It turns out the physical infirmities that ultimately doomed the Red Sox in defending their world championship extended to their manager.
''Physically, I felt like I got run over by a truck the whole year," Terry Francona said yesterday, acknowledging for the first time he never fully recovered from a health scare that landed him in a New York hospital before the third game of the season.
''This is the toughest thing I've ever gone through," Francona said the day after the White Sox swept the defending champs in the Division Series. ''I don't mean that I hated it. I just mean that it was a very difficult year."
In guiding the Sox to their third straight regular season with 95 or more wins -- a first in franchise history -- Francona struggled almost daily to maintain his stamina as he tried to compensate for debilitating injuries to key contributors such as Curt Schilling, Keith Foulke, Wade Miller, and Matt Mantei, and confront additional obstacles such as disruptions involving Manny Ramirez and former outfielder Jay Payton.
''There were times I worried about him," said Brad Mills, Francona's bench coach and confidant. ''Sometimes he would talk about it, but other times he would keep it in and wouldn't share it with anybody."
The most second-guessed decision maker in New England, the Sox manager knew by the time he broke camp in Fort Myers, Fla., that the new season would be nothing like the glory year of 2004. Schilling was a shell of himself as he rushed back from right ankle surgery. Foulke's future was shaky after he rebuffed the team's advice to undergo surgery on his right knee. Miller and Mantei, with histories of health woes, were medical problems in the making.
So, too, was Francona, whose health has required close monitoring since he suffered a life-threatening pulmonary embolism in 2002. Francona said in an interview he suspects he may have suffered another embolism April 6 in New York, where a medical team rushed him from Yankee Stadium to a hospital by helicopter. He said the experience felt eerily similar to the earlier embolism.
''I never seemed to bounce back after that," he said of the April 6 incident. ''It really took a toll."
Mills suggested stress might have played a role in the scare.
''We had to make some changes in our roster that were bearing on him," Mills said. ''We were opening against the Yankees. It was a big series, and things might have come to a head."
While Mills guided the Sox that night in Francona's absence, general manager Theo Epstein sat by the manager's hospital bed. Epstein described the event as ''the scariest moment" of Francona's season of health woes.
''It was not fun sitting in that hospital in New York listening to that game on the radio," Epstein said.
Though Francona's illness was officially described as a virus, he said doctors increased the dosage of his blood thinners to help prevent the recurrence of another life-threatening clot.
''I can't prove it was another embolism," he said, ''but it was too much of a coincidence for me."
Just as Francona protected his players from disclosing their injuries -- only yesterday did he acknowledge that Edgar Renteria coped with groin and lower back problems during the season -- the second-year manager generally concealed the extent of his own struggle. He suspects his condition may have been aggravated by his hectic offseason schedule and a lack of free time this season.
Francona spent the 2005 All-Star break managing the American League team in the Midsummer Classic. He devoted another traditional off day to managing the Sox at a Hall of Fame exhibition game in Cooperstown. And he lost another off day coping with the fallout from Ramirez refusing to play a game in Tampa Bay in July after an injury to Trot Nixon.
Though the confrontation with Ramirez may have improved their relationship in the long run, Francona said, ''That was a tough couple of days."
So was the day earlier in July when Payton lashed out at Francona and Mills for asking him to enter the game as part of a double switch against the Rangers in Texas. Francona dealt swiftly with the insubordination, sending a message to the rest of the team.
''He called Theo and said, 'I want him gone and I want him gone now. I don't want him on the flight to Baltimore,' " Mills recalled.
With Epstein's blessing, the Sox departed for Baltimore without Payton. The move paid dividends as the Sox rid themselves of a disruptive influence in exchange for Oakland's Chad Bradford. Payton's departure also cleared the way for Gabe Kapler's return, which, several coaches and players said, lifted the team's spirits.
Still, Francona was so exhausted after a night game at Fenway Park later in the season that he was unable to return to the hotel room in Brookline he was sharing with his son, Nick. He slept on his office couch and rose early the next day to join his coaches in preparing for an afternoon game.
''We try so hard to be as good as we can and when things aren't going that way, the obvious answer to all of us is to spend more time here [at the park]," he said. ''You kind of run yourself into the ground."
While the rotation suffered from the injuries to Schilling and Miller in particular, the bullpen was plagued by a rash of ineffectiveness, none more damaging than Foulke's.
''I couldn't imagine having to manage the ball club this year because of all the things we had to go through every day," said third base coach Dale Sveum. ''I mean, my God, what if [Jonathan] Papelbon hadn't come through? What would we have done?"
The more the Sox struggled, the longer Francona and his staff worked. Francona generally arrived by 10:30 a.m. for games that started at 7:05 p.m., and he stayed until after midnight. His work ethic was not lost on his players, several of whom praised his ability to maintain his calm despite his frenetic pace.
''Tito has been great," David Wells said. ''He stays out of our way. He says, 'You know what you need to do. Just come out and play hard and do whatever you have to do.' He doesn't sit there and make rules and point fingers at guys. We're grown men and he respects that."
Francona has one year remaining on his contract, which includes a team option for 2007. With Epstein's contract about to expire Oct. 31, the team has yet to focus on Francona's long-term future. But Epstein yesterday gave Francona a strong -- if informal -- endorsement.
''Terry did an outstanding job this year," Epstein said. ''The way he manages this club is for the long haul, to get the best out of these guys for the whole season. He makes the whole greater than the sum of the parts, and he deserves a lot of credit for that."
Epstein also endorsed Francona's plan to rest and improve his health.
''I don't ever want to shortchange anybody in this organization because of my lack of energy," Francona said. ''I need to work a little bit at that."
He said he plans to undergo a physical soon and hopes to recover well enough that he can report early next February for spring training.
''I love what I'm doing and I want to do it well," Francona said. ''But I can't sit here and say I want to do it for the rest of my life."