EVANSTON, Ill. -- Luke Farrell awoke from the first surgery attempted to remove a golf ball-sized tumor from his neck and asked his mother Sue for a piece of paper.
On it, Farrell drew two hands folded together and wrote underneath it,
"Lying in the hands of God," and handed it to his mother. Farrell asked her to make it into a necklace for him.
Six months later as the Farrell family sat down for its Christmas Eve dinner, Sue handed out artist-made necklaces of the design to her husband, John, who is the Boston Red Sox's pitching coach; her three sons, Luke, a Northwestern freshman pitcher; Shane, a Marshall junior pitcher; Jeremy, a third baseman in the Pittsburgh Pirates' organization; and Jeremy's wife, Bridget.
"It was a special moment," Jeremy recalled.
The necklaces were presents from Sue and John to celebrate Luke's health and recovery. He had survived two extensive surgeries, had the tumor removed, was pitching again and would shortly be leaving for his first quarter at Northwestern.
As they all sat around the table gazing at the necklace's design, they couldn't also help but think of all Luke had endured and how fortunate they were the tumor was benign and there hadn't been any surgical complications that could have paralyzed him or worse.
"The words are so hard for me," said Sue as she tried to explain the necklace's meaning to her. "I'm not doing them justice. [It means] just what an incredible journey it was, how thankful I was able to be with him every step of the way, how I'm just awed at how incredible of a person he is and that his inner strength is just inspiring."
In the fall of 2009, Luke Farrell was as jacked as any 18-year-old who was about to leave home and journey off to college for the first time.
Farrell was headed to Northwestern and considering a degree in economics from its prestigious business school. He would also be pitching for the Wildcats. A 6-6, 200-pound right-hander with an abundance of baseball in his family genes, Farrell was a substantial recruit for Northwestern. He had gone 8-2 with 60 strikeouts in 55 innings as a high school senior at St. Ignatius in Cleveland.
With Northwestern's student orientation beginning on Sept. 15, Farrell had decided to knock out a dentist appointment in early August before departing from home. He had noticed a lump in the back of his throat and some swelling near his jaw and left ear. His tonsils had been taken out six months previous, so he assumed the effects had something to do with that.
Farrell's dentist saw him and recommended he return to the doctor who had removed his tonsils. There, he had a CAT scan and MRI done on his neck.
Four days later, he, his mother and father sat in a doctor's office at the Cleveland Clinic and were given the test results that would change his life. Farrell had a tumor about the width of a golf ball and the length of 1½ golf balls located inside the left side of his neck.
"It was a pretty shocking thing," Farrell said. "I sat in the chair, and the doctor looked at me, and he said, 'This is pretty serious.' There was an enormous tumor sitting there. It kind of took my breath away."
Nothing could absolutely be known until a biopsy was performed, but Farrell was told it could be a benign tumor, a malignant one or Hodgkin's disease. It wasn't known how long the tumor had been there or how it came to be. Farrell was also informed there were possible surgical risks, including a stroke, paralysis and speech impediment.
Throughout the process, Farrell wanted to know those scary details. It was important for him to understand as much as he could about what he had and what he was facing.
"I didn't want to wake up and be shocked by the results and the situation I was in," Farrell said. "I definitely asked some pointed questions to some people. It wasn't easy at all, but I never thought about not asking or not wanting to know about it.
"I didn't feel sorry for myself for this happening. This was the hand I was dealt with. I'm not the kind of person that shies away from things being thrown in front of me."
John and Sue were amazed by their son's strength.
"It was remarkable," John said. "It was visible he was confident he would get through this and continue on. He might not know this and realize this, but how he handled it gave us a level of confidence and strength to help us through it."
From the answers Farrell received from the Cleveland Clinic, he wasn't confident in its doctors. Looking for a second opinion, his dad was referred by a Red Sox team doctor to Massachusetts General Hospital. It was there Farrell met with Dr. Christopher Hartnick and decided to move forward.
The plan at Massachusetts General Hospital on Sept. 10 was for Farrell to undergo a surgery to have the tumor removed. A biopsy on the tumor would follow.
John and Sue waited in their son's hospital room and were updated hourly on the surgery's status. After 8½ hours, they received unwelcome news. Because the tumor was pressing up against the carotid artery, getting to it presented a major obstacle. The doctor's concern was that his surgical team would be unprepared if the artery bled out.
They would have to postpone the surgery and choose another course of action.
When Luke awoke in his room afterward, he was under the assumption his ordeal was over, and the tumor had been removed. He soon discovered otherwise.
"He was crushed," Sue said. "He had this inner strength and hadn't allowed anything to affect him. I told him, 'It's OK to be mad.' He did finally let it out a bit."
John remembered his son voicing his anger. He wasn't upset at anyone in particular, but at the situation.
"I definitely felt a little despair," Farrell said. "I was shocked by it. The whole time I thought the tumor was coming out in the surgery. When it didn't, it kind of frustrated me. I don't think I lost hope."
The second surgery was scheduled five days later, and it terrified Farrell even more than the first.
There was another grand unknown associated with the second surgery. Hartnick would either attempt to remove the tumor by going through the same incision in Farrell's neck as he did the first time around or he might have to approach it by making a pathway through his jaw.
Farrell's jaw would have to be split in half and some of his teeth would have to be removed. The second option would also require Farrell to undergo a tracheotomy and be put into a medically induced coma for two to four days as he recovered.
Just before Farrell was taken into surgery, he told his mother he wanted her to signal afterward whether the incision had been made through his neck or jaw.
Again, Sue and John waited in their son's room for hourly updates. They were told the surgery could take as long as 12-14 hours. Five hours later, they were called and told that Hartnick was on his way to their room. They feared something was wrong, and they braced themselves.
