Richie Suarez stands on the pitcher’s mound at Rowan University, the sun sinking behind him into the Delaware River, his crisp white uniform contrasting against the pink, then purple, of the darkening sky. It is a quintessential picture, the kind a kid sees when he imagines himself one day playing college baseball. For most of Suarez’s life, it was the image he could visualize, too.
The little scene atop the mound looks like this: Suarez’s hazel eyes land on the glove of his catcher. He brings his right hand to his lips and licks the tips of three fingers, then brushes them on the leg of his uniform. He adjusts his hat. Then, he takes the ball in his right hand – for a right-handed batter, he’ll probably go with his slider – and his hand grips the ball just like his dad taught him: across the railroad tracks, with the middle finger inside the groove of the seams. He conceals the ball in his glove for a long moment, gulps a deep breath as he raises his left knee. Then, he corkscrews the trunk of his body back toward third base and releases – his breath, and the ball.
Suarez experimented with this pitch as a boy, playing at the diamond down the street with his dad. He honed it in Little League and American Legion ball. And when he was at Eastern Regional High School in southern New Jersey, coaches began to notice that pitch. The chance of playing baseball in college began to become a reality.
Back then, 23-year-old Suarez knows now, he had the dreams of a child. That was before he started losing weight and wondering what was wrong. Before a diagnosis kicked him and his family in the stomach and sent them careening down a path they never would have imagined. Before doctors poisoned his body to heal his blood and radiated his brain to protect him from the disease returning. Before his joints went soft and doctors urged him to focus on walking again, not playing baseball.
During those years, Suarez had days when the baseball felt foreign in his hand; days when he couldn’t throw hard enough to reach home plate; days when he lay in a hospital bed, unable to bring himself to even watch his Phillies on TV.
The past five years have aged him, converted the dreams of a kid into the thoughtful, serious perspective of an old man. Keep that image of Richie Suarez on the pitcher’s mound in mind – strong, healthy, in control – because sometimes, as he traveled the road that brought him back to the mound, even he had a hard time keeping that picture in focus.
Suarez and his friends had big plans for Aug. 27, 2010 – his last Friday before college. They were going to the New Jersey shore – one last day at the beach before life propelled them in different directions. Suarez was headed to Rowan; he thought he wanted to major in math and become a teacher and coach, but he knew he wanted to play baseball for the Profs. Freshman year was about to begin.
Suarez hadn’t yet rolled out of bed when his mom was suddenly at the door of his room, beckoning him to get up. They were going to the hospital.
Suarez protested: “Mom, you’re out of your mind.” But there was no disputing Denise Suarez that morning. She and her son had visited the family doctor the day before, trying to get to the bottom of the sluggishness and weight loss her son had been experiencing all summer. He had gotten through American Legion baseball on DayQuil, Advil and resolve, but he felt worse, not better, as the season wore on. With the start of school approaching, Suarez finally went to the doctor and hoped he didn’t have mononucleosis.
The physician ordered blood tests. And when the results arrived early the next morning, the doctor who had treated Suarez since childhood called the family and ordered Suarez to the emergency room. The doctor hoped the tests were wrong, he told Denise as he delivered news that made her gasp and fall to her knees: “I think he has leukemia.”
Richie’s parents didn’t share the threat with their son. So at the hospital, as medical staff drew blood, then drew blood again, he watched the clock, eager to wrap up this hospital business and meet up with his friends. Suarez also needed to pack for school; in two days, he would move out of the house and into his college dorm. He was ready to start a new life.
Suarez vaguely remembers the doctor who delivered the news. She had dark hair, maybe dark eyes. Her message was direct, but those eyes welled with tears:
“You have leukemia. It’s cancer of the blood,” Suarez recalled her saying. “For the next six months, your life is going to be upside-down. You will not be able to go to school. You can’t go home.”
Suarez’s mind wrapped around the words: leukemia. Cancer. He was sure they meant he would die. His parents cried. He cried. His older sisters and their husbands arrived at the hospital. More people, more tears, more grieving for the normalcy – a Friday morning at the beach, the little thrill of the Phillies’ victory over the Padres that day, the anticipation of starting college – they had known just hours earlier.
Time began to slip by with purpose: The Hospital of the University of Pennsylvania admitted Suarez, diagnosed him with childhood acute lymphoblastic leukemia and determined the Children’s Hospital of Philadelphia would be better equipped to help him. From the outset, his chances of survival were good – pegged at 80 percent – but the road ahead, doctors warned, would be meandering and unpredictable.
