Initially, your eyes lock in on the the small patch of light brown freckles sprinkled across his cheeks and nose. Before long a crooked smile curls his lips, indicating that Keegan Morgan is a typically mischievous 7-year-old boy.
One moment he is engrossed in his hand-held video game. The next he is in a plastic-swords duel with his younger brother Christian, who at 3 years old already is several inches taller than Keegan.
And that's when the realization sets in that Keegan, an adorable kid who is a blur of spunk and sass and giggles, has had to fight through a series of nightmarish medical obstacles since birth just to enjoy the days that aren't filled with needles and MRI scans and limitations.
Keegan has had 10 surgeries for a variety of health issues. The latest, in February 2010, was to remove a brain tumor that, although benign, impaired his vision and stunted his growth.
Keegan and his family spent this week back at St. Jude Children's Hospital in Memphis for another post-operation checkup. While the Morgans were away, the Make-A-Wish Foundation granted Keegan's wish to have a basketball court built in his back yard.
Keegan's mother filled out a Make-A-Wish request and had it reviewed by his St. Jude doctors, who approved him. Keegan then attended a wish-granting party in January to tell the foundation what his wish was. The personalized court and goal is a surprise gift that he won't know about until the family car pulls into the driveway of their home on Missionary Ridge.
"People hear us tell Keegan's story and what we've gone through, and they're like 'Oh, my Lord.' But it's just our routine now," said Keegan's father, Chris. "The reality is we're one of thousands of families who deal with this type thing every day.
"But it can still be overwhelming at times. I mean, it's your child, your little boy. As parents, you plan for their future so they have it better than you did, but from almost day one, Keegan's life changed dramatically from what we had planned."
There were no signs of problems as Chris and Leslie Morgan were expecting their first child. Each test during Leslie's pregnancy showed no cause for concern. But less than two weeks after she returned home with Keegan, it became obvious something was wrong. He would regurgitate the milk he drank almost immediately, and it was only after a series of tests that the couple learned their infant son had been born with his intestines in a "V" shape, which didn't allow the food to be digested properly.
Feedings took hours as baby Keegan could process only an ounce or so at a time. As a toddler he was fed through a tube in his side for a year and a half, and doctors told his parents he likely would never be able to eat solid food. But through months of his parents coaxing him to "take one more bite," Keegan eventually learned to eat solid food on his own.
Having cleared that hurdle, the Morgans faced another when Keegan stopped growing two years ago and began suffering from migraines so severe that he would drop to his knees and put his head in his hands and cry.
"I knew something was wrong when we got home from the doctor's office and had an urgent phone message to call their office back immediately," Leslie said. "I'm a Google freak and I found out the number one cause for his symptoms was a tumor in the pituitary gland. And that's what it turned out to be. It was growing rapidly and pushing on his optic nerve, so it meant him having more surgery.
"It's a helpless feeling and your heart breaks every time they wheel your child back for surgery."
Thirtee months ago, surgeons went through one of Keegan's nostrils to drill into his skull and remove the tumor. When the nerve-racking five-hour procedure was over, doctors told the Morgans that they feared there could be fluid leaking from Keegan's brain and he was at high risk for infection.
"We were both physically ill at that point," Leslie said. "What can you do besides wring your hands and pray?
"It turned out it was fluid from the tumor, but after the surgery his body no longer produces steroids or hormones. So not only does he not grow at all, but if he gets even a slight cold and I don't increase his steroids he could die within hours."
Test results also showed that Keegan's body had stopped producing any growth hormones, which meant he remained exactly the same height for nearly a year. Even his hair and fingernails will not grow unless he is cleared to begin taking growth hormone injections again. Further tests also revealed a small hole in Keegan's heart, which limits some of his physical activity and puts him at risk of a stroke.
"He's a very sharp kid. None of this has affected his learning development," Chris Morgan said. "We've always spoken to him like he was a mini-adult and been up front with him and where he stands medically. But whether he comprehends and processes all of it is another thing.
"We try to reassure him that he has his own individual God-given gifts. I've never been big into sports and neither is my wife, but since Keegan was born he's loved sports. When he was a baby he would roll a ball back and forth on the floor for as long as you would keep playing with him. He's either watching a game on TV or playing outside all the time."
Keegan has played in both fall and spring baseball leagues since he was 4 and typically attends summer sports camp at Notre Dame. His mini-basketball goal was damaged during last week's severe storms, but the new backyard court will more than make up for that loss.
If his latest checkup clears him to begin those shots, there is the chance he will begin growing at the four-inch-per-year average rate of other boys his age.
Although he's only three and a half feet tall and 51 pounds, his personality lights up any room he enters like a 1,000-watt bulb.
"Just from looking at him you wouldn't know he's so fragile," said Eddie Salter, who teaches elementary physical education at Chattanooga Christian School, where Keegan is in kindergarten. "He's all boy and goes full throttle in my class, whatever we're doing. Boys his age like to roughhouse, and he definitely has that male gene to be daring. He has limitations, of course, but he never pouts and he gives it everything he's got. He loves to play and compete.
"I'm usually out in front of the school in the mornings, and he's so excited he jumps into my arms or high-fives me getting out of the car," Salter said. "The way he carries himself, he's kind of a rock star with the other kids calling out his name in the halls. He makes other kids want to be around him because he has such a wonderful spirit and this great big personality. Despite everything he's already gone through, he's the one kid I know is going to walk around with a big smile on his face every day at school."