BOSTON -- He made the decision from a hospital bed: Someday, he would compete in the Boston Marathon.
Jason Fowler got his first motorcycle when he was just 6 years old. At 11, the Brockton, Mass., native got his first major sponsorship (for Kawasaki). At 17, he was already an eight-time New England motocross champion, looking like a future star.
Then he hit a rock while practicing and was thrown from his bike, suffering a severed spinal cord. The accident left him paralyzed from the chest down.
That was on March 13, 1991. When Boston rolled around on April 15 that year, Fowler was watching from the hospital and what he saw inspired him.
"I was like, 'Wow, guys in chairs are doing that?'" he said Monday, outside the VIP recovery tent. "I saw my childhood hero, David Bailey, on TV that year and I was like 'I'm gonna do that race someday.' So right away, I had it in my head that that was a possibility."
In the immediate aftermath of the accident, Fowler didn't know what to do with himself. He and his family -- his parents Mike and Luanne, and younger siblings, Clinton and Beth -- had been away from home in Kingston, Mass., more than 40 weekends a year for motocross events.
"When all of a sudden it was taken away, it was like, 'What do you do on Sunday? What do people do on Sundays?'" he said. "So it was hard to find something to replace it."
It didn't take him long to find a way back into racing. Just a few months after the accident, a friend of a friend loaned Fowler his racing wheelchair, and off he went.
"That gave me something to focus on and get back to the things that I loved," Fowler said. "Even though it wasn't motocross, it still filled the void."
In 1993, two years after his accident, Fowler qualified for and competed in Boston for the first time. In 2013, he was back for his 12th race.
Hiroyuki Yamamoto, a 46-year-old from Japan making his Boston Marathon debut, won the men's wheelchair race with a time of 1:25:33. Tatyana McFadden, a 23-year-old from Clarksville, Md., won the women's wheelchair race with a time of 1:45:25.
Fowler, whose focus is on triathlons, finished in 36th place at 1:57:01.
"It's a different race for me," he said. "I'm not as competitive with this as I am with triathlons. It takes me 16-17 miles to warm up here. When people hear that they're like, 'What? What are you talking about?' For me, it's more about the experience. It's something special to do every year."
Fowler, who lives in Belmont, Mass., and works as a medical device consultant for Medtronic, said he enjoys the community around the Boston Marathon. And, of course, he loves competing in front of family and friends.
He saw his grandmother in Ashland, around the 6-mile marker. A friend was posted at Coolidge Corner. And his sister Beth was about a half mile from the finish line.
"The energy in the crowd is amazing," he said. "When people are screaming at you, it just goes through you. It's really electric."
Richard A. Nelson, 54, of Carver, Mass., competed in his third Boston Marathon on Monday in the handcycle division. Paralyzed in the '80s when he was electrocuted in an accident at work, Nelson works for the VA in Brockton.
Nelson said he used to play a lot of wheelchair basketball, but wanted a change and decided to give this a try.
"It felt pretty good," Nelson said of his race Monday. "It was a great day for it -- better than last year. The weather was good, the fans were crazy they get you pumped up."
While Nelson said the biggest reason he competes is staying in shape, for Fowler it's about more than that.
"One of the toughest things was going from being top in the country in my age group with motocross and then all of a sudden I'm last place -- way, way last place -- starting wheelchair racing," he said. "It basically allowed me to stop focusing on my disability and start focusing on what I could do, which was get out there and suffer like everybody else for that 5-miler or 10k and push myself, compete with everybody."
And, perhaps more importantly, it also allowed Fowler to spread a message he believes is important.
"I've been in wheelchair sports now for 21 years," he said. "And at first it was just wanting to win, and I still want to win. But at the same time I want to really savor the experience, what it has to offer.
"I'm grateful that I can do it, especially using a chair, and show the world that it doesn't matter that you're in a wheelchair -- you can still do whatever it is that you want to do."
Jack McCluskey is an editor for ESPN.com and a frequent contributor to ESPNBoston.com. Follow him on Twitter @jack_mccluskey.