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Like a golfer who remembers each shot, recalled the late Steelers owner Art Rooney, Lombardi remembered all the breaks of the season that went in his favor, fumbles recovered, punts that rolled out of bounds instead of into the end zone Again, I take all this with a grain of salt He never talked about luck with his players; he talked about preparation And on more than one occasion, he used the parity argument to make exactly the opposite point: Luck doesn t favor the lucky; it favors the prepared team In pro football, he once told an assistant, the balance of personnel is so even that the difference between success and failure is player control in every phase So again, we have a paradoxical, somewhat elusive figure at the heart of this book My father made forceful statements statements that he obviously believed that were contradictory.

He sometimes said less than he intended to say and puzzled his listeners He sometimes said more than he intended to say and had to beat a quick retreat For all of these reasons, we will have to proceed carefully as we attempt to tease his leadership model out of the things he said and did Red Blaik, the head coach at West Point who taught Lombardi much of what he knew about coaching football, once made an eargrabbing statement about my father: Lombardi, Blaik said, is a thoroughbred with a vile temper..

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soon followed by amitriptyline (Elavil) and then by desipramine (Norpramin) and nortriptyline (Pamelor) Another important dibenzazepine derivative is carbamazepine (Tegretol), which is widely used in the control of seizures but has also found a place in the treatment of lancinating neuropathic and myelopathic pain and possibly of depression and mood instability Subsequently, a number of additional antidepressant drugs were introduced Included here are variants of the conventional tricyclic drugs (amoxapine, protriptyline, trimipramine, doxepin), tetracyclics (maprotiline), bicyclics (zimeldine), and others (trazodone, bupropion) A full account of these drugs, which will not be attempted here, can be found in the monographs of Hollister and of Pirodsky and Cohn The mode of action of these agents is not fully understood, but there is evidence that they block the reuptake of amine neurotransmitters, both norepinephrine and serotonin.

Blocking this amine pump mechanism (called the presynaptic plasma transporter), which ordinarily terminates synaptic transmission, permits the persistence of neurotransmitter substances in the synaptic cleft and does no more than support the hypothesis that endogenous depression is associated with a de ciency of noradrenergic or serotoninergic transmission The tricyclic antidepressants and the serotoninergic drugs discussed in the next section, are presently the most effective drugs for the treatment of patients with depressive illnesses, the former being particularly useful for those with anergic depressions associated with hyposomnia, early morning awakening, and decreased appetite and libido The side effects of the tricyclic drugs are less frequent and far less serious than those of the MAO inhibitors The tricyclic (dibenzazepine) compounds are potent anticholinergic agents, which accounts for their most prominent and serious side effects orthostatic hypotension and urinary bladder weakness.

They may also occasionally produce CNS excitation leading to insomnia, agitation, and restlessness but usually these effects are readily controlled by small doses of benzodiazepines given concurrently or in the evenings Rarely, they may cause ataxia and blood dyscrasias As indicated earlier, the tricyclic drugs should not be given with an MAO inhibitor; serious reactions have occurred when small doses of imipramine were given to patients who had discontinued the MAO in the previous days or week It must be repeated that both the MAO inhibitors and the tricyclic antidepressants are dangerous drugs when taken in excess Tricyclic compounds are a frequent cause of accidental poisoning and a favored suicidal instrument of depressed patients.

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