Originally published April 17, 2005

It's just a number, he says.

He sits on a love seat supported by concrete blocks in his Valentine living room and says it's just a number.

He knows he's the only one who sees it that way.

Doctors care about it. So do dietitians, physical therapists and the thousands of supporters, detractors and simply curious who follow his story.

The number hit 1,072 on June 4, which, according to one published list, made Patrick Deuel the eighth-heaviest person ever recorded.

"It's just a number," he repeats defiantly. "Personally, the weight isn't that important to me. As long as I feel better, feel stronger, that's what counts."

It's easy to understand why he's fed up with numbers. He's been surrounded by them for nearly a year.

Take 1,200, for example. It's the number of daily calories his doctor limited him to after he was admitted to Avera McKennan Hospital in Sioux Falls, S.D. That number put an end to some of his favorite things: Pizza Hut, McDonald's, Lay's and Chef Boyardee; Blue Bunny, Milky Way and Little Debbie.

And 11, for the number of team members at McKennan who helped save his life by overseeing his therapy, administering his medication and monitoring his vitals.

And 421, the number of pounds he lost by diet and his first exercise in years. He is proud of that number -- it's almost as much as one formerly obese man weighed before he started hawking Subway sandwiches.

"Jared, eat your heart out," he says, his voice slightly higher than you would expect from a man his size. "Eat your heart out."

The laughter dissipates as his thoughts return to the numbers.

It's March 15, almost two months since the 42-year-old man returned to Valentine weighing a little more than 600 pounds. In nine days, Dr. Fred Harris -- the surgeon who persuaded the hospital to accept Patrick when no others would -- will fly to Valentine to check his progress.

"I can tell you, if I haven't lost a pretty good chunk of weight, he isn't going to be too happy."

He remembers the first time Dr. Harris came to the little brick duplex in Valentine.

It's June 2004 and Patrick lies in the bed where he's been for months, so bloated with fluid his wife avoids touching him, fearing his skin might tear under the pressure. He can move only one arm and partially rotate his head.

"Patrick, you haven't long to live," Harris says. "I think I can save your life, but you have to do what I say, when I say."

Patrick agrees.

He wants to live.

Now, nine months later, as he struggles to follow doctor's orders, some might question if he still does.

* * *

It may be Super Bowl Sunday, but hours before kickoff, the TV brings professional golf into the Deuel living room.

He left the hospital 16 days ago, but boxes of medical supplies and personal belongings make the small room feel cramped.

On the love seat, Patrick's 5-foot-11 body assumes the form of a mountain, his head a peak that quickly broadens on descent, cascading into an immense midsection that covers both cushions. He looks grounded to the spot, immovable.

It appears a pair of bed pillows are stuffed down the front of his black sweat pants. In fact, the bulge is a panniculus, a sheet of stretched skin and fat that would form a mound of a belly if not for gravity.

A yellow pallor tints his loose, almost shapeless face. Semicircles the color of partially healed bruises hang under his eyes.

Directly in front of him, a desk on casters holds a personal computer, a container of celery, a saucer of reduced-fat bleu cheese dressing and a can of Diet Coke. His wife, Edith, sits to his right in a padded glide rocker. Although she faces the TV, she's more likely to read a book than watch Woods, Singh and company.

Meanwhile, her husband dips then crunches a celery stick, engages in an online chat, answers a reporter's question and reacts to a missed putt by Phil Mickelson more or less at the same time.

"I am an avid sports viewer, especially these guys," he says.

Maybe for now, but in the fall his heart belongs to the Huskers. One of his goals -- publicized by Sports Illustrated columnist Rick Reilly -- envisions a 240-pound Patrick Deuel occupying a single seat at Memorial Stadium. The previous seven months have given the goal at least a fighting chance.

In late October, after four months of supervised diet and exercise had melted away 421 pounds, Harris performed gastric-bypass surgery on Patrick. The procedure sealed off his stomach and gave him a thumb-sized pouch, greatly reducing the amount he can eat in a sitting.

Harris warns Patrick the surgery isn't magic. Constant eating - grazing as Harris put it -- can defeat the bypass.

In Patrick's condition, weight gain means death.

McKennan staff gave Patrick guidelines on what to eat, what not to eat and how much to eat before he went home.

Three eight-ounce meals per day and an occasional snack. Protein should make up half of each meal, preferably from low-fat meats and fish. Include starches with every meal, but avoid gummy breads and pasta. Incorporate vegetables and occasional fruit. Fat is a caloric culprit; use sparingly.

Eat slowly. Chew well. Aim for variety and balance for long-term success and health.

