The day that Brian Keefer arrived at his Newberry Township home after 2 1/2 months away, he was pleased to see the ball still lying at the base of the basketball net, his green Saturn still parked out front.
Everything just how he left it.
Only nothing was the same.
Brian couldn't dunk the basketball. He couldn't hop in his car and go for a spin.
The college athlete who used to live here had returned -- but in a wheelchair, paralyzed from the chest down.
Unable to feed himself, bathe himself or go to the bathroom alone. His youthful independence now confined to the metal bars of wheelchairs and hospital bed railings.
Brian might not be able to spend his junior year at Lock Haven University with friends, or compete in track meets and volleyball games.
And doctors might not know whether he'll regain feeling and movement.
But he can already do sit-ups in his chair and flex his left bicep if he concentrates. And he plans to win this match of Brian versus his body that began with a July 1 gymnastics injury.
"I'm so over this whole being paralyzed thing."
The Brian Keefer of a few months ago was never able to sit still for long.
If he wasn't playing club volleyball or practicing gymnastics, he'd be sprinting for the track team, competing in the long jump or working as a camp counselor for the West Shore YMCA.
His parents worried when he did flips off trees or on concrete.
On July 1, he decided to practice his moves in a professional gymnastics gym. Brian was at The Viper P.I.T. in Fairview Township with his brothers, flipping from a trampoline into a foam pit.
A single front flip, and a double.
Then for a triple -- more than he had ever attempted.
"I almost made it," Brian said.
When he landed, he couldn't move. He didn't feel pain, but he knew something was wrong.
At Hershey Medical Center, doctors discovered Brian had broken his neck. They operated to relieve pressure on his spine, removing broken pieces of bone in his neck and realigning the spine.
Thirteen days later, instead of celebrating his 21st birthday with dinner at Texas Roadhouse and a night out on the town with his brothers and friends, Brian marked the milestone in the hospital.
Brian spent a little more than two weeks in acute care at Hershey, then doctors transferred him to Magee Rehabilitation Hospital in Philadelphia.
"People in the hospital -- the nurses, aides and therapists -- they'd go out of their way personally to do things for him," said Kayli Devlin, Brian's cousin.
Matt Marshall, Brian's best friend since elementary school, said: "A lot of people who would come down with me worried about how they would react when they saw him. But (Brian) would always be in a really good mood. He'd be the first to say 'Hey, how are you?' or ask about something he knew was going on in their lives."
In early September, the Keefers learned that Brian wasn't ready for Magee's intensive rehabilitation program. Doctors and therapists there had done all they could . . . for now.
It was time for Brian to go home.
The news pushed the Keefers into a flurry of action.
How would they get Brian's wheelchair through the narrow doorways of their Colonial-style home? How would they transport him to appointments and social outings?
"It breaks my heart," Kayli Devlin said. "The one thing that this could take away is the one thing that is Brian -- the running, jumping and being active."
In between work and trips to Magee, Brian's mother, Dawn, worked the Internet and phone, trying to figure out what type of assistance they could get. She and Brian's father, Steve, rearranged furniture and filled out paperwork for Social Security and disability benefits.
Friends and family held fundraisers. Members of their church provided meals and gasoline gift cards.
Family friend Colleen Marshall, who has been coordinating many of the fundraisers, said they've raised about $36,000 so far: "It sounds like a lot, but it's really not."
Not when a shower chair, for instance, costs $2,500.
On Wednesday, Sept. 17, Brian got in an ambulance once more. This time, to go home.
When he reached the end of his cul-de-sac, banners and posters welcomed him, and lime green ribbons waved in the breeze.
"It's my favorite color -- my theme, I guess," he said.
For the first few hours, his parents practiced wheeling him in and out of the house, through doors that didn't open automatically, over terrain that was anything but level.
They dug through kitchen cupboards in search of bendy straws to give Brian a drink of water and searched for fitted sheets that would work with the hospital bed set up in their living room.