Hartnick walked through the door and told them straightaway everything was fine. He was able to go through Farrell's original incision and the tumor had been removed. Later, they discovered it was also benign.
Farrell awoke about five hours after the surgery and looked at his mother.
She gestured to her neck, and he fell back asleep.
"It was definitely a big relief, a huge relief," Farrell said.
The surgery was a success, but Farrell now faced a long road to recovery.
Two weeks of constant pain medication, a lot of sleeping and little eating in the hospital led Farrell to lose nearly 25 pounds. He dropped to 175 pounds at one point and being 6-6, his weight loss was easily noticeable.
"I remember the first time I took my shirt off and looked at myself in the mirror," Farrell said. "It was definitely strange to see yourself so much smaller so quickly."
Farrell's initial focus was simply regaining weight. Food was a constant for him. Sue was willing to make him whatever he wanted.
In time, he began taking short walks, then longer ones. As his energy increased, he often made his way to Fenway Park. He hung around the clubhouse, and the Red Sox players often sat down and talked with him.
There wasn't anyone in particular who stood out, but the players' support meant a lot to him.
Actually playing baseball was still unrealistic, though. John was adamant that his son couldn't rush his return. Building up his weight and strength were vital. Farrell did use baseball and Northwestern as motivation.
"I thought about that to keep my spirits up," Farrell said. "It was something to look forward to."
The first time Farrell threw a baseball after his surgery came in, of all places, a major league ballpark.
The Red Sox were traveling to Angel Stadium to face the Los Angeles Angels of Anaheim in the American League Division Series in early October, and John invited his son to come with him for the trip.
"The thing he loves to do more than anything is something we take for granted at times -- the game, the experience you have on the field," John said. "It was a chance to get back to something basic."
Before the first game, the two of them went out to the field and threw the ball around. Farrell was able to make only five tosses before he became fatigued and had to sit down, but it was a step in the right direction.
"It was pretty cool for me to do it so soon after," Farrell said.
John cherished being there to witness that joy.
"To be able to put a ball back in his hand brought a smile to his face," John said. "Three weeks previous, you're looking at your son lying in a hospital bed. That was a pretty detailed procedure he came through. To see him doing something he loves, those are the moments that make life what it's all about. Even in the simplest form, to bring back some joy and some relief and some fun into someone's life was great to see."
Jeremy Farrell felt awful for his youngest brother. Farrell was supposed to be enjoying his first tastes of college in the fall, not having to spend more time at home with his parents.
Jeremy talked it over with Bridget, then his fiancée, and they decided they would invite Farrell to come live with them in Charlottesville, Va. It would give Farrell an opportunity to get away from home and improve his strength and stamina while training with Jeremy.
Farrell jumped at the chance.
Jeremy set up a program in which the two of them worked out for three consecutive days and then took one day off before restarting the cycle. They spent a day on strengthening their upper bodies, another on their lower bodies and finally they concentrated on cardio.
The first day of the program didn't go so smooth for Farrell.
"He'll hate me for telling you this, but after that first workout, he was throwing up for an hour," Jeremy said with a laugh. "But he rebounded quickly and worked hard and got his body in a position where he could come in to Northwestern and compete right away for a spot on the staff. His spirits were definitely coming back. He was always pushing more and working hard. It was a testament to the dedication and time he put in."
Farrell began getting back into his pitching shape and started throwing again. His control and velocity improved throughout the six weeks he spent with his brother.
Aside from benefiting his brother from a baseball standpoint, Jeremy also saw the time as a bonding experience for the both of them
"It made us closer," said Jeremy, who is five years older than Farrell. "As we're further apart in age than Shane and I, we connected in a way that we hadn't connected before."
Farrell's first season at Northwestern hasn't exactly been what he hoped for on the mound.
On his arrival to Northwestern in January, Farrell had made progress in his pitching, but he still wasn't nearly 100 percent back. He has gotten closer since, but overall it's been a season of ups and downs. He's made 10 appearances, four starting, and has a record of 1-1 with a 10.19 ERA. He's allowed 32 hits, 20 earned runs, walked 13 and struck out 13 in 17 2/3 innings.
Farrell understands how to keep it all in perspective, though. He has a 5-inch scar along the left side of his neck to remind him where he's come from.
"Statistically speaking, this year hasn't been the way I wanted it to be," Farrell said. "All things considering, it's been a great year. I take things lighter now. Certain things aren't the end of the world. Obviously tests and everyday experiences are important, but nothing is earth-shattering."
Northwestern coach Paul Stevens believes the same.
"I will tell you, Luke Farrell and his family, all of us, are very blessed," Stevens said. "A lot of times by the grace of God these type of situations work themselves out. There's no other explanation for it. Every time I see him in a uniform, I close my eyes and am very thankful to have him around. He reminds us we're all blessed to have the opportunity to wear a uniform.
"Next year, I have nothing but great expectations for what he'll bring to this program. He's a very talented young man. He's hasn't shown half of what he's capable of."
His mother is just as sure of that. Sue thought she knew almost everything to know about her son before last August. She now realizes she didn't.
"I learned so much about him," said Sue, who always has her son's necklace with her. "There's not a thing in the world he can't conquer if he has to. I take him back to the time of us sitting in the hospital room together. It was as pure as a relationship can get. You're just hoping and praying and thinking about surviving and quality of life. You're hoping that he can get to do as he planned to, play college baseball and start his dream.
"I have no words. He's an amazing, amazing person."
Scott Powers covers high school and college sports for ESPNChicago.com and can be reached at firstname.lastname@example.org.