After what he describes as a near-death situation, driver Mark MacDonald has his health in order and his sights squarely set on a return to competition back in his home country.

MacDonald, now 47, established himself as one of the top reinsmen in all of harness racing with back-to-back O'Brien Awards as Canada's Driver of the Year in 2005 and 2006. It certainly doesn't seem like 20 years ago that the Prince Edward Island native won 739 races in a single season to establish a new Canadian record, but a quick look at the calendar reveals exactly that.

Now, after a move stateside some 15 years ago, MacDonald told Trot Insider that he plans to return to Ontario and compete at Woodbine Mohawk Park.

And that return, according to the man himself, is imminent.

However, if that last line evokes sentiments of déjà vu all over again, it's understandable.

In November 2024, MacDonald indicated to Standardbred Canada that a return to racing in Canada wasn't out of the question for 2025. His quote, at that time, was as follows:

"I'm on the fence, but I am leaning towards maybe starting back at [Woodbine] Mohawk [Park]. I don't know what I could get but that's what I'm thinking right now. But first, I'm just trying to get healthy again."

That last sentence is, of course, the most crucial. And not even MacDonald — who has survived his share of serious accidents and roads to recovery — could have envisioned the obstacle-riddled path he would be forced to travel and conquer over the next year.

"It started the year before, to be honest with you," said MacDonald, referencing his 2024 accident. "I broke my back and a couple of ribs. It wasn't the end of the world. But it started things. They gave me this contrast, which is the dye they put in so you can see your back in an MRI. And I had a little bit of a reaction to the contrast. I had to have it one more time and they were watching my kidney function and my kidneys were okay. They did this is to clear me to go back to drive, because I wanted to make sure...I mean, we're talking spinal injuries. I had three broken transverse processes in my lumbar and a fracture that could have went right through my spinal cord. So they did the contrast again, and I did the MRI. And I was okay. But I just didn't feel great."

MacDonald returned to the racebike in April at Yonkers Raceway. Driving and competing, but not quite back to himself.

"So I get back to racing and I'm okay, but my kidneys are just not 100 per cent. And my blood pressure was elevated all the time. They wanted me to take this low dose of a blood pressure medication," said MacDonald, hoping to find a solution to his malaise at the time, while skeptical of the proposed solution.

Just two months after returning to competition, MacDonald went down in another accident at Yonkers on June 19. Not as severe as the October 2024 spill, but enough to keep MacDonald out of action for two weeks. The resilient reinsman resumed his regular regimen on July 3, competing through to the middle of October.

That's where the racelines end. Four months have elapsed. For MacDonald, it felt like an eternity.

"What happened was I broke my hand," said MacDonald, referencing the June 2025 spill. "And at the time, I didn't know, it just looked like I had a huge hematoma on my left hip. It all swelled up and turned purple. Two weeks later, they said I was okay to go back racing. The hematoma on my leg had come down. The hairline fracture in my hand had closed. My hand strength wasn't 100 per cent, but it wasn't awful. I broke that wrist really badly when I was a kid. It wasn't the end of the world. I just felt like though, when I came back,  I didn't have the hand strength in my right hand and — for whatever reason —my blood pressure wasn't right.

"So now we're rolling through the summer and I'm just not doing great. I don't feel great all the time. I'm not sleeping great. And my kidneys were bothering me a little. And this hematoma on my left leg comes back. You know, when a hematoma is gone, it's gone. All of a sudden this thing comes back. It blew up like it just happened. Like it never even went away."

With elevated blood pressure added to MacDonald's growing list of ailments, he returned for medical reexamination.

"They don't know. They think maybe the pain in my leg is probably from my back. They checked my kidneys and they wanted to do a nuclear dye test on me again. This is the third time now. And both times I didn't have a good reaction to it. They check my back. It's not my back. They figure it's just the hematoma in my leg.

"I come home. This is in September, before the New York Sire Stakes finals. And I just feel terrible. I'm just not good. I get through the finals, but I just had a terrible year. I was feeling okay but I wasn't sleeping good. And now I started where like, I'm in pain all the time. I have to pee all the time. In the nighttime, up 25 times to pee...I couldn't sleep, and my blood pressure was getting worse."

Worried that MacDonald might have a blood clot after seeing the hematoma back on his leg, medical practitioners suggested more testing and another round of the nuclear dye that his compromised body has yet to handle well.

"I had elevated creatinine and protein levels in my kidneys," noted MacDonald. High levels of creatinine can indicate that the kidneys are not filtering waste efficiently and functioning properly. His health care providers downplayed his concerns regarding the dye.

