PROVO, Utah — For BYU defensive coordinator Jay Hill, the offseason carried a lingering sense of frustration.

After nine years as the head coach at FCS Weber State, Hill joined longtime friend Kalani Sitake’s staff at BYU ahead of the Cougars’ much-anticipated move to the Big 12. The season started promisingly, but after a 5-2 start, the Cougars lost their last five games to miss a bowl game and finished one game out of last place in the conference.

“We all felt like we were a better team last year than maybe the record showed,” Hill said.

With nine months between games, it can feel like there is too much time to stew over what went wrong, but as the offseason progressed Hill was encouraged. He saw players who were a little more disciplined, a little tougher, a little better with responsibilities.

Hill was working as many as 90 hours a week, and as training camp came to a close at the end of August, he believed the Cougars were prepared to take a significant step forward. And if they didn’t, it wouldn’t be for lack of effort on his part.

At 49 years old, Hill doesn’t lack energy. A former cornerback at Utah, he runs regularly, lifts weights with players, plays pickup basketball and — outside of a Mountain Dew habit — has kept a generally healthy diet. Last season, he experienced some unusual lightheadedness while running, but after getting checked in the spring, he was told there was nothing to worry about.

“They were doing a bunch of heart tests just to make sure that the blood was pumping and everything was going well,” Hill said. “And I did all those tests, and everything came back better than normal. I felt like I was in great shape for someone my age.”

All of that is a backdrop for what made Thursday, Aug. 29, so shocking.

The night before, he complained to his wife, Sarah, that he was experiencing heartburn. When he described a localized pain in his chest, she was skeptical, but he figured it was something that would subside with a night’s sleep.

It did not. After practice, he lifted weights with players. That didn’t help. Then he sat in a sauna. That made it worse. He went through with plans to get a haircut on his way home, and that’s when he finally let himself believe something might be seriously wrong.

“I just started sweating so bad that the poor girl that was cutting my hair grabbed a towel, and she was wiping me off,” Hill said. “I felt so embarrassed. And then she took the cape off me and my pants were just drenched.

“I was having a heart attack, and I didn’t know it. Right in the barber chair, I’m having a heart attack.”

BYU did turn things around this season, winning its first nine games and earning a spot in the Valero Alamo Bowl against Colorado (7:30 p.m. ET Saturday, ABC). And it did so with one of its most important assistants in the coaches’ box, monitored by his wife.

SARAH HILL WAS home when her husband called to tell her he was in bad shape and on his way from the barbershop. She told him to stay put, and she would come get him, but he insisted he could make the short drive.

They stayed on the line as Sarah tracked his progress with the Find My app.

“I kept trying to convince him to just pull over and I would come get him — and then he wasn’t able to talk,” Sarah said. “I said, ‘OK, if you can’t talk then I’m getting in the car and I’ll find you right now. I can see where you’re at. I’ll come to you.'”

At about this point, Jay turned into their neighborhood and made it safely to their house. He got out of his truck, made his way to their back porch and lay down.

“I knew at that point it was a heart attack,” Sarah said. “I knew that I had a short amount of time, but I also was very calm and very at peace that it wasn’t going to be what takes his life.”

Sarah acted swiftly and firmly, telling him he needed to get back in the truck and she was taking him to the hospital, about a 7-minute drive. At first, Jay insisted he just needed to catch his breath, to which Sarah responded, “Get in the truck or I’m calling 911.”

At the hospital, things were a blur. With Sarah by his side, he was immediately whisked to a room for testing.

“[The physician’s assistant] pulled the paper out of the computer, and she just turned around and it wasn’t 10 seconds, 15 seconds before the doctor was in there saying, ‘You’re having a heart attack, we got to go [to surgery],'” Jay said.

Jay felt helplessness.

“I think I was still pretty calm. And in that moment, what do you do?” Jay said. “You just kind of go along with what they’re telling you. I remember something vividly going through my head, ‘No way. Not me. You’re too young. I thought I was in shape. This can’t be happening to me.'”

During the successful surgery, which Sarah estimates took about an hour, the doctors found that his right coronary artery was 100% blocked. They inserted a stent to open the artery and scheduled another procedure for two days later — the morning of BYU’s season opener against FCS Southern Illinois — to insert another stent into a different, partially blocked artery.

When Jay woke up, he felt much better, and the idea of sticking around until Saturday’s procedure was not appealing.

“They wanted to watch him the whole time,” Sarah said. “He’s like, ‘Nope, I got to get practice tomorrow. My son has a cross country meet. Can you release me to do this stuff and then I can come back and I’ll do the surgery next week?’ In his mind, he’s just like, ‘It’s the first week of the season, I need to get going.'”

