AUSTIN, Texas -- There's a story behind the skin below Case McCoy's left eye, one he usually doesn't spend much time telling. He didn't know what to say when he was younger. People asked if it was a burn or scar. He'd just call it his birthmark.
He feels no shame about the stretched, discolored skin that marks portions above and below his cheek. Those blemishes are what remain from his eight-year, childhood battle with a rare autoimmune disease.
They serve as his daily reminder to keep battling.
"Every time I look in the mirror and see it, I know what I'm doing. I know why I'm fighting the way I am and what I'm fighting for," McCoy said. "I knew as a young boy that those marks aren't going away. It is who I am and I can either embrace them or be embarrassed by it."
All his hard work has led to this. Texas' self-assured senior quarterback is finally getting his moment. He's won three straight games to begin Big 12 play and is playing the best ball of his life. This is his team now.
He's injected much-needed swagger into these Longhorns, but where does that come from? The source of McCoy's moxie isn't found in a 3,000-seat high school stadium in Graham, Texas, nor the Cotton Bowl, where he beat Oklahoma two weeks ago in the finest game of his career.
The story of how Case found his confidence takes place in a hospital.
The first sign wasn't found on his face. It started with a spot near his left ankle.
A spot dark enough that Debra McCoy just assumed her 4-year-old son had dirt on his foot. She tried scrubbing it off. Nope, not dirt. Case took off his shirt. More spots, on the left side of his back. They continued to develop on his face and arm. His family had no idea why.
"As a mom, little red flags were going up," Debra said.
The family sought answers from physicians and specialists. A biopsy performed by a dermatologist produced the reason for the spots: Case was suffering from a form of scleroderma, a disease that involves the hardening of skin and the tightening of connective tissues.
The type of scleroderma he was facing, morphea, is usually found in adults age 20 to 50. Not pediatric patients.
"There was so much fear and so much anxiety," Debra said, "and we had these three healthy kids, and then overnight, Case went from healthy to not-so-healthy. ... You have a 5-year-old that gets himself out of bed and he's walking around like an 85-year-old arthritic man."
Soon after the diagnosis, McCoy and his parents began traveling regularly from West Texas to visit Texas Scottish Rite Hospital for Children in Dallas. The first two rounds of treatment he tried didn't slow the disease, and the side effects were brutal. He was shedding weight, wouldn't eat and started losing his hair.
"I started to realize, OK, this is pretty serious," Case said.
So doctors tried methotrexate, a drug used to treat rheumatoid arthritis. The results were promising. The process was excruciating.
Every Wednesday night after church, Brad McCoy had to give his son the shot. And every time, the boy ran right to the bathroom and puked. Many times, Brad said, Case would get violently sick and nauseous for more than 30 minutes.
"Wednesdays are not my favorite day," Case said. "I don't know why. I can only blame it on this."
His father set a standard from the very beginning: No excuses. Case got up on Thursday and went to school. Rarely did he ask if they could skip the week's shot or wait until the morning. The answer was never yes.
The treatments continued for nearly eight years. Once a month, the McCoys drove back to Scottish Rite. Older brothers Colt and Chance joined them on every trip.
Case remembers the Texas Rangers games and family dinners they'd squeeze in during their weekends in Dallas, but far too much of their time was spent in a hospital.
"He was a tough, tough kid," Brad McCoy said. "I don't know how much blood they drew on those days, but he would leave saying, 'I don't know if I have much left. Do I have any blood left?'"
In 2004, finally, some good news. After all the shots and pills and car rides to Dallas, his case of scleroderma was no longer active.
"They finally said, 'Hey, you are good to go,'" Case said. "'This is done. You are good to go on about life.'"
"I'll never forget Case looking at him," Brad recalled, "and he said, 'You mean, no more shots?'"
Around that time, folks were starting to figure out Colt had a bright future as a quarterback. Doctors weren't so sure Case would get that opportunity.
During his long bout with scleroderma, his immune system had turned against the left side of his body, effectively stunting its growth for a year.
