Sean Sanderson was encased in a neck brace, with three fractured vertebrae, seven broken ribs, a broken femur, a collapsed lung, a bruised spleen, ligament damage and deep "road rash" over most of his body.
He had one question for his doctors when he regained consciousness after he was hit by an SUV in July 2010.
When could he run again?
"I didn't doubt for a minute that I would walk or run again," he said. "God kept me around for a reason."
In October, 48-year-old Sanderson ran the 7 Bridges half-marathon.
He breathed in the fall air, savoring the moment so nearly taken from him.
It felt good.
"Just being alive is one thing; being able to do what I love is beyond expectation," Sanderson said. "It was a very spiritual moment."
Sanderson began biking seven years ago. He quit smoking and was soon hooked on his new active lifestyle.
He liked road riding, doing an occasional 100-mile bike ride, enjoying the freedom of the road.
Several years later he began running. He ran 5k's, 10k's and marathons.
"It was a release, to get out there," he said.
On that July morning, he was riding his Trek Madone on Georgetown Road in Ooltewah, about 26 miles into a 40-mile ride.
An SUV hit him from behind.
His wife tells him he asked about his bike in the emergency room at Erlanger.
As doctors began the operation to fuse together his vertebrae, they told his wife he might never walk again.
His spinal column had been pushed aside, the vertebrae crushed.
Sanderson's next clear memory was his body being slid into an MRI machine. Technicians warned him not to move his body inside the scanner.
"I couldn't move," he said.
Sanderson pushed hard to recover. By October 2010 he was running, even if it was slow and painful.
Eighteen months later, he still has nerve damage and vertigo. He has no idea how his damaged body will continue to recover.
But for now, he treasures every stride he takes.
It hasn't been easy; he still hasn't ridden a bike on the road. He misses the feeling of the wind in his face.
Sometimes he'll see a cyclist and think, "Gosh, I want to get out there."
Fear stops him.
"You have this passion in your life you'd like to do, but you're scared to do it," Sanderson said. "I hope someday to get back out there, but it will probably be limited. I don't know how I'm going to react."
Instead, he pursues other passions.
He and his 14-year-old son, J.D., are training to run Nashville's Country Music half-marathon in April, the first his son has done.
Sanderson was a stay-at-home dad and part-time computer program designer before the accident, but now he plans to go back to school to get a degree to teach physical education.
On Christmas morning, he plans to open gifts with his family and savor every minute.
"It's a total blessing just to be able to participate in the activities I enjoy," he said. "You realize what is really important and what is special in your life -- it's family and not stuff."