Stress-related illness puts Trescothick's future in doubt

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Marcus Trescothick's England career is in the balance following his withdrawal from next month's Champions' Trophy. Trescothick made himself unavailable for the three-week trip to India after receiving medical advice from a specialist treating him for a stress-related illness.

Trescothick's fate could well have been decided in Leicestershire yesterday, when the England selectors met to discuss their squads for the Champions' Trophy and the defence of the Ashes. David Graveney, Duncan Fletcher and Geoff Miller will be keen to show loyalty to one of their most committed and experienced players, but they must also have fears that he can no longer cope with the pressures of international sport. And in light of his absence from the Champions' Trophy, there seems little point in him playing in the two remaining NatWest series matches against Pakistan.

Trescothick returned home suddenly from England's tour of India in March for what were believed to be personal reasons. The diagnosis had changed to a virus when he made his first public announcement on the issue at the start of the English season and this, along with the stress-related problem, was reiterated yesterday in a statement released by the England and Wales Cricket Board.

A spokesman from Performance Healthcare, the specialists treating Trescothick, said: "After his return from the tour of India in March, Marcus sought specialist help for his ongoing symptoms. In addition to the deleterious effects of the acquired gastro-intestinal infection on his health, it later became evident that he was also suffering from an underlying stress-related illness.

"He has been receiving specialist treatment, which has allowed him to resume his position in the England team. However, we believe that it would be premature for him to tour India in October. Rest is an important part of his treatment and he will need recovery time before the Ashes tour of Australia which begins in November.

"Marcus has made significant progress, witnessed by the fact that he is now at a stage where he has openly accepted the full extent of the illness which he has suffered. The medical regime put in place to support him has enabled him to play a full part in this summer's international programme, however being overseas for the Champions' Trophy would interrupt the current treatment."

Trescothick's intestinal problems were probably picked up in India and they could well explain why he is reluctant to return to the country, but they are only a small part of the problem. The main issue is his state of mind. Trescothick has stated his determination to play a full part in the Ashes tour but he and the medics must be mad if they think that the Australians will not attempt to make his life a misery from the moment he lands in Sydney in early November.

Trescothick's welfare will be debated in all areas of the media and there are likely to be some unpleasant things said. But these comments will seem innocuous when compared to what will be uttered to him by the cricketers he plays against and the spectators who watch. Playing in front of an unsympathetic and partisan Australian public is the toughest challenge a fit, strong, successful and thick-skinned cricketer can face, and it is difficult to see a player with emotional and mental issues coping.

Trescothick has an introspective personality and it is the fear that he may revisit the territory that caused him to return from India that will concern the selectors most. England's most successful one-day batsman will be missed next month but England can live without him. It is what takes place in Australia that counts. England's last visit to Australia was undermined by the uncertainty and eventual departure of injured players and the selectors will not want to take such risks again.

Trescothick's decision came as a surprise because there has been nothing about his demeanour to suggest that his problems were ongoing. Yes, he has struggled for runs, an issue that was highlighted by his first-ball dismissal against Shoaib Akhtar during Tuesday's two-wicket defeat to Pakistan at the Rose Bowl, but his behaviour and interaction with the media throughout the summer have been exemplary.

The 30-year-old gave no clue to his feelings in an article published in the official programme for the NatWest series against Pakistan. In it Trescothick said: "I can't wait [to go to Australia]. Crowds will be huge and intimidating. The Aussie media, much like our own - only worse because they are against you - will do all in their power to put us off. It's all part of the big picture and coping with it is a requirement of the job."

The England set-up is a far more compassionate place than it was 10 years ago. Last winter Duncan Fletcher, the coach, gave Michael Vaughan, Andrew Flintoff and Andrew Strauss permission to return home to attend the births of their children, and the wives and girlfriends of the current side get better looked after by the ECB than when I played for England.

But Fletcher is no fool or soft touch, and he does not want his players to feel that they can pick and choose the tours they go on.

Fletcher yesterday warned his players about missing future tours. "I've said all along we've just got to come up with a method of making sure players do not pick their tours," he said. "It's difficult, and there is a lot of cricket being played but I would want my players to be available for all tours that are played."

Acceptance the first step to recovery

Marcus Trescothick was more seriously ill than he thought he was. That much is clear from the statement from Performance Healthcare. It says he has now "openly accepted" the full extent of his illness and this is a sign of progress.

A glance at the list of conditions on Performance Healthcare's website, for which it offers "psychological treatment and support", shows why this could be important. The list includes drug and alcohol problems, family and marital problems, depression, eating disorders and sexual dysfunction. These are problems to which people can find it difficult to admit, even to themselves. Accepting you have the problem is the first step to recovery.

"Stress-related illness" is a portmanteau term beloved of the medical profession for its capacity to hide a multitude of sins. Treatment may involve drugs and/or therapy.

If Trescothick is receiving some form of therapy, his doctors will not want to interrupt the treatment. That could explain why he has been able to play at home this summer but not in the Champions' Trophy overseas. The hope must be that his treatment will be over and his condition better by the time of the Ashes.

The prognosis remains uncertain. But with appropriate treatment, and given his progress so far, there is no reason why he should not make a complete recovery.

Jeremy Laurance, Health Editor

What they said after India

25 FEBRUARY 2006

"Marcus Trescothick is flying home for a family reason and I hope his privacy is respected."

England's coach, Duncan Fletcher, after the second game of the tour of India

10 APRIL 2006

"We spend 300 nights of the year out of our own house. Pakistan and India are tough tours, the hardest. It's not easy to take your families. The main reason [I left the tour] was I picked up a bug and it really hit me hard."

Marcus Trescothick