Colleen Kelly Alexander flatlined twice after being hit by a truck. Now she’s running marathons.

Colleen Kelly Alexander knows what it means to bounce back. An experienced triathlete, she was cycling home from work one day in October, 2011, when a 30–ton truck ran through a stop sign and over her on Boston Post Road in Madison, Conn. Her injuries were overwhelming: her lower body was ripped apart, her pelvis was crushed, and she flatlined twice after nearly bleeding to death.

In the three years since, Kelly Alexander has undergone 22 surgeries at Yale-New Haven Hospital and has another handful ahead of her. That she survived at all is impressive, but even more remarkable is her approach to life in the wake of her injuries. A long–time activist for community service and human rights, she now advocates for road safety and raises money for organizations that have played a role in her recovery. Since the injury she has participated in more than 30 races, including eight triathlons and two Ironman events. A buildup of scar tissue limits her mobility and she can only run slowly—she had to walk during 90 percent of her last Ironman—but she is proud to cross the finish line at all and is redefining what it means to be an athlete.

Kelly Alexander, 39, credits a large part of her recovery to her medical team at Yale and the support of her husband, but it is clear that her exceptional resiliency and spirit have spurred her achievements. She spoke with Yale Medicine this summer about how she has managed to thrive despite unremitting pain and the limitations caused by her injuries.

The trauma you suffered would be life-crippling in a different person. Why do you think this hasn’t been the case with you?

None of these injuries have made me lie on the couch because there’s no room for that in my life. Too many people worked too hard, too many people gave their blood, gave their time, gave their energy, gave their prayers. For me, giving up was never an option.

Since you were injured, you’ve dedicated yourself to physical activity and social activism. What made you choose this route?

I was an athlete and activist before, so I’m not going to let the poor choice of someone that blew a stop sign ruin my life. Certainly I’ll never be the athlete that I could have been, or the mother, or the wife, but I am who I am now, and I’m so grateful for this life and I’m grateful for this opportunity. If anything it fuels me even more because I want to be able to get out there and move and be active and show people that anything is possible.

How important was your previous athletic training to your physical and psychological recovery?

Being an athlete prior to being run over has been a blessing and a curse. For a very long time I wasn’t able to leave bed. The athlete in me was always screaming to get back out there to run and to bike and do all these things that I love. Suddenly all of that was taken away. My dad said to me that when athletes are injured it’s a bigger curse than if you’re not an athlete, because all you know is that active lifestyle and suddenly it’s taken away from you and it’s such a huge loss. But what it did provide me with was a strong beating heart. So being an athlete has allowed me to sit here today and be shining, which is really nice.

How chronic is your pain? How do you compete and function while in pain?

I am in pain, but I’m not going to let it completely define me. I’ve had pain way past a 10. I typically hover around a six. Sometimes I spike up, sometimes I go down to a two or three. I made a decision early on that I wasn’t going to take heavy drugs more than I needed to because I knew there was a chance of addiction and I didn’t want that to be an option. If I wasn’t in weekly psychotherapy I would have a much tougher time handling my pain.

You’ve had the opportunity to meet some famous and wise people, such as Jody Williams, who won the Nobel Peace Prize in 1997 for her efforts to ban land mines. Did they shape your philosophy?

Jody Williams was my kick in the pants. I met her years ago, prior to the trauma. Her words, “emotion without action is irrelevant,” were very much a mantra for me prior to this trauma. After the almost seven weeks at Yale–New Haven Hospital and close to three months at Gaylord Hospital, I finally developed depression and anger and frustration, and I remembered those words. And I thought, if I’m this angry and in this much pain, I can harness this and do something with it. That began a change in my outlook.

You’ve said that during triathlons you need to pull over and cry at least once. Why and what makes you keep going?

I’ve got this hidden battle inside. As my heartbeat picks up and my breathing picks up, it brings me back to the trauma. So that fear that I have starts to take over—and it does take over—when I pull over to the side of the road, that’s when I offer up gratitude that I’m on this earth.

Watch an interview with Colleen Kelly Alexander here.