The first thing you notice about Ean Katz is the tattoo that runs along one forearm, bearing a muscular response to the ordeals of the last three years.
The tattoo reads, "We have two options, medically and emotionally: Give up, or fight like hell."
Katz, 20, is preparing for the 2015 football season at Towson University, and he has been fighting like hell.
He's fought through cancer and chemotherapy, and he's fought through kidney failure that left him weak for five months. He's fought through a ruptured appendix that left him collapsed on a football field in agony during his senior year at Atholton High School in Columbia, Md., until he struggled to his feet and somehow lined up for the next snap.
"All the things he's gone through, it's just remarkable," Towson head football coach Rob Ambrose said, sounding slightly awed. "Knowing what's been stacked against him medically, oh, my…"
When Ambrose's voice trails off, you hear Kyle Schmitt, now head coach at Archbishop Spalding in Anne Arundel County, who coached Katz at Atholton.
"Kids sometimes have setbacks," Schmitt said. "But nobody's like this, not in their high school and college years, and they keep playing ball. It's pretty much unmatched. The setbacks just came and came. Each one topped the previous one. And this kid, with his incredible determination, has just taken on whatever's been put in front of him."
Katz is 6-foot-3 and 255 pounds. Put some pads on him, and you picture him pulverizing a tailback. He's played linebacker. He's played defensive end. And he looks like a guy who relishes serious physical contact. He was Atholton's team MVP when it was the No. 1-ranked defense in the state.
But since he was 17 and playing high school ball, Katz has been through surgery. He's been through chemotherapy and radiation at Johns Hopkins Hospital, and he's had lengthy times when he simply laid in bed too weak to get up.
So how does he find the gumption to keep playing serious football when others might have long since packed it in?
"I don't know," Katz said. "There was never a sense of giving up. People go through stuff -- that's all. And I guess I figured if I could go through all this, and not let it beat me … well, maybe that makes it a bigger deal if I could play college football after going through all this."
He's also had some help. Katz's mother, Jennifer, is a nutritionist. She made special meals for him. His father, Dr. Jeffrey Katz, is an emergency room physician.
"Well, when he got that cancer diagnosis, that was pretty crushing," Jennifer Katz said. "But Ean never showed that he was discouraged. There's a real toughness there."
Jeffrey Katz agreed.
"There were times when Ean was in miserable pain, looking horrible," Jeffrey Katz said. "But you rarely saw him looking down. I have no doubt his experience in sports got him through this. You know, you get knocked down, you get back up."
But his parents' support was also part of Ean Katz's pain.
"It was real comforting to have them there," Ean Katz said. "I was almost relieved that all this stuff happened to me, because I had the best help. But I couldn't imagine how my parents felt, having to watch me go through this. I didn't have to watch me -- to watch a son -- go through this. They did."
In the fall of 2012, Ean Katz was a senior in high school when the health issues began to blindside him. Atholton was playing River Hill High School three years ago during an emotional rivalry game on a Friday night. Two days before the game, he started throwing up.
"I kept saying to him, ‘Go to a doctor,'" Jeffrey Katz said. "But he refused. He said it was just an upset stomach. I said, ‘Look, you're too big for me to throw you into a car and take you there, but you got to go.' And he kept saying, ‘No, I'm fine.' And I turn around and, you know, he's gone."
Ean Katz knew he had to play.
"All week long, I thought it was a food thing or a pulled muscle," Ean Katz said. "I was so sick. I wasn't going to go to school, but I knew that if you didn't practice, you didn't play. And this was our big game. And I remember walking down the hall and seeing guys suited up, and thinking, ‘I got to. I got to play.'"
He got through the first half, feeling nauseous and parched, playing middle linebacker. He remembers drinking huge amounts of water. Atholton held River Hill to 7 yards of offense through the first half. Ean Katz's coaches described him as being "all over the field" that game.
Ean Katz has vivid memories of the experience.
"And then, in the second half, I remember I was the second man in on a tackle, and it happened," Ean Katz said with a laugh. "I felt like I was shot. Anybody in his right mind would have called timeout. But I got up and lined up for the next play."
Fortunately, cooler heads prevailed. When his coaches saw him doubled up, they called timeout.
"He had acute appendicitis, and now it's ruptured," Jeffrey Katz said. "I run onto the field, and he's screaming. I was freaking out. I mean, I'm an ER doctor, but he's my kid. I'm used to stab wounds, gun wounds, heart attacks. But when it's your own family …"
Jeffrey Katz drove his son to Howard County Hospital. Ean Katz spent the next four hours in surgery and awoke to find tubes in his stomach and nose with thoughts of a football future in doubt.
But three weeks later, he was back in action and leading his team in tackles.
"Amazing," said Justin Carey, who was Ean Katz's defensive coordinator at Atholton. "They take out his appendix, and a couple of weeks later, he's back in action. He's playing at his usual high level, no excuses, and holding his teammates accountable, too. This is a kid who perseveres, who's uplifting, who wants to be better today than he was the day before."