SITAKE AND HILL have known each other since the late 1990s. They played against each other — Hill for Utah; Sitake for BYU — but a friendship was born when Kyle Whittingham made Hill and Sitake two of his first hires when he took over for Urban Meyer at Utah at the end of the 2004 season.

Their paths diverged after Hill took the job at Weber State following the 2013 season, but while he turned the Wildcats into a Big Sky and FCS power — winning four conference titles and reaching the playoffs six times — their relationship stayed intact.

“It wasn’t like there was this huge lapse, we’ve always been communicating,” Sitake said. “We’ve never gone a long period of time without talking and we’ve always been in each other’s lives.”

So when Sitake was looking for a new defensive coordinator and Hill was getting the urge to get back to the Power 5 level at the end of the 2022 season, the timing worked for them to reunite in Provo, where they picked up where they left off nearly a decade ago.

It is not unusual for Hill to call Sitake late at night, so when his phone buzzed that Thursday, he answered, “What’s up, bro?”

Sarah was on the other end, and delivered the news from the hospital. Sitake was shocked but quickly offered to help in any way he could. Shortly after they got off the phone, texts from Jay started arriving. Then he called. Fresh out of life-saving surgery, he was concerned about how BYU would call the defensive plays in two days.

“Bro, you don’t need to call me. Just rest,” Sitake said. “We can talk about this later.”

Go Cougs! pic.twitter.com/Hn9hoR8IUr

— Jay Hill (@CoachJayHill) August 31, 2024

When BYU met as a team the next afternoon, Jay remained at the hospital. Sitake told the players what had happened, then Jay joined the meeting via FaceTime.

“We were all pretty shocked because Coach Hill is a super active, healthy guy,” safety Tanner Wall said. “But he made it very clear from that moment that he didn’t want us to be distracted or worry about him, but to worry about going and winning our game.”

At the hospital, Jay was negotiating. He was told he would feel even better the next day after he underwent his second angioplasty procedure, after which it was recommended he should go home and rest.

But what if he went to the game and sat in the coaches’ box and watched?

“What the doctor said was, ‘I would not recommend it. Ultimately, you get to make the decision, but I wouldn’t recommend it,'” Jay said. “And I just told him, I’m going to watch the game one way or the other. So whether I’m at the stadium or at the house, I’m going to watch the game. So I might as well be at the stadium where I feel like I at least have a little bit of control.”

After his second surgery in less than 48 hours, Jay made his way to LaVell Edwards Stadium about an hour before kickoff. As he was escorted down to the field, he wasn’t feeling well, and it was there when he was embraced by his players that the mental stress of it all caught up with him.

“I don’t ever get emotional, but I got so emotional going on the field,” he said. “This is where I want to be — down on the field — and I can’t.”

Jay usually calls plays from the field, but he was relegated to the coaches’ box, where Sarah joined him. During the game, Sitake and linebackers coach Justin Enna shared playcalling duties on defense. Jay wore a headset and had the play sheet in front of him, but he mostly sat back and let his colleagues take the reins.

He was under strict doctors’ orders not to get too excited during the game, but his natural instincts made that a tough assignment. When signs of emotion started to show, there was Sarah — with a subtle squeeze of his leg or a knowing glance — to reel him back in.

It helped that BYU won comfortably 41-13 and that the defense made the game enjoyable for Jay.

“It was fun for me to sit in the box and just watch all the hard work from fall camp,” Jay said. “The players executed, they rallied behind what had just happened with the heart attack — for me it was a pretty surreal moment just to sit up there and kind of just see it from afar.”

HILL DECIDED HIS brush with death wouldn’t require any sort of lengthy absence from the team.

The coaching staff had Sunday off, but he was back in the office at 8 a.m. Monday, ready to work a full day ahead of that Friday’s game at SMU.

But he also realized there needed to be some concessions. During practice, he sat on a balcony overlooking the field and coached with a headset. He cut Mountain Dew and was more careful about his diet. Sarah joined him for regular walks that replaced his usual runs and weightlifting.

Hill was advised that most patients in his situation were supposed to take it easy for four to six weeks, and that a full recovery was six months out.

“In his mind as a coach, what does that mean, taking it easy?” Sarah said. “If they work 90 hours a week sometimes, does that mean now you’re just working 60?”

Jay’s path to recovery ran parallel with an encouraging start to the season for BYU. A brilliant defensive performance led the Cougars to an 18-15 win against SMU — it would be the Mustangs’ only loss in the regular season — and they made quick work of Wyoming to move to 3-0.

After the win in Laramie, Sitake walked into a celebratory locker room. It was a scene he usually would have been thrilled to see.

“There’s this big monster pit of dancing going on and there is Jay Hill in the middle of it,” Sitake said. “So, I go and pull him out and am like, ‘What are you doing? You’re not supposed to be doing that.’

