Start at the knee. One joint, twisted almost a month ago and iced, examined and MRI'd. Held in pain after the cleat on the same leg held fast in the turf, but every other part of the body continued in cockeyed momentum. It's a minor injury, no major tear, nothing to be worried over.

Now step back and see it as one joint of a whole body.

Let the whole picture come into focus: it's an entire body of joints that broke down and were redefined, only to be broken right back down again.

And now, finally, perhaps, rebuilt for good.

It's a staggering fact, in terms of health, that Grady Renfrow got struck by lightning twice. Once in high school, by thyroid cancer. A second time in the spring semester of 2004, his freshman year, by leukemia. Two cancers, and an active sophomore defender on the Penn State men's soccer team? That's downright improbable, if not unbelievable.

But just looking at him with his cleats laced up and his yellow LIVESTRONG bracelet, one can give a picture of the pristine survivor.

If you could, you'd peel back Grady Renfrow layer by layer, like veils, to see that his body is far from perfect.

Diagnosis

Peek into the car of Kenji Treschuk, Grady's soccer teammate in his freshman year of 2004. They're on their way to Mt. Nittany Medical Center on the snowy Feb. 10, since Treschuk's car is readily available.

Grady had been sick a couple times earlier that year, like a lot of students. But he didn't normally have the flu for a week and a half in the middle of November, like he did that year. At the beginning of the spring semester, he got sick again and was throwing up routinely after soccer team lifts and lagging behind in team runs.

Penn State athletic physician Douglas Aukerman had given him a blood test earlier that day, and Grady was fully expecting to see a mono diagnosis. All the signs were there.

"They were like, 'Yeah, well, we think you have leukemia.' I was like, 'Are you serious?' " Grady said. "I thought I was done with college; I thought I was done with soccer."

But they wouldn't joke about something like that. His tiredness, nosebleeds and sicknesses were all symptoms of leukemia. Even symptoms like bruises went unrecognized, until the doctor asked if he had any.

"I was like, 'No, I don't think so,' " Grady said. "I scratched my arm, [and] he's like, 'What about that one?' "

The bruise seemed to develop instantaneously, a synecdoche for the entire diagnosis. Back in Treschuk's car, he was on a trip to confirm what the blood tests said: He was diagnosed with Acute Myeloid Leukemia (AML).

The events of Grady's freshman year pieced together a mosaic. When you look at the smaller pieces, they appear to be benign chunks of tile. But when you put them all together, one after the other, it's a slow zoom out to see the larger picture.

Grady's family was on edge when he came home to Washington, D.C., the week before not feeling well and with swollen glands around his neck, the same physical symptom associated with his thyroid cancer in high school. The biopsy he had to make sure turned out negative, but cancer was on their minds. Still, they couldn't forecast leukemia. How can you expect something you're not even looking for?

"Of course, we didn't believe it. He must have looked at the wrong sample," Phillip Renfrow, Grady's father, said about the results of his son's blood test. "We were certainly driving fast to get back up there."

The Renfrows, who had just dropped Grady off at Penn State the morning of Feb. 10 and had been driving back home, switched course to meet their son, Aukerman and other medical personnel at Mt. Nittany. Sitting there awaiting the confirmation, they were all smacked in the face by the larger picture, the gigantic canvas of Grady's misfortune.

Hospital

Look into Grady's hospital room on the fifth floor of Georgetown University Hospital. But don't take off your gloves, mask or surgical gown. You need to wear them all so you don't get Grady, whose immune system has been lain bare, sick.

Like in April 2004, when he developed sepsis, a bodily response to infection that causes organ failure. Burdened with this malady, according to Phillip, Grady said he didn't think he would make it one day when he didn't get enough fluids.

Grady's five months in this room were as much about overcoming the treatment as the disease. Chemotherapy is extremely violent -- as the number of cancer cells drops with each successive treatment, so do the hair, fingernails and white blood cells.

His treatment, termed a chemotherapy "bomb," administered an intravenous chemotherapy cycle over the course of a couple days but required weeks and weeks of recovery. In doing this, three times over the course of four-and-a-half months, his body was sucked of substance like dried fruit.

He got floodgate nosebleeds, a result of a low number of platelets, which aid blood clotting. It could come out eight to 10 ounces at a time, sometimes causing him to gag on blood in his stomach or have his nose packed because they wouldn't stop. Just imagine it pouring out, a volume near to a full can of soda draining into a glass.

"That's not something you're used to seeing," Phillip said.

His physical symptoms were like that of many other cancer patients: losing his hair and eyebrows, atrophying muscles. But it's not a club he asked to join, and it didn't make it any easier to see the legs that he trusted so much turn into ghosts of themselves: transparent and spooky looking, not altogether there.

"It seriously melted away to like bone," Grady said. "You could see my shin bone."

But even with his physical tank on empty, it could have been worse.

Early on, his treatment plan called for a bone marrow transplant before he responded so well to the chemotherapy.

