Fred Hoiberg found the promised land with his jump shot.
Time and time again, the Ames Little Cyclone turned Iowa State Cyclone turned Indiana Pacer turned Chicago Bull turned Minnesota Timberwolf proved himself worthy of his “Mayor” moniker — cashing checks for 10 NBA seasons for his automatic spot-up shooting. Despite a stature somewhere between that of a true point guard and a stereotypical shooting guard, he led the NBA in 3-point percentage as a 32-year-old.
He’d made it. He could feel it. His time on mostly one-year deals would soon be over. The NBA was beginning to reward shooters, and he’d been told he was about to become a starter. The Hoibergs were all in on Minnesota. They purchased a lake house cabin for their young family. The avid golfer joined Hazeltine National, the exclusive club in Chaska that had hosted the PGA Championship a few years before.
People are also reading…
Two weeks after the ink dried, a gut punch worse than taking Karl Malone’s knee to the ribs: a dire message from his world-renowned cardiologist at the Mayo Clinic.
You’re lucky you're here. You have an aneurysm growing in your aorta, and you need surgery. Now. If this thing ruptures, you will bleed out and die. It’s very rare that people survive this.
A wave of disbelief washed over Fred and Carol, high school sweethearts in their ninth year of marriage.
“I had no symptoms,” Fred reflected to the Journal Star. “I felt as good physically as I had my entire career. And he’s telling me that I needed open heart surgery? I was in denial.”
Saturday marks the 20th anniversary of Fred’s first open heart surgery — the procedure that transformed everything.
It ended his basketball playing days. It began his front office and coaching careers. It shifted his perspectives.
It saved him — even if a complication did nearly kill him.
“I can’t believe it’s been 20 years,” Fred said. “That’s the other scary thing — just how fast life goes. It just seems like yesterday when I got out of that appointment and the day-to-day of the first couple months of the recovery — feeling every beat of my heart and thinking, ‘Is this normal?’ And the doctor saying, ‘Well, it’s probably something you’re gonna have to get used to and deal with for the rest of your life.
“And it still is. To this day.”
Hoiberg's Heart
Minnesota Timberwolves guard Fred Hoiberg (left) gets a lift from teammate Latrell Sprewell during a timeout after Hoiberg sparked a run in the second quarter of Minnesota's 94-89 victory over the Sacramento Kings in Game 2 of the NBA Western Conference semifinal series in Minneapolis on May 8, 2004. Associated Press file photo
In January 2005, Fred Hoiberg failed his life insurance physical.
It didn’t matter that he was in his 10th season in the NBA, lighting up the scoreboard from deep. It didn’t matter that he felt as healthy as ever. The insurance company decided Fred was too risky to insure, but didn’t disclose the reasoning.
The Hoibergs assumed the rejection was due to Fred’s bicuspid aortic valve — something discovered during his sophomore or junior year in the early 1990s at Iowa State. His heart raced something fierce at one practice in particular after a late night of studying that resulted in minimal sleep and extra caffeine. An echocardiogram revealed his “fish mouth”-looking valve worked perfectly with no leakage or regurgitation.
“They said it was probably something that I would never even have to worry about in my life,” Fred said. After that, Fred only thought about his heart condition thrice more in the next decade: at the NBA Combine in 1995, when he signed with the Chicago Bulls in 1999, and when he was rejected for life insurance in 2005.
The echocardiogram at the NBA Combine revealed no abnormalities. The same test conducted by the Bulls showed no serious issues. But years later, the results for insurance were never shared with the Hoibergs.
“Looking back on that, that seemed very negligent almost, very dangerous, that they didn’t tell me that I had a life-threatening condition growing silently inside of me,” Fred said.
Fred relayed the rejection to the Timberwolves’ team doctor, who knew of his pre-existing condition and advised him to schedule a work-up at the Mayo Clinic in Rochester, Minnesota, after the season.
Learning the news of his “ticking time bomb” — a prominent bulge in the root where the artery meets the heart’s aortic valve — was hard enough to take in for himself, but telling his young children was another matter entirely.
The youngest Hoibergs, twins Sam and Charlie, were approaching their second birthday. The middle child, Jack, had just turned six. Their oldest, Paige, was coming up on her eighth birthday.
Paige’s reaction is seared into Fred’s memory.
