MARSHALL, Texas (9/15/11) – The old man shuffled past him, noticeably weak. He was completely bald and had no eyebrows, but he could at least smile.

The sounds of children playing were all around him, yet the voices were of those who also had lost every hair on their head and who ran about with pale looks and deep-set looks in their eyes. But other than outward appearance, one would think you had stumbled onto a group of kids playing on a sunny day in a school yard playground.

It was at that moment last February that James Fugate realized he had entered a world that was entirely different from the one outside the walls of the oncology unit at Baylor Medical Center in Dallas. The sounds were right, but the sights were something he would never forget.

It certainly wasn't what he was expecting the day he walked into the old Bennett Student Center on the campus of East Texas Baptist University and signed up – almost on a whim – to become a bone marrow donor. It wasn't what he expected when he was whisked onto a plane and flew about 20 minutes from Longview to Dallas when it was determined he had proven to be a match for a nameless, faceless person in need of his bone marrow.

But when he walked into the cancer center and saw the old man and then the kids, all fighting for their lives but living as much as they possibly could, Fugate was hit with the reality that despite all the decades of medical advances and the increase of knowledge and skill among medical personnel, cancer remains the second-leading cause of death in the United States today, trailing only heart disease.

For a 6-4, 290-pound offensive lineman preparing to enter his junior season at ETBU, it was as if someone had punched him in the face. As he made preparations to donate his marrow, the soft tissue found inside bones that produces red blood cells and is also vital to the heath of the lymphatic system, with tests and needles and all kinds of medical procedures just to make sure he himself was healthy enough to even donate, Fugate was faced with the reality he was, on some level, becoming part of a daily fight between life and death in America.

And based on a current shortage of bone marrow, unfortunately, death sometimes has the upper hand.

"The sad part of all this is that there just isn't enough bone marrow donations," Fugate says. "They are really struggling to keep up a supply and then there's the deal of having to find the perfect match. I had no idea what to expect, but when I saw that man and those little kids I was touched deeply inside knowing that with everything going on in our lives, we have so much to be thankful for with our health. I saw people who are fighting a battle in their lives just to see the next day, in a lot of cases. My thought was, why do I take one minute for granted, whether it's being able to go to college or play football?"

Unlike a lot of potential donors, Fugate was determined to be a match rather quickly. The patient he was linked to – Fugate doesn't know his name, or even where he lives – had two potential matches found, a twin and James Fugate. Unfortunately, the twin didn't exist, so Fugate was the match.

After the actual procedure, which took about seven hours, Fugate began having doubts and worries. What if he got the dreaded call that the man had died? What if he wasn't a match, as had been the case with two other attempts at a transplant for this particular patient? What if the man's body rejected the marrow again, and what if another match wasn't available?

It was too much to think about. Fugate was only promised a one-month report, a six-month report and then a one-year report. After one year, if the patient so desired, he could request a face-to-face meeting. But Fugate found that he couldn't wait. He kept texting his "Because I Care" recruiter, Scott, searching for any information he could find.

"It helped me that I could keep a journal that I just wrote down every thought I had through the whole process," Fugate said. "It still helps me today. I also understand that this is completely in God's hands. God showed me early on that this wasn't my deal, that it really wasn't my marrow to give. But even with all that, I couldn't stop thinking about him. I texted Scott every day, two or three times a day, needing to get an update."

Finally, the one-month date arrived and it was determined the patient's body had not rejected the transplant. Fugate was also told the man was attending rehab, which meant he could physically do things he couldn't do before.

Today, Fugate admits he's a little on edge because it's been seven months and he hasn't received an updated report. He's been told that doesn't necessarily mean anything, but the worries still exist.

Football has been a release for him. For most bone marrow donors it is advised to set aside at least two weeks to recuperate physically following a procedure. Fugate gave it three days. The worrying and the anxiety from just not knowing about the patient drove him into the arms of the Tiger weight room, and he began to try and recover physically as he always has – working out and focusing on football.

He went through the complete spring training period with the Tigers, finishing in the two-deep tackle rotation. But every day, he dreaded the call. And every day, he thought about what he'd seen during his trips to the cancer center.

"I recommend that everyone go and spend just one day in a cancer unit," he says. "It will shake your world. I am so blessed to be able to play football. The people there, they are fighting every second for their life. Anybody who struggles with being happy, of little things that we think are important, needs to go spend some time with those little kids or other patients. Nothing in this world overshadows that."

Fugate stresses that through his experience of being a bone marrow donor that God was also showing him something about himself.

"This has taught me something, sure," he says. "It's taught me to not let suffering affect me. It was a long summer for me personally. There have been some tough times. But none of it is what these people are going through. I just pray that all this helps, but it is out of my hands. And there is a lot of comfort in that."

ETBU head coach Mark Sartain nominated Fugate for the annual Joe and Marilyn Hogue Servant Leadership Award, an honor that was given to Fugate during last spring's athletic banquet. The award is presented to ETBU student-athletes who "have displayed, not only the highest levels of character, academic achievement, and commitment to their athletic teams, but have gone above and beyond through acts of Christian service to fellow students, university family and community."

Sartain counseled Fugate through the entire process and has been touched by his player's compassion and sacrifice.

"Not one time during this whole experience did James ever want any recognition for himself," Sartain said. "As a matter of fact he was afraid of it. He will not talk about it unless he is asked. His spirit of humility is genuine. What he has done, no matter what happens from here on out, is set an example for Christ. As his coach, I couldn't be more proud of a young man."

Fugate does downplay his role, seeking to point all attention toward the well-being of his match and giving all glory and control to God. But he admits there is a big fear he also struggles with outside of just not knowing what the future holds.

"I struggle with the prospect of meeting him one day," he says. "My prayer is that I don't want to be thanked. My prayer is just that I want him to live. I didn't do this for me. I did it for God, because I felt it was something God wanted me to do. I want for this fellow man to live. I'm not the one he should thank, because like I said, it's not mine to give away. God is our Creator and owns all things, it is just my desire to do His will."

To that end, Fugate said representatives from "Because I Care," including his friend Scott, are scheduled to be in attendance at ETBU's Oct. 15 homecoming game against Mississippi College in Ornelas Stadium. There, they will seek possible donors for future bone marrow transplants, and Fugate encourages anyone who is willing to consider the possibility.

"It's changed my life," he says. "I try to wake up every day and thank God for my health and for my life. We had a tough practice the other day and at the end all I could see was the looks in those little kids' faces, that man as he walked through the cancer unit…and that gives me strength."