By Shweta Mishra

Final Trip to ER

No one noticed Ray Staples was on the throes of death that Monday, much less weeks later.

At 1:20 p.m. on Aug. 27, 2012, he sat stock still on a bench on East Franklin Street, head bent gently, a Swisher Sweet dangling from his lips. His straw hat hid his eyes from the sun. At his feet lay a cardboard box with a dollar and change.

Over the years people downtown had dubbed him Cowboy — for his hat, his chivalry and spare words, his patient roaming.

But now his muscles had atrophied so much he couldn’t walk. His pensive, gleaming gaze had dimmed.

Finding a Place to Rest

At midnight 16 days later, the 62-year-old homeless man with advanced cirrhosis took two hours to shuffle and crawl a span of five feet into a nook behind a line of Japanese laurels on the Peace and Justice Plaza in Chapel Hill.

He moaned when mere leaves brushed his abdomen, which was round with fluid and engorged veins, a set of symptoms called ascites.

When he reached his destination, he buckled into a fetal position. “No one’s gonna see me here,” he said.

By mid-morning, despite the brick rampart and newspaper stands bordering the bushes, he had not only been seen but ousted.

Now he sat on the brick wall next to the Plaza, one rheumy eye squinting almost shut, the other blinking into the glaring sunlight.

He said six police officers had dragged him out of the bushes at 9:30 a.m., and it hurt.

Urine stained the crotch of his blue jeans. His five layers of sweatshirts, given to him the night before by a passerby, were still wet from “punks” tossing beers behind the bushes.

The good Samaritan, a Mediterranean Deli manager named Parker Emmerson, had also wrapped Staples in three Mylar emergency blankets.

“I wasn’t cold at least,” Staples said.

But now, unable to move into the shade of the holly tree before him, he was overheating and parched. He asked a stranger to dial 911, and an ambulance drove him to the UNC Emergency Room.

Room Without a View

Lying in a curtained off corner on a Hill-Rom Advanta electric bed, he glared at the nurse who slid a needle into his arm.

“He’s enjoying causing me pain,” he groaned. “He’s a vampire.”

His thin hospital gown bared a jaundiced, emaciated back splotched with spider angioma, liver spots resulting from hormonal imbalance.

Even after nurses laid five blankets on him, he said he was “freezing to death” in his gown. He repeatedly asked for more blankets, but medical attentiveness waned fast.

Staples said the acute trauma wing had become surrogate homes in the past month.

“I’ve been here at least once a week. I always end up feeling worse than I did when I got here. I get hungry and cold, and they always put me back on the street.”

Hospitalization

At night, Emmerson visited and criticized hospital staff for not admitting Staples into the hospital for long-term or hospice care.

“That’s clear negligence under the law to let someone who’s in trouble fend for themselves. You can’t just ignore someone who’s getting raped, mugged, bleeding,” he said.

A nurse who couldn’t disclose her name said no food except crackers and a Coca Cola were available, so Emmerson brought Staples aloe vera juice, Odwalla smoothies and boiled eggs. “They don’t know about nutritional medicine here,” he said.

Why, after UNC doctors diagnosed Staples with 90% cirrhosis and said he had less than a year left to live if untreated, did they repeatedly release him from the E.R.? The nurse said it was because they didn’t have Staples’ consent, that he had refused offers of medical intervention and social service care the week before.

Staples denied this claim. “I just didn’t want an injection in my belly right then,” he said.

Kristin Lavergne, Community Services Director at the InterFaith Council, says that Staples’ limited means were also a barrier.

“Funding and insurance always makes an impact, unfortunately,” she said. “And I know UNC has cut social service staff recently.”

She said that with staff stretched thin, it’s hard to ensure follow-up after a patient is discharged, or that Staples is relocated somewhere that specializes in long-term care for the needy, like Carrboro Community Health.

Staples would also be more eligible for long-term care if he lived in the InterFaith Men’s Community House, Laverge said.

“IFC operates a medical clinic for its shelter residents. They’re able to handle routine items, like colds, and refer to local providers.”

Staples rebutted that he couldn’t live in the shelter because men bullied him there. He said he wasn’t reassured by the presence of Sylvester Bethea, the Community House security officer, who said, “We’re all family here. And I protect my sisters, my cousins and my friends, especially women or older guys.”

Strangers

The next day, Emmerson learned Staples had been released. Emerson found him lying on a bench on West Franklin Street. He looked like a bloated prune and reeked of waste, Emmerson said.

This time he carried Staples into his black SUV, drove him to his house, carefully bathed and dressed him in clean clothes and pressured UNC Hospital to admit him for long-term care.

On Emmerson’s last visit, Staples was settled on a bed on the 8th floor of the N.C. Memorial Hospital, surrounded by containers of Boost, Coca Cola and V8 Original.