Suarez began a steady diet of drugs to kill the cancer, served with a side of other drugs to ease the impact of the treatment. His face swelled from prednisone. His urine turned red from daunorubicin and doxorubicin. He broke out in hives from morphine. High doses of methotrexate kept him in the hospital for weeks so doctors could monitor his body’s reactions.
Suarez wrestled with the diagnosis. He asked his doctor: What did I do to cause this? And when the answer he received – “a cell went rogue” – didn’t satisfy him, he asked more.
One doctor urged him on. “He said, ‘Try to learn as much as you can about it. It helps it to be less scary. There are fewer surprises, and you’ll know what you’re dealing with,’” Suarez recalled. “The more I learned about it, the more I understood my prognosis and my chances.”
Every doctor who approached his room faced an avalanche of questions:
What’s this drug called? He rolled the syllables around in his mouth, willing himself to remember how to pronounce his meds.
How does it work? Why do I take that dose? Why does it make my hair fall out?
“I would ask them every single question under the sun. I wanted to know everything that was happening in my body, on a chemical level,” Suarez said. “You feel very passionate about it because it’s happening to you.”
Suarez’s parents, meanwhile, wished they could shield him from this new education. But their son, though at a Children’s Hospital, was an 18-year-old man. They couldn’t even learn his prognosis, let alone protect him from it, unless he gave medical staff permission to share it with them. Ralph and Denise Suarez could have been more selective about what details they shared with Suarez if he were 17; but as an adult, he was informed of every possible complication and side effect. “If he was little,” Denise said, “you could put him on your lap and say, ‘You’re OK. You’re fine.’”
Suarez’s salve, as usual, was baseball. The long hair that had crept over his neck was beginning to fall out – onto his pillow, in the shower. But as his friends started college classes, Suarez focused on the one thing he had and they didn’t: time to watch the Phillies. He tuned in for the blessed distraction of every game, and in late September he watched them clinch the National League East championship.
Around that time, he had such an extreme reaction to a medication that his parents could see his muscles spasm beneath his thin hospital gown. The nurses offered morphine, but Suarez found the best relief came from sitting on his knees in bed and burrowing his forehead into the mattress while hugging a pillow and curling into the fetal position.
“Is this helping?” the nurse asked.
“Yup,” Suarez recalled muttering into the mattress.
The nurse left. And then, another visitor arrived – the kind a typical Children’s Hospital patient might welcome.
“Elmo strolls into my room,” Suarez said. “He’s got his little friend with him” – Abby Cadabby? Zoey? Suarez, at 18, didn’t know her name – “and they’re like, ‘Is Richie here?’ I was on morphine and thought I might be hallucinating. I wasn’t.”
The spasms, the swelling, the headaches, the lack of self-control, the fact that Elmo had caught him in his weakest moment – they all conspired to lead Suarez to spew his frustrations at the furry creature.
“Get out!” he screamed.
Elmo and his friend reversed course, backing slowly out of the room, apologizing. But Suarez, consumed with pain and anger, wasn’t done with them. “Why are you still in your Elmo voice?” he yelled after them. “Turn it off!”
He spent five weeks in the hospital, imagining that if he could just get home, life would feel normal again. But his friends were away at college. He was still on an intensive chemotherapy regimen.
Nothing felt normal.
His body was taking so long to go into remission – too long, doctors thought – that they adjusted his meds. On top of the weekly chemo treatments he still took at the hospital, Suarez began injecting his stomach daily. For the first time since his diagnosis, he began to vomit. His athletic 6-foot, 175-pound frame withered to 117 pounds.
Even baseball, the love that carried him through the autumn, no longer made him happy. A couple of friends talked Suarez into visiting the neighborhood diamond about seven months after his diagnosis. He was feeling pretty good that day, and his hair had started to return. So when they said, “Let’s go throw,” Suarez was willing to give it a try.
“I went to the mound,” Suarez recalled, “and I almost couldn’t get the ball to home plate.”
For his friends, who had last seen him pitch a year earlier, when he had bulked up for his senior year and was the strongest and fittest he had ever been, the pitch was heartbreaking to watch. Would Richie ever be the same again?
As it turned out, he wouldn’t – but for reasons neither Suarez nor his friends could have anticipated that day on the baseball diamond.
