East Stroudsburg’s Ryan Smith, dealing with leukemia, appreciates support from highest levels of Pennsylvania hoops | Mike Jensen

What was going on out there? Ryan Smith heard the commotion getting closer to his room at the Hospital of the University of Pennsylvania. Sure enough, coming right at him. Then inside his room. A most familiar face ... and voice.

“Not loud in a bad way,’’ Smith said. “Just kind of a booming voice.”

Yeah, that’s what Charles Barkley brings. The commotion that day last autumn didn’t stop once Barkley got to Smith’s room.

“All these nurses came flying by,’’ said his mother, Kim Smith. “Here, the lady next to Ryan, across from him, had a heart monitor on. She must have seen Charles Barkley, and her heart monitor went berserk. They thought she was having a massive heart attack. She was like, ‘No, I saw Charles Barkley just went in that room.’ He had to go say hi to her.”

Ryan and his mother were sitting recently in his own family room on Willow Street, Lancaster County. Smith is a basketball player, 6-foot-10, and was the PSAC freshman of the year last season at East Stroudsburg. Then a diagnosis of acute myeloid leukemia last summer changed the game. Smith was suddenly watching more basketball than playing it, which meant Barkley was on his television a whole lot of the time.

In his room? Same guy. Charles being Charles.

“He just sat down and talked about basketball,’’ Smith said.

Like the time Moses Malone, a mentor when Barkley got to the 76ers, sat him down and told him, “ ‘You’re fat. You need to lose weight or you’re not going to play in the NBA.' … He said he woke up and got in shape.”

How did this little visit happen?

“Did you set it up?” Ryan asked his mother.

“No, Fran Dunphy set it up,’’ his mother said. “We all knew he was coming. We thought he was coming.”

“I had no idea,’’ Ryan said.

Dunphy, the former Penn and Temple coach, and current Penn coach Steve Donahue had visited Smith separately and together in the hospital. Dunphy then played a round of golf with Barkley. During the round, Dunphy said, he asked Barkley for a favor, to film a little video that he could show to Smith.

“I’m not doing that. Why would I do that?’’ Barkley said, something like that.

In the telling, Dunphy paused to make you wonder what the heck Barkley was thinking there.

“When are you going to see him?’’ Barkley then said. “I’m available next Tuesday or Wednesday.”

It took a long time just to get up to the room, Dunphy said, since Barkley kibitzed with everybody in his path. Later, after he was out of the hospital, a call came to Ryan’s cellphone from Phoenix.

“I’m not going to answer this,’’ Ryan said. “It’s probably just a spam call. Like 20 seconds later, I get a voice mail … ‘Hey, this is Charles Barkley …’ I’m like, oh my God, I just declined a call from Charles Barkley.”

“Then [Barkley] called me — he was at the Army-Navy game,’’ Kim Smith said. “He’s like, ‘I just wanted to let you know I tried to call your son, but he declined a call from me.’ ‘’

Just because Charles Barkley shows up at your door doesn’t make the day a breeze in other respects. This has been a tough road for Smith, with another hurdle coming. Still, it all mattered.

Smith used the word compassion in describing his visitors — “They didn’t even know me before. Steve Donahue’s goddaughter is one of the managers [for the women’s team last season at East Stroudsburg] who has Down syndrome. She was awesome. … I’m good friends with her. Knowing that made a connection with Steve Donahue.”

Smith said there “definitely” is this basketball community locally that maybe he didn’t know about until he got sick.

“Some of the Villanova basketball players reached out to me, texted me,’’ Smith said. “I would get pictures on Twitter where all these teams are having this wristband on — it’s RelentlesS, and has my initials, that East Stroudsburg made for me — they sold them. I’d look on Twitter and there would be pictures of all these teams that had my wristbands on. Penn did it. Holy Family. A lot of local teams here. Penn State Harrisburg. Penn State Berks, I think. I just got a letter … there was a team in Minnesota. They sent me a card with all their names signed.”

Many of the PSAC teams held fund-raisers that really moved him, Smith said.

“All those teams,’’ Smith said. “My AAU coach would always say, ‘the power of the ball.’ So, like, the power of the basketball is just real. To see all these teams lift me up is just awesome.”

There was a moment after he got out of the ICU, his mother said, when a couple of East Stroudsburg teammates “who had a Philly base … they kind of put a shout-out to people, to let them know about Ryan. He got this influx of all these Snapchats and Instagram things. It gave him such momentum to get through a couple of days. He’d wake up in the morning and look at his phone and say, ‘Mom, look at this …’ “

De’Andre Hunter, Virginia’s NCAA Tournament title star from Philly, reached out.

“He was my favorite player to watch from Virginia,’’ Smith said. “He was an absolute monster on both ends of the floor. It was Instagram. I think he DM’d me, just messaged me. I think Marc Rodriguez, who was on my [East Stroudsburg] team [from Father Judge] knew De’Andre Hunter and reached out to him, told him about me.”

After Smith received his diagnosis, his East Stroudsburg team stayed close. It’s still close.

“My head coach constantly texting and FaceTiming, coming down once or twice a week, even when I was in ICU,’’ Smith said of Jeff Wilson. “Before I got super sick, [teammates] would come and see me.”

Making a day easier for Smith didn’t make it easy.

“I went through five rounds of chemo,’’ Smith said. “I just got super sick after the second one. It’s just really tough because I’m on all these meds and it was tough for me to comprehend why I was on them all. After that second round, I was sent to ICU …”

He started ticking off medicines he hadn’t heard of in his life. One, he said, causes muscle atrophy. Rhabdomyolysis causes muscle breakdown, resulting in a release of myoglobin into the bloodstream. It was a life-threatening situation. Smith survived it, but the frustration lingered.

“All my muscles just kind of went away,’’ Smith said. “All this work I put in over the summer just went away, in like a week. It’s really tough to see that.

"I know there’s an end to all this, and there’s definitely better days ahead. That’s kind of what’s pushing me forward. I see the light at the end of the tunnel. This next step I’m going to take is going to be the last step in my treatment process. It’s a really big one. A bone marrow transplant. But I can see the end. A little bit easier.”

The transplant is scheduled for late February, maybe the beginning of March. They’ve found three 100% matches who have given blood samples. The doctors are testing to see which person is the best match.

So if he is secluded back in his room in March, Smith said, the television will be on, March Madness, “my favorite time of year,’’ Smith said. He’ll be seeing a lot of Barkley.

“OK, that’s one way we’re going to get through the transplant, March Madness,’’ his mother said, laughing.

There was barking from the other room.

“That’s Barkley,’’ Ryan’s mother said.

Not Charles. They’d decided to get a dog recently. Ryan’s father spent a lot of time looking at possibilities, and when he saw one actually born on Ryan’s birthday, this was the one, a Shih Tzu. Charles texted when he heard about the dog’s name, telling the Smiths, “He better be a good dog.”

“I have him in his crate right now because the nurses were here,’’ Kim Smith said.

The nurses who had taken blood had just left, so Ryan’s pooch was freed up and raced in the room. A little commotion coming right at him.

“The name works, honestly,’’ Ryan said.