He was too sedated to recognize the young man he had recently called his angel. His wispy hair fluttered in the AC as he slept.

After that, Staples was transferred to hospice care. The hospital told Emmerson it couldn’t disclose Staples’ whereabouts to strangers.

By Shweta Mishra

No challenge is too great for Miles Oree Hill, who went from idolizing his surgeons in kindergarten to playing competitive wheelchair-basketball 14 years later. Now he wants to play in either the Paralympics or Special Olympics.

Miles never required legs to travel the world, much less dribble and dunk. His world adventure began when he was just a spark in his parents’ eyes, when his dad, serving in the Navy’s information technology branch at NATO headquarters in Oreis, Portugal, met his mom. At the moment of conception, Miles tacked yet another continent under his belt when Timothy Hill and Ana Costa left Ana’s home in Cascais for NATO headquarters in Verona, Italy. And when Miles gulped his first lungful of air in Italy, he boasted dual Portuguese-American citizen and secured his adult entitlement to Italian citizenship. To boot, he beat his twin brother Martin by a whole minute in the race to be born.

But the journey was just beginning, and it would be about much more than geography. When the doctors pulled the twins out via C-section, they found that Miles had spondyloptosis and a tethered spinal cord. So Miles’ father had to ask the Navy for early return stateside, landing Miles on his third continent at nine months of age.

“Getting a full diagnosis and finding a doctor to work on such a severe case took us from Italy to Portsmouth Naval Hospital in Virginia, to Walter Reed National Military Medical Center in Maryland, to Norfolk Children’s Hospital and finally to Duke,” Tim says.

Getting fixed

Miles didn’t just roll onto the basketball court after all the surgeries. His first dream was to be a doctor. In kindergarten at Holt Elementary in Durham, NC, he scrawled a man with a stethoscope and the words ‘I’m a doctor’ on a slip of paper.

“The legs were bow-legged, like went in,” he says, laughing. “I don’t know why I drew his legs like that. His arms were off at weird angles.”

Miles had at least three operations to correct clubbed feet before he was six years old. In 2006, doctors fused his spine and substituted malformed vertebrae with artificial parts, and he finally began walking.

“So I thought doctors are cool,” he says. He adds with his characteristic warmth and bubbly ease: “Doctors are wassup.”

Peering Out

In 6th grade, Miles began reworking his dreams. At home he often played video games with his twin and younger brother, crowding three PlayStations and a Nintendo, each vying for top scores. But sometimes Miles was alone at the two-player consuls. When his brothers went to play ball around the hoop outside, he didn’t follow.

“I never actually played with anybody else in the neighborhood.” He lowers his voice as if making a confession. “It’s because I was some buns at basketball back when I was young – like I was trash, I was horrible. I wasn’t fast and I wasn’t tall either.”

Then he adds, “But let me tell you, I really loved that PlayStation. That was – that was real.”

And it was through video games that Miles first encountered sports.

From homebody to fantasy football

“One day in 2010, some of our friends gave us their GameCube because they were headed off to college, and it had this one football game, Madden NFL ’07,” Miles says. “The game assumed you already knew how to play football – never told you how to score. I didn’t know what touchdowns and field goals were, nothing like that, and the first way I learned how to score was a safety. And then I pushed the stick forward, and I just ran to the end zone and scored more points, and I was like, okay, let’s try again! And that’s how I learned to play football, through the video game.”

When his Xbox disk-reader broke, he sat and jotted down enough football stats to fill a binder. He read voraciously about sports because he felt exasperated around adult conversations. Probably as a result, his sports commentary and knowledge are remarkable for his age.

“I picked up a book the other day, it was ‘Pro-Football’s Best Seasons of the Greatest Teams’, by Eddie Epstein,” he says. “The best team of all time was the ’85 Bears is what the author said. Their offensive rating was 3.3 and their defense was 3.4, so their rating was 6.7, which is the highest since like 1950. ”

But reading goaded Miles. He actually wanted to be on the field.

His yearning to play came to a head in 7th grade.

Getting into the game

“I talked to my dad. I was like, dad, can I play football at school? And my dad told me no doctor was gonna clear me to play football because of my disability. He was like, even if you want to and even if I let you, a doctor wouldn’t clear me. I was 12, and that really hurt me. He said you don’t always have to play football to be involved in football, you know what I’m saying. You can be a manager or something. And I thought about it, and I was like nope. I never can understand how people commentate for soccer and football without being able to play. You can’t affect what happens, the only thing you can do is talk about it. I can’t do that, I would hate it.”

But he said news about concussions from football and requirements for Heads-Up-certified coaches helped convince him to refrain from the sport.

“So that’s when, when football season was over and it was basketball season, I asked my dad — dad, can I play basketball? And he said, a doctor won’t clear you to play basketball either. So that’s when I was like, what can I play? I know I got a disability, but what can I play. And then we found the flyer.”