That spring, just months after being diagnosed with leukemia, Suarez received more devastating medical news when he was told he has avascular necrosis, a rare side effect of one of his medications. AVN, as it is commonly known, cuts off the blood flow to the bone, denying it oxygen. The cells of the bone die, never to be awakened. More of them die, and the disease spreads, particularly impacting the joints.
AVN cannot be cured, only treated.
“It was just one last nail in the coffin,” Suarez said. “Just too much. I was already going through all this. I was already starting school late. Things weren’t looking good for baseball. I just wanted to be normal again.
“That’s what you crave so badly when you’re sick – normalcy,” he continued. “For me, most of my ‘normal’ growing up was baseball. Not being able to play, not being able to compete like I always had, was driving me out of my mind.”
The finish line of his treatment moved farther away. He had fought through a disease he once thought would be a death sentence – only to learn that while he would likely survive, his chances of returning to the pitcher’s mound were dim.
His first question to the doctor: “Am I going to be able to play baseball again?”
The doctor responded: “Let’s see if you can walk first.”
The Children’s Hospital of Philadelphia readmitted Suarez, this time to check the severity of his AVN. Doctors were hopeful because it was in only his femurs and tibias, the thigh and calf bones. But they warned Suarez that it can spread quickly in its early years.
Suarez’s medication kept him awake, so he stayed up late while other patients slept. He began striking up late-night conversations with nurses.
Suarez had started to think about a career in medicine – perhaps as a nurse or a physician’s assistant. And suddenly, he had a private audience with pediatric nurses at one of the nation’s top children’s hospitals. He peppered them with questions about leukemia and AVN.
“I started to become fascinated with it,” Suarez said. “I actually enjoyed learning about it. I could almost occupy myself with learning about the disease. It actually helped me.”
One nurse surprised him not just by answering his questions, but by sharing her own story. “I’ve never told a patient this, but I’ve got to tell you this,” she told Suarez on one of those late nights. “I had what you had. I was about the same age. I was 17, I had childhood acute lymphoblastic leukemia, and then I had AVN. I had a knee replaced.”
Suarez was enthralled with her story. The smart, successful nurse in front of him represented his life’s potential beyond the cancer treatments and the unexpected extra burden of an ailment in his bones that he imagined would make movement difficult for the rest of his life. One day, he thought, he could help people the way this nurse did. He could be an example as well as a good doctor – one who knows from experience how to talk to people on the worst days of their lives. “After that,” Suarez said, “I started to push even more and know what I wanted to do.”
He took one class at Rowan in fall 2011, just to get accustomed to class work again. When the school year began, he still had two months of intensive chemotherapy to go – and in October of that year, doctors added cranial brain radiation to his treatment. As a male, Suarez had a higher likelihood that the leukemia would come back; the radiation helped ensure it wouldn’t.
By spring 2012, Suarez was in maintenance chemo, taking one intravenous treatment each month and some chemotherapy pills each day. He became a full-time student that semester – and even walked away with a 3.9 grade-point average.
Maybe, he dared to think, returning to baseball wasn’t such an unattainable goal.
Doctors were still keeping an eye on Suarez’s AVN, but it still hadn’t progressed beyond his legs. So in summer 2012, less than two years after his leukemia diagnosis, Suarez pitched in a local baseball league. Just the act of suiting up and stepping onto the mound – licking the fingers, adjusting the hat, concealing the ball – made Suarez feel more like himself. More normal.
Then, one day, he corkscrewed his body back toward third base, lifted his left knee and sprung forward with his pitch – but when he stepped forward to plant his foot, the bones in his hip failed to brace for contact. “I felt like I had stepped in water,” he said.
The AVN had spread. His surgeon said Suarez’s hips were the texture of marshmallows; there was no hip left to repair. The doctor discussed replacing one, then another, with ceramic plates. Eventually, the doctor told Suarez, his knees would need to be replaced, too.
Suarez’s road had just gotten longer. But he returned again to school that fall, getting around campus on a bike because it didn’t seem to hurt as much as walking. He arranged with his professors to take his finals one week early so he could build as much rehabilitation time as possible into his winter break. He was told he would need six weeks to recuperate, but he had only five before the spring semester at Rowan was scheduled to begin.
He told the doctors to replace both hips at once. Why draw this out?
And then, Suarez started a new semester in January 2013 with two new hips and no crutches.
Six months later, what Suarez’s high school coach saw surprised him. He came out one day to watch him play amateur-league baseball just for support, to welcome Suarez back to the game.
