May 24, 2024, started akin to any beautiful spring day. Kelly Metzger waited in a Manson, Iowa, park after a doctor’s visit while a pharmacist filled her prescription.
“A police car drove by with its sirens going,” says Kelly, a public health nurse who also helps her husband, Jeff, and sons, Joel and Justin, on their Palmer, Iowa, farm. “I wondered, ‘Could that be my kid? And then I’m like, ‘Oh, no, it couldn’t be.’ So, I headed over to the pharmacy, and that’s when Jeff called.”
The news was stunning. Justin had been in an accident and was in an ambulance headed for Trinity Regional Medical Center in Fort Dodge, Iowa.
Kelly experienced “pure terror,” she says: “I wondered, ‘Is my son going to die?’ I had no idea, you know?”
‘Don’t call them just yet’
Meanwhile, Justin was fighting the gnarliest battle of his 16 years.
“My buddy Dane and I rode our dirt bikes into school for the last day,” Justin recalls. “As we were riding out of town after school, there was a corner that I went around in fifth gear, doing a wheelie, trying to show off. I hit a patch of rocks, lost control and flew 89 feet through the air before landing.”
Justin blacked out, but he soon fluttered back into consciousness.
“I tried to get up, but realized I couldn’t,” he says. “Dane was going to call my parents, but I said, ‘Don’t call them just yet. Just call 911 and wait to tell them until after I'm in the ambulance. I didn’t want them to stress out until I was safe.”
After Jeff called, he picked up Kelly and quickly raced to the hospital to meet Justin.
“It was scary — a really weird feeling,” Jeff recalls. “We were with him [in the emergency room] until they loaded him on the Life Flight [helicopter] to Des Moines. It’s hard, seeing a Life Flight take off when you know it’s your son.”
‘Will my son walk again?’
Justin was rushed into a five-hour surgery that lasted until 1 a.m. at Blank Children’s Hospital.
The next morning, he woke up with numb feet. Still, he could feel everything down to his ankles, and he even was able to bend his knees a few inches.
The next day, though, Justin felt nothing below his knees.
“On the third day, I could feel nothing below my mid-rib line,” he says. “I couldn't feel when I was hungry and couldn't feel when I was full.”
Doctors told the Metzgers that the accident had partially severed Justin’s spinal cord at the L1 vertebra, the uppermost section of the lumbar spinal column. He also suffered compression fractures in six other vertebrae, a concussion, a punctured lung, broken ribs, a fractured nose and a swollen tongue that made breathing difficult.
Jeff and Kelly simultaneously felt heartache and horror about Justin’s condition.
“The first few days, he was in very, very bad pain,” Kelly says. “Some of the pain meds took the pain away quickly but had really bad side effects, so we didn’t do those.”
Then, Kelly asked the doctor the dreaded question: Will my son walk again?
“He answered, ‘I don’t know,’” she says.
Meanwhile, Justin experienced myriad emotions, particularly at night.
“It was an absolute nightmare,” he says. “I would just think and think and think, and I couldn’t fall asleep. I was really worried about how life was going to go on and how everything would work out.”
In several days, doctors rendered the diagnosis: Justin would not walk again. He left the hospital after 17 days for Madonna Rehabilitation Hospitals in Omaha, Neb.
‘OK, here we go’
Things started looking up for Justin when he met Madonna’s rehabilitation therapists.
“We start by chatting with [patients], finding out what’s important to them and what their goals are,” says Bailey Leversee, a pediatric physical therapist at Madonna. “We won’t say to a patient they’ll get back to walking if it’s not realistic, but we do tailor therapy according to their diagnosis.”
Madonna therapists also incorporate patients’ hobbies, interests and career goals into a rehabilitation plan.
“Typically, my first question is, ‘What do you want to get back to doing?’” says Jessie Franks, a recreation therapist at Madonna.
For Justin, the answer was easy. Like five Metzger generations before him, farming is in his blood.
“I've always wanted to be a farmer, just as long as I can remember,” he says.
So, Madonna therapists aimed to get him in shape to do just that. They first concentrated on strengthening Justin’s core muscles.
“I had lost all ab control,” Justin says. “I had to relearn how to sit normally again.”
He used a tool called a slide board that enabled him to transfer between surfaces, such as between a bed and chair. This led to strategies Justin uses today to transfer from his wheelchair into his pickup.
He started lifting weights to strengthen his shoulders.
