Florida freshman Randy Russell walked into football coach Dan Mullen’s office last month, just one week after he had arrived on campus, and saw his mother, his girlfriend and a team doctor already seated there.

The redness around his mother’s eyes gave it away. This wouldn’t be a happy meeting.

“I could see it in her eyes,” Russell said. “I figured it was bad.”

An echocardiogram had confirmed an earlier test result — Russell was diagnosed with hypertrophic cardiomyopathy (HCM), a genetic condition in which the heart muscle grows too thick. HCM is a leading cause of sudden cardiac death among young athletes, meaning that if Russell’s condition hadn’t been caught, he could have died on the field or during a workout with little or no warning.

So on Wednesday — a day when hundreds of football players his age all over the country will sign National Letters of Intent just as he did in December — Russell will sit with the knowledge that his college football career ended before it had a chance to begin.

Russell, a safety from Opa Locka, Fla., signed with the Gators on Dec. 20, the first day of college football’s first early signing period. He had never noticed any of the symptoms experienced by most non-athletes with HCM — symptoms like difficulty breathing, dizziness and heart palpitations. The NCAA does not mandate that schools perform electrocardiogram (EKG) tests on athletes before participating, but since 2012, Florida has put all incoming Gators athletes and spirit squad members through an extensive preparticipation cardiac screening that includes an EKG.

Three years ago, the NCAA’s chief medical officer Brian Hainline planned to recommend that member schools administer EKGs to incoming athletes, but a petition by more than 100 team physicians outlined their opposition to that plan for multiple reasons. They wrote that such tests are expensive, they can often produce false positive results for HCM — thus requiring additional testing — and many team doctors lack the expertise to accurately read EKG results.

Still, Russell wants to become an advocate for such testing — testing that be firmly believes saved his life.

“I want to promote mandatory screening in college and high schools,” Russell said. “People need to be made aware of this and know that it saves lives.”

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Michelle Fields-Wilson said she thinks about her son, Nick Blakely, “daily and hourly.” And that’s why she has devoted her life to raising awareness about sudden cardiac arrest.

Blakely was a sophomore at Stetson University when he began to feel dizzy during a preseason football practice last August. He went to the sideline for about 30 minutes, then collapsed and died. The 19-year-old had never experienced any warning signs before that day, and after he collapsed the people around him were so confused about what was happening that they believed he was having a seizure, Fields-Wilson said.

Cardiac tests are not part of Stetson’s preparticipation protocol. Blakely went through a redshirt season in 2016 and an offseason of intense workouts without any problems, so there was no reason to think anything was wrong. When it was clear something was wrong, it was too late.

So when Fields-Wilson saw an article online about Russell’s situation, she reached out to Keisha Carnegie — Russell’s mother — and then to Russell himself.

“We have been uneducated about this for far too long,” Fields-Wilson said. “I told Keisha, ‘I would rather have been standing next to Nick saying, ‘Son, you can’t play,’ than be where I am now. Early detection is the key to saving lives.

“When I talked to Randy, I told him that just because he can’t play, there’s a place for him. And we’d rather it be up standing than in the grave.”

Russell was a star at Carol City High School in Miami Gardens and took extra classes to graduate early and begin his college career in January. On his first day after arriving in Gainesville, he went through a physical and other tests just like the rest of his fellow early enrollees.

But his EKG came back abnormal. Team doctors told Russell he would have to go through some more tests, but Russell didn’t worry because he thought the first test must have been a mistake. He’d never had any heart problems — or even a hint of them.

A week later, there he was, in Mullen’s office grappling with the fact that he can’t ever play football again.

“I was crushed,” Russell said. “You can ask anybody — I did everything right. I’m not a smoker. I’m not a drinker. I couldn’t understand why this happened.”

HCM affects approximately one in 500 people, according to Mayo Clinic cardiologist Steve Ommen. Most can live a completely normal life. But the slim portion of the population that has the physical fitness to play sports at an elite level, such as football at the University of Florida, is more susceptible to having HCM without any symptoms, Ommen said.

“Most athletes don’t know about it because they are able to compete and function at super-normal levels compared to the rest of us,” Ommen said. “It’s not due to their heart compared to everyone else with HCM. It’s just because they are in such prime physical shape.

“For the general HCM patient, most of the non-athlete patients are diagnosed because they have symptoms and go to get evaluated.”

