Ralph Napier has never been the type to sit still.

After 15 years in the coal industry and 20 years teaching math and coaching basketball at Rosspoint Elementary School in Baxter, Ralph was gearing up for his third act: launching an excavation business to help communities across Eastern Kentucky and beyond rebuild after devastating floods and hurricanes.

Then, a routine lung screening changed everything. A nodule on Ralph's lung led to a surgery at a nearby hospital that didn't go as planned, leaving him with a damaged lung.

Complications mounted, pneumonia developed, and by the time Ralph arrived at the University of Kentucky Albert B. Chandler Hospital, both lungs were inflamed and critically damaged. He was then placed on a life-support machine while doctors evaluated his condition.

Ralph needed a double lung transplant. An incidental finding by Naureen Narula, M.D., medical director of the UK Transplant Center, during his evaluation revealed he had developed black lung after years of working in the mines.

On February 20, 2025, after 45 days on the life support machine, Ralph received his transplant. The road to recovery brought four additional surgeries and treatment for damage to his hands and feet.

Through it all, Ralph had his team of health care providers bringing a level of care the Napiers knew he wouldn’t get anywhere else — and a community of thousands supporting him in Harlan County and beyond.

"Anywhere else, I would have died," Ralph said. He was one of 14 patients to receive a life-saving lung transplant at UK HealthCare in 2025.

One year later, Ralph is doing the work of recovery, from respiratory therapy and physical therapy to follow-up appointments with Narula and Lung Transplant Program Medical Director Michael I. Anstead, M.D.

"UK ain't basketball anymore," he said. "UK is the family that saved me."