“Shoulders substitute for legs in everyday tasks, so it’s important to strengthen them beyond what is normal,” Leversee says. “We taught him efficient propulsion techniques with his wheelchair in order to reduce the chances of a shoulder injury.”
It was grueling. Justin spent up to six hours doing physical, occupational, speech and recreational therapy each day during the week. Weekends consisted of 1.5-hour workouts.
“He was such a hard worker,” Leversee says. “Sometimes, I asked him to do crazy tasks, and he would just look at me like, ‘OK, here we go.’ We had a lot of good laughs, even though at the time it was very hard for him.”
‘Nerve-wracking’
Part of readying Justin for his return to the farm involved finding the correct wheelchair with the proper backrest and cushioning.
To prepare for driving vehicles, Justin used a driving simulator with hand controls for braking and other tasks. The simulator prepped him for night driving and navigating obstacles — such as deer — that he would face once he returned home.
Then, he drove a vehicle for real with hand controls in Omaha.
“It was nerve-wracking,” he says. “We don’t have nearly the people driving here as in Omaha.”
Still, he persevered, as he did on outings to test his wheelchair mobility.
“Clearly, a farm isn’t as accessible [in a wheelchair] as in town,” Franks says. “So, we worked through some of those things as much as we could at the hospital and in the community. We went up and down curbs and went across bumps and cracks in sidewalks. It was good insight to see what we needed to work on and what life would look like once he got out of these walls.”
‘A leader’
A spinal cord injury can affect emotional and mental health. That’s why part of the healing process involves meeting peers who have similar injuries. Therapists matched Justin with Will Meyer, a Palmer, Neb., farmer who injured his spinal cord in a 2015 vehicle accident.
“I told him there are certain things that you won’t be able to do, but you can figure out a way to do most everything else,” Meyer says. Meyer also demonstrated a lift for Justin that he uses to enter farm equipment.
Justin also met Thomas Joy, who owns Para Polishing, a firm that polishes semis and restores car and pickup wheels in Cushing, Iowa. Joy became paralyzed after a vehicle accident in January 2016.
“He showed me a lift that enables him to polish trailers higher than he had been able to,” Justin says. “He also gave me ideas about things I can do with my wheelchair to make it better.”
Madonna therapists pulled Justin into patient peer groups. “He ended up being a leader on the unit and really connected with the other kids,” Franks says.
Family support is crucial in rehabilitation, Franks says. Kelly spent almost every day with Justin, and Jeff and Joel regularly visited him on weekends.
‘It made me feel really good’
Back home, Jeff and Joel also kept busy farming and retrofitting their house to make it accessible for Justin.
“Our house is a century farm home,” Kelly says. “As with old houses, all the doorways are super narrow, and bathrooms are really tiny. So, we had to go in and widen all the doorways and put ramps in.” They moved Justin’s bedroom from upstairs into a remodeled downstairs room that formerly served as an office.
On Aug. 7, the big day came: Justin returned home with his buddy Dane.
“Leaving rehab was bittersweet,” Justin says. “I really liked everyone there, and I really enjoyed it, but I was excited to get home. Once I got home and saw all my friends and everyone, it made me feel really good.”
At school, Justin has made some adjustments, such as altering class schedules to allow for more time to go to classes. “Other than that, not a whole lot [has] changed,” he says.
‘He’s still here’
A shattered helmet that Justin wore during his accident — which saved his life — is a reminder of that awful day in May 2024. Ditto for the permanent screws and rod in Justin’s back. He can’t feel or taste on one part of his tongue. Months later, his ribs still hurt.
“Every so often, it gets hard thinking that I am never going to walk again,” he says. “I will fall down and get really mad and say I’m done with this, I’m going to quit. But I just can’t lay on the floor forever.
“Every time I flip over my scooter, I will call Joel and ask if he can put me back,” Justin says. “He will put me on his shoulder, throw me in the seat, and tell me to go to it.
“And I do.”
Last fall, the Metzgers used a lift to load Justin in a combine to open some soybean fields. This spring, he did tillage work.
“When I first got in the cab, it was an emotional time,” Justin says. “I’d been thinking about doing it for a while. When I finally got in, it was awesome.”
After high school graduation, he plans to study agricultural business or agronomy. He’d also like to work on a wheat harvest run that starts in Texas/Oklahoma and moves northward.
“Eventually, though, I want to plan my future around the farm here in Iowa,” he says.
Through it all, Kelly says, the family has learned the importance of sticking together and supporting each other. “We want the best for Justin and want him to do what he wants to do,” she says.
“He’s still here,” she adds. “That’s all that matters.”