"Basically, they said you know you can try, but we can't guarantee you," Case said, "and if you can't, you are going to have to live with that."
Colt would go to Texas and, well, become Colt McCoy. Chance played receiver at Abilene Christian and Hardin-Simmons. And Case grew in their shadow. When it came time for Case to play for his father, then the head football coach at Graham, he made a demand: "Coach me hard. Make me what you've made Colt."
He's been playing -- and embracing -- the underdog role ever since, constantly buoyed by a belief that, no matter the odds or what anyone says, he's good enough.
Under his father's tutelage, Case became an all-state quarterback at Graham. Colt warned him about going to Texas. Case needed to recognize the pressure he'd face and how hard he might have it in Austin. He chose to sign with the Longhorns anyway.
Now he's a senior, and he isn't afraid to reflect on these 3½ seasons at Texas with frank honesty.
"It hasn't been the Cinderella story that you would want when you go to college," he said.
McCoy has backed up David Ash and Garrett Gilbert. He's dealt with transfer rumors the past two summers. He's made mistakes, none bigger than getting sent home from the Alamo Bowl last December and the brief suspension that followed.
And he's had a few moments he'll never forget.
The scramble at Texas A&M to win the rivalry finale. The last-second comeback at Kansas in 2012. The second-half cameo against Kansas State last month. And of course, the stunning 36-20 upset of Oklahoma two weeks ago. That performance might not have been possible had he not left the program this summer.
McCoy left for a 10-week mission trip to Piura, Peru, in late May. He worked on a mango farm in the mornings and spent his afternoons installing water purification systems.
He wouldn't have been afforded that opportunity had he been Texas' starting quarterback at the time. The coaching staff agreed to McCoy's summer plan on one condition: He promised he'd come back.
McCoy packed a bag of footballs and kept throwing and working out in Peru. He admits now that he needed to get away.
"It made me realize how much passion I have for this game and how I wasn't showing it," McCoy said. "I was taking this small glimpse in life that we have at this university to play the game we love, and I was taking it for granted."
He returned to Austin re-energized. McCoy didn't know what his role would be, but he wanted to be a spark. Six games in, he's been more than that.
Case McCoy knows this is it. He's in business school and plans to get into real estate next.
He's playing this 2013 season like it's his last, though that's always been his approach. He's leading a Texas team that overcame a 1-2 start and still clings to its hopes of winning the Big 12.
He sees his Longhorns teammates adopting the philosophy he's always lived by: Why can't I? McCoy's irrational confidence can be infectious. He's felt like an underdog ever since he was 4. He'll never give that up.
When asked Monday why TCU is a two-point favorite over Texas, he was quick to drop this defiant quip: "Probably because I'm the quarterback, right?"
"Little brother syndrome or backup quarterback syndrome, whatever you want to call it, he certainly has a chip on his shoulder," Texas co-offensive coordinator Major Applewhite said. "It doesn't just come out in feistiness or words. It comes out in his preparation, his dedication to his teammates. I see it every day."
His teammates recognize it, too.
"Nobody else does it like he does," guard Mason Walters said. "Case has just got a little bit different fire about him. He usually has a grin on his face and he's ready to play ball."
He conceded he's not the most gifted quarterback in Texas history, but McCoy is proud of the story he's written so far. And the beginning of the story has always been his driving force.
There's a memory, one far more vivid than any from those days in the hospital, that he and his father share. These days, that memory feels particularly poignant.
They were sitting together on a Saturday morning when Case was 8 or 9, still in the midst of his treatment. A segment on ESPN's "College GameDay" grabbed their attention.
They don't remember the subject. They don't recall why Colt and Chance weren't in the room. They just remember a tearjerker of a story about a football player who'd overcome great adversity. When it ended, Brad turned to his son.
"And I just said, 'One of these days, Dad, we are going to have a story like that,'" Case said.
"Everyone asks where I get my confidence. Why do I have confidence? Where do I get it? I think it's because of that. It goes back long before everyone said we couldn't beat OU. Why did I think I could? Because I knew I could. I knew the more people tell me I can't do something, I'm gonna make sure I can."