There's a complicating factor, Deuel says: His stomach pouch won't tolerate some foods. He says his caregivers advised trial and error to determine what stays down.

"With this particular diet, you can pretty much eat what you want to eat," he says. "There are certain things I absolutely love to eat that I can't have anymore."

Foods that work: eggs, refried beans, lightly seasoned chili, turkey, cheese, yogurt, canned spinach, canned ravioli, roast beef, sherbet, a few tortilla chips, pizza toppings scraped off the crust. Foods that don't: pork, regular milk, cabbage, lettuce, most breads and more than one bite of rich sweets.

About 90 minutes after finishing the celery and dressing, Patrick turns to his wife.

"Edie, can you bring me some cheese and buttermilk?"

She disappears into the kitchen and returns with a juice glass of buttermilk and a half-inch-thick piece of yellow cheese cut from a 3-inch brick.

* * *

At about noon the next day, Patrick is back on the love seat, having negotiated the short distance from his king-sized bed in the adjacent room.

On the TV, Perry Mason cross- examines a witness as Patrick expresses his dissatisfaction with the Patriots' victory the night before.

Something hums in the background. Patrick points to a device smaller than a shoebox attached to clear, plastic tubes that run underneath his T-shirt. The rechargeable vacuum draws drainage from three wound sites on his torso.

Patrick calls the wound vac Wilbur. Except he stretches out the W and the R, in the fashion of Mr. Ed, the talking horse.

He asks Kathy McBride, who assists him during the day while his wife works, to bring lunch. After a few minutes, she sets buttermilk and a pair of bean-and-cheese burritos on his desk.

"Thank you, ma'am."

"Do you want sour cream?"

"That's OK," he replies as he types something on his computer.

With a fork, he cuts a corner off a burrito and puts it in his mouth. He struggles to chew it. Last year, about two months before he checked into the hospital, he had 11 abscessed teeth removed in Omaha.

His teeth went bad the seven years he was homebound. Pain raged in his jaws to the point regular doses of OxyContin, Motrin and Ambusol brought no relief. Finally, his doctor in Valentine persuaded the University of Nebraska Medical Center to perform oral surgery.

Now, he has only one pair of opposing molars.

He swallows a couple of bites and drinks some buttermilk, but something's wrong. His face gradually fades to the color of drywall mud.

"I'm starting to get the feeling something's not going to stay down."

He leans back in the love seat, then forward, trying to find a comfortable position. Finally he snatches a tiny wastebasket off the floor and retches.

"Sorry about that. Normally I can tolerate burritos, but not today," he says. "God knows what I can eat today."

After a few moments, he shakes a cigarette from a pack of USA Gold Light 100s and clicks a disposable lighter. He closes his eyes during the first drag.

He's been a smoker most of his adult life, peaking at 2 1/2 packs a day. He quit while he was in the hospital, and now, he says, he smokes about half a pack a day.

"I know my doctor doesn't like it, but right now, it's the one thing I can have that I know for sure won't be coming back up."

* * *

He weighs 7 pounds, 12 ounces on March 28, 1962, virtually the only time his weight will be normal.

Three months later, a doctor tells his parents he's obese. At 4, he weighs 75 pounds. By junior high, nearly 260. And at high school graduation, about 400.

Still, as a kid, he finds it intolerable to sit still, says his mom, Betty Deuel. She and his dad, James, still live in Grand Island, where they raised Patrick.

The boy gets plenty of exercise, especially on his bike. He hikes up Pike's Peak and Mount Baldy in New Mexico on the way to becoming an Eagle Scout in 1979.

He completes the hikes, in part, because other Scouts openly complain that he will slow them down.

"He's a little bullheaded," his father says.

"That can be bullheaded or that might be persistence," his mother adds.

Growing up, he is outgoing, loving, and as far as they can tell, happy. He generally earns Cs and Bs in school, except for music and band, which are always straight As.

He sings tenor in the high school choir and is a talented trombone player. He manages to write a three-part harmony passage for the trombone section after his instructor told him it was impossible to do so for the piece they were playing, his father says.

Betty Deuel, who sold nutritional supplements for more than 20 years before her retirement, says her son ate healthy meals and reasonable portions at home.

"But from the time he was small he said, 'Mom, I never feel full.'"

His parents, who are overweight but not morbidly so, say their son acquired a genetic makeup for obesity. One of his grandfathers and a couple of his uncles tipped the scales at more than 300 pounds.

"It's not like he was eating 35 hamburgers a day," his father says. "I know people thought, 'Look at that dumb fat kid who got himself into that position. He should have known better.'"

