What do you say to someone who refuses to take a hint? What do you say to someone so stubborn and relentless that she refuses to believe what so many others feel is inevitable?

If that someone is Caitlin Howe, you say nothing at all. You do not tell her that athletes on their fourth surgery as their 19th birthday approaches rarely have futures in competitive sports. Instead, you sit back and watch her prepare for another grueling rehabilitation process and marvel at her perseverance.

"When I was younger, basketball was all I wanted to do," Howe said, the limp present as she stood off court while her Blue Devil teammates practiced.

"When I was younger I had blinders up: I saw everything else in my life as interfering with me getting to my goal, which was being the best basketball player I could be. One of the huge changes that I've noticed in myself is that having the injuries has kind of taken the blinders off and let me see other parts in my life, other parts of my personality. That's a huge gift that having these problems has given me, so I try to appreciate it."

For many Duke fans, Howe is the forgotten Blue Devil. She has not played a competitive basketball game in a very long time.

She tore the ACL of her right knee during the state quarterfinal game her junior year of high school. She tore it again on opening night her senior season. And yes, after a stabilizing surgery earlier this fall to trim away some meniscus, Howe tore her ACL last week. Again.

While she may have been just a girl when her knee problems began, the relentless pain that has followed her attempts to recover have certainly seen her become a woman. Mature and well aware of the long odds that are against her toward having a sustained future in basketball, she openly accepts the challenge that she faces.

"It's scary," she admitted. "There are very few basketball players that have gone through the extensive surgeries that I have. But I'm a very positive person. Of course those thoughts like 'this sucks' creep into my head, but every time I say that to myself, or say 'why can't this happen to someone who doesn't really care about their sport?' I think 'why not me, why not?'"

Traumatic events can affect a team very much. Players suffering debilitating injuries can find themselves isolated by frightened teammates. Howe, however, has received only love and support during her fight to get healthy.

"Like most athletes, I hate hospitals," she said. "My palms sweat when I walk in just to visit someone else.... It was pretty neat [in the fall] because Alana [Beard] and Michele [Matyasovsky] came to my surgery.... My teammates have been awesome. I couldn't ask for more support or more caring from them."

Lindsey Harding, who has thrived on the court this season while Howe has had to watch from the sidelines, revealed how earnestly she has observed her classmate struggle.

"She has so much love for the sport," Harding said. "She works so hard, and I've learned not to take any time on the court for granted because one day it can just go like that. She's taught me that."

A tenacious devotee to her gym workouts--her football player-like grunts are well-known among Duke's athletes--Howe appears ready to once again endure the arduous process of knee rehabilitation.

Moreover, she's composed enough to crack jokes about the surgery-veteran that she is. When asked to recall any memorable anecdotes about the past three years, Howe found a silver lining to the black cloud that has followed her.

"The best part about surgery is the drugs," she said, sporting a rueful smile. "You come out of surgery and you have no worries. Every time I get down, every time I'm like 'oh no, not surgery again,' and I think about the pain and all the little things that I only know about because I've had surgery before, I just remember about the drugs. They'll take care of me."