For those who beat cancer, they're often given a five-year window to determine if their health is on the right path.
Make it to five years with the cancer in remission, and there's a very good chance they'll go on to live a relatively healthy life.
Maddie Hill reached this marker in the winter of her sophomore year at Dover High School. Five years earlier, Hill had received her final chemotherapy treatment, overcoming a 2 1/2-year battle with lymphoblastic syndrome, a type of cancer that initially caused the right side of her lungs to collapse.
"The five-year mark is usually the big milestone," Scott Hill, Maddie's father, said recently.
Maddie's point of being five years cancer-free came Feb. 15, 2013.
"We were thinking 'we're good, we're good to go,'" Scott Hill said.
And for a full six months, the Hills were good. Until the end of July last year, when Maddie didn't feel right following soccer practice with a local recreation team.
"I picked her up at an open gym," Scott Hill said. "They were running around the field and I was like 'that's not Maddie' because she was so far behind everyone else."
On the drive home, Scott looked to Maddie in the passenger seat and recognized a complexion he had seen before. Maddie's color very much resembled the shade she had worn years earlier leading up to her cancer diagnosis.
Through a battery tests over the next month, one of them finally gave the Hills an answer they didn't want to hear. On Aug. 30, Maddie received a diagnosis of having myelodysplastic syndrome (MDS) — a blood disorder involving the bone marrow.
"We couldn't believe it happened again. Nobody should have to go through it one time, let alone two," said Abby Patterson, Maddie's best friend and teammate on the Dover girls' soccer team.
Patterson, her teammates and friends responded by selling T-shirts and collecting donations at school sporting events and from the community, eventually raising more than $4,000 to donate to the Hill family to help pay Maddie's medical costs.
The Eagles' soccer team also dedicated its 2013 season to Maddie. It turned out to be the best season in program history, with Dover winning its first 21 games, nabbing the program's first York-Adams League Division II title and second league tournament title, then reaching the District 3-AAA semifinals for the first time ever.
"Maddie gave us something to work for and to fight for," Patterson said. "We know if she could've been there with us on that field she would've been working hard. She really made us work hard. We wanted to do it for her. We fought like hell just for her."
"Just to be a normal teenager:" Fortunately, this story doesn't end there. It's only continued to get better.
Maddie, as she had done in the past, continued her fight. Through eight days of chemotherapy last November. Through bone marrow transplant surgery Nov. 15 (her younger brother, Travis, a starter on the Dover boys' soccer team, was the donor). Through a slow recovery process involving several medications and lots of rest, first for a month of being confined to a room at Penn State Children's Hospital in Hershey, then another month staying at the Ronald McDonald House in Hershey until finally returning home Jan. 23. And through five months of physical therapy from February through June, trying to gain back some of the 16 pounds she had lost off her 5-foot, 2-inch frame.
"It doesn't sound that bad, but weighing 112 pounds before, that's a lot for someone my size," Maddie said recently during an hour-long interview at her home sitting next to mom and dad on the living room couch.
You may recognize Maddie's name from a story The York Dispatch did about her last November, just before she left for chemotherapy, cutting off her long, blonde hair and donating it to the Pantene Beautiful Lengths hair donation program.
Never completely lost but made very sparse from the chemotherapy, Maddie's hair began growing back a couple months ago, shortly after doctors gave Maddie a clean bill of health in the spring. She has since been trying to get back to the life she had before.
"Just to be a normal teenager," she said.
Maddie says she was the one to ask Dover football player John Sterner to junior-senior prom last spring. She spent the summer working with friends as a lifeguard at Green Valley Swimming Pool in Dover. And she began the process, along with mom and dad, of visiting colleges — she hopes to study physical or occupational therapy.
Maddie also participated in a few soccer practices with her rec league team the last couple months and hit the weight room with her Dover teammates, trying to get back in shape for her senior season, the last for her on the high school soccer field.
"In the weight room before last year during the season I could max out at 90 pounds benching," she said. "This year we had the 45-pound bar and I had fives on the end and that was super hard for me. I could do three. I would have a hard time anyway but at the same time I lost all my muscle."
"Come out a better athlete": Four days into the start of fall sports practice last week, the temperature hovered in the upper 70s under a sunny sky Thursday morning on the soccer field next to Dover Intermediate School. The Eagles' girls' soccer players finished up a cardio drill, running around cones on the side of a hill. Maddie, who has the ability to play every position on the soccer field except for goalie, stood at the bottom of the hill, hands on her hips and partially bent over stretching out her left leg. Having started a few games her sophomore season two years ago, Maddie is aiming to lock down a full-time starting gig this fall as a senior. She has a ways to go, though. Not because of her skills. Rather, her endurance is still a work in progress. As is regaining the speed she had previously been known for. But she refuses to use her recent illness as a crutch.
"Talking to the doctor, he said that 'you were a good athlete before. If you work at it you'll come out a better athlete,'" Maddie said.
And this is where she summons the plan of attack that's become common for her when faced with prior obstacles.
"Basically it's gonna be how much heart and work I put into it," she said. "I'll get the results if I work for them. If I don't I'm not gonna get anywhere."
— Reach John Walk at firstname.lastname@example.org.