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Sickle cell and football: Why the disease that mainly affects Black people needs more research

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Sickle cell and football: Why the disease that mainly affects Black people needs more research

This article is part of The Athletic’s series marking UK Black History Month. To view the whole collection, click here.


Lassana Diarra was preparing for the 2010 World Cup in South Africa. 

The midfielder, who had spells with Chelsea, Arsenal, and Portsmouth in the Premier League, was coming off the back of a difficult first season with Real Madrid. That campaign, 2009-10, he had made 30 appearances in all competitions for Manuel Pellegrini’s side as they finished second in La Liga, three points behind Barcelona. They had also crashed out of the Champions League at the last-16 stage against Lyon.

Keen to put an underwhelming club campaign behind him, Diarra, aged 25, joined up with the France squad — which included Thierry Henry, Franck Ribery, Hugo Lloris, Nicolas Anelka, and Karim Benzema — in a pre-tournament training camp. Tignes was the destination, chosen for its high altitude that would mimic conditions in South Africa.

However, on May 22, 2010, his hopes of playing on the world stage were dashed.

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“Further to his intestinal pain contracted on the glacier in Tignes, check-ups have detected evidence of an unpredictable illness which justifies rest for an indeterminate period,” a statement from the France Football Federation read.

Diarra’s diagnosis was later confirmed as sickle cell anaemia.


Diarra playing for Real Madrid in 2010 (Elisa Estrada/Real Madrid via Getty Images)

The National Heart, Lung, and Blood Institute (NHLBI) defines sickle cell disease — the most common being called sickle cell anaemia — as a group of inherited disorders that affect haemoglobin (the major protein that carries oxygen in red blood cells). In sickle cell disease, red blood cells are misshaped, typically crescent- or “sickle”-shaped due to a gene mutation that affects the haemoglobin molecule. When red blood cells sickle, they do not bend or move easily and can block blood flow to the rest of the body.

Symptoms include painful episodes called sickle cell crises, an increased risk of serious infections and anaemia — where red blood cells cannot carry enough oxygen around the body — which can cause tiredness and a shortness in breath.

According to Healthline, a provider of healthcare information in the U.S., Black people are at a much higher risk of being affected by sickle cell disease. Researchers believe the reason lies in how this condition has evolved over time to protect against malaria — most common in sub-Saharan Africa, where sickle cell is prevalent. Having the sickle cell trait helps to reduce the severity of malaria.

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The sickle cell trait is found in one in four west Africans and one in 10 Afro-Caribbeans. It is also found in people who originate from the Mediterranean, Asia, and the Middle East. It is less common in white Europeans.

Sickle cell disease and the sickle cell trait differ, as people with the trait carry only one copy of the altered haemoglobin gene and rarely have any clinical symptoms related to the disease, while people with the disease carry two copies.

The American Society of Hemotology say more than 100 million people worldwide have the sickle cell trait.

Despite how common the condition is and its sometimes fatal consequences, sickle cell is still a relatively unknown condition and its effect on sporting performance is lesser known still. 

Part of the conclusion of ‘A Case Study of Two Premiership Footballers with Sickle Cell Trait’, a 2014 study conducted by the British Journal of Sports Medicine (BJSM), stated that “further research would be necessary with a larger cohort in order to further establish the relationship between redox homeostasis (defined as the maintenance of a balance between reducing and oxidizing reactions within a cell) and sickle cell trait in athletes”.

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The BJSM did not respond to requests for comment from The Athletic.

Geno Atkins, a former defensive tackle for the NFL’s Cincinnati Bengals, spoke on his experience with the trait earlier this year. “I knew from my research that it would not be good for me to play in high altitude, so I prayed I wouldn’t get drafted by Denver, which is at a high altitude,” he told the Centers for Disease Control and Prevention (CDC). “I ended up in Cincinnati and have played at a very high level without any adverse effects of the sickle cell trait.”

He added: “Having the sickle cell trait does not exclude an athlete from participating in sports; however, the training staff and coaches need to take precautions to ensure the athlete is not put in dangerous situations.” In this case, Atkins cited an example of training in extreme heat.


Former Bengals defensive tackle Geno Atkins (Ian Johnson/Icon Sportswire via Getty Images)

Professional basketball player Billy Garrett Jr and former NFL running back Tiki Barber are two high-profile sportsmen with the disease, and wide receiver John Brown, most recently of the Buffalo Bills, possesses the trait.

Dr Mark Gillett, a consultant in sports and exercise medicine, tells The Athletic: “I’m not aware of it (sickle cell disease) in Premier League football or high-level football. I’ve not really seen it an awful lot at all. I am surprised that I haven’t. I would think that a player with full-blown sickle cell disease would find it difficult to compete at that level, just because of the physical demands of the game.