“‘Daddy, are you gonna die?’” Paige asked, tugging on Fred’s heartstrings. “I said, ‘Well, I hope not.’”
Hoiberg's Heart, 6.18
Fred Hoiberg lies in a hospital bed a few days after his first open heart surgery in 2005 with his daughter, Paige, by his side. Fred Hoiberg
June 28, 2005
Fred Hoiberg knows he wore a blue and white hospital gown. He knows what his intensive care unit room looked like while at the Mayo Clinic. He knows nurses came in and checked on him. He knows his family visited him.
He remembers none of it — heavily sedated after the eight-hour procedure that featured a sternal saw slicing through his sternum and having his ribcage spread apart in order for Dr. Hartzell Schaff and the rest of the surgical team to access Fred’s heart to remove the aortic root aneurysm and repair the damage with a synthetic graft before closing him shut with copper wiring.
The aneurysm had ballooned to 55 millimeters — a common size of an eyeglass lens. If Fred’s tissue had measured 60 millimeters, that would have put him at an even greater risk of a rupture. Aneurysms of that size rupture roughly 50% of the time, Fred said.
“There was actually quite a bit more diseased tissue in there than they originally thought,” Fred said, noting that they were able to spare his bicuspid valve since it was functioning fine.
Despite the post-operation haze, one memory survives. Fred’s surgery date coincided with the NBA Draft, so the television in his recovery room was tuned to the broadcast. His brain fog momentarily cleared for the analysis of the 14th pick — the highest pick the Minnesota Timberwolves had in years, in which they drafted Rashad McCants out of North Carolina.
Before going to commercial break, the camera panned to a solo shot of Mike Tirico, as if he were speaking directly to Fred through the screen.
“Hello, and our best wishes to Fred Hoiberg of the Minnesota Timberwolves. Fred — one of the top three-point shooters in the league — is at the Mayo Clinic today, had a heart procedure done because of an enlarged aortic root. This was found last week, came to light, and Fred had to have surgery today. So while we’re on Minnesota there for a minute, our thoughts are with Fred.”
“I don’t remember anything else before that or after that,” Fred said. “It was really weird that I looked up at the TV at the exact time that they talked about me.”
The next day, his medical team instructed him to take a lap.
Hoiberg's Heart, 6.18
A nurse carefully removes bandages from Fred Hoiberg’s chest during his post-op recovery. Fred Hoiberg
“‘How?’” Fred thought. “I felt like I just got hit by a Mack truck and now I had to get up and walk.”
Fred took slow steps down the hallway, fighting nausea and the wobbles as 80-year-old women and toddlers cruised past him. Seeing the immediate change in Fred was sobering for Carol.
“It’s sad to see your strong, healthy husband go from that one day to the next day needing help walking down the hallway,” Carol reflected. “To see him so weak was something that I’ll never forget.”
Three days after the procedure, his heart rate dropped into the 30s and he needed to be hooked up to a temporary pacemaker — a black box that rested on his chest. The upper chamber of his heart functioned properly, but the lower chamber had difficulty keeping up.
Fred knew this was a possibility. A slight, remote, unlikely possibility. When he and his surgeon reviewed the potential risks beforehand, the doctor mentioned that this particular problem — a 100% heart block following an accidental nick to the invisible cardiac conduction system — had occurred only twice out of his thousands of patients.
“I was lucky number three,” Fred said. His rhythm never returned, and doctors implanted a permanent pacemaker a few days later. “I fully planned on coming back and playing after this procedure, and everybody was on board with me doing it. After I developed the heart block, that obviously changed things. I had a tougher decision on my hands.”
July 5, 2005
Fred Hoiberg saw stars.
At first, he didn’t think much of it on his first day home from the hospital. But by the time he had nearly ascended the carpeted stairs leading up to the main level of their house?
Fred lost consciousness. He cracked open his chin and smacked his right shoulder on the hardwood floor at the top of the stairs. Blood poured out of his chin, a grim side effect of his anticoagulant medication, and he began convulsing.
Adrenaline coursed through Carol as she flipped her 200-pound husband off his face and right shoulder. Frantic, she called 911 as she held her husband in her lap. It’s uncertain just how long Fred was unconscious, but it felt like an eternity for Carol.
As Fred regained consciousness, he heard Carol pleading for her husband.
Dear God. Please. Don’t leave me.