“He just lives life, man. But we have had to watch him a little bit, because he’s always worried about others and focused on helping them get the energy they need.”

On one occasion, multiple staff members noticed that Hill’s complexion wasn’t right, so cornerbacks coach Jernaro Gilford called Sarah. Hill went home early.

“He gets into it and loses himself in the work and the service and what he’s trying to accomplish,” Sitake said. “And that’s what makes him special. But it’s also why we have to kind of watch out for him. It’s OK. We can be our brother’s keeper for a little bit.”

Sarah was there for Jay at every step. For the first several games of the season, she remained with him in the coaches’ box during games. They would measure his blood pressure before the game and monitor it as needed.

The fourth game of the season was at home against No. 13 Kansas State. On the field before the game, Jay felt his heart start to race. That was his cue to head up to the box, where he measured his blood pressure with alarming results. It was on par with the reading on the day of his heart attack.

“It was like 200 over 130 or something like that, stupid high,” Jay said. “And that scared me a little bit. That was a moment where I’m like, ‘If we don’t figure out how to monitor this, I don’t know if I can coach.”

(At this level, it is recommended to consult a doctor immediately, according to the American Heart Association.)

Sarah did her best to keep him calm, and the numbers improved a bit as the game began. But after the Cougars scored 31 straight points during a chaotic run between the second and third quarters, he was back in the danger zone.

“Then after the game, we win, and I think that’s when it kind of starts to drop and chill out a lot,” Jay said.

It wasn’t the first time Sarah and Jay, who have four children — Ashtyn, Alayna, Allie and Jacob — went through a medical scare together. This time, Sarah’s role as his de facto caretaker represented a role reversal in their relationship.

In 2016, she was diagnosed with Stage 4 Hodgkin lymphoma. It required a year and a half of intense treatment that included radiation, a bone marrow transplant and several rounds of chemotherapy. Going through that, she said, allowed her to maintain a sense of calm when helping her husband through his time of need.

“I was in the hospital for a month, and getting that perspective switch of me coming in, watching him in a hospital bed and him sitting in the hospital bed was actually a really beautiful experience,” Sarah said. “We were able to experience the other person’s side, and you just grow in love and compassion for each other, having experienced the opposite.

“So, we have joked that it’s a competition of who cannot die the best.”

Sarah’s original diagnosis, like Jay’s, came during fall camp. Throughout the season, he would accompany her to chemotherapy treatments every other Wednesday and do his best to be there for her while managing the demands of being a head coach.

Jay said they both felt the support of an entire college football program.

“I saw a very special thing in both instances where the team kind of rallied behind us,” he said. “The team rallied for sure behind her and her cancer situation. I’ll bet you 90 percent of the players shaved their heads that year. It was a pretty special moment of just how players can offer support and show someone that they loved her.”

AS HILL’S RECOVERY progressed through the season, BYU kept winning.

After beginning the year picked to finish 13th in the 16-team Big 12, the Cougars won their first nine games to rise to No. 6 in the College Football Playoff rankings. But just as the prospect of receiving a first-round bye started to seem possible, BYU lost back-to-back close games to Kansas and Arizona State in November.

The Cougars finished in a four-way tie with Colorado, Iowa State and ASU, with tiebreakers sending ISU and ASU through to the Big 12 title game.

After missing on a chance to play for the conference title, BYU and Colorado — which did not play during the regular season — were selected to play in the Alamo Bowl.

“It’s been great having him here, but it’s been really cool to see him recover and help us have the type of year we’ve had,” Sitake said. “We anticipated that we were going to have something special this year — even from the beginning — and he’s a big part of that.”

After BYU ranked near the bottom of the country in almost every major defensive category in 2022, this year it was among the best. The Cougars finished the season ranked No. 1 in the Big 12 in scoring defense (20.1 points per game), total defense (317 yards per game) and forced turnovers (27). Hill was nominated for the Broyles Award, given to the top assistant in college football.

“I think if you look at our defense over the past two seasons, you can definitely see the impact that he’s made,” senior defensive end Tyler Batty said. “His impact is unmistakable for sure.”

It resonates far beyond the X’s and O’s.

“This dude had a heart attack, and the same day he was operated on, he is at our game in the booth,” Batty said. “It just goes to show that he is a great example of grit and resilience. Guys like him and Kalani are guys you want to run through a wall for.”

By the last quarter of the season, Hill felt like he was back to normal. He returned to the practice field midway through the season and ramped up the intensity of his workouts near the end. Routine check-ins with his doctor have continued, and the signs have been positive.

For Hill, though, the major takeaway from the past few months hasn’t come from his recovery.

“I think we’re a little better in all areas as a team and it’s made a huge impact on just the success overall,” he said. “And then to see that pay off in wins has been pretty special.”

Spoken like a true coach.