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“At the same time, if you have sickle cell trait, you have that type of disease whereby extreme physical stress, altitude, or hydration can produce some symptoms. We may be seeing players with that and just not recognising it.

“Most Premier League football clubs are very diligent in the way they screen players. I think players at risk would have had their profiles done. If they have sickle cell trait, doctors would know about it. At the grassroots level, I suspect it happens a lot.”

Altitude was cited by Raymond Domenech, France’s national team manager at the time, when speaking about Diarra’s World Cup withdrawal in 2010.

“He wasn’t ready physically, he was really exhausted,” he said. “The illness was triggered by the altitude. He had predispositions that we couldn’t detect in advance. He needs a good 15 days of rest to fully recover, and he will recover, that’s for sure. It won’t have any bearing on the rest of his career but he’s not fit to play in a World Cup.” Diarra did not respond for comment when contacted by The Athletic.


Diarra, left, speaks with Domenech during France’s pre-2010 World Cup training camp (Franck Fife/AFP via Getty Images)

When asked how top-level teams would react to a player with the disease, Gillett says: “If they did find that when screening a player, obviously they would have to group that with the other things we look for when we assess players. We would have to speak to the player about it and make sure that their treatment is optimised.

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“It would be a concern for players and clubs. Particularly when you get to the end of the season when the weather gets hotter and you’re more likely to be dehydrated. Sometimes, games have more riding on them and become more meaningful. It is certainly an added stress for them. It is hard enough being a Premier League footballer without having that to deal with as well. It would be a significant worry for them.”

The extent of Diarra’s illness was later confirmed by his club at the time, Real Madrid. In a statement, they said that Diarra was “now resting at home following medical advice due to asthenic syndrome secondary to a sickle cell anaemia that will be subjected to a hematological study (the study of blood and blood disorders) in Lyon Hospital”.


Valerie Davis, a haemoglobinopathy nurse counsellor at the Sickle Cell and Thalassemia support project in Wolverhampton, wants footballing authorities to increase their efforts in raising awareness and educate people within the game about the disease.

“There needs to be sessions whereby everybody is encouraged to be screened, irrespective of ethnicity,” she says. “Often it is thought that only specific ethnicities, such as those from African and Caribbean backgrounds can be impacted by this disease. The truth is anybody and everybody can be affected. Anyone who has haemoglobin and red blood cells can be impacted by sickle cell. It is the least likely for someone who is not from those backgrounds, but it can impact everybody.

“It could be a start to encourage everybody entering the sport to be screened. They then could do more work to bring in an expert to talk about the disease. Over the years, there has been a stigma around the disease and there shouldn’t be at all. This could help highlight the importance of screening. If someone is a carrier, they are normally absolutely fine. With rest, hydration, and nutrition, somebody can live an absolutely normal life. 

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“With a good lifestyle, it is a possibility that someone who is a carrier should have no issues going far in football. Even if they’re affected by the full-blown condition. I would encourage the football authorities to never reject someone based on them being a carrier of the sickle cell gene, but even with the full-blown condition with conditioning and support, it will not stop them from reaching the top.”

In 2022, former England international Emile Heskey discovered that two of his children had the sickle cell gene. He began giving blood and encouraging other Black donors to not only register but also be tested for the condition.


Emile Heskey revealed that two of his children have sickle cell trait (Mike Egerton/PA Images via Getty Images)

“We need a whole new generation of blood donors, especially people of Black heritage,” he told the Mirror. “Because they are more likely to donate better-matched blood to treat people with sickle cell disorder.

“Some patients with sickle cell rely on regular transfusions to stay alive. Giving blood is simple, easy and can save up to three lives.”

Davis shares Heskey’s sentiment in encouraging people to be tested for the disease.

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“A lot of people do not know that they carry the sickle cell gene, perhaps until later,” she says. “A woman, for example, may only discover during pregnancy that she is a carrier of the gene.

“We are going all-out to educate people individually because sometimes people may know within their families that there may be a carrier but they often will deny they have it themselves. There is a stigma about the condition, so some people do not go and get screened for it.

“Unfortunately, partners decline screening and that is the sad case (that) very often we see the birth of children that are affected by sickle cell. There needs to be a lot more initiatives to highlight the importance of it. We need to explain ultimately what can happen if it is ignored.”

A treatment for sickle cell cure was approved by the Food and Drug Administration (FDA) in December 2023, with the therapy, called Casgevy, from Vertex Pharmaceuticals and CRISPR Therapeutics, becoming the first medicine to be approved in the United States. The same treatment was approved in the United Kingdom in November 2023, with experts calling it “a historic moment for the sickle cell community”.

