LOS ANGELES – Only 2½ miles to go.

James L. Smith had run every previous Los Angeles Marathon, but as he closed in on finishing his 26th consecutive one Sunday, a feat accomplished by only about 230 runners, he just wanted this one to end.

Strong winds, heavy rain and cold temperatures had made for miserable conditions – the worst he’s seen at the race.

“It was the first time I’ve ever felt hypothermic during a run,” says Smith, 74, a retired Orange County judge who has completed some 100 marathons.

Fighting to keep from freezing, Smith jammed his hands into the pockets of a fleece jacket under a poncho as he and three running companions passed mile 23.

They were halfway to mile 24 of the 26.2-mile race when Smith tripped on a discarded rubber shoe insole and, unable to break his fall with his hands, slammed onto the asphalt head first.

“I was defenseless,” Smith says.

Suddenly, the cold, wet weather wasn’t his main concern. Blood was gushing from a gash on the right side of his head near his eyebrow, and splattering onto his bright-yellow poncho,

“It was a bloody mess,” says Kristin Smith, who was running with her father.

She knew that if he could hang on for only a couple more miles, he would remain in the select group of “Legacy Runners” who have completed the Los Angeles Marathon every year since 1986.

Smith had only one message for his daughter and two other running friends:

“I’m gonna finish this.”

***

If Smith knew, at the time, how potentially serious of an injury he had, he says his response would have been different.

“I would have stopped,” he says.

Blisters, cramps, sprains – all are common reasons why runners pull out of races.

He didn’t know it, but Smith had a much bigger problem than a nasty gash on his head.

His daughter kept pressure on the wound as Ron Cooke, his longtime running buddy, and Jim Graves, his nephew, moved him to the side of a road.

A stranger held up an umbrella for them.

Smith was conscious, and says he never felt lightheaded. He also says he couldn’t feel much pain – the cold weather undoubtedly helping.

EMTs soon arrived and recommended that an ambulance whisk Smith to the hospital.

He refused.

“As long as I was conscious,” Smith says, “I was going to finish.”

They put a bandage on his wound and circled his skull several times with medical tape.

Still, Smith’s companions urged him to stop. He wouldn’t hear of it.

“Rationality had nothing to do with it,” Smith says. “But they understood my decision.”

After about 20 minutes of tending to his injury, Smith and his companions got up and continued running.

He crossed the finish line in 7:30:14 – his Legacy Runner status intact.

***

There was no time to celebrate.

UCLA Health System medical workers, tending to runners with hypothermia and other ailments, recommended that Smith take an ambulance to a nearby hospital.

A car was faster, so a relative drove him to Santa Monica UCLA Medical Center and Orthopedic Hospital’s emergency department.

After stitching him up, doctors ordered a CT scan.

The scan revealed that Smith had an acute subdural hematoma – blood inside his skull.

The injury is potentially fatal.

Smith was rushed to the Ronald Reagan UCLA Medical Center.

Bleeding on the brain can cause it to swell and lead to all sorts of problems – up to and including coma and death, said Dr. Yince Loh, the attending neurocritical care physician when Smith was brought into the intensive care unit at Ronald Reagan UCLA Medical Center .

“They’re very precarious (injuries),” said Loh, an assistant professor of neurosurgery and radiology. “He faced critical danger.”

Smith takes an aspirin a day, which led to concern that his thinned blood would not clot properly.

By Wednesday, however, two more CT scans had revealed that the bleeding had “stabilized out,” and that Smith was out of danger, Loh said.

Age likely helped him, according to Loh. The brain gets smaller as one gets older, creating more room in the cranial vault and giving such injuries a better chance of healing.

The outcome could have been much different, Loh said.

“He’s a very lucky guy,” said Loh.

***

Smith’s wife, Judy, stayed with him bedside after the fall.

She was not at the marathon. Text alerts kept her updated throughout the day.

She says she’s not surprised her husband finished the race.

“That’s just the way he is.”

Smith took up running soon after becoming a judge in 1971. Since retiring from the bench in 1997, he’s been working as a mediator and arbitrator. He and his wife are longtime residents of Orange.

On Wednesday afternoon, Smith was discharged from Ronald Reagan UCLA Medical Center – on his 74th birthday.

Before he was discharged, doctors and nurses sang “Happy Birthday” and gave him a cake.

***

Smith says he plans to resume running next week on the Santa Ana River Trail. He logs up to 50 miles a week there.

Looking back at his fall, Smith says he has no doubt he made the right call to continue running – especially given how things turned out.

“If I would have dropped dead 100 yards from the finish,” Smith says, “people would have said, ‘Well, he made the wrong call on that one.'”

Loh, his doctor, admires Smith’s drive, but says he would have advised him to stop.

“Mr. Smith is a perfect example of perseverance and how someone can accomplish anything when he sets his mind to the task,” Loh said.

“As a general rule, though, he should probably have been evaluated by a doctor immediately after his fall.

“In this case, the story thankfully turned out to have a happy ending.”

Contact the writer: 714-704-3764 or ghardesty@ocregister.com