Nick Ricks’ family knows if he’s crying, it hurts.

A builder by trade, the 38-year-old Ricks was accustomed to doing everything by hand. He was the sole provider for his wife and two kids. He used to tackle their large yard with a push mower. He seemed invincible, his relatives say.

Then a gunman fired six bullets inside the Crossroads BBQ Pit & Pub in Prineville on New Year’s Eve.

“It’s hard to watch someone who’s been so active and so physical lay in this bed and cry because of the pain,” said his father, Morrie Christensen. “Nick’s never been much of a crier.”

The bullets cost Ricks the use of his legs. He’s experienced blood clots, organ failure and infection. He experiences extreme pain every day. He’s come far in his recovery, but he has a long way to go.

It’s an experience Ricks said he wouldn’t wish on anyone, even his alleged assailant, Omar Ramzi Araim, who’s currently housed in the Jefferson County Jail facing attempted murder and other charges.

Those who know him say Ricks has a natural edge in his fight against death: an unconquerable spirit.

Let’s go out

According to Ricks and his wife, Christina, the couple has been fairly domestic in recent years. But on the last night of 2017, they joined friends at a Prineville home to play games. Ultimately, they decided to continue the night at a bar.

Once at Crossroads — one of the larger establishments in Prineville — Ricks remembers everyone dancing and having a good time.

Then a scuffle broke out among some women, his wife among them. He made several moves to break it up.

Ricks’ family believes Araim, 27, was there with one of the women involved in the dust-up. Security footage shows Araim leave the building and return.

Ricks remembers a chaotic scene, then a “thud.” Then a great force from behind. He could “taste” the gunpowder.

Christina ran outside, told people to call police. Araim walked up and pointed the gun at her face, she said. Without an explanation, he ran away, dropping the weapon nearby.

He was picked up by police walking several blocks from the bar.

At Crossroads, Ricks lay on the ground, dying. He asked for someone to pray with him. A bar patron knelt by him and prayed.

Back in Baghdad

When Ricks arrived at St. Charles Bend about 2 a.m., trauma surgeon Mike Woll was there.

An Army veteran, Woll had cared for civilian and military casualties over six deployments and a wide range of rugged environments in Iraq and Afghanistan. He commanded hospital and trauma teams in Kandahar and Mosul. At one moment in time, he was chief of the busiest trauma center in the world — the 86th Combat Support Hospital in the Green Zone of Baghdad.

Woll got a lot of job offers after his retirement from the U.S. Army. He ultimately chose St. Charles Bend because he felt it had commitment to team-focused care. Woll was instrumental in the decision in 2015 to start the St. Charles Trauma service.

Prior to 2015, Ricks would have required a transfer to a Portland-area hospital, which would have cost him precious seconds in the fight for his life, Woll said. The benchmark St. Charles tries to follow is to initiate surgery for trauma patients within one hour of injury.

Woll said when Ricks was wheeled into the trauma bay, it was like being “back in Baghdad.”

“Finally,” he joked. “Something I know how to fix.”

Damage control

The term “damage control” actually comes from the U.S. Navy, Woll said. It refers to the repairs needed to allow a damaged ship to limp out of battle and return to dry dock for definitive repairs.

Ricks’ initial surgery was a damage control laparotomy — a procedure to do what needs to be done to stop bleeding and control contamination and bowel injury.

“Nick had some horrific injuries,” Woll said.

Ricks was bleeding from deep inside his liver. Woll packed 16 towels around it, putting pressure on the bleeding artery. He wasn’t stitched up; rather, the opening in his abdomen was covered with a plastic drape.

Ricks was then moved for further examination. An interventional radiologist applied Gelfoam on the bleeding artery so the towels could be removed without starting more bleeding.

Six gunshots were heard New Year’s Eve at Crossroads. Ricks was hit by four, all directed from the right posterior side, probably as he was turning around, according to Woll.

Bullets do a number to a human body as they penetrate, fragment and tumble unpredictably. In Ricks’ case, they fractured his liver tissue and ruptured his bowels. Bullets don’t even need to strike an organ to rupture it, as was the case with Ricks’ kidneys.

Two bullets are still inside Ricks — one in his kidney, resting between his venal artery and vein, and one lodged in his spine.

Over his career, Woll has learned the importance of what he calls the “patient factor.” Those patients who are unwilling to be cowed by their injuries invariably do better than those who allow their injuries to dominate them.

“Nick’s indomitable spirit and will to survive have been every bit as important to his recovery as any care that we have provided,” Woll said.

Pain and comfort

Despite the pain, there is comfort in recovery, Ricks said last week.

For one thing, there’s the postcard-worthy view from his corner room on the fifth floor surgical ward at St. Charles.

There are the doctors and nurses, medical assistants and administrative staff at St. Charles.

Family support

Ricks has two children, 6 and 14. He’s the youngest of six siblings. His injury has been hard on all of them, he said.

His father, Christensen, stops by every morning on his way to work, and hasn’t missed a day. The injury has been hard as well on his mother, who, like any mother, wishes she could do something to take away her child’s pain.

Last Friday afternoon, his pain was “anywhere from a 7 to a 9” on a pain scale that goes to 10. But it was a big day for Ricks: he’d successfully put on one of his shoes.

“That was kind of awesome,” he said. “It sounds weird: ‘Yay, I put a shoe on.’ But it’s a big deal.”

Even more promising: He recently felt a twitch — a muscle firing — in his right leg.

Woll told The Bulletin that Ricks’ chances of walking again “are not zero,” especially given the advancements of exoskeletons and other technology.

They helped hold a 6th birthday party for Ricks’ son, Cainen, downstairs at the hospital.

Ricks was in “tremendous” pain that day, probably a 10 out of 10 on the pain scale, he said.

“But it was worth it to see him smile,” Ricks said. “He was excited. It was worth the pain.”

— Reporter: 541-383-0325, gandrews@bendbulletin.com