"Nine," I responded when asked by the sports medicine nurse to "rate the pain in my left knee on a 1 to 10 scale." This was not good. I was sent to have my knees x-rayed and soon met with my sports medicine M.D.

"If you were any other patient" he began, "I would tell you that you will never run another step. But I know you, so maybe we can figure out something."

Flashback to mid-April 2012. I'm sitting in a hotel room in Marion, Illinois, the night before my team runs the River To River Relay for the 20th time. My cell phone rings (an unusual occurrence given that I only turn it on once every three weeks). It is my oldest son Noah who says he needs an immediate answer to a question. I don't have to say yes, he tells me, but he needs an answer right now. "OK, what?" I ask.

Noah tells me that he wrote a letter to the New York Road Runners. His letter outlined how I have run for years, how my son was influenced to run as a child and ran throughout high school, four years at Dartmouth College and to this day. He also tells the running club of how I wanted, 35 years ago, to run the New York City Marathon with my dad. It never happened. While I gained entry to the marathon via lottery, my dad did not.

Despite having run marathons all over the country, I have never run New York. Noah thought that in honor of my 60th birthday, it would be a great thing if he could run his first marathon as I ran my last there in the Big Apple.

Noah said he somewhat amazed that the good folks leading the New York Road Runners and organizing the ING New York City Marathon actually read the letter and agreed to let us in, lottery or not. He needed to know immediately if I'd do it because we still had to enter, and the deadline loomed. My younger son, upon learning all this, said he was in as well. All three of us could line up and run New York together.

I have not run a marathon in eight years. I told Noah that I had absolutely no interest in ever running another marathon. However, I would do this in a heartbeat.

My lack of marathon distance training, coupled with winters spent cross-country skiing (or rollerskiing last winter) has allowed me to run mostly injury free. I have generally run about 50 miles per week with long runs of no more that 17 miles. Clearly I would need to be careful about any increase in volume as I prepared for what was going to be a memorable Sunday in New York.

Knee, don't fail me now
I know exactly what time it happened on September 1, 2012. I just don't know what caused it.

After a summer filled with two hour and 30 minute long runs of 19 to 20 miles, I felt I was ready to run the marathon at a reasonable speed and without any long-term effects. However, the day before my younger son's wedding, while on an easy six-mile run with Noah on the trails around the Dartmouth College campus, I went from being able to easily run 20 or more miles to not being able to walk. The difference came in the space of 50 meters. Something under my left knee was beyond excruciating.

Back in the doctor's office I looked at the x-rays. "It's just gone", said the doc. "There is no space between your patella and the underlying bone." That space would normally have some cartilage to cushion the knee. Neither of my knees has anything left. One feels pretty good most of the time. The other, not good at all. My knees have probably been this way for years.

We discussed some treatment options and I was left to ponder my circumstances. The diagnosis that I may "never run another step" kept ringing in my ears.

In the big picture, my not being able to run anymore is not even a blip on the radar. It's not fatal. It doesn't affect my family. It doesn't mean that I have to give up skiing or my other activities. The pain and suffering that some people must endure makes my situation look trivial.

But for the past 45 years and some 90,000 miles, I have been a runner. I was a runner before it was cool. I was a runner before Nike existed. Heck, I was a runner before you could buy much of anything that resembled a running shoe. Running was part of what fueled my interest in pursuing a degree in exercise physiology. Running is what I coach. Runners are many of my best friends. I have run in every place I have ever visited. Never run another step? This was something that was not going to be easy to process.

Like father, like son
What would you do if so large a part of who you were was taken away? People are faced with this question in much more serious situations than mine. My previous experiences with this question mostly revolved around deaths of loved ones. My dad, with whom I had planned to run New York, was killed on his bicycle by an inattentive driver. I thought about this as I drove home from the doctor's office.

You see, part of the reason my dad became such an avid cyclist is that when he was about my age, the damage to his hips had gotten so painful, he was told never to run again. How's that for juxtaposition? When my dad was told to stop running he stopped and found another outlet. I was long since out of my parents' home so I don't know if he complained or not. He would often tell me that while cycling was great, it never completely took the place of his daily runs.

I also thought about how my dad approached most decisions. He would gather as much information as he could, weigh the options and proceed in what he felt was the most logical direction. Not everyone would agree with his logic, but his decisions were rarely knee-jerk reactions (no pun intended). My dad stopped running because he had to. He tried some treatment options but eventually decided that the long-term risk of was too great to continue running.

I spent a week thinking about my doctor's words. I spoke to people who had either undergone different treatments for this condition or had friends/family members who had. I also thought about what running the New York City Marathon with my sons would mean for all three of us.

Most of my friends would probably say that I am not someone who gives in easily. I enjoy challenges and will often take them on. So after a week I decided that I was not going to cave in quietly. I got over my needle phobia and opted to try a fluid injection to help cushion my knee. It wasn't cortisone for the pain. But it might help. It might not. Either way, I'm not ready to throw in the towel. In the week since the treatment, I went from barely being able to hobble a short distance at a 12-minute-per-mile pace to actually running 12 miles at an 8 minute pace. Will I continue to improve? Will I attempt to run the marathon on November 4? As I write this, the answers to those questions remain to play out.

However, I owe it myself, to my dad, to my sons to see what I can do. Give up? My dad wouldn't do it. My sons wouldn't do it. And I sure as shootin' am not going to do it. Give up? That's the easy way out. I may take a way out, but it certainly will not be without a fight.

So get out and go for a run! You never know what's around the next corner.

Tom Kaufman, of Madison, Wisconsin, has run more than 40 marathons in as many years of running. He teaches high school phys ed and coaches high school track and cross country, as well as community and masters athletes. He has a master's degree in physical education and a specialization in exercise physiology.