Ean Katz never doubted he would return to the field.
"It never occurred to me that I wouldn't play football again," Ean Katz said. "My mindset was, I'm 17. I'm bulletproof. I want to play football and be a hero, you know? People were saying, ‘You're not going to play, are you?' I'd say, ‘Why not?' They'd say, ‘Your appendix burst. You lost 20 pounds.' Yeah, but I was still me. I wanted to play."
And yet his troubles were just beginning.
That winter, Ean Katz's legs swelled. When he pressed his fingers against them, the fingers went in half an inch. In a single week, during which he found himself constantly exhausted, he put on 16 pounds.
He went to Johns Hopkins Hospital, where doctors diagnosed him with nephritic syndrome. His kidneys weren't filtering protein, and water was settling in the tissues in his legs -- and, when he slept, settling in his back and buttocks.
He spent most of the next five months in hospital rooms, hooked up to intravenous lines. Or he was home in bed, "horribly nauseous," swallowing "tons of pills" and getting homeschooled.
"A lot of loneliness," Ean Katz said. "It's the spring of my last year of high school, and all my friends are cutting loose, having a great time, playing lacrosse without me, and I'm home. And it never seemed to stop. The doctors told me it'd take two months, but then they kept extending it. It took five months. And it seemed endless."
Emotional Roller Coaster
A telephone call helped. One afternoon when Ean Katz was nearing recuperation from the kidney problems, Schmitt called.
"The University of Maryland wants you," Schmitt said.
A "preferred walk-on spot" to play varsity football, Schmitt said.
It wasn't a scholarship offer, but he would have a spot on the team.
"This was in February [of 2013], and I was so excited," Ean Katz said. "I'm putting the kidney thing behind me. There's no more thoughts about health problems, and then …"
By the spring of 2013, all of his features seemed swollen, and he was noticeably ill at Atholton's graduation.
"I wouldn't let anybody take pictures of me," Ean Katz said. "I didn't want anybody to remember me this way."
That summer, he made it through a two-week football camp in College Park, Md. But something was wrong. He was having so much trouble breathing, he purchased an inhaler. He was coughing terribly.
When his weight dropped to 215 pounds, he told his coaches he was too weak to play that season. He went to class, did well academically, but grew increasingly concerned about his breathing.
The following winter, he couldn't stop coughing. A CAT scan brought the bad news: enlarged lymph nodes in Ean Katz's neck and lungs and esophagus. Ean Katz had just come home from a workout when his father told him to sit down.
"Hodgkins lymphoma," Jeffrey Katz said.
Ean Katz didn't know what it meant.
"Can we handle it with pills?" Ean Katz asked.
"No, it's a type of cancer," Jeffrey Katz said.
Ean Katz was in a transition at the time of his diagnosis.
"By this time, I was headed for Towson to play football," Ean Katz said. "I was on a real pedestal. Then, my dad explained what I had, and what I had to go through. I fell right off that pedestal. I cried. I thought I had done my time. I thought I could get on with my life, play football and all the rest of it."
Instead, there was chemotherapy to endure: 21-day cycles for three months at Hopkins Hospital, injections every three days. His immune system plunging. He was taking medications every day. He experienced intense nausea and fatigue, with his stomach lining raw.
Then, when the chemotherapy was done, he underwent two weeks of daily radiation treatments.
"Yeah, but you look around at Hopkins, and there were five or six kids my age, and 10-year-olds, and they're going through it, too," Ean Katz said. "And you tell yourself, ‘Why can't I?'"
A month after his last radiation treatment, he went for the tattoo: "Give up, or fight like hell."
Transferring to Towson in the fall of 2014, his treatments finally behind him, he went through spring ball playing defensive end and on special teams. The coaches showed "a lot" of concern for his health.
"They saw me as a person, and not just an investment," Ean Katz said. "I appreciate that kind of support a lot."
Ambrose echoed those sentiments.
"We think Ean's a very, very good kid," Ambrose said. "He's got great speed and size, and he's a quick study. He's an above-average walk-on. How good can he be? It's too soon to know, but he's certainly got a lot of potential."
Ean Katz's story poses a fundamental question about not just him, but all of those who struggle with health issues, with the torn ligaments and broken bones so prevalent in a game of high-impact hitting: what is the allure of football that compels young men to play when the risks are so high?
"For those of us who have played the game, it's a virus," Ambrose said. "It's a virus combined with a brotherhood unlike anything anyone in the world can understand.
"The game allows you to find more in yourself. There's a ton of people with physical failings. You know, ‘I'm not strong enough or fast enough or some kind of disease.' But, with football, the way you handle it is different. It knocks you down, but you find a way to get back up. The game teaches that. ... And Ean kind of personifies that. Internally, that's where strength comes from."
It's the choice everyone makes: Give up, or fight like hell.