Fred looked up and said, “Make sure my heart’s beating,” before he looked down and saw all the blood and realized he was coated in sweat. The EMTs arrived swiftly and took Fred to the emergency room at Abbott Northwestern. Fred’s parents met them there.
“Carol just collapsed into our arms sobbing,” Fred's mother, Karen Hoiberg, said. “She was so scared.”
The trauma team at Abbott Northwestern, without knowing Fred’s history, ran multiple tests as they attempted to ascertain what was wrong before he was rushed via ambulance to the Mayo Clinic.
“Looking back, the surgeon was like, ‘You guys should have been in a helicopter,’” Carol said. “It was that dire.”
Testing revealed that Fred had a pericardial effusion — a buildup of excess fluid in the space immediately surrounding the heart. Typically, a person has about a tablespoon of fluid in their pericardium. Fred had accumulated almost a liter, which meant blood wasn’t circulating to his head.
The removal process: A 6-inch long needle is inserted between the ribs near the heart to extract the fluid. Fred was sedated, but not entirely unconscious, for the procedure.
“I remember looking at this — it almost looked like a two-liter bottle of pop, and it was just full of blood,” Fred said. “I remember that very, very vividly. If you’ve seen ‘Pulp Fiction,’ that’s what it was like.”
While the situation was serious, he was also lucky.
His children were not home. They were out getting ice cream. He didn’t fall directly on his incision, and he didn’t fall on his left shoulder, where his pacemaker is. If he had, it could have caused significant, life-threatening damage.
“If I would have taken one more step or fallen on my left, I don’t know what would have happened,” Fred said. “It could have been it for me.”
Hoiberg's Heart
Minnesota Timberwolves guard Fred Hoiberg talks with reporters about his heart surgery during a news conference in Minneapolis on July 13, 2005. Hoiberg's basketball career was uncertain at that point. Associated Press file photo
Fred spent another four or five days at Mayo under observation. When the fluid didn’t reaccumulate, he was sent home.
For good this time.
Click. Click. Click. Click. Click.
If you listen closely, you can hear Fred Hoiberg’s heart. It’s a mechanical sound — the valve clicking and shutting with every beat.
The sound is a blessing. It means Fred is alive.
The sound is maddening. It means restless nights — unless there’s a fan or a white noise machine whirring to drown it out.
“After the surgery, I remember Carol saying, ‘Your side of the bed is shaking,’” Fred said. “It was beating so hard at the time — and still, if I have an extra cup of coffee, the pounding is exacerbated.”
In the early days, Fred made countless calls to Mayo.
Is it normal to feel every beat? … My heart is racing. Is that abnormal? … I felt great yesterday, but I feel terrible today. Is that normal?
The recovery “was hard,” Fred said, with “a lot of ups and downs.”
Symptoms of depression set in. Two things affecting his mental health: not knowing if he’d ever play basketball again, and knowing he couldn’t be the active, playful father he wanted to be.
“I did go through bouts of that,” Fred said. “But what helped? The Timberwolves did a thing where fans could send me (mail), so I had a huge stack of emails. Reading those well-wishes — I don’t know how you get through that if you don’t have a really good support system.”
His Timberwolves teammates also helped boost his spirits. Mark Madsen was the first person to come and visit him. Kevin Garnett showed up shortly thereafter — and stayed for hours and played video games with Jack, the second-oldest Hoiberg child.
“Kevin had no mercy,” Fred said with a laugh. “Jack’s this little kid, and they’re playing some baseball game, and he’s beating him like 40-1.
“But he really helped the family. All that meant a lot. And that certainly helped me get out of it.”
Eventually, there were more ups than downs.
Walking to the mailbox and back without stopping was a win. Eventually getting his shot back was a big deal. The act of attempting push-ups was notable.
Getting back out on the golf course was a victory… until it wasn’t.
In August or September, Fred golfed with Timberwolves general manager Kevin McHale and video coordinator Mike Lindahl. It was the first time since the operation that he’d even attempted to play. His swing, as he tells it, was smooth and easy.
Until the 12th hole.
“I looked down and I had a little pool of blood that was starting to accumulate right at the bottom of the incision,” Fred said, noting he was wearing a white shirt. “And Kevin looked at Mike and he said, ‘‘Can you believe we’re getting our ass kicked by a guy that’s bleeding?’”
He developed a slight infection in his incision that required another visit to Mayo and another surgery to effectively chisel the copper wire off his sternum.
