Riding the White Pine Trail north of Cedar Springs, Michigan, on a chilly April afternoon in 2022, Dave Medema failed to notice the large branch hanging over the asphalt path.
“Maybe the tree had blended into the wooded background along the way,” he said.
“I didn’t see him until the last minute.”
With no time to swerve, Medema braked hard.
He flew over the handlebars and landed on the pavement, head first.
The next thing she remembers is a man kneeling beside her, assessing her condition.
“I told him, ‘Just give me a couple of minutes. I’ll be fine. I’ll be able to get on my bike and go home,’” said Medema, 69, a lifelong cyclist who lives outside Rockford, Michigan.
“He kindly asked me, ‘Well, who’s the president?’ And he couldn’t name it. … So I thought, ‘Oh, this is not good.’
level 1 trauma
The Good Samaritan, a motorist named Will who witnessed the accident, stopped his vehicle and ran into the ravine between the road and the trail to render assistance.
He called 911 and called Medema’s wife, Fenna Diephuis.
First responders soon arrived.
After immobilizing her neck with a rigid neck brace, EMTs transported Medema to Corewell Health’s Spectrum Health Butterworth Hospital, the region’s Level 1 trauma center.
“It was level one trauma, which means we mobilized our entire team,” said Cathryn Chadwick, MD, a critical care surgeon who was on duty the day of Medema’s accident.
“We have the trauma surgeon, our residents, radiology, ER documents; everyone is in the trauma room waiting for this patient to arrive so we can quickly stabilize him…and quickly get imaging and then get him to the ICU.”
CT scans and a subsequent MRI showed severe compression of Medema’s cervical spine. The injury had caused paralysis from the neck down. His brain function, however, remained healthy: he escaped with only a concussion.
Medema has her helmet to thank for that.
“I had a helmet on and that saved my life,” he said.
“So if you do one thing in this article, make it bold, large print, red print, underline, italics – always wear a helmet.”
Diephuis, who was already in Grand Rapids running an errand at the time of her husband’s accident, arrived at the hospital before the ambulance and sat in an emergency room, waiting for news.
He was allowed a brief look at it, but the full report arrived later, at his bedside in ICU.
Dr. Chadwick had already consulted with the spine surgeon on call when she delivered the medical team’s assessment: that in order to remove the damaged discs in Medema’s neck and stabilize her cervical spine, she would need spinal fusion surgery the next morning.
This would relieve pressure on his spinal cord, giving the nerves a chance to regenerate over time.
To optimize Medema’s care, the ICU team placed a central line to deliver medication and an arterial line in her wrist for continuous blood pressure monitoring.
“We know that if we keep people with a normal heart rate and blood pressure, they’re going to get better outcomes, and especially with these spinal cord injuries, they’re going to get better perfusion of the spinal cord and therefore a better outcome.” said Dr. Chadwick.
Exactly what that outcome would look like for Medema, no one could say. She had good health to her credit, but nerves regenerate more slowly in people her age.
In speaking with the couple, Dr. Chadwick tried to strike a balance between optimism and realism.
“I was able to help them get to that point where they were like, ‘My life isn’t over’…and get through those early stages and days where things feel completely out of control.”
Dr. Chadwick’s clarity, confidence, and compassion resonated.
Medema and Diephuis took her words to heart and worked hard during those first hours and days to process their thoughts and emotions.
“Our retirement plans just did a 180 degree turn, you know?” Medema, management consultant and self-employed trainer.
“But I knew if I went into victim mode, or if I said, ‘Why, God, why? Because I?’ …then I will have a miserable life.”
So she set two goals for herself, right then and there: “practice radical acceptance” of her circumstances and return to the White Pine Trail on an electric-assist trike.
“I told Fenna right away, and I told my cycling friends. I said, ‘I’ll go back there with you. It will be on an electric trike.’”
For his part, Diephuis followed the advice of a hospital chaplain and created a CaringBridge page to keep family and friends informed about Medema’s condition.
“I blogged every day. I would come home and it was my way of winding down before going to bed,” she said. “It was great therapy for me to do that.”
rehabilitation and recovery
Medema’s spinal surgery went well.
The following day, Corewell Health’s physical and occupational therapy team assessed his core and extremity strength in preparation for moving on to inpatient rehabilitation. Overcoming the pain, Medema worked with her therapists to sit on the side of the bed and begin some preliminary exercises.
His discharge from the Mary Free Bed Rehabilitation Hospital came just one day later.
As he left, Dr. Chadwick asked him for a favor: to see us again one day.
“I see patients in the most acute phase of their injury, but rarely can I see when they have recovered and how well they are doing and how much function they have recovered,” he said.
“I rarely get to see the post-trauma stuff.”
Medema and Diephuis remembered the request.
Ten months later, they arranged a return trip to Butterworth Hospital.
Carrying goodie bags, they joined Dr. Chadwick and several team members from the ER, ICU and Multidisciplinary Trauma Clinic to express their deep gratitude for the world-class care they received.
But this reunion could come only after months of slow, steady, excruciating work—physical and occupational therapy that continues in some form to this day.
First, Medema completed seven weeks of intensive rehabilitation at the Mary Free Bed, where attendants got him to his feet on the second day, even though he couldn’t feel his feet.
Within four weeks, a physical therapist, himself an avid cyclist, had Medema ride a trike inside the building.
Six weeks after the accident, he was able to stand, turn, and walk with a walker.
After her discharge on June 6, Diephuis, a medical massage therapist, became her husband’s full-time caregiver.
Medema began working with a team of outpatient physical therapists to rebuild muscle mass and mobilize her shoulders, arms, hands, legs, and feet.
“A large part of my body was turned off by the accident,” he said. “The trauma not only damaged my spinal cord and nerve endings, but my body doesn’t know how to move.”
Life now involves a cycle of work and wait: working the muscles and waiting for the nerves to heal and wake up.
“What I can control is doing exercises to recover muscle mass and mobility,” he said. “Nerves? I can’t really do anything about it other than exercise and get good nutrition.”
To promote healing, Medema also receives acupressure treatments and other holistic therapies.
The progress he has made in a year has been remarkable and he is hopeful that he can regain full functionality.
She now walks without a walker, up to a mile at a time.
Most mornings, he spends an hour or two in his makeshift home rehab gym in his basement, working on stretching, strength training, balance and range of motion, all with the equipment Diephuis set up for him.
4,000 miles to go
Last September, just five months after the accident, Medema hit the road again on a bright orange custom electric trike.
His physical therapist at Mary Free Bed helped design the specifications; Her riding buddies helped raise funds to purchase the Bluetooth-enabled three-wheeler from TerraTrike, a local manufacturer.
Before winter, Medema had already covered 300 miles.
His lifetime goal of biking 100,000 miles remains in his sights.
“I’m at 96,000 right now, lifetime miles. I bet I’ll be there in two years,” he said.
She dreams of finishing a loop around Lake Michigan that she started with a friend a couple of years ago, and of biking the 45 miles to Spring Lake, Michigan, to hit the trails with her grandkids.
Today, one year after the accident, Medema reflects on her circumstances with pain and gratitude.
“My pain for what I have lost, physically and everything, is there. My emotions are still pretty raw,” she said. “I’m going through grief.”
Yet at the same time, he celebrates his renewed strength and marvels at how far he’s come: “So much further than anyone thought he’d go.”