However, in May 2024, the gene-editing sickle cell drug was not approved for National Health Service (NHS) use. The National Institute of Health and Care Excellence (NICE) did not recommend the gene therapy treatment, saying that it required “additional data” beyond the current proposal.

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In September 2024, Pfizer voluntarily withdrew large amounts of the sickle cell disease treatment medication Voxelotor, sold under the brand name Oxbryta, from worldwide markets.

However, with stories like that of Diarra’s still sporadic within football, Davis believes the condition’s unpredictability means that conversations about sickle cell within the sport must continue.

“Like many conditions, there are varying degrees of the impact that it has on individuals but ultimately, it does limit because of the unpredictable nature of the condition, what very often people can do and when they can do it,” she says.

“Particularly in sport, and football, there is a lot of training and of course, a lot of commitment required to the sport. Somebody who is impacted or affected by sickle cell cannot always commit because they simply do not know when they will be affected. It is very hard to commit to a sport, especially football.”

Although progress has been made in the fight to find a cure to find a cure for the disease and raise awareness of the condition within sport, more needs to be done.

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(Top photo: Franck Fife/AFP via Getty Images; design: Dan Goldfarb)

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Vikings stave off Jets' 4th-quarter comeback attempt to remain undefeated in London

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Vikings stave off Jets' 4th-quarter comeback attempt to remain undefeated in London

The Minnesota Vikings’ offense had its worst performance of the year, but Brian Flores’ defense came through to stave off a New York Jets comeback to remain undefeated. 

With the 23-17 win over New York in the NFL’s first London game of the year, the Vikings are 5-0, while the Jets move to 2-3 on the year. 

Aaron Rodgers had a brutal first half with multiple interceptions thrown, including one to Vikings linebacker Andrew Van Ginkel, who ran it back 63 yards for the pick-six. 

New York Jets quarterback Aaron Rodgers looks to pass against the Minnesota Vikings at Tottenham Hotspur Stadium in London. (Shaun Brooks-Imagn Images)

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But, as the Vikings stalled most of the second half, Rodgers found himself with less than three minutes to play in his final drive looking to mount a comeback from 17 or more points for the first time in over a decade.

Rodgers was working his way down the field, using Garrett Wilson, who finally had a breakout game with his quarterback, as well as other targets to find himself in Vikings territory with more than enough time to score a touchdown with an extra point needed for the victory. 

But, on third-and-10 from the Minnesota 26-yard line, Rodgers wanted to throw a contested ball to Mike Williams on the right sideline. However, it was veteran cornerback Stephon Gilmore who made the tough interception to seal the victory. 

JETS KICKER’S PRE-GAME WARMUPS INTERRUPTED BY VIKINGS CHEERLEADERS IN HILARIOUS SCENE

It marked Rodgers’ third interception of the game, as he was 29-for-54 for 244 yards with two touchdowns. 

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Sam Darnold went into this game saying all the right things about his bad tenure with the Jets in press conferences leading up to the game. The Jets selected him third overall out of USC six years ago. With the Vikings, Darnold has looked like what Jets fans hoped he would be, but the Gang Green defense made it hard on him in this one. 

Sam Darnold in pocket

Minnesota Vikings quarterback Sam Darnold throws against the New York Jets at Tottenham Hotspur Stadium. (Kirby Lee-Imagn Images)

Darnold had his worst game as a Viking, going 14-for-31 for 179 yards with no touchdowns and one interception. 

Justin Jefferson was his top receiver with six catches for 92 yards, but he had 14 targets in this one, though many flags were called on the cornerbacks trying to keep him at bay for holding and pass interference. 

It’s also worth noting that veteran running back Aaron Jones had to leave the game due to an injury in the first half, which took a big piece out of this red-hot Vikings offense. 

Still, the Vikings proved they are a true contender because, despite the offense’s shortcomings, the defense stepped up and made the plays needed to head back across the pond with the victory. 

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Andrew Van Ginkel scores touchdown

Minnesota Vikings’ Andrew Van Ginkel celebrates as he scores after an interception against the New York Jets, Sunday, Oct. 6, 2024, in London. (AP Photo/Ian Walton)

As for that Rodgers connection with Wilson, the speedy receiver had 13 receptions for 101 yards with his core on 22 targets. If there is any positive to take from a tough loss, Jets fans should feel good knowing Rodgers and Wilson look to finally be on the same page. 

