SCOTTSDALE, Ariz. – Golf is not a team sport, but life is. That’s one of the lessons in the story of Phoenix Small, 14, who met with Jon Rahm on TPC Scottsdale’s famous 16th hole Wednesday in the pro-am for this week’s WM Phoenix Open. They walked through the tunnel together, allowing Phoenix to take in the wild, fully enclosed stadium hole for the first time, his eyes wide. They walked 17 and 18 together, too. In addition to his parents, sister, doctors and friends, Phoenix, a patient at Shriners Hospitals for Children, now has the world’s No. 1 golfer in his camp, which he calls “a blessing.” Rahm, too, has relished the friendship. Play was slow, and they did radio and TV interviews together as they waited. The emcee at the 16th tee announced Phoenix as Rahm’s good luck charm. “I think I would have been a lot more nervous than he was,” Rahm said after the round, in which he and Phoenix were mic’d up and embraced behind the 15th green while spending roughly two hours together. “He composed himself in such a great manner, it was incredible.” Phoenix is from outside Salt Lake City, Rahm is from Spain. Shriners connected them by video chat last fall because each was born with clubfoot, which affects an estimated 200,000 children a year. Rahm first spoke publicly about his right foot last summer. Phoenix had two club feet. But we’re getting ahead of ourselves. Because neonatal doctors at the Shriners in Salt Lake had to be sure Phoenix would survive infancy before they considered his feet. A long and twisty road Wide-eyed? Phoenix had never been on a plane before flying to Arizona to meet Rahm, and in his maiden voyage they encountered pockets of turbulence. Perhaps that’s fitting, for the journey to sunny, surreal TPC Scottsdale has required the family’s full reservoir of faith. Phoenix’s mom, Chariti, was trying to get up to speed on parenthood and 18 weeks pregnant when she and Phoenix’s dad, Shane, learned that their son would be born with club feet. “I was devastated of course,” she says, “and there was no way of knowing how severe the clubbed feet were until we saw them with our own eyes. I wondered and stressed and lost sleep over it.” Then everything changed. Phoenix was born with bleeding on his brain and a virus attacking his lungs. His color was off, he wasn’t breathing on his own, and suddenly his club feet were a lesser concern. Doctors intubated him and began a series of tests as his life hung in the balance. “Those first days were exhausting,” Chariti says. “We were scared and tired and didn’t know what the future held in store for our family, which is the scariest thing of all, the unknown.” Leaving her new baby in the hospital, she adds, was “beyond hard.” At one point he reached up and deintubated himself, and doctors realized he was breathing on his own. Meanwhile the body was reabsorbing the bleeding on his brain. He was stabilizing. “There were a lot of prayers on that baby’s behalf,” Chariti says, “but all we could do is leave it in God’s hands. Thankfully the prayers worked, and he came home two weeks later. He had a long road ahead of him, but he improved quicker than doctors thought he would.” The next medical hurdle: what to do about his feet. The late Ignacio Ponseti, from the island of Menorca, Spain, was as famous in his field, the treatment of clubfoot, as Rahm, from Barrika, on the other side of the country, is in his. Traditionally, the treatment of clubfoot involved invasive surgery; that was what was available to Rahm. “I’m tired of hearing that the reason why I have a short swing is that I have tight hips or other things,” Rahm said at The Open Championship last July. He went on to explain that he was born with club foot on his right leg, his foot, “90 degrees turned inside and basically upside down.” He continued: “They basically relocated, pretty much broke every bone in the ankle and I was casted within 20 minutes of being born from the knee down. I think every week I had to go back to the hospital to get recasted, so from knee down my leg didn’t grow at the same rate. I have very limited ankle mobility in my right leg. It’s a centimeter and a half shorter.” Lacking stability in his right leg, Rahm knew that taking the club back to parallel was going to be out. He was going to have to learn to create power and consistency with a short backswing. The old method lingered perhaps longer than it should have. Ponseti, a medic in the Spanish Civil War before fleeing the Franco regime and building his career at the University of Iowa, found that scar tissue led to long-term tightness and pain in the foot and ankle. By avoiding the big surgery and instead manipulating babies’ pliable foot and ankle bones – a process he likened to playing the piano – followed by casting, outcomes improved. No one took him seriously, but what finally made the difference was the internet, so that when a few pioneering patients saw the benefits of the Ponseti Method for themselves, around the year 2000, word spread quickly. Other doctors, too, began to take notice. One of them was Dr. Kristen Carroll, a rising star in Salt Lake. ‘Our superhero’ The Chief of Staff of Shriners Salt Lake City and professor of orthopedics at the University of Utah, Dr. Carroll has been there from the beginning. Chariti calls her “our superhero.” It was Carroll who performed the infant Phoenix’s casting and Achilles Tenotomy, in which the Achilles tendon is cut, the foot is brought up to a neutral position, and the tendon regrows in a longer position. “It’s not really a surgery; we do it under a local anesthetic,” Carroll says. “It’s a clinical procedure, but it’s scary for the family. After that, roughly 30% of children will require other work down the road, and he was one of those.” Phoenix wore braces, which he had to take off for bath time and to splash around in the little plastic pool in the backyard. On one of those occasions, he surprised everyone and stood up and scampered around on his ankles. “I think it hurt each one of us watching him,” Chariti says. A quarter of the bones in the human body are in the feet, but those bones don’t become visible on an X-ray until kids are toddlers. Until then, they’re mostly cartilage. The Ponseti Method: push the feet back into position, followed by casting, and repeat three to five times. The small group of doctors who specialize in treatment of clubfoot know it’s a science and an art. Dr. Carroll, who had taken a course from Ponseti, used both. Phoenix was 2 when he got a tendon transfer, in which the anterior tibialis tendon is transferred to make up for the peroneal tendon, which