the virus. The threat that comes with the overwhelming stress and sorrow on the front lines has been more difficult to define and understand, even as it remains pervasive.

Worse, the hero label almost denies the threat, as if they are somehow shielded or immune, as if they are different because they are “heroes.”

“An additional roadblock is coming for them to be able to process what their experience is,” Delaney said. “I think there’s an appreciation but also think COVID fatigue is causing us to kind of minimize it now. If you think back to the early days of COVID, you hear ‘heroes work here’ and the applause and the banging of pots and people lining up during shift changes to clap — there was an honoring of those.

“It’s hard not to have a political conversation, but the politicization of COVID actually, at times, caused crazy theories that doctors and nurses are prolonging this to bring more money into hospitals, just bizarre statements made. Think about if you’re the person wearing the scrubs and the lab coats, working 14 hours a day, how those stories impact your psyche. The underappreciation starts to be felt.

“I drew that analogy with the Vietnam vets. At times, we were not respectful to those who served. It was more because of the political beliefs as opposed to what the service was.

“They’re overworked. They’re underappreciated. And there’s so much death surrounding COVID, those feelings of someone working in that environment is very, very difficult to process.”

In his book, Delaney introduces a variety of individuals hit by the pandemic: a nurse who took a leave of absence in Florida to go to the initial front line in New York; a patient who barely survived and his family; a Korean war doctor who speaks of the added hardships of serving in “the Forgotten War.” They tell of treating patients near makeshift morgues and among body bags too numerous to be promptly moved.

Delaney said he has learned the burden becomes greater when those on the front lines feel forgotten.

“I was in Iraq outside of Mosul at one of our military posts, what they call a forward operating base, an FOB,” Delaney said. “It was handwritten in paint: ‘America is at the mall, and we are at war.’ It was what the soldiers were expressing. Those that are in the middle of these battles, whether it be COVID or a physical war on foreign soil, those feelings are that you are isolated and in that fight.

“It was a reinforcement to me what those similarities and parallels were, but it also was I wanted to end with Hank (his friend, Hank Litvin). Korea was referred to as ‘the Forgotten War.’ From a historical perspective, World War II had ended. The fatigue of World War II was very strong in our society. It was a celebration and an end. Now, the Korean War starts. People did not want to hear about it. Military members that came home from the Korean War were not celebrated the way World War II veterans were.

“With COVID, we have fatigue in our society. Some wars are fought on foreign soil. Some are fought against an invisible enemy. That’s what COVID is to us: an invisible enemy.”

Delaney fought that fight while he was undercover and for years after he left the police and began his career as a basketball official.

“Everybody told me I was a hero, but they didn’t see me in my house at 2 o’clock in the morning pushing shower curtains back with my gun out because I was paranoid they were coming to get me,” Delaney said. “I was afraid to go out my front door. But I didn’t express those things to people, because that would have made me look scared or not the person they were trying to make me be. I was trying to live up to the expectations, into the image they were projecting on me. When I could finally be honest about that, what a relief that was.”

Delaney had throughout his life turned to basketball, from high school and college competition to just shooting alone or playing one-on-one. He began officiating, not realizing he used it to escape the anxiety that came from everything, from the enormous danger that came with his assignment to the feelings of testifying against mafia members whom he had befriended.

“I found an inner peace on the basketball floor,” he said. “I completed the undercover job. Something drew me to basketball. This game that I played as a kid was always there for me, in good times and bad. I knew I couldn’t play anymore, so I started refereeing.”

Delaney was working in summer pro leagues when Darrell Garretson (the longtime NBA official who became NBA Supervisor of Officials) discovered him. When Delaney retired, he continued to study PTSD and what he called “operational stress.”

When he spoke at an FBI conference, military members there introduced him to various generals and admirals who sought his help with service members dealing with the stress he had battled as an undercover operative.

“My boots are not their boots, but I have to go where their boots go to understand what their life is like,” Delaney said. “The decision was made that I would go to Iraq and Afghanistan on visits and spends weeks embedded to live with them, to understand better what they were experiencing.”

That led to his second book, “Surviving the Shadows: A Journey of Hope into Post-traumatic Stress,” telling the story of service members who overcame the despair associated with post-traumatic stress. Twice awarded the U.S. Army Outstanding Civilian Service Medal and also given the NCAA’s highest honor, the Theodore Roosevelt Award, Delaney had little reason to believe a sign outside a health center would someday lead to work with health care workers.
As a young New Jersey state trooper, he had assumed the identity of a mob associate. As a referee, he had worked next to elite athletes. Embedded in war zones, he had lived with soldiers in harm’s way and battling many forms of enemies.

To Delaney, all of that trained him to help on another front line, where health care workers needed care, too.

“This is not about ending post-traumatic stress; it’s about better interacting with it,” Delaney said. “I started to realize health care workers need the same approach we took with the military years ago. We’ve been finding there’s a lot of commonalities between my story and what they experienced because it’s … a story about humanity, what human beings experience when they are exposed to and work in the area where trauma takes place.

“This is not unique to law enforcement. This is not unique to those in the military. It’s a human condition. Any human being that is exposed to trauma is going to have some kind of impact.”