“You’re doing way better than I expected you to,” Suarez recalled his coach saying. “Why don’t you give it a try in the fall?”
Suarez had never lost the mechanics that got him noticed by Rowan coach Juan Ranero. But the poisons that attacked his leukemia also dampened his strength, and the ceramic hips that allowed him to walk stole some of his agility. By tryouts, he was throwing 78 or 79 miles an hour – respectable, but not the 87 or 88 he threw in high school.
He told Ranero: “Don’t make me the mascot. I don’t want to be the kid with cancer. Please don’t put me on this team if I don’t make the team.”
Yet Suarez also knew he would only get better. When he tried out for Rowan baseball, he still had four months of maintenance chemo left.
“If I don’t do anything else to get better,” Suarez told his coach, “coming off chemo is going to help me throw harder.”
The coach had no reason to doubt him. At that point, Suarez was a man who spoke from the other side of a transformation. He had the hips and the soul of a man four times his age, with his whole life still in front of him.
Suarez wore the brown and gold of the Profs uniform for the first time in February 2014 for a trip to Ashland, Virginia, where Rowan was to face off against Randolph-Macon College. Suarez was only a month removed from his last chemo treatment. But he had envisioned this moment for so long that he felt, simply, at ease – as if he stepped into a picture that had been waiting for him all along.
“In my head,” he recalled, “I was just a ballplayer.”
Which might be why, when Suarez stepped onto the mound in the fourth inning, his mind was on the hitter at the plate, not on the fact that he was a guy back from chemo. Lick the fingers, wipe them off, adjust the hat, conceal the ball. “All right, I’ve got to keep this slider low to this guy so I can get this ground ball,” Suarez thought. “We got to get out of this inning.”
He released his breath and the ball, and Randolph-Macon’s Christian Sanderson grounded out to second base to end the inning. Suarez left the mound, heading to the Rowan bench.
If not for his teammate and close friend Dylan Johannink, the moment might have passed without fanfare. But Johannink clasped his arms around Suarez and picked him up in a hug, awakening his friend to what had just happened.
If Suarez had started school on time, this would have been his senior season. Instead, he had taken a detour – 3½ years of chemo, weeks of cranial brain radiation, dual hip-replacement surgery, countless drugs to fight the leukemia and others to fight the side effects of the drugs fighting the leukemia – and still went on to play college baseball. I’m a pitcher, he says now when he thinks about the disbelief he felt at the time, and I’m playing baseball.
This past season, under the direction of new coach Mike Dickson, Suarez pushed those odds further. He pitched in 12 games and started four. He struck out 29 batters in 38 innings. He ranked third on the team in ERA, wins and strikeouts.
“If you ask any athlete about their season, I don’t think anyone is going to say, ‘Oh, I’m completely happy with it,’” Suarez said. “If you look at my numbers, I was 4-1, and my ERA was 3.03, which isn’t bad. I could improve on it and get better.
“But for me as an athlete,” he continued, “a bad game is still a great day. I get to play baseball, and that’s something.”
That earned perspective lingers. Since returning to baseball, while the national anthem is sounding, Suarez forces himself to pause, to look around, to think about what this game means to him. He stands there with his hat in his hand, and breathes in the baseball.
Today, more than normalcy, Suarez wants solitude. He is studying for the MCAT – the standardized test for medical school – with a regimen more demanding than a training schedule: four hours of studying, followed by a workout, then four more hours of studying. He hopscotches among libraries and Starbucks to fit in his study time. Every few days, he takes practice tests, requiring seven uninterrupted hours.
Suarez could graduate in December. He doesn’t plan to start medical school until fall 2016, so he thinks sometimes about returning to Rowan baseball next spring. Cancer might have robbed him of time, but he still has two years of eligibility.
He thinks about something else, too: what it might have been like to be an irresponsible freshman instead of showing up on campus for the first time with “chemo brain” and a will to live.
“Sometimes, it was hard to relate with my classmates,” he said. “Something happens when you go through cancer. You lose any sort of innocence that you have. You’re not really naïve anymore.”
Suarez can’t go back to the person he was before he fought his way back to the game that was once the center of his life. He can settle into his hips, but the weighty thoughts he carries now – like the pain in his joints – aren’t going anywhere.
His mother frets over him. “Do your knees hurt?” she asked after a long walk.
“Ma,” Suarez replied, swatting away the attention, “my knees hurt all the time. And that’s OK.”