It seemed like divine providence that Miles and his mom were at the Durham County Library in time to spot the ad for wheelchair basketball on the bulletin board.

“I was like, we gotta go try this, and my mom said, okay, we can try. My dad ended up taking me, and because he has work, we were really late. It started at 4:30 and ended at 5:30, and we walked in the door at 5:29.”

But days later, Miles was a walk-on for the Junior Thunder.

Bridge II Sports would change his life.

The game changer

The organization holds its wheelchair basketball practices in the recreation center of Braggtown Baptist Church, memorably located between the Sikh Gurudhwara temple and Pelican’s SnoBalls in Durham.  Brianna Edwards, a 22-year-old UNC-Greensboro alum, is the program coordinator, managing the organization’s 12 recreational and sports programs. She studied recreational therapy and joins the throng on the white expanse of a basketball court, sliding around in a wheelchair herself.

“Okay, let’s do suicides now!” she yells cheerily, and Miles, a couple of wounded warriors from Iraq and volunteers begin racing from one end of the court to the other, warming up for a practice game.

Miles explains that Junior Thunder has practices in Durham on Tuesdays and in Raleigh on Fridays, but he mainly attends the local practice. He beams with adoration for his team and the organization.

“It’s built my confidence. Now when I see somebody closed like I was, I’ll reach out to them. Now that I play wheelchair basketball, I’m happy that I am the way I am. That’s what I love about it — I see a whole bunch of people, and I’m like, wow, the way they play, if everybody in the NBA had that drive – and if people in wheelchairs didn’t have that disability – they would be at the caliber of Lebron. It shows that anybody can do – as long as you put hard work into it – can do anything.”

Of all his coaches, Miles most admires Michael Atkins, his older head coach, and assistant coach Hakim Hassel.

“The way they play is how I wanna play,” he says. Miles admires that Hakim demonstrates strength and agility in the wheelchair through core muscle exertion.

“He was born with spina bifida, so his lower body is really weak, but he has a really strong upper body. And one thing that I’ve never known how to do in wheelchair basketball that he does is use body control, where instead of putting your hands on the wheel, you can move your body so that your chair will turn with you. The one way Hakim plays is he uses his core and just takes his two pushes, and he can go down the court and never dribble the ball, just straight turn and make his way past everybody and do the layup. Sometimes he gets on one wheel and he does it on purpose, but for some reason he never falls. His balance is crazy.”

Miles also looks to Mike for role modeling. He says that after Mike, a long-time basketball player, had a car accident that made him paraplegic, he didn’t give up the sport. He persevered.

“And he’s so good,” Miles says. “He takes his two pushes, and he’ll just stare at the goal with the ball like this and bring it up real slow and when he hits the three-point line he’ll shoot it. He has a 60% three-point percentage, it’s crazy how he does it.”

Miles says that Mike has helped him refine his performance in several ways, in particular by holding onto and pushing his elbows inward so they maintain correct form rather than going akimbo as he throws the ball.

Moving forward

In the short time Miles has played at Bridge II Sports, he’s made strides in strength and technique. He’s been able to walk without his wheelchair for the longest time yet, and he’s participated in nationwide in both wheelchair basketball and track, which he practices to condition his body during basketball off-season. Tim lists his “busy-body” son’s basketball tournaments and conditioning races for track: Miles has played in Cary, NC, for the 2012 Winter Classic; Smithfield, NC, for the 2012 and 2013 Hog Wild; Charlotte, NC, for the 2013 Winter Classic; Atlanta for the 2012 and 2013 Southeastern Conference Championship; Birmingham in the Lakeshore 2013 Youth Southern Regional Tourney; and Louisville, KY, in the 2012 to 2013 season of National Wheelchair Basketball Association Championships.

They’re looking forward to the Winter Classic in Cary on November 1st and 2nd.

Wide horizons, great expectations

Miles also has his eyes further along on the timeline. He’s interested in pursuing an education on a wheelchair basketball scholarship to one of five universities that fund the sport: University of Alabama, University of Illinois, Missouri University, Auburn University and Oklahoma State University. His dad says Duke University is not on their list because it currently lacks a wheelchair basketball program. Miles asserts that Bridge II Sports is trying to get wheelchair basketball into a North Carolina college for him.

“I have four years till I go to college, so they say they’ll try to get it as quickly as possible,” he says.

But even colleges have limits in terms of what they can offer an athlete of Miles’ caliber and grit.

“They only have ten teams that play at their school, so only so many of them play each other,” he says. “They don’t have enough money. I mean, I’m pretty sure the school has enough money, they just don’t fund it for wheelchair basketball.”

So Miles raises his bar as high as he can, hoping to enter the Paralympics in 2016. His dad says he also has hopes to play professional wheelchair basketball in Italy.