This is where training and recognizing symptoms comes in handy. Twelve states have laws on the books mandating that high schools give coaches and players training on sudden cardiac death and warning signs to look for. Georgia Rep. David Clark recently introduced similar legislation — called the “Jeremy Nelson and Nick Blakely Sudden Cardiac Arrest Prevention Act” — in his state after Blakely and another young athlete from Clark’s district suffered sudden cardiac deaths.

“More than ever, we’re seeing these kids push themselves to whole new levels,” Clark said in a phone interview. “Most of the time, you’re gonna tell your buddies how you’re feeling before the coach. You want to look good for your coach, so chances are, you’re gonna want to tell your buddy next to you if something is wrong.”

That’s why Clark sees it as important to train young people to notice signs that something may be wrong with their teammates. If the legislation were to pass, schools would be required to put coaches and athletes through sudden cardiac arrest training before each school year.

“It’s basic,” Clark said, “but I’m thinking that if this can pass, then maybe we can push it to more school levels.”

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Mandating EKGs at the college level and possibly at high schools, too, is what Russell wants to see happen, and it’s at the center of what Fields-Wilson sees as her “mission” since her son’s death.

“Doing this work means his (dying) was not in vain,” said Fields-Wilson, who has started The Nick Blakely Foundation to raise awareness for sudden cardiac death.

Each time there is progress in her fight, she goes to the cemetery and tells her son about it.

But many experts say mandatory EKG testing would be difficult for myriad reasons. The costs alone have been a deterrent, especially for smaller colleges and high schools.

“That’s a complicated discussion to get into, because if a life is saved, how much money is that worth?” Ommen said. “You can’t put a value on that.”

Ommen also said that EKGs are prone to producing false positives for HCM because, “it’s a very rough tool and not very specific for this diagnosis.” That means additional tests and maybe even an athlete giving up his or her sport unnecessarily.

The American Heart Association actually recommends against routine, widespread use of EKGs. The AHA has published a 14-step screening process to help identify if someone is prone to suffering a sudden cardiac arrest. If anyone answers “yes” to any of those 14 points, it is recommended that person seek further testing. The AHA’s 14-step process is at the heart of the NCAA’s guidance — released in April 2016 — on preventing sudden cardiac death.

“The key for athletes is to be brutally honest,” Ommen said. “Are you truly able to keep up with your peers? Are you having any symptoms that seem funny? Do you get dizzy at the extremes of exertion? Do you have a funny heartbeat? I think it’s really important to pay attention to those items on that 14-point checklist and follow up on them.”

Last week, the medical journal Circulation published a study that challenged the conventional wisdom that a person diagnosed with HCM should quit their sport, concluding that “the incidence of event/symptoms (of sudden cardiac death) is largely independent from continuation or interruption of regular exercise and sport programs,” although it did say more research is needed to corroborate those findings.

For his part, Russell is thankful that Florida’s screening process caught his condition and — although difficult — ended his football career. That goes double for his mother.

She has wondered, what if her son had enrolled at a school that didn’t mandate EKGs? What if he hadn’t graduated high school early and had instead spent the spring going through intense workouts to get ready for college? What if Carol City hadn’t lost in the Florida Class 6A quarterfinals, meaning the possibility of two more games?

“I have four children and they all know it — he is my favorite,” Carnegie said with a laugh. “I mean, I love all my kids the same, but he’s the favorite kid because he’s always taken the initiative to, say, take out the garbage. He’s always been mature for his age.

“Sometimes I forget that he’s only 17. And then when he does things that a 17-year-old does and I really get angry, I have to remind myself that he’s still 17.”

A recent sign of that maturity: Russell has decided to find inspiration in his situation. He plans to advocate for more awareness and is now thinking about a career in medicine. He recently began shadowing a doctor at Gainesville’s Shands Hospital to learn more about the medical field.

“I want to try to go as much as I can to stay busy,” Russell said. “I was inspired, just seeing the doctors and how they treated me, and the way it must feel to save somebody’s life.”

He’s also still firmly part of the Florida football team, even if he can’t play. He is living in athletic dorms with football players as roommates. He plans to help out as a student coach next fall. Though he will never play a down for the Gators, he will retain his full scholarship on a medical exemption.

“I feel like something really big is going to come of this,” Carnegie said. “I don’t know what yet, but it’s gonna come.”

(Photos of Randy Russell and his mother courtesy Keisha Carnegie)