The bases were loaded with no outs and the score was tied 4-4 in the bottom of the fourth inning when Victoria Vics manager Mike Poppitz went to the bullpen. It was mid-May on the road at Moorhead, and the Vics — one of Minnesota's premier amateur baseball teams — had high expectations. But the season opener was on the verge of slipping away.

Did Poppitz summon a veteran, accustomed to negotiating this minefield of a situation? Or perhaps a fireballing youngster who might be able to rack up a much-needed strikeout or two?

Neither. He went with a pitcher who hadn't stepped on a mound in nearly a year. Kasey Ralston, a former high school star and budding Division I prospect, had lain unconscious and seriously injured in a crumpled car 11 months earlier. If not for two nurses who witnessed the accident and rushed to the scene, he likely would have died.

If not for Ralston's determination to recover since that day, his baseball career was over.

"He didn't say much," Ralston remembered of his manager's advice. "Just 'Go get 'em, bud.' It was an awesome feeling."

Life hung in the balance

June 23, 2013, was a typical sun-soaked summer Sunday, the type where life's harsh realities seem far away.

Kasey Ralston, who was nearly killed in a car accident just over a year ago, made a miraculous recovery and pitched this summer for the Victoria Vics.

Ralston was riding in a car driven by Dalton Sawyer, a teammate on the St. Cloud Rox in the Northwoods League, a top-end summer league for college players. Heading south on County Road 33 at the intersection with Hwy. 7 in rural Carver County, Sawyer pulled out in front of an eastbound truck, authorities said.

The truck, traveling at what Ralston said was the posted speed limit of 55 miles per hour, plowed into the passenger side of Sawyer's Silver Grand Am, where Ralston was sitting. Sawyer sustained bumps, bruises and a concussion. Ralston wasn't as lucky.

"My jaw was broken, my head was separated from my shoulders — the same injury that killed Dale Earnhardt — I broke all the ribs on my right side, had a collapsed lung, broke my pelvis in four places and had a lacerated bladder, liver and spleen," Ralston said. "I don't remember any of it."

Luckily for him, two nurses from the St. Cloud area, Sharon and Carol Johnson, were stopped at a gas station at that intersection. They saw the crash, immediately drove over and made a crucial decision to move his head that likely saved Ralston's life.

"I was unconscious, my chin was against my chest and I was gurgling blood," Ralston said. "They raised my chin up or I might have choked to death."

Ralston's seemingly charmed life was in disarray. Barely a year earlier, he pitched two shutouts in three state tournament games, leading Holy Family Catholic High School in Victoria to the Class 2A baseball championship. He had gone on to pitch for the University of Indiana, one of the top baseball programs in the Big Ten.

Now, he lay broken and unconscious, having needed to be mechanically extracted from the car. He required a tracheotomy just to breathe.

"We knew he was bleeding inside," said his father, Mike. "For about 10 hours, we couldn't see him. We didn't know if he would live or die."

With arm intact, the mound calls

Ralston awoke from a medically induced coma three days later to find himself in a hospital bed, a halo brace screwed into his head to keep him from moving his neck. It was uncomfortable and obtrusive and clumsy. And necessary, if Kasey was going to have a chance to get back his former life.

"We had to make the decision between the halo and possibly fusing the vertebrae in his neck," Mike Ralston said. "If we fused the vertebrae, he'd never play again. We took a chance with the halo. It sucked for Kasey, but it turned out to be the right choice."

If anything about the accident could be considered fortunate, it was that Ralston's right arm — the one used to throwing 90-mile-per-hour fastballs — was spared. It was the arm closest to the door when the collision occurred, but somehow nothing was broken, torn or damaged.

"I know," Ralston said. "Everything that happened and my arm came out fine. That's crazy."

It was two months before Ralston could walk, even longer before he could move without pain. But his arm was fine, his neck was healing. It was time to set a goal. The mound beckoned.

"I never had any doubt that he would come back," said Brandon Arnold, a longtime friend and teammate on the Vics. "At first, it was shocking to see him like that; it was the worst thing I'd ever seen. But knowing Kasey and how important baseball is to him, I knew he could do it."

Last spring, Ralston began taking a comeback seriously. He worked out, doing everything from simple catch with Arnold to training with former teammates and coaches. He volunteered to help out with the Holy Family baseball team, even finding time to get in a few cuts in the batting cages.

"I was lucky that I was in pretty good shape when the accident happened," he said. "The doctors said that's a big reason why I've been able to recover."

'Nothing better' than playing

Butterflies the size of barn owls swirled around Ralston's stomach that day in May when he got the call to pitch in relief for the Vics. Despite permanent nine-inch pins in each hip, he felt like his old self.

But he still had to prove it. To his team. To his family. Most of all, to himself.

It didn't take long. The pitcher's mound was always a place where he felt comfortable. That quickly became evident. Ralston struck out the first batter he faced.

"After I got that first out, I started thinking, 'All right, there it is,' " Ralston said.

He got out of the inning without giving up a run, thanks to a pair of strikeouts. Victoria went on to win the game, and Ralston resumed the life he had originally planned.

The Vics have had a successful summer. They are ranked No. 1 among Class B amateur baseball teams in Minnesota, thanks to a lineup packed with current and former college baseball stars. Ralston has been a key contributor, piling up 44⅓ innings on the mound with a 3.06 ERA, a 3-1 record, one save and a team-leading 48 strikeouts.

In the fall, he'll resume his college baseball career, pitching for the University of St. Thomas. It's an opportunity that, not that long ago, seemed improbable at best.

"I know how lucky I am," Ralston said. "The biggest thing for me is that I appreciate things so much more now. I don't worry about little things too much. If I get hit around, that's OK. At least I'm out playing baseball again. And there's nothing better than that."