"I had the dye test, and they find that the [2025] accident I had at Yonkers, I had fractured my femur. So it wasn't that it was the hematoma had come back, I was walking around with a broken leg."

Relieved to have this part of his mystery solved, MacDonald returned home. But his overall health remained a serious concern. He went back to his doctor, who ordered a blood panel — a group of tests that assesses overall health. In October, those tests indicated that MacDonald's kidneys were in renal failure. In that case, his kidneys operated at around 15 per cent efficiency.

"He said I had a reaction to the dye that they had given me in the MRI, and he said they want me to come off blood pressure medication, everything, right away. The problem is that I had high blood pressure and the blood pressure medication was messing up my kidneys."

Confused, MacDonald and his wife, Alea, decided to head straight for the hospital, where Mark would stay for the next eight days. Those days, according to MacDonald, were nearly his last.

"They had to monitor me coming off the blood pressure medication and everything, and work with my kidneys...they wanted to set it up where maybe they could flush my kidneys with some dialysis. Once I came off the blood pressure medication, this was like the second day, I kind of just went dark on everybody. I didn't want to worry everybody, especially my mom or my dad or my brothers, but I told my wife — who was super supportive — if I don't get any better, you're going to have to call everybody.

"I was really scared. And I'll tell you, I'll be honest with you. I almost died two times. One was at Western Fair in that horrible accident in 2003. And last October."

MacDonald likened the feeling to drowning. Terrified, he felt as though he was being held underwater and couldn't breathe, unable to control his fate.

"I didn't want to die, but it was out of my hands...When your kidneys aren't working, and you have high blood pressure, and it's putting all the strain on your heart, you can just have a stroke and die."

Or, in the case of MacDonald, you can pick yourself up and dust yourself off like you've done before — and, quite possibly, better than anyone. He was back up and walking after his fifth day in the hospital. Three days after that, he was sent home with strict orders to rest and drink eight glasses of water per day — no more, no less. He also obtained a blood pressure monitor to watch those levels from home.

"I was just told to rest, and so I rested through December, and around the end of the month, I started feeling better, and I started feeling like myself," said MacDonald. "They pulled my blood, and, by the grace of God, my kidneys started working again perfectly, and the creatinine levels were gone, the potassium levels had equalized, and I wasn't in danger. And they said I could start exercising again."

Back exercising and training for the last five weeks, MacDonald sounds healthy, passionate, appreciative.

"I literally feel like I'm 25 years old again," said the man who's nearly twice that age. "I feel great, and it's exciting because I did think there was a chance...  I'm not talking about racing. Let's just say death was on the table there. It was very scary and I'm very grateful for my wife. She was so supportive. We have a six-year-old daughter (Kiara), and we're down there all by ourselves. With no support. And we lean on each other a lot."

That return to racing in Ontario mentioned by MacDonald in 2024 that was originally in the mix for 2025? It's now back on the agenda for 2026.

"I wanted to come home last year. I had said to you, remember?" asked MacDonald. Suffice it to say, many people remember. The news article with that tidbit was one of the most viewed stories on the Standardbred Canada website that year.

"I'm so excited to go home. I love racing at Mohawk. It's where all my family is. I've won most of the big races in Canada. I've been very fortunate, you know, but I haven't been there in a while. But racing here last year, I spent the whole summer either driving in my car or in the freaking emergency room."

When MacDonald left Canada to race in the U.S., that shift stateside was the right move for him at that time. Now, his heart is telling him to come home.

"The racing at Mohawk is the best racing in the world. And I would love to be part of it again. I almost feel like someone breathed a little life into me again.

"To have this — to be able to be talking, and my body's healed and to feel good mentally and physically, and to be able to have another chance to go back home and race, I'm super excited about it. I am."

MacDonald's excitement quickly meets an understanding: the importance of opportunity. The last nine winners of Canada's Driver of The Year — James MacDonald, Bob McClure, Doug McNair and Louis-Philippe Roy — compete regularly at Woodbine Mohawk Park. The depth of talent is apparent to MacDonald, whose own résumé boasts 6,743 lifetime victories and more than $116 million in purse earnings.

"I'm just going to show up and hopefully it works out. It's competitive. It's just like anywhere. Super competitive. But I feel like if I'm 100 per cent and I show up, I'll make it even more competitive.

"I feel like I haven't worked in like a year and a half. So I'm going to work my ass off."

According to MacDonald, that return to Ontario could come as soon as the end of February.

"I think I should be ready towards the end of the month."

(Standardbred Canada)