"At Magee, everything is there for you and you don't think about it," Dawn said. "We're discovering that the real world isn't like Magee."
Steve wheeled Brian outside to enjoy the late summer afternoon. In a sunny patch of driveway, not far from his car, Brian held court in his wheelchair, chatting with visitors.
His grandparents Frank and Sally Schatt came over. It was the first time they had seen their grandson since his injury. They covered him with hugs and kisses. When Sally went inside, Frank told Brian how much easier it is for him to let his wife drive them around: "I'm not interested in driving anymore."
"I am," Brian said.
"I bet you are."
Steve popped the wheelchair into a reclining position to shift Brian's weight -- something they do every half-hour so he doesn't get pressure sores -- and Brian closed his eyes to soak up the sun.
Friend Patrick Hogan took advantage of the moment to scratch Brian's right knee and laugh when fingers on Brian's right hand moved involuntarily in response.
"When does your (motorized) chair come?" Hogan asked.
Steve Keefer: "Not for two or three months."
Brian: "I'm not gonna need it by then."
When school let out for the afternoon at nearby Red Land High School, discussion turned to how they'd get Brian there in the family's Ford Windstar to watch his cousins' volleyball practice.
Together, his parents lifted him in the wheelchair and slid a sling underneath. They hooked the top of the hammock-like contraption to a wheeled pole with a hydraulic pump that lifted Brian into the air.
Steve slid onto the floor of the minivan, supporting Brian from below. Dawn maneuvered the pole closer to the vehicle.
"Is that all the farther the door opens?" Brian asked.
"You're going to have to let it down," Steve said. "You know how to do that honey?"
"No. I wasn't trained on that," Dawn said.
After a few minutes fumbling with the pump, Dawn figured it out -- but a little too well.
"Stop letting it down!" Steve yelled, Brian's 150-pound frame collapsing on top of him. "You're squishing him! Crank it up!"
"You're not squishing me, you're squishing dad," Brian said. "This is too much of an ordeal."
"It is," Dawn agreed. "We need to get a van."
The Keefers wheeled Brian into the Red Land gymnasium and a group of girls -- some wearing lime "Pray for Brian" T-shirts -- saw him immediately. "Brian's here! He's here!"
"The coach is going to love this," Dawn said. "We're going to totally disrupt their practice."
Seconds later, Brian's cousins Maggie and Jill Devlin dropped their volleyballs and ran shrieking and crying to the wheelchair, where they smothered Brian with hugs and kisses interspersed with sobs.
Members of both girls' volleyball teams froze, then crowded around Brian.
"I didn't mean to stop practice," Brian said. "I came here to see it."
A week later, it was all Dawn Keefer could do to stay awake in the middle of the afternoon. Each night, she, Steve and their son Scott take turns rousing themselves from sleep every two hours to turn Brian in his bed.
They heard about a bed that mimics normal sleeping patterns and would automatically shift Brian every night, but $37,000 is more than they can afford.
With physical therapy still being arranged and friends and family busy with school and work, Brian spent much of his first week home watching TV. The voice-activated system that will allow him to use a computer wasn't set up yet, nor was the mouth stick he will use to write with a pen or pencil.
When his cell phone beeped, alerting him to a text message, Brian's brother Scott had to get it and respond.
"Let me see it, let me see!" Brian begged, craning his neck to peek over Scott's shoulder.
From his younger brother, Colin, a freshman at East Stroudsburg University: "Get the (expletive) out of that chair."
Dawn: "Let me see."
Scott: "Don't get mad."
Dawn: "He better clean up his language."
Scott's thumbs flicked out Brian's reply: "I would love to. Someday I'll get up and surprise you."
Brian: "What is he saying?"
Colin: "You better. . . . I'm dead serious."
Friday was Steve Keefer's last day of work at the Defense Distribution Depot in New Cumberland. He retired early to stay home and care for Brian.
When Brian wanted to visit Colin during family weekend at East Stroudsburg, the excursion became a production. Last weekend, it was a trip to Lock Haven so Brian could see his friends and thank those who are raising money for him there. Columbus Day weekend, the family will take him camping in their motor home.