Harris supports their insistence that Patrick's condition isn't solely the result of overeating. The surgeon says Patrick has a "genetically superior metabolism" that extracts calories efficiently and stores them quickly. Such a combination works well in harsh environments where food is scarce and people expend lots of energy obtaining it. But when calorie-rich food is plentiful and exercise involves walking from a bed to a couch, a highly efficient metabolism wreaks havoc.

His parents never hear such explanations when Patrick is a child. Instead, doctors say he needs to lose weight and the parents restrict his calories. The boy experiences the classic dieting yo-yo of loss followed by rapid gains.

Early on, he manages to separate his self-worth from his body image. But the cruelty of teenagers wears him down and by the time he's old enough to drive, he hates school.

He has a few good friends, but most of his classmates either avoid or insult him.

The derision still stings.

Fatso. Lard ass. Egg on stilts. Fat Pat the water rat.

Sometimes he fights back with words, occasionally backing up his threats by getting in a tormentor's face or shoving him into a locker. But the verbal barrage never ends.

"Most of the time, I tended to curl up in the corner."

Generally, he avoids crowds, but at the urging of a friend, he asks a girl to senior prom. She accepts. It's his second date in high school.

He wears a navy blue tuxedo to match her gown.

He takes her to a Grand Island social club for dinner, but she asks to be seated in a back room, away from other couples.

At the prom, she wants to leave five minutes after the procession.

Music offers sanctuary. When he plays his trombone or sings a solo, his peers appreciate him for what he can do, instead of reducing him to how he looks.

"But when it was over, it was back to 'There's the fat kid.'"

After graduation, Patrick studies at Hastings College for a semester before transferring to the University of Lincoln-Nebraska. But he spends more time on pool than classes, then drops out and begins a string of restaurant jobs in central Nebraska and Wyoming.

Long hours and easily accessible food fuel steady weight gain and push him over 500 pounds in 1983. But he hurts his back while managing a restaurant in Rock Springs, Wyo., in 1984, and, a year later, the injury forces him to quit.

Over the next five years, he applies for disability benefits through the Social Security system. In the meantime, he lives in low-income housing on $122 monthly assistance payments and $90 in food stamps. A soup kitchen provides one hot meal a day, and food pantries provide mostly day-old bread, bagels, doughnuts, cake, government cheese and canned vegetables. He eats few fresh vegetables or fruit because they are rarely available at the pantries and he can't afford to buy them.

The constant stream of carbohydrates combined with decreasing activity piles on the pounds.

Finally, in 1990, he qualifies for disability and moves back to Grand Island, where he lives with a friend before moving to a low-income apartment.

Later, after moving to Kearney, he hits one of the loneliest times in his life. He places a personal ad describing himself as physically challenged and gets six calls. After face-to-face meetings, he never hears from four of the callers again. A fifth didn't get that far.

The sixth is Edie Runyan.

Before she can ask about his "physical challenge," he tells her he weighs more than 500 pounds. She likes his forthrightness and agrees to meet him at a coffee shop.

She's 14 years older than him and has two adult children from a previous marriage. And she knows about obesity because she struggles with her weight as well.

"We visited for about an hour and I decided it didn't really matter what he weighed," she says. "There was a personality there."

Dates are games of King's Corner or episodes of "Star Trek" and "Quantum Leap." They both enjoy genealogy and good conversation. Before long, she notices she can finish his questions or thoughts before he can, and vice versa, just like her grandparents used to do.

About six months later, out of the blue, Patrick says, "Why don't we just get married?"

"I might as well; I don't have anything better to do," she replies.

He rolls his eyes when she recounts the story, and they laugh. Now it's a running joke.

"I spent the rest of time until we got married making sure her life was very dull so she didn't find anything better to do," he says.

They marry on Sept. 23, 1995, and live in Kearney for three years, then Alda for nearly four more. Edie works at the Cabela's call center and does some substitute teaching, putting to work her master's degree in developmental psychology. in Kearney for three years, then Alda for nearly four more. Edie works at the Cabela's call center and does some substitute teaching, putting to work her master's degree in developmental psychology.

Money is tight, but they're happy. While Edie works, her husband stays at home, getting bigger.

When they visit his parents in Grand Island, he has to sit on the front steps because no chairs inside will support him. Traffic passes and inevitably, a few vehicles slow down.

Drivers and passengers stare. They laugh and point. Some speed around the block for another look.

A few shout parting obscenities at the 700-pound man.

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Reach Joe Duggan at 402-473-7239 or jduggan@journalstar.com.

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