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JACKIE MACMULLAN

Season exacts a toll

The Red Sox manager pieced together another makeshift lineup last night at Fenway Park, in a game that no longer has significant ramifications for his team.

Terry Francona will argue that point, quite vociferously, given the chance. His front office all but ran the white flag up the pole when it dealt the manager's most consistent August pitcher,

David Wells, to the Padres a week ago, but Francona does not acknowledge that his team's playoff mojo was shredded by a lifeless five-game series against the Yankees, a slew of injuries, a heart scare for his slugger, and the shocking revelation that his 22-year-old pitcher, Jon Lester, has cancer.

Tito is tired, run down, and battling his own health concerns. The jar of Metamucil on his desk is as much a staple as his computer printouts. His circulation problems -- not to mention his own past heart episode -- are constants. The season has exacted its pound of flesh, but the manager resolutely presses on.

His coaches fret about him. They worry about his heart, his legs, his mind-set. They remind him the lineups he's trotted out recently have been a punchline to a sick joke, but Francona does not see the humor. He only sees the losses building, which leads to more hours poring over numbers, more nights sleeping on the couch in the clubhouse, and more opportunities to collapse from exhaustion.

``Of course it's been hard," Francona said. ``But regardless of how I feel, when I come through that [clubhouse] door, those guys can't see me dragging my tail. I won't let them see me that way. If they do, I'm not doing my job."

As one Red Sox player after another has taken turns being shut down, the manager probably should have taken his own brief respite. His wife, Jacque, a former nurse, was pushing for that scenario after Francona began spitting up blood in a press conference in Seattle.

``But I think she knows I'm not going to do that," Francona said. ``She knows I can put it into overdrive if I need to. This job takes so much of my life. Even when I'm not here, I can't shake it. I don't know if I want to shake it."

General manager Theo Epstein said he and Francona never seriously considered having the manager sit out any games, but they did discuss in detail the need for him to take better care of himself.

``The worst moment was in Seattle, when we were right in the middle of everything going wrong," Epstein said. ``I came down after the game to ask him a couple of questions. I got a phone call, and all of a sudden I looked up and he was spitting blood on my shoes. I said, `Hey Tito, we need to get you checked out.' He said, `Nah, I just took one too many blood thinners.'

``This season has been hard on everyone, but no one is closer to it than the manager. He lives it, every single inning, every single day."

Lester's recent diagnosis has weighed heavily on Francona, who has spent countless hours counseling his young pitchers. ``I try not to sound hollow to anyone," Francona said. ``When I saw the Lester family in Seattle, I told them, `I have four children. When their nose runs, I'm not very happy.' I wanted them to know how much I care.

``I love this kid. I was dying to call him but I didn't because I wanted to respect their privacy."

Lester is just one year older than Francona's son, Nick, who was a staple in the clubhouse this summer. Nick Francona is a ballplayer, too, and he learned plenty watching his father's major leaguers. He has since gone back to the University of Pennsylvania with a profoundly better understanding of what his father endures.

``In some ways, he's a typical 21-year-old who knows everything," Francona said. ``But he's getting older. He saw a lot. A couple of times this summer he came in and said, `Are you OK?' He was worried. But he knows. We talked a lot on the way home from games."

It is never out of fashion to blame the manager in this city, even one that won its first World Series in 86 years, but to lay this year's debacle at the feet of Francona is absurd. He's not had a full complement of pitchers all season. Nobody puts in more hours. He has dealt with player issues quietly, and internally. Players confide that Tito has taken on both Manny Ramírez and Wells at various times, yet the criticism lingers that Francona is too easy on his players.

Ask him if he's able to squash conflicts before they become public nine times out of 10, and he deadpans, ``I'm hoping for an even higher percentage than that.

``I don't think the fans realize this isn't the era of Vince Lombardi," Francona said. ``You can't just bang somebody across the head anymore.

``I don't watch a lot of television, but I laugh when I see the perception that I'm too soft on the players. That's not a very informed opinion."

Losing Wells hampers the manager down the stretch but, he said, he was in full accord with Epstein when the team made the move.

``I'm like any manager," Francona said. ``I want a 90-man roster, three pinch hitters, four lefties off the bench. But I'm also realistic. I wasn't going to make Theo's decision any harder than it already was.

``We've been through a lot this season. Both of us. And in this city, to have our relationship get stronger through all of this is pretty good."

Francona prides himself on building relationships with his players, and insists those relationships pay dividends ``during the horrendous times, not the good times.

``I caught Gabe Kapler coming out of the weight room, and we spent 45 minutes just talking," Francona said. ``I came out of there knowing I'm in the right job."

He is thankful for veterans such as Jason Varitek and Mike Lowell, who has proven to be a reliable sounding board.

``I was thinking about calling a team meeting recently," Francona said. ``I went to Lowell and said, `What do you think?' I thought it was the right thing, but I wanted to see how he felt. He agreed, so we did it. It's just so valuable to have guys like that, who are professional."

Professional athletes tend to be self-absorbed. Their single-mindedness enables them to thrive. But these Red Sox players couldn't help but note the price their manager has paid this season.

``After Seattle, it makes you stop and say, `Wow,' " said Jonathan Papelbon. ``He's got a wife, a family. When your health starts getting involved, you've got to say, `When do I say no more?' But he can't. He's got to keep going."

The manager still checks the wild-card standings daily. Last night's horrific 8-1 loss to the White Sox left the Red Sox six back. You tell him it's over.

He tells you he's got a lineup card to fill out for Kansas City tomorrow.

``I try to balance things," Francona said. ``I try to keep some perspective. I don't want to have a heart attack. But I want us to win."

Jackie MacMullan is a Globe columnist. Her e-mail address is macmullan@globe.com.

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