"We're trying to get him back into as many of his regular activities as possible," Dawn Keefer said.
Maybe by January, he'll be able to resume classes, if not in person, online.
Kayli Devlin said she thinks Brian didn't realize the enormity of his injury at first or how much time it would take to recover. "He springs back from everything so quickly," she said. "I think he's getting frustrated now because this is taking longer than he thought."
Then there's the whole pride thing -- asking someone to scratch an itch on his face or adjust him in his wheelchair.
Doctors can't say how much mobility Brian will regain. Spinal cord injuries are too individualized to make such predictions.
Dawn Keefer said the family doesn't know when Brian will be ready for intensive rehab until he resumes therapy and professionals can evaluate his progress.
Brian won't entertain the possibility that his condition might be permanent.
He's convinced by the time his 22nd birthday rolls around in July, he'll be able to celebrate for real. He finds comfort in something he read that 80 percent of the population will spend time in a wheelchair at some point in their lives. He figures this is just his turn.
Kayli Devlin said she thinks the same kind of determination that led Brian to set school records in high school track and push himself in sports will get him through this latest challenge.
"He's the kind of person who never gives up until he gets what he wants," she said. "So there's something in my gut that says he's going to walk again; that day will come."
ABOUT BRIAN KEEFER
Residence: Newberry Township
Family: Parents, Steve and Dawn; brothers, Adam, 27, Scott, 25, Colin, 19
Education: Junior at Lock Haven University majoring in health and physical education, 2006 graduate of Red Land High School
Interests: Gymnastics, volleyball, track
Dr. G. Timothy Reiter, director of spinal neurosurgery at Hershey Medical Center, said Brian fractured and dislocated his C4 and C5 vertebrae. The fractured bones pinched and bruised his spinal cord, leaving him paralyzed from the chest down.
Doctors operated to remove broken bits of bone and fused the C4 and C5 vertebrae together to stabilize Brian's spine. The spinal cord, however, must heal on its own. Because each individual heals from such an injury differently, doctors are hesitant to say how much feeling and/or movement Brian will regain, and whether he'll walk again.
The complete or partial paralysis of both legs and arms and the parts of the body below the injury, usually a spinal cord injury.
Cases are categorized by the cervical vertebrae injured. People with C1 to C4 injuries are in the most serious condition and might need help breathing. C5-8 patients have increased use of arm, chest and hand muscles, providing increased levels of mobility and independence.
About 150,000 Americans have quadriplegia, most between the ages of 20 and 40. Quadriplegics are susceptible to circulation and respiratory problems and to dangerous pressure sores and infections -- all of which can lead to death, if not monitored. Even temperature changes can be problematic. The autonomic nervous system, which is controlled by the spinal cord, regulates the ability to sweat and shiver.
Because the spinal cord is damaged, most quadriplegics cannot sweat and are highly susceptible to heat illness. The body uses the moisture produced by sweating to cool itself through evaporation.
The complete or partial paralysis of the legs and possibly trunk. The arms are not affected.
Cases are categorized by the thoracic level of the spinal cord injury. For T1-8 patients, there often is control of the hands but no stomach muscle control. Lower-T injuries enable good trunk and abdominal control.
T6-12 patients might be able to walk for short distances with long leg braces and a walker or crutches, with the abdominal muscles "throwing" the paralyzed legs forward.
Donations can be sent to the Brian Keefer Medical Fund at any PNC Bank.
Panera Bread on the Carlisle Pike in Mechanicsburg will donate a portion of proceeds from sales the evening of Oct. 17 to the fund.
The Capital Area Performing Arts Center Operation Youth Theater Juniors will do a production of "Don't Touch that Dial: A musical salute to the golden age of television," with all proceeds going to the Brian Keefer Medical Fund. The show will be 2:30 p.m. Oct. 19. Seating is limited. For details, call 938-9800.