It was just the sixth game of the 2010 season for Phegley and his teammates, but the young catcher certainly knew what to do: Brace for impact, hang on to the baseball and record the out.
But it turns out the small stature of Boomer Whiting, the Potomac player heading home, served Phegley well.
"That guy I got in a collision with was  pounds, and I was thinking afterward, 'What if that is [6-foot, 210 lb.] Derek Norris instead of Boomer Whiting?'" said Phegley. "I'm happy the guy was tiny and didn't affect me as much."
It's not that Phegley's not built to handle the physical demands of the catcher position. There are special circumstances that impact the young backstop.
"I played 10 innings in that game, had the collision at the plate, got the game-winning RBI the night before and my platelet count was at 2,000 the next morning," said Phegley during a recent phone interview from his home in Terre Haute, Ind. "And I felt 100 percent.
"There's no indication when this thing is at its worst or at its best."
The "thing" described by Phegley is a condition called Idiopathic Thrombocytopenic Purpura (ITP), and it hampered Phegley's 2010 campaign from the outset. According to WebMd.com, ITP is a "rare autoimmune bleeding disorder characterized by the abnormally low levels of certain blood cells called platelets."
Platelets help prevent and stop bleeding by inducing clotting, which makes collisions or even taking a foul tip dangerous for Phegley when his platelet count is as low as it was in the example above. On top of these potential complications, there's no clear-cut cause for this medical malady.
The morning after that strenuous Winston-Salem-Potomac contest, Phegley learned his platelet count stood at just 2,000 per micro liter, which is about as low as one can get.
A normal platelet count checks in at 150,000 to 300,000 per micro liter.
"Unless you have blood work run, there's no sure way to know," Phegley explained. "I don't feel any different, but you get a bruise and it can get out of hand.
"My immune system is attacking my own platelets, and it acts like Leukemia, a blood cancer. What has made this a little difficult is, I'm having to keep my [platelet] numbers up because of the position I play.
"Eventually, I've been told my system will flip itself around. There's a 90 percent chance it never reoccurs. It's kind of a big speed bump in the road right now."
Phegley, 22, was the 38th overall pick in the 2009 First-Year Player Draft, selected by the White Sox in between the first and second rounds. At 5-foot-10, 215 pounds, the one-time Indiana University standout doesn't possess a classic catcher's build, but he has the fortitude and toughness needed to excel behind the plate.
Even with the issues associated with ITP weighing upon him, Phegley put together a decent showing while splitting the 2010 season between Bristol, Class A Winston-Salem and Double-A Birmingham. He hit .292 in each of his last two stops, though concessions clearly had to be made to protect his health.
"Our organization was careful with Josh for that reason," said Ever Magallanes, who raved about Phegley's contributions with the Barons, where Magallanes managed him in 2010. "So he didn't play every day behind the plate. He DH'd one day and caught one day. He doubled up catching maybe twice in the month and a half or two months we had him.
"That's a definite matter for him, because you are not behind the plate every day. You have to do your blood work once per week. I'm sure it was taxing, but he handled it great.
"He's a great kid with great aptitude," Magallanes said. "He can hit. From not playing every day and catching behind the plate, you definitely don't get in rhythm. But I think he did a great job making that jump."
During his first big league Spring Training this past February and March, Phegley felt as if he gained great knowledge about his chosen field from working alongside other more experienced catchers, such as Donny Lucy, Tyler Flowers and Cole Armstrong and by watching starter A.J. Pierzynski.
Near the end of Spring Training, though, Phegley started noticing little red dots on his skin -- in the place where the equipment bag was carried on his shoulder, for example. The trainer asked if Phegley felt tired or any different, but Phegley felt great, so it was basically a watch-and-see process to see if there was any change associated with the spots.
When the season started, Phegley caught a contest where he took a few foul balls to the leg -- again, nothing out of the ordinary in the life of a catcher. But two or three days later, a bruise near the back of his hamstring had grown eight to 10 inches wide. At that point, Phegley was sent to have full blood work done.
"I'm pulling out of this clinic where I had the blood work run, and I got a call," Phegley said. "They told me, 'You need to admit yourself to the hospital right now.' So, I was kind of freaking out. I had no idea what it was.
"They ran tests for everything and narrowed it down to ITP. When those platelet numbers are low, even a bruise to the leg can be dangerous."
Strong support from his family helped Phegley deal with the setback. He also learned more about how the game is run after being forced to the sideline, where he watched intently and studied the decisions made by his managers and coaches.
Most of Phegley's treatment took place at Wake Forest Baptist Hospital, and Phegley gave huge credit to the White Sox organization for its ongoing support. As an up-and-coming White Sox prospect, Phegley was scheduled to take part in the Arizona Fall League so that he might pick up missed at-bats, but instead of trying to get the ITP under control while also playing baseball, Phegley went home to focus on getting well.
His spleen was removed during surgery on Nov. 5, a process that caused Phegley's platelet count to automatically spike. If post-surgery blood work had revealed that his platelet count had plummeted again, that would indicate that there still was a problem. But his platelet count not only didn't drop, it elevated further, as evidenced by tests taken in early December, which leads an ecstatic and encouraged Phegley to believe "all is well."
"At the beginning, it was so surreal that it didn't hit me that it was that big of a deal. You have this life-threatening illness, but you feel 100 percent normal," said Phegley, who has been working out for the past month and only has to guard against certain bacterial infections that could do damage without the counteracting antibodies produced by his spleen. "It happens to thousands of people per year. It's like a genetic thing.
"Some people I talk to, they get strep throat, and their system will do this. You can get a common cold, and it happens."
Phegley no doubt feels it's a true holiday gift that he has been allowed to remain at catcher, despite the risks inherent in the combination of his condition and the physical nature of his position. Given his on-field talents, Phegley has emerged as the potential heir apparent to Pierzynski, but he has been aided just as much by his character and makeup in the way he handled this startling situation.
"Josh is no slouch," Magallanes said. "We joked around [about] how he took one; someone came around and tried squaring him up at home, and he didn't budge. It's almost like hitting a brick wall. He's a strong kid."
"[Josh] just handled it like a man, sort of, like, 'It's not a big deal. I'm fine,'" said White Sox Minor League director Buddy Bell. "There's no question in my mind, if he had a full year, he would have definitely been able to help us [at the big league level] in this coming year. He's a tough, athletic, approachable kid who plays hard. He's going to make everyone better."
Scott Merkin is a reporter for MLB.com. Read his blog, Being Ozzie Guillen and follow him on twitter at @scottmerkin. This story was not subject to the approval of Major League Baseball or its clubs. This story was not subject to the approval of Major League Baseball or its clubs.