"That's where you lose most of the patients," Grady said. "Had I had to have done the transplant, I probably wouldn't be here right now."

He said he was "crushed" at the prospect of having a bone marrow transplant, not only for the risks, but because he had no donor to match. And despite having cancer before, the only thing he knew about leukemia was from his time on a club soccer team when a teammate's sister had gotten it, and died.

"I remember going to her funeral," Grady said. "That was the only story I knew about it, about leukemia. I was real scared of death, definitely."

Which might be fitting, considering the relative rarity of leukemia. The American Cancer Society estimates just fewer than 35,000 new leukemia cases for 2005, or 2.5 percent of all new incidences of cancer.

It's also rare for people Grady's age to be diagnosed with AML, which makes up about a third of all leukemia cases. The average age of an AML patient is 65. But it's bad news to be 65 or older with AML, as only four percent of these patients live five years after diagnosis. Being younger helps slightly, as the five-year survival rate increases to 33 percent.

However, as Phillip said, "Stats are for people who need to know it. You're going to be in what percent you're gonna be in." They don't bring much comfort. Instead, Grady wants to be done with the whole deal completely and ignore the numbers, wipe off the slate.

But until he's five years past with no recurrence, he can't. The hours he would spend dealing with his twisted knee are a reminder that his body doesn't heal the way it did before he had cancer. Instead of the clean blackboard, he's still in detention and the teacher's written that he can't leave yet.

Internal

When you look at Grady in the context of his cancer, chances are you're looking at him sitting alone. He said he didn't want people to know and make a big deal out of it, so he could forget it as much as he could. His father said he doesn't let his emotions out very much, and that's part of his personality.

Then you start talking about cancer or he gets reminded of the experience by a morning nosebleed, and his voice gets a little more contemplative and deep. His eyes look everywhere, anywhere for the words. His leg jitters, a mirror for the thoughts stampeding through his head.

"Every once in a while when I get that constant reminder ... it's like 'Bam,' like you're not in the clear yet," Grady said. "I, like, close down, get real quiet, get kinda reserved. I start thinking about all that stuff that happened last year, basically."

He said the routine of school helps keep those thoughts away, and he did have an enormous net of support. In addition to the soccer team visiting him while on its way to playing a spring game in North Carolina, many of Penn State's varsity sports sent him signed shirts or cards.

And his parents, who he said with no hesitation were his main pillars of support, saw him every day while their friends brought them dinner. U.S. men's national soccer team coach Bruce Arena, Georgetown men's soccer coach Keith Tabatznik, stock car racer Jeff Gordon: Grady met or became good friends with them all.

None of them can help him feel totally beyond the disease or conquer the biggest fear he has, which is a recurrence and subsequent bone marrow transplant. Instead, it's through athletics. It's not some crazy metaphor like he's trying to run away from his past. It's when he's playing soccer, cycling or swimming that he said he feels the most pure.

"No one else is around, I'm just doing it by myself. That's when I feel my best," Grady said. "I guess I can say it's especially true now. I didn't necessarily go through this alone, but I kinda feel like I did."

Luckily for Grady, he's had his perpetual motion machine of a spirit to push him along. Picture this: his fifth-floor room, overlooking Georgetown's soccer fields, and there Grady sat with the vantage point of a prison guard but without authority over anything except for the tremendously boring TV, and that just wouldn't do.

"Even if I saw something I liked, 'Change it, change it, change it,' " Grady said.

To keep his fitness up in a low-impact way, he got what he said was the "first stationary bike they ever made" in his room. While he could see the Georgetown soccer team practicing on the field below, he was spinning away.

On the rare occasion he was let out of his room, he took the same spirit with him. Having been taken to the hospital's basement one day for an X-ray, Grady was left in the hall in a wheelchair waiting for someone to push him back up. Whoever it was didn't come quickly enough, and, using his feet to propel him, he found his own way.

"He walks himself to the elevator and the guy sitting next to him says, 'Hey son, you breakin' out of here? Where you going?' " Phillip said.

If he could, Grady might make his way to the elevator once again and break out of everything -- the bone marrow biopsies every three months to make sure, the blood tests, the worries and mental reminders.

But if you take one last look at Grady, look at the footprint he's left on his way out of that classroom door. To go from his high school soccer life of daily practices and weekend games to none at all would be a change, but if there was ever a plight that could rearrange your life, cancer is it.

Grady plays with a combination of his own toughness and the "no limits" approach he's adopted since cancer pushed his body to its absolute edge. He wouldn't suit up in the Penn State uniform if he couldn't get "the hell knocked out of him," as Penn State men's soccer coach Barry Gorman said. The cancer didn't turn his bones into months-stale peanut brittle, so no one treats him like a china doll. Still, he knows he's not as he once was.

"Your legs have that kinda deep strength, inside them, sort of, that you can play every day," Grady said. "And now, it's not totally there."

But Grady's totally here, so totally and remarkably here.