“I’m like, ‘Oh my God. I don’t remember this pain from the first time around,’” Fred said. “But that started with that golf deal that day.”
In a salary cap move, Fred’s contract for the 2005-06 season was placed under the one-time amnesty clause — which meant he received his $1.76 million salary from the Timberwolves, but it didn’t count against the salary cap or the luxury tax. The downside: if he wanted to return to play that season, he couldn’t suit up for the T-Wolves.
By October 2005, Fred — who was serving as a sort-of assistant coach for the Wolves — had slowly worked his way back to running, shooting and lifting weights. He wasn’t cleared for contact until later.
By March 2006, Fred felt ready to play and began his quest to become the first player in NBA history to play with a pacemaker. He flew to Detroit to explore his options to play for his former coach, Flip Saunders, during the Pistons’ stretch run. He talked to Gregg Popovich, but the San Antonio Spurs wouldn’t touch him. The Phoenix Suns came within inches of signing him — drafting the contract papers and asking him which number he’d like to wear — but the Suns’ team doctor stepped in.
“He said, ‘I don’t think there’s much risk, but we just can’t guarantee there’s none,’” Fred recalled of their conversation in the Suns' training room. “That’s really what I was waiting to hear. I was waiting for somebody to give me a reason.”
Fred officially retired on April 17, 2006, and joined the Timberwolves front office.
With that news, Carol exhaled.
Secretly, she was terrified of Fred playing again. She wasn’t going to forbid him from suiting up, but being supportive was hard. She knew she wouldn’t be able to watch any of his games moving forward because it made her sick to think of what could happen.
Fred thinks about that, too.
He hypothesized what could happen if he happened to take a charge from Shaquille O’Neal or any number of the league’s more physical forwards and centers. He thought back to the most painful moment of his career: when he took a charge from Karl Malone in the 2004 Western Conference Finals, and The Mailman’s knee ended up in Fred’s ribs.
“What if he hit me higher?” Fred asked.
“They were OK with me doing it. But the 1% chance if I got hit in the wrong place and it dislodged a wire, (doctors) just didn’t know the potential of what could have happened.”
Even though Fred knows he made the right decision, he wonders about more than the morbid, too.
What if he signed with the Suns? What if he accepted the risk? He knows he would have earned playing time in the Western Conference Finals after Suns shooting guard Raja Bell went down with a calf injury. Would that have propelled him to more? How much more?
“God, I still don’t know if I’m at peace with it,” Fred says now. “If I would have kept shooting the ball, I think I could have played 18 to 20 years. I was feeling as good as I ever had in year 10 at 32. Could I have gotten to 42? I don’t know. But I think I could have.
“Listen, I understand how fortunate I am to be where I am today. I know everything happens for a reason. But I still look back on it, ‘What could I have done in this game?’”
Hoiberg's Heart
Fred Hoiberg watches his Iowa State team during basketball practice before an NCAA tournament game in Louisville, Ky., on March 14, 2012. Associated Press file photo
April 17, 2015
Fred Hoiberg knew this day was coming.
Iowa State’s head basketball coach had known for years that his bicuspid valve was slowly showing signs of degeneration. At first — six or seven years after his first open heart surgery — the valve started to mildly regurgitate. A year or two later, that escalated to moderate regurgitation. The following year, his doctor at the Mayo Clinic said the magic words.
It’s time to start thinking about getting your valve replaced.
Fred could feel it, too. Neckties now made him dizzy, so he stopped wearing them — causing confusion among the Cyclone faithful. In December 2014, his doctors told him it was time.
But the Cyclones were in the midst of a phenomenal run — ending December ranked as the nation’s No. 9 team with All-American Georges Niang and All-Big 12 Monte Morris and Jameel McKay earning plenty of the national spotlight.
“I said, ‘Listen, if we can wait until the end of the season, I think we have a chance to do something here with this team,’” Fred told his doctors.
The Cyclones ultimately beat nine ranked opponents that season en route to Iowa State’s Big 12 Tournament victory and earned a No. 3 seed in the NCAA Tournament before losing to UAB.
“As that season went on, I really did feel tired,” Fred reflected. “You’re always tired as a coach, but I felt it even a little bit more, especially looking back on it. I’m like, ‘Man. I should not have been coaching.’
