Anchorage Daily News

Shop owner Steven Small stands in the garage at Superior Automotive with his head buried under the hood of a brown Cherokee, a cup of coffee waving in his hand as he points to a faulty alternator. He takes a long gulp of coffee and bustles off to the other side of the garage, where a mechanic is putting a new clutch in a truck the size of a small house.

With his blue mechanic pants, crisp white shirt and down vest with the shop logo patched over the chest, Small blends right into this masculine world of dirty sinks and cement floors, of tools and exhaust fumes and the constant, almost comforting smell of grease. He looks casual and confident and smugly content.

But according to two doctors, he should have been dead long ago. The 41-year-old husband and father has been battling liver cancer for more than two years. Despite ominous predictions, surgery, chemotherapy, radiation and a discontinued clinical drug trial, he's still going strong.

"I just try to make every day the best I can." He wipes a fleck of dirt from the front of his vest. "Life can still be fun."

DOCTORS AND DULL SPOTS

Small shuffles through the parts room looking for a battery as he talks about how it bothers him when people try to squeeze past crucial repairs. To him, this is an accident waiting to happen, and if you come in with bad brakes, you are going to leave with good ones and forget the fact that you might not be able to pay. He'll set up a plan or wait until a paycheck comes in, and while this might sound like bad business sense, more often than not, people come through. It's a small price to pay for peace of mind. Or, as he puts it, how could he sleep at night knowing that he allowed someone to drive off with shoddy brakes?

Small understands that life is unpredictable, that no matter how we prepare ourselves, gaskets blow, clutches snap and radiators leak. He explains all of this in a steady voice that veers toward stillness. Whether discussing engine problems with his mechanics or steering a customer over the rocky road of car repairs, he remains diplomatic and thoughtful. He appreciates the value of a well-placed joke and throws out one-liners with a face so straight he often leaves folks wondering: Should I laugh? Was that a joke?

Behind the humor, Small is serious and intent. His eyes, which have sunk deeper since his illness, move constantly, as if he is hungry to know what lies ahead. When he smiles, those same eyes fill with an odd, almost profound light. Mention his attitude, though, and he shrugs and insists that he isn't unique, that there are hundreds -- no, thousands -- of cancer survivors coping as well as or better than he is.

"I'm not overly optimistic," he says.

Then he shakes his head and thinks a moment before finally agreeing that, yes, he is pretty optimistic after all.

"But I haven't always been this way. I had to train myself. It didn't come naturally."

Small attributes much of his attitude to faith. He believes that things happen for a reason, that the best you can do is surrender your fear and doubts to God while reserving your strength for upcoming battles. Though Small is the first to admit it isn't always as simple as it sounds.

"There are spots in my day that aren't easy. And every day too."

A few weeks ago, he returned from the Mayo Clinic in Minnesota, where he traveled with his wife and young daughter to check out treatment options. After discontinuing a clinical drug trial at the City of Hope cancer center near Los Angeles due to adverse side effects, he was on the lookout for new treatment programs. The news wasn't encouraging. According to Small, he was told there was nothing that could be done, that with his type of cancer and its growth rate, he had approximately six months to live. He was depressed for days.

"I mean," he says wryly, "this was the Mayo Clinic, the fix-everything cancer hospital. And it turns out they couldn't fix me."

In the end, Small decided to ignore the doctor's assessment. He's good at this. The way he tells it, it has happened twice before.

"First a doctor tells me to pack my bags and go to Fiji because I only had three months to live, and that was over two years ago. Then another tells me six months, and that was 13, 14 months ago." His voice becomes almost triumphant. "So this doctor is just like those other two."

But how does Small ignore three doctors' predictions and keep going against the odds? According to him, there's no magic formula or miracle. He gets up in the morning and gets dressed. He goes to work. He runs the shop and orders parts and eats lunch.

"I'm not ready to die in six months," he says. "But if I do, I do. It's not up to that doctor at the Mayo Clinic. It's up to God."

