LA JOLLA, Calif. -- In terms of difficulty, the doctor said the operation was a 1 on a scale of 10.
Still, it was brain surgery, and J.B. Holmes had every right to be nervous. Would the bouts of vertigo stop? Would the pounding in his head go away? And on a purely practical level, would the two-time PGA TOUR champ still be able to launch the ball in excess of 300 yards?
There was only one way to find out. Holmes had been diagnosed with Chiari malformation, which is a neurologial condition where the skull is either too small or misshapen and it starts to press on the brain tissue, pushing it down on the spinal canal and interfering with the normal flow of cerebrospinal fluid. That in turn can cause dizziness, headaches and problems with balance and coordination.
So on Sept. 1, Holmes let the surgeon take out a piece of his skull about three-quarters the size of a golf ball to relieve the pressure on the cerebellum. The covering of the brain was then opened and a patch -- in Holmes' case, made of a titanium mesh -- sewn in to provide more room for the brain.
"I just kept it out of my mind, basically until the day of (the operation)," he said. "Then I got to the hospital and started putting on the gown and everything else, and it was like, wow, I'm about to have brain surgery. So it really hits you then.
"But you've just got to put your faith in God and just hope everything comes out good."
So far, it has. His brown hair has grown back and you can hardly see the scar now. Holmes keeps the missing piece of skull sitting on the sill of a window in a closet in his house in Orlando where he sees it every day. He grew it, he figures he should keep it.
"It's just a reminder that I'm very fortunate to be able to go through something like that and be able to come back and play," Holmes said. "(I am) just very fortunate to have this job and be able to play a game for a living. ... I never really thought I wasn't going to come back, but there is always a possibility that everything doesn't go right and I don't get back out here.
"So (I am) just learning to appreciate the situation I'm in a little bit more and just enjoy it."
Holmes plans to do just that this week at the Farmers Insurance Open. It's his first tournament since the surgery and lengthy recovery, much of which he spent sitting as still as possible because he couldn't move his neck. Even now, he thinks he's only got about 85 percent rotation but it's getting better every day.
He's having fun seeing old friends at Torrey Pines, and Holmes is looking forward to putting that peg in the ground when it means something on Thursday.
"The first goal is to make the cut, the second goal is to win the tournament," he said. "It's always, when I come out, that's my goal. But realistic expectations, if I come out here and make the cut and just play solid, that's probably a pretty good start back."
Indeed. Holmes' recovery was not without issues. He had first started having vertigo-like symptoms during last year's PLAYERS Championship, where he tied for sixth. He withdrew the following week and only played six more tournaments from May to August. He had appointments with five or six different doctors, underwent MRIs and other tests.
Maybe it was an ear infection, one said. Cluster migranes suggested another. Dr. George Jallo at Johns Hopkins made the final diagnosis. He told Holmes not to worry; he'd done about 250 or 300 of the same operations. And Holmes didn't, not after the doctor rated it 1 out of 10.
"I just assumed that was like me making contact with a golf ball, and I have't missed it too many times," he said matter-of-factly.
Roughly a month after the surgery, though, Holmes started getting fluid around the scar. Turns out he was allergic to the adhesive the doctors used to attach the titanium. He was getting severe headaches as they tried to wean him off the steroids, too.
One Saturday, Holmes was helping with a tournament at his golf club back Campbellsville, Ky., and he felt so bad he went home to lay down. By dinnertime, he was vomiting, and the next thing he knew, he was at the emergency room -- and then airlifted on Sunday to Johns Hopkins where he would have a second operation on his brain.
"They had me on so much painkillers I didn't remember much," Holmes recalled. "I started out in Campbellsville and woke up in Baltimore. So I remember vaguely getting on the plane and getting off. I woke up and just kind of looked around, and a head nurse came in. I said do I have a cell phone, clothes, anything? And she's like, nope. And I was like, okay."
Holmes remembers waking up on Monday, ready to watch football and check how his fantasy team was doing. His parents told him he was a day late. "I was like, I missed Sunday?" he recalled with a smile. At the same time, Holmes knows how frightening things must have been for his family and his girlfriend, Erica Kalbhin, who is a nurse just like his mother was.
"I'm on medicine and not remembering anything; they're really going through it and worrying," Holmes said. "The second surgery when I was sick and went to the E.R. and things -- that scared everybody pretty good. Like I said, I don't even remember that day, so it wasn't as bad for me as it was for them."
Holmes didn't get the go-ahead to hit his driver until last month. The first one he struck on Dec. 1 went 240 yards -- or about 80 yards less than he averaged in 2011. His instructor said his swing looked fine "so my body didn't forget what it's been learning for the last 28 years," Holmes said. His clubhead speed is about 115 right now, about five less than his average last year.
Holmes was happy to report, though, that he's not giving up the same kind of distance he was in early December anymore. He can now bust a driver more than 300 yards again which is "far enough to get out here and play," Holmes said. He needed every bit of it, too, as he played a practice round with Bubba Watson on Tuesday.
"It's great to see any fellow golfer, anybody you work with come back from an injury, any kind of injury," Watson said before the two teed off. "But something like that ... I mean, brain surgery is not easy. That's something that is serious. That could be career-ending.
"But him coming back, who knows how he'll hit it. Who cares if he misses the cut, makes the cut, if he wins, it's just good to see him back out here. I bet he's going to be happy to be here and be out of his house."
Holmes agreed. He's ready to move forward and get back to what he does best.
"The surgery feels like it was so long ago that I had already forgotten about some of it," he said. "... I'm past that. I'm ready to start a new chapter."