Matthew Small, of Levittown, loves the outdoors, his motorcycle, his family and his Irish heritage.
After arriving in Ireland for Christmas, his father Greg and mother Sandra got sick, then he got sick. They recovered, but he wasn't so lucky.
On December 30, 2022, he told his mother he couldn't breathe and they took him to the emergency room. A day later, he was on a ventilator.
"He was diagnosed with pneumonia on New Year's Eve. He was then positive for Influenza A. The combo wiped his immune system down and this group A strep out there was like, party doors are open, let me go in. He got that and it crashed everything," said his mother Sandra.
At one point, the family said a doctor in Ireland said Matthew was classified as "the sickest person in all of Ireland" and that they "had never seen anything like this before."
"They are playing whack-a-mole with infections. Every time they knock one down, another surfaces," said his father Greg, who is a detective for the Falls Township Police Department.
According to the family, the last time Matthew was able to speak was New Year's Eve.
"He was in complete organ failure. There was talk of a transplant list for his heart, and he was on dialysis," said Sandra.
After a week in a local hospital, Small was transferred to The Mater Hospital in Dublin where he remains. It's also where he turned 21 years old on Monday.
"All the nurses put decorations up in his room, cards and balloons and sang happy birthday. One of the nurses said when they sang, he smiled," Sandra said.
The family said Matthew is aware at times, but that the ups and downs have been grueling.
"I try to maintain the middle road, and not give in to despair. At the same time, when he has these rallies and comes back, I don't want to get euphoric and think the worst is behind us. He has had peaks and valleys and emotionally, that's the hardest part," said Greg.
They do have high hopes that he will make it out of the hospital and one day return home, but it will be a long road to recovery.
Sandra said the cardiologist treating Matthew said he might be in the ICU for another six to eight weeks and he will likely have to learn how to walk again.
Friends have set up a GoFundMe for the family.
They also want everyone to pay attention to their health.
"Don't let it get as far as we did with Matthew. He was a healthy 20-year-old and now he's on life support over a simple cold, or so we thought," Sandra said.