“Carol was the one, really, that said to me, ‘Listen. I know this may not sound right, but I’m probably the one Cyclone fan that’s happy we’re done because you weren’t right.’”
Fred opted for a mechanical On-X Aortic Heart Valve. He will have to be on blood thinners for the rest of his life, but he’d rather take a daily pill than take the risk of potentially needing a third open heart surgery.
Hoiberg's Heart, 6.18
Fred Hoiberg poses for a photo with his two heart surgeons, Dr. Rakesh Suri (left, 2015 procedure) and Dr. Hartzell Schaff (right, 2005 procedure). Mayo Clinic
In total, Fred has had seven procedures related to his heart condition.
There were two open heart surgeries — the one in 2005 and the one in 2015. There were two emergency procedures: the pericardial effusion and the removal of his copper wire. He’s had three pacemakers put in, including the most recent one in 2024.
“I’m pretty scarred up,” Fred said with a laugh. “I’m in the zipper club. My pacemaker, you can see the outline of it every day. Drainage tube scars, falling on my chin. I still have the scar on my chin from where I had to get stitches.”
There are other small lifestyle changes too, but as he says, “it’s not a big deal.”
He can’t go through metal detectors, so he has to get patted down when he flies or goes through stadium security. He can’t get an MRI. He avoids foods high in Vitamin K, since Vitamin K is a coagulant and he’s on blood thinners. He keeps his phone away from his pacemaker and usually talks on speakerphone. He tries to stay away from microwaves out of an abundance of caution. His pill regimen consists of a nightly blood thinner, a statin and a twice-daily beta blocker. He still avoids neckties, which is less of a problem now since coaches don’t wear suits anymore.
“‘I tell people who are going through it, I say, ‘I’m not going to sugarcoat this thing. It is hard. It is painful. Every day, you’ve gotta trust the process, to use a basketball term,’” Fred said. “‘You’ve gotta listen to the doctors. You gotta follow it to a T. And if you do that, you’re gonna gradually get better. And then one day you’re gonna feel — maybe not totally like yourself again, but you’re gonna feel pretty normal again.’”
October 27, 1976
Karen Hoiberg picked up the phone.
“Dad’s dead,’” Karen remembers her sister saying of their father, former Nebraska basketball coach Jerry Bush.
Bush went out for an evening walk in their neighborhood near the Country Club.
He died less than half a mile from home at the corner of 27th and Calvert due to an apparent heart attack. His death certificate cites atherosclerosis as the root cause, which can lead to heart attacks or strokes, but the coroner didn’t perform an autopsy to know for certain.
“I think he had some warnings about heart things, but he chose not to go to the doctor,” Karen said. “I can’t remember if he ever did go or not. I think he was afraid. He had just turned 62. That’s such a young age, and Fred’s just 10 years away from that.”
Because there wasn’t an autopsy, it’s impossible to know if Bush had an underlying heart condition. Knowing the strong genetic link, Fred wonders if his grandfather also had a bicuspid aortic valve. Fred also wonders what could have happened if his grandfather had been checked out by a medical professional.
But those “what ifs” end here.
Everyone related to Fred — his brothers, his cousins, his children, etc. — was evaluated. Everyone who talks to Fred will hear him emphasize the importance of getting evaluated, regardless of whether they have a family history.
In fact, inspiring people to get tested is Fred’s “No. 1 motivation.”
“It’s an easy test,” Fred said. “A lot of it can be an EKG, which takes three minutes. If they find something there, maybe they’ll do a stress test, maybe they’ll do an MRI. I just can’t stress it enough. The No. 1 killer in the world is heart disease. So it’s important that people get checked.”
Fred knows he’s a perfect example.
He was in the best shape of his life as a 10-year NBA veteran. He had no symptoms. He was performing at an all-time high.
And yet? A silent, would-be killer lurked beneath the surface.
“When I look back on this whole thing, I realize how fortunate I was and how blessed I am that I found out about it before it was too late,” Fred said.
“It’s kind of ironic, getting rejected for life insurance probably saved my life.”
Cal State Fullerton vs. Nebraska, 11.26
Nebraska's head coach Fred Hoiberg talks to his team in the huddle during the second half of a game on Sunday, Nov. 26, 2023 at Pinnacle Bank Arena. ARTHUR H. TRICKETT-WILE Journal Star
0 Comments
Be the first to know
Get local news delivered to your inbox!