VESTAL, N.Y. - Forget soccer. It turns out, sophomore defender Gabby Piontkowski's life was in the balance when she went to Lourdes Hospital on the night of September 13, 2018.

That day, BU had beaten Bryant 1-0 in overtime at the Bearcats Sports Complex, but then-freshman Gabby could hardly celebrate. She hadn't been playing due to increasing fatigue, cramping and breathing issues that began at home in Baldwinsville, N.Y. and continued as preseason camp began at Binghamton. She initially thought they were a result of limited training as she recovered from strep throat and a sinus infection in early August. As Piontkowski sat in her residence hall that evening, though, her pain reached a peak.

"I couldn't fall asleep because my breathing and cramps were so bad that I couldn't even lay down without crying from pain," she says.

After heading to the hospital with her father, she was diagnosed with a deep vein thrombosis in her leg – a condition that had in turn become a very serious one – a pulmonary embolism that had now reached her lungs. That explained the breathing trouble, rapid heartbeat, severe pain and cramping she had been feeling as the Bearcats moved from preseason training into their 2018 fall season. But nothing could prepare Piontkowski for the message she then received from the doctors.   

"The first thing the doctor told me was that if I didn't come to the hospital that night I could've passed away from a stroke," she says. "That was super scary. It was definitely the last thing my family and I expected all these issues to be."

For now, soccer was on hold. Getting her back to full health was the focus. "All we knew at this point was that we had to do whatever it was to get myself normal again," she says.

Gabby finishes her high school career in style
Two months earlier, Piontkowski was riding high after graduating from Charles Baker High School outside Syracuse. During her stellar four-year career, her team lost just nine games – a win percentage of near 90 percent. She was coming off a senior season capped with a state title for her team and individually, national All-America honors. In previous summers, her play with club team Syracuse Development Academy had attracted the interest of BU head coach Neel Bhattacharjee.

"We could see how competitive and coachable she was and those are two main elements we look for in any prospect," Bhattacharjee says. "We knew with her skillset she could play anywhere in our backline. Gabby's positive demeanor, academic standing and work ethic made her a terrific fit for us."

Now Piontkowski turned her attention from her high school career to the challenge of NCAA Division I athletics in the fall.

"The state title and All-America honors were a great ending to my high school career but I also knew that I had to work even harder for college soccer," she says. "My main priority was to focus in improving my game during club ball and get stronger and more fit for college. I didn't want to let myself or the coaches down."

She dove into the Binghamton workout packet and trained every day throughout the summer. But toward the end of July, she started to quickly fatigue when she worked out. She also began to experience leg cramping and swelling. A driven athlete, Piontkowski still thought it was a byproduct of overtraining … perhaps a pulled muscle or pooling blood due to being bedridden with her strep throat.

Challenges mount as she heads to Binghamton for preseason
When Piontkowski arrived on campus for her first college preseason camp on August 1, she was worried. She wasn't in the shape she wanted to be and still had frequent cramping and breathing issues. Those concerns were layered on top of the usual freshman emotions of leaving their families and starting over in a new, competitive environment with strangers.

Freshman teammate and roommate Kayla Mackenzie, could see the frustration and pain that accompanied Gabby every day. "I felt horrible for Gabby when she was going through such a difficult time."

Even with an unknown medical condition, Piontkowski still showed her overall physical conditioning by passing the first fitness test and nearly hitting the mark on another – an accomplishment that made her discomfort all the more mysterious. Despite being held back from scrimmages and games, Piontkowski still pushed herself through practices as the regular season began on Aug. 17. But there was no relief to the symptoms and stress.

"I felt myself getting 'panic attacks' during practice because my heart would start beating so fast and I could never catch my breath," she says.

As the team worked its way through their early schedule, Piontkowski's personal discomfort grew. In addition to uneven breathing, her cramps had now advanced to her chest and collarbone. She couldn't breathe, sit or talk without pain. 

Piontkowski's teammates noticed her mounting health concerns and frustration.

"When Gabby first started feeling really fatigued you could tell she was really confused and had no idea what the problem was," freshman teammate Haylee Poltorak says. "She would always just say 'it's probably nothing … most likely cramps' but as time went by, you could see she was getting uneasy and frustrated."

Pulmonary embolism diagnosis jolts everyone
When she was discharged from Lourdes Hospital two days later, there was a new normal. Appointments with an oncologist and pulmonologist and plenty of blood tests. At minimum her season was over.

Her coaches and teammates wrestled with the news as well.

"Personally I was gutted for her," Bhattacharjee said. "She put in her time and preparation like everyone else and to see her season end with no control over an unforeseen circumstance was hard to accept. We all tried to do our part to incorporate her into the things she could do with the team and just be as positive as we could during that difficult time."

"I saw both frustration and sadness from Gabby," sophomore defender Erin Theiller says. "She's a competitor and loves the game and I know how much it broke her heart to not be out there on the field with us. I can't even imagine what it was like for her but she did it and never complained."

On the field, Piontkowski's teammates continued their season without her. After a strong start that included a 6-0 home record and two early conference wins, the Bearcats struggled through October and missed the playoffs by one win. 

Meanwhile, Piontkowski was cleared by her pulmonologist on November 26. Her oncologist then said she would be away from competitive soccer for just six months – welcomed news that gave Piontkowski her first piece of positivity. Except it wouldn't last.