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Column: Verbum Dei tries to rise again after suspending football program

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Column: Verbum Dei tries to rise again after suspending football program

If you need someone to get rid of ghosts, you call Ghostbusters. If you need someone to clean up a mess in Catholic education, you call the Jesuits.

Father Travis Russell, a 39-year-old Jesuit priest, is in his third year serving as president of Verbum Dei, the iconic all-boys Catholic high school that opened in Watts in 1962 and was almost shut down for lack of funds in the late 1990s until the Jesuits took over and created a corporate work study program to help each student pay for tuition.

The school has a long, proud history of producing quality athletes, with the 1970s particularly remembered for its powerhouse basketball teams that featured the likes of Raymond Lewis and David Greenwood. Football also has had its share of stars, including Hardy Nickerson, who played 16 seasons in the NFL after graduating in 1983.

So it might have come as a shock to Verbum Dei alumni and community supporters when Russell announced last month the suspension of the football program after four games this season because of safety concerns from lack of players. The team was 0-4 and down to less than 19 healthy players.

“We were everybody’s homecoming game,” he said. “We had injuries. Kids were dropping. I, in good faith and with our values, couldn’t put our kids out there.”

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Russell was expecting an angry reaction from alumni. Instead, he’s been getting calls from people offering support.

“Hardy Nickerson gave our AD a call. ‘I want to help,’” he said.

The school of more than 300 boys faces a big obstacle — the work study program that students must participate in. Practices are affected, former coach Kevin Smith said. It’s a balancing act that requires patience and persistence.

Russell said he will look for a new coach who understands Verbum Dei’s mission.

“We’re the only school in Los Angeles where the students go to school, work a full-time job and play sports,” he said. “It is hard, but Verbum Dei’s history is always about overcoming adversity.”

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Russell, who grew up in rural Oregon and first worked at Verbum Dei when he was 23 and beginning to study to become a priest, is one of those Jesuit-trained leaders who isn’t afraid to be blunt.

“I believe every kid in Los Angeles is born with the same potential but not the same opportunities,” he said.

He said 94% of his students are accepted to college programs. He said the school has eight students at Notre Dame on academic scholarships. Verbum Dei has always attracted students from nearby Nickerson Gardens, the federal housing project. Verbum Dei tries to make it financially feasible for a family of four making $49,000 to allow a son to receive a private education.

He reminds everyone that Verbum Dei made it through the Watts riots of 1965 because students protected the campus from burning. By 2000, enrollment had plunged to 186 students. The Archdiocese of Los Angeles turned to the Jesuits to use a corporate work study program employed at a Chicago high school to subsidize Catholic tuition. It saved the school.

Now Russell is starting a $30-million fundraising campaign to improve the campus facilities. And he’s committed to making sure football rises again.

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“I love an underdog and I’m a fighter,” he said.

In regards to the sports program, he said, ‘We have standards we won’t compromise.” That means he’s not participating in this era of Catholic schools taking transfers for sports reasons. Verbum Dei doesn’t accept senior transfers. The school does take transfers for other grades.

“They need to be good in the classroom and have a good behavior record,” he said.

He said there’s no reason Verbum Dei can’t become the “Harvard-Westlake” of South Los Angeles, featuring academics and athletics.

“Verbum Dei’s history has been one of resilience, getting knocked down, getting back up,” he said. “It’s the best-kept secret.”

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Now he needs to find a new coach willing to take on a big challenge, starting from scratch.

“We want to rebuild with purpose,” he said.

A national search for a new coach will begin when this football season is completed.

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Howie Rose matches moment of Pete Alonso’s home run, gets standing ovation from players

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Howie Rose matches moment of Pete Alonso’s home run, gets standing ovation from players

As Howie Rose’s call of Pete Alonso’s season-saving home run began playing over the public address system on the New York Mets’ joyous charter flight out of Milwaukee, the veteran broadcaster briefly cupped his hands to his ears.

From his seat on a plane full of Mets players and staffers, Rose, 70, was embarrassed. No broadcaster, he’d later say, wants to be present as people listen to their words. It’s weird. Uncomfortable. That’s true no matter how good the call was, and Rose’s call was epic.

“I wanted to crawl under the seat when that thing was playing,” Rose said.

Instead, Rose got up. You see, had Rose continued to cover his ears with his hands, he may have succeeded in blocking out his words. But he had no chance against the accompanying raucous ovation from the players in the back of the plane. They hooted and hollered, clapped so loudly for Rose and gave him a standing ovation.

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“I wanted to acknowledge it,” Rose said. “I really wanted to embrace Pete because he’s a guy I’ve known since he came up.”

After Rose stood from his seat and looked toward the back of the plane, he saluted the players. He pointed in Alonso’s direction. Then Rose did something he had never done before. He wandered to the back rows, where the players reside.

