When you drive up to the Pughs' house in Ladson, they look like the All-American family -- Big Wheel in the yard, cars in the driveway, flowers on the porch and 6-year-old Drake Pugh riding his "big boy" bike without training wheels.
But sometimes the things unseen tell a much bigger story. As Drake spends his days riding his bike, his father, 35-year-old Dave Pugh, is fighting a rare form of cancer, fighting for air and fighting to see his son grow up.
It was a normal day two years ago when Dave, a Chapin native, was at work at Rick Hendrick Toyota and felt a stabbing pain in his right shoulder. He tried to shake it off by taking ibuprofen, but the pain didn't let up. It was so bad, he went to a local hospital and got an X-ray. It was a picture that would change his life forever.
He sat alone as he heard news that no one wants to hear: A grapefruit-size tumor was in the center of his chest, and it was pushing everything inside toward his right shoulder and pinching his phrenic nerve.
He called his wife, 33-year-old Alicia Pugh, whom he met while attending Lander University and married in 2002, to tell her the news. After days of tests and biopsies, the tumor had a name: stage IV squamous cell thymic carcinoma, a rare and aggressive form of cancer in his lung.
The five-year survival rate of people with thymic carcinoma is about 35 percent, but everyone with the disease has a different journey.
For Dave, the diagnosis was devastating, but he wanted to maintain a positive outlook for his family.
"When I was first diagnosed, my mom asked me what I was going to do. I said fight and pray," admits Dave, whose soft voice lulls over the sound of his full-time oxygen machine, sometimes taking small breaks between talking to close his eyes and rest in his recliner.
For his bubbly wife, explaining the cancer to their son, who attends The Oaks Christian School, was scary.
"We told him that dad had cancer and it was making him sick and that he would have to get medications to get it out of his body," she says.
Because the tumor was so large and had penetrated the first layer of his heart, physicians at the Medical University of South Carolina wouldn't remove it immediately.
Instead, they implemented an extremely heavy dose of chemotherapy: six rounds where he would be hospitalized each round for a week due to its strength. Thanks to the chemo, the tumor shrank 50 percent and surgeon Dr. Carolyn Reed was able to remove the middle and upper lobes of his right lung, phrenic nerve and the first layer of his heart.
The surgery took longer than an average workday.
"We were so ecstatic because the surgery was so risky, but he made it through and then needed more chemo and radiation as a precaution," Alicia says.
The Pugh family thought that they would be on the road to recovery, but that wasn't the case.
In December 2010, the cancer came back. This time, it had invaded the chest wall and the pleura of the lung. The pleura is a thin membrane that protects and cushions the lungs.
Because the diagnosis was so close to Christmas, Alicia and Dave decided to wait to tell Drake.
It was another crushing blow. And Dave started chemo again in February 2011.
"We thought all of that was behind us," says Alicia, a full-time vision therapist for babies and toddlers at the S.C. School for the Deaf and Blind.
However, the cancer was spreading to other places in his body. An annoying headache was actually an egg-size tumor on his cerebellum. The cancer seemed to be everywhere and slowed down Dave even more.
After a depressing trip to Indianapolis to see a specialist, their spirits were broken and they prepared for the worst. But after the long drive back, they decided to change their attitude.
"They pretty much gave us a death sentence," Alicia recalls. "They told us it was pretty much over. We talked about it and decided we would try harder."
The brain tumor was removed successfully, but the lung cancer was still there, along with a paralyzed diaphragm. The Pughs never seemed to get a break.
All during this time, Drake would secretly listen to his parents talk about the cancer and even told his teacher the side affects of chemo. He was growing up quickly because of the horrible disease.
Dave's oncologist, Dr. Keisuke Shirai, decided they should try another route, a new type of chemotherapy. Dave was willing to go through it because of his only son whom he loves so much.
"I never said, 'Why me?' The hardest thing for me is Drake, knowing I won't be able to see him grow up. But I know that if God does take me, he will put someone in my place to raise him right."
His setbacks seemed to get bigger. From a rare infection to weeks of being supported by an extracorporeal membrane oxygenation (ECMO) machine, which supports the heart and lungs, and another dose of chemo, Dave's fighting spirit and his love for his family helped him through it all.
But he doesn't consider himself a miracle man, actually quite the opposite.
"This makes me feel like a failure. I know everyone says, 'You're such a fighter, you've made it through all this,' but I don't see where I made it through anything," Dave says in-between breaths. "My faith has helped me make it. It's not me doing it, it's God."
Brave for Dave
Friends and family have come out of the woodwork to help the Pughs. The large support system has provided rides to doctor visits and baby-sitting and planned fundraisers, and Alicia believes she's seen more good than bad in all of this.
"It has made us better people and regardless of what happens, Drake will grow up to be a sweet soul. He's seen all the good."
The shy 6-year-old asks occasionally why his father still is sick after almost two years of hospitals, surgeries and more. Both Dave and Drake see a counselor regularly to make sense of it all. For Alicia, a support group of other 30-something women with husbands who have cancer around the nation is her escape, but she admits that finding other women her age going through similar experiences locally is difficult.
And the hardest part is knowing that the deadly disease still is inside Dave.
"I have grown stronger from this," Alicia says. "And I let the little things slide. I'm thankful for my health and wish I could give Dave some of mine. Recently, I had to write the word 'terminal' on a form, and I just couldn't write it. It was so hard."
Dave, who will have another PET scan in December, had only one piece of advice for other cancer patients: "Don't give up hope. When you do ... that's when the cancer wins."
To follow Dave's journey, visit the Brave for Dave Facebook page or his Caring Bridge page at www.caringbridge.org/visit/davidpugh76.