No more competitive soccer
After additional blood tests, the doctor changed his mind and on April 11, he shared a much-more drastic prognosis.

"He said I should quit soccer because it would be too dangerous for my health," she says. "That was the toughest day of my life, being told to quit a sport I had played since I was three years old. I felt like my life was over because all I had dreamt of since I was younger was playing college soccer."

Her teammates were quick to lend their support.

"When Gabby first found out the news I could tell she wasn't completely herself for the first few days … it hadn't quite hit her yet," Poltorak says. "I felt so bad … it's hard to see someone receive news like that. I knew all I could do was be there for her when she needed me and prevent her from getting down on herself."

Even as Gabby and her family considered getting a second medical opinion, she remained part of the team on a daily basis. She came to spring practice with a smile on her face, locked into the strategy discussions and did her best to remain a contributor to the team. Piontkowski had completed team conditioning throughout the winter and now practiced outdoors without contact during the month of April, despite carrying the emotions of the initial medical prognosis.

The way she attacked her rehabilitation impressed her coaches and teammates.

"Whenever she achieved a milestone in her recovery, I wanted all of us to make it a point to recognize that step," Bhattacharjee says. "Gabby looked for ways to incorporate herself within training, whether that was helping with equipment or keeping score during a small-sided training game. She kept up with her appointments, followed the instructions of our team trainer Kara (Gorgos) and medical staff and balanced that with her academic demands."

"She came to every single practice with a smile on her face and a positive attitude," Poltorak says. "Despite all of this she always did well in school and didn't let this get the best of her."

In the spring, Bhattacharjee could see the progress Piontkowski was making.

"Gabby was at the front of the pack during conditioning," he says. "During ball exercises she would keep her focus high and then do some more on her own whenever the team moved on to something that involved playing and contact. She always did her technical work to a high standard."

That high standard extended to her academic work as well. Despite all the medical challenges and emotional waves, she earned a 3.42 grade-point average in the spring semester.
 
Second opinion in May provides a new plan
It was the recommendation of a second oncologist, appointments with specialists at University of Rochester, along with more blood tests that paved the way for a new prognosis. In late May, Piontkowski was now cleared to play soccer again.

"I was so grateful to know I could be back on the field with my team, playing the game I love," she says.  
 
When classes ended, Piontkowski returned home to Syracuse and continued her training. She worked with Corey Parker, Syracuse University trainer and highly acclaimed strength and conditioning coach, focusing on raising her fitness and strength levels. After an unforgiving freshman season, she was determined to be healthy, fit and a strong presence on the field when she returned to campus in August. It didn't take long for her coaches and teammates to witness her impact.

A new season and outlook
"It was very evident early how fit Gabby was," Bhattacharjee says of her preseason work this past August. "As a staff we expected her to perhaps be a bit behind, given the limitations placed on her over the previous months. But she was a beast in the fitness tests and then really stood out with her play at the outside back position. We didn't know how much she would be able to handle but she eradicated any doubts quickly."

After preseason scrimmages against Bucknell and Marist, Bhattacharjee knew she had earned a starting spot and heavy minutes on the outside of BU's back line. She lined up as a starter for the team's opener against St. Bonaventure on Aug. 22, played a full 90 minutes and never looked back.  

"Going through everything I did during my freshman year and after nine long months of not playing soccer, I could say I was the happiest and most grateful girl on that field," she says.

With Piontkowski helping anchor a back line that featured Theiller, Mackenzie and senior Lauren Spinnato, BU won 10 games and returned to the postseason. She logged more than 85 minutes a game and the Bearcats' back line produced eight shutouts.

At the team's annual banquet in December, Piontkowski was awarded the "Comeback Player of the Year" award by her team. Assistant coach Emma Firenze, herself a standout collegiate player who also had to overcome health issues, shared the collective sentiment when presenting her with the honor.

"She controlled everything she could, including her attitude, effort, technical ability on the ball and fitness, all while continuing her rehab. She continued to push herself through the summer. Tough times don't build character, they reveal the character that one already has inside. You are an inspiration to us all Gabby."

Bhattcharjee remains inspired by what he saw from Piontkowski and his entire team.

"Her resilience and resolve are such an inspiration to all of us," he says. "I was just so impressed with Gabby and how she handled that extremely tough situation. And I also was proud to see her teammates step up to give her encouragement because she needed to hear those reassuring words too. Gabby's selflessness and dedication are why her teammates and staff admire and love everything about her."
 
Handling adversity and staying focused also helping during COVID-19
After a rollercoaster freshman year, Piontkowski's second college year now has been altered due to the COVID-19 pandemic. She and her teammates lost their spring training season - the second time she will miss the key program-shaping time period. Along with BU's 400+ student-athlete base, she is adjusting to online classes and solo workouts from home, and hoping for a return to normalcy come August.

But regardless of the timetable, Piontkowski is perhaps more prepared than most for this stressful and unpredictable period.

"The good news is that our team is full of girls who are motivated and driven to work hard and get better every single day," she says. "All we can focus on right now is ourselves, in terms of getting fitter, stronger and better on the ball. If we do that, we will be better prepared for whatever is thrown at us."

Spoken from experience.