Generally, on a baseball team’s plane, players and the traveling party (which includes the radio and television broadcasters) are cordial, but there’s an inherent understanding of space. As Rose put it, the parts of the plane might as well be different zip codes. Not late Thursday night.

“Under normal circumstances, it would never ever, ever happen,” SNY’s Mets field reporter Steve Gelbs said. “But in this instance, it would’ve actually been weird if it didn’t happen.”

With each row Rose passed, he received a pat on the back or a high five. When he reached Alonso, Rose leaned in and told him, simply, “I’m really, really happy for you.”

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“With one sentence,” Rose said, “I wanted him to know that I’m in his corner.”

That’s Rose. He doesn’t overdo it. He doesn’t have to. He understands moments. And he nails them with a tasteful blend of the right words, observations and emotions.

“It was Pete’s and the team’s night, but Howie enhanced it,” Gelbs said. “There was so much genuine love and appreciation for Howie’s ability to provide the perfect soundtrack to an all-time moment for the franchise.”

With the Mets oozing Team of Destiny vibes, Rose delivered Thursday night, presenting a how-to in the art of calling a big play.

Rose got it all. And that’s saying something. A few days earlier, on another astounding call, Rose captured the aura of Franciso Lindor’s home run that helped the Mets clinch a playoff spot. As fans replayed it over and over in awe, Rose was somewhat irked he neglected to mention Michael Harris II climbing the wall. Yes, that’s the kind of detail, kind of level Rose strides for when making these calls. He’s a perfectionist.

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The Alonso call may have been perfect. Before the home run, Rose had introduced the idea of the Mets’ season as a “fairy tale.” He’d remember to use that word again. On the call, he mentioned Brewers outfielder Sal Frelick jumping at the wall. The emotion came out raw. He accurately called it Alonso’s most memorable home run. He captured Alonso’s emotion running the bases. He relayed the score within the pandemonium. He acknowledged the rarity of everyone “pouring out” of the Mets’ dugout. He shared the scene at home plate. Then Rose capped it off, saying, “Pete Alonso keeps this fairy-tale season going with the fairy-tale swing of his career — 3-2 New York!”

Alonso helped send the Mets to the National League Division Series, which starts against the Philadelphia Phillies on Saturday. The moment instantly joined the list of all-timers for the franchise. Behind so many of them has been Rose.

“It’s very much a case of being a reporter,” Rose said. “I’m charged with the responsibility of doing it succinctly, accurately, and hopefully, in the best-case scenario, somewhat eloquently. And you know, when I listened back, I think as emotional as I was, I think I checked all the boxes I wanted to check.”

A predictable understatement, to be sure. Rose crushed it. Within hours, clips of the call had ricocheted throughout social media, racking up thousands of shares.

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More than any other sport, baseball gives team broadcasters the most chances to connect with audiences whether at home, in an office cubicle or the car.

The connection starts in the spring and lasts through the entire summer. Then, come October, that link is abruptly severed. For the playoffs, national broadcasts displace the ones produced locally, and the voices that guide fans through most of the season go silent. That’s the case on television.

But not so on the radio. This is why Rose, a familiar voice to New Yorkers, was behind the mic for one of the most memorable moments in franchise history.

“When it’s done right,” Rose said, “it’s art.”

Before Rose’s call replayed over the plane’s public address system, so many people, including Mets president of baseball operations David Stearns and manager Carlos Mendoza, approached him, not just to congratulate him on the call, but to thank him as well.

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Rose has endured as one of radio’s most polished practitioners. He has called Mets play-by-play on radio or television since 1995. In 2022, Rose began to cut back his schedule, following health issues. Rose, a native New Yorker who grew up a Mets fan and basically doubles as a walking encyclopedia of the franchise, views this year’s run as special. The Mets keep rising to the occasion. Rose keeps matching them. Fans of the club would have it no other way.

“They know that I’m invested, and that makes us kindred spirits,” Rose said. “And what’s more important than that, though, is that I think, over time, and, obviously I’ve been doing this for a long time, I’ve built the kind of trust that enables me to say something, whether it’s critical or opinionated in any way, and know that the listener understands where I’m coming from. I’m not trying to short-sell them or sell them a bill of goods. I’m just saying it as I see it, and they trust me. And the added advantage I have is that I’m emotionally invested in this team because I was a fan of theirs from day one. And a lot of those fans will say they’ve been fans since their earliest baseball memories. So again, I like to use the phrase we are kindred spirits.”

(Photo of Pete Alonso after his Game 3 home run: Patrick McDermott / Getty Images)

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