Dr. Louis E. Mayer, Small's doctor for almost 30 years, said Small is living life to the fullest regardless of circumstances.

"He hasn't sat down and crumpled," Mayer said. "He has a family to keep and a business to run and essentially hasn't let his treatment or disease interfere any more than necessary. Because of that, he is doing a lot better than he would have done."

Attitude isn't the only component in recovery, Mayer said, but it's a big factor.

"You can't cure yourself with a good attitude," the doctor said. "It isn't everything, but if everything is equal, the person with the more positive outlook is going to win out. I think you can generalize that if you have a better attitude, you'll have better results."

BEHIND EVERY GOOD MAN

Rachel Small sits behind the desk in the upstairs office, where she does the bookkeeping. The room is homey and warm, with her daughter's plastic toys scattered across the floor.

After just a few minutes with her, it's easy to see where her husband gets much of his strength. Rachel is energetic and kind, with a warm smile and small, lovely hands. Married for 15 years, they have three children: Trenton, 15; Clinton, 12; and Coryne, 4. A fourth, their oldest son, Cameron, died in a drowning accident two years ago.

She is quick to admit their lives haven't been easy. First they lost Cameron. Then Trenton was diagnosed with Crohn's disease, her husband with liver cancer and Coryne as borderline autistic. All this happened within two years.

"But you can't give up," she says, "even if you feel that way. If you give up, it's hard. It's so dark out there in that place."

Rachel says that being a mother is difficult enough; being a mother when your family has gone through as much upheaval as hers is beyond words. She tries to maintain a sense of normalcy for the children's sake, though she wonders if her efforts are futile. Mostly, she worries. She worries that her daughter has been emotionally scarred, that her sons are distancing themselves more than is healthy, that her husband works too hard and needs to slow down and take it easy. Because she can't stand such worries, she tries to keep busy enough that she won't have time to think.

"If I don't keep moving," she says, "I'll stop. I'll just stop."

According to Rachel, living with someone who is fighting for his life isn't like those made-for-TV dramas that turn everything into poignant lessons. It doesn't open you up to insights or offer wisdom. It just makes you tired. It wears you out. It plays on your nerves and depletes your senses. And while you do learn to appreciate things more, especially the smaller moments, so much depends on what else is happening at the time.

Rachel correlates fighting cancer to living in a military zone. She's had to build up resistance, harden herself to realities that would have flattened her a few years ago. At the same time, she worries about these walls. In keeping so much out, she's afraid that she might not be letting enough in. Especially when it comes to the children.

"There's no way that the kids won't be affected," she says, adding that she doesn't lie to them; she tells them everything upfront. Yet she can't help feeling bitter when she thinks of the things that have been taken from them.

"This is their childhood," she says angrily, "and childhood isn't supposed to be about cancer and death."

A minute later, her voice warms and fills with pride when she talks about her husband, whom she refers to as a "medical miracle." She tells how he has managed to work full time through the majority of his cancer treatments, how he has never given up, how the doctors at City of Hope were "dumbfounded" by his progress and were unable to understand how he could be doing so well.

It's no secret to Rachel, though. She knows it's his attitude, his faith, how he refuses to let a doctor tell him when he is going to die. The way Rachel sees it, life is about change, and that is exactly what has happened to her family: It has changed. Even if everything that has happened could be erased, she still believes that things would be different now.

"Except," she says quietly, "Cameron would be here and Steven wouldn't be sick."

Still, she won't let herself dwell on the what-ifs, at least not for long. She believes that a happy person has more hope. So she prays. She focuses on the good things. She concentrates on finding blessings in the small, ordinary moments she used to take for granted. Like getting to go Christmas shopping this year with her husband.

"It was the first time we had been alone together for a long time," she says. "It was nice. I couldn't help wondering where we will be in a year. But for right now, we're going on. We're just going on."

Cinthia Ritchie can be reached at critchie@adn.com.