is underpowered in clubfoot patients. He was in the hospital for a week, during which time Disney’s Monsters, Inc. played on repeat in his room. It was a success, but with the severity of his case he was scheduled for another operation less than two years later. Already battle-tested over the course of nearly four years, the family braced themselves yet again. It wasn’t ideal, but another invasive procedure seemed inevitable. “The day that we showed up for the surgery,” Chariti says, “Dr. Carroll walked in our hospital room and said, ‘I have an idea and if you’ll trust me, I’d like to try it instead of surgery.’” Taking a page from Ponseti, Carroll wanted to correct the remaining deformities with manual manipulation – playing the piano – and serial casting. The Smalls were ecstatic, and having been spared the knife, Phoenix dressed up as Frankenstein for Halloween, trick-or-treating in his casts. There were still a few bumps along the way. When he got out of his casts, he would not walk. He was brought back to see Dr. Carroll, who said to give it time. The family did, but to no avail. Back at the hospital, she X-rayed his feet, solving the mystery: He had osteoporosis, a web of tiny fractures. The fix was an unusual looking pair of soft boots, plus physical therapy. “For somebody who was born with both feet clubbed, you look at him and you wouldn’t be able to tell,” Rahm said. “It’s amazing. He’s a remarkable young man, remarkable family, and I’m sure he’ll have a really bright future, because with what they’ve endured early in his life, I mean, there’s not going to be many challenges that are worse than that.” A normal kid Phoenix’s father, Shane, says he never lost faith that everything would turn out OK. Golf has helped, although he might not have anticipated the role it would play in his life upon his introduction to the game. “I started playing about 25 years ago,” he says. “My first time out I ended up in the ER with a fractured leg. I went after work with a few guys and the person driving the cart turned on a hill and tipped the cart and it landed on my leg. I couldn’t make that up if I tried.” Phoenix was about 6 when he went out with his dad for the first time. He drove the cart – more carefully than his dad’s old friend – and supplied balls for mulligans. He was about 9 when he started to show interest in playing, and he got a set of clubs for his birthday. His interest was further stoked when, as a patient ambassador at a Salt Lake Shriners golf tournament, he became friends with Maleah Johnson, another patient ambassador who as an amputee, on a prosthetic leg, was playing on her high school’s varsity golf team. “They continued to participate together in every golf event for the hospital until last year when she went off to college,” Shane says. “He has had a few very positive influences in the game.” Chariti says she didn’t know what to expect when the best golfer in the world came into their lives. Indeed, no one could have predicted how well Phoenix and Rahm would hit it off. “I was happy for them both,” Shane says. “Jon had never met anyone else with their condition. So, it was fun to see his reaction. I was very grateful to Jon for taking the time to talk with Phoenix. Jon is a class act and true ambassador for the PGA TOUR. “I definitely find myself following the game more,” he continues. “Especially how Mr. Rahm is doing. I believe he gained quite a few new fans from this experience, and we will be forever grateful and rooting for him. I truly believe that Jon Rahm is a legend in the making.” Phoenix says no one at his school has any idea about his labyrinthine medical journey. He plays trumpet in band – he is a fan of 1940s music, owing to Louis Armstrong – and recently started a new 3D design class that he says is “pretty cool so far.” Soccer and other sports are too hard on his feet, but golf with his father, always in a cart, has been a fit. Admittedly new to the game, he has been thrilled to get some tips from the down-to-earth Rahm. “I learned that I might actually have a chance at being a decent golfer someday,” he said. These days, if the weather holds, Phoenix and Shane hit the driving range at Fox Hollow G.C. in American Fork. If not, it’s Mulligans in South Jordan, which has an overhang with heaters. Dr. Carroll still sees him roughly once a year. She diagnosed his little sister, Madeline, with hip dysplasia and fixed him up when he broke his elbow at age 7. That Phoenix still has foot pain is normal, she says, as 20-30% of clubfoot kids still do even as adults. “The clubfoot seems to be secondary to the muscle imbalances,” she says. “There are underlying weaknesses and imbalances in the strength of the foot. That’s kind of what causes the clubfoot. “I think golf is a great sport for him,” she continues. “It isn’t a contact sport. You don’t have that many kids who come in injured from golf. He can walk on a soft surface, versus a hard surface, and go at his own pace. And I think some residual foot abnormalities are minimized by the fact that you use your upper extremities more than your feet in golf.” Phoenix remains a patient ambassador for Shriners, attending events and fundraisers. Sometimes it means public speaking, and as always Chariti and Shane and Madeline have his back in a supporting role. Rahm says he hopes he and Phoenix keep inspiring and leading by example, proving to others with clubfoot that it need not hold them back. Carroll says she’s already inspired. “When I see Phoenix in clinic, the whole room just lights up,” she says. “He has this wonderful smile, and this unassuming, disarming sweetness about him even though he’s a teenage boy. What teenage boy still wants to hug their doctor? The wonderful and extraordinary thing about him is his spirit and kindness and intelligence and thoughtfulness of others.” The patient ambassadorship, paying it forward, is only natural, Chariti says, for Shriners was there from day one. She reserves her highest praise for Dr. Carroll, “The most compassionate, humble, sweet, and caring doctor I have ever experienced.” As for Phoenix himself, a trumpet-playing, golf-loving wonder, she calls him an inspiration to all who know him – most of all her. “Phoenix is appropriately named,” she says. “His entrance into this world was a scary one but he has risen from the metaphorical ashes to live an incredible life. Life is funny that way, it will make you grateful for the weirdest things. If you asked me now if I would change things if I could, I would tell you not in a million years.”
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