Football takes a backseat to real life

The usually jovial world of sports came to a screeching halt last night, interrupted by a life-and-death issue when Buffalo Bills safety Damar Hamlin suffered cardiac arrest and collapsed on the field during a game against the Bengals in Cincinnati. As of this writing, Hamlin is “sedated and listed in critical condition” — leaving the entire league shaken and wondering how best to keep players safe while maintaining the sport’s popularity.

Some Things in Life Are Bigger Than Football

You could see in the other players’ eyes that this was not just another injury and that something was terribly wrong. Grown men, selected and renowned for their toughness and endurance, were in tears, shaken, as if they had just witnessed a car accident.

Last night’s Monday Night Football game between the Buffalo Bills and Cincinnati Bengals never ended, as Bills safety Damar Hamlin suffered from cardiac arrest during the first quarter, and the outcome of a football game simply isn’t that important when a young man’s life is hanging in the balance. In a sight rarely, if ever, seen on an NFL field, medical personnel administered CPR to Hamlin before he was removed from the field in an ambulance and taken away to the University of Cincinnati Medical Center.

At 1:48 a.m., the team issued a statement declaring that Hamlin’s “heartbeat was restored on the field and he was transferred to the UC Medical Center for further testing and treatment. He is currently sedated and listed in critical condition.”

Football fans, as well as players and coaches, are used to seeing players get injured — “Football is a violent game,” goes the mantra. Fans know that when a helmet hits another helmet, there’s a risk of a concussion. When one player rolls up on the back of another player’s leg, and the momentum of the collision clashes with the planted foot, ligaments and tendons are likely to tear. Non-contact injuries are surprisingly common, as heavy, strong, fast football players suddenly stop, and the knee’s anterior cruciate ligament and medial collateral ligament suddenly tear with an unpleasant popping sound. Just about every football fan has heard those dreaded acronyms — ACL, MCL — and known that a player is out for the year with a long road to recovery ahead.

But the injury to Hamlin didn’t seem like anything familiar. The irony is that the hit didn’t seem out of the ordinary and there was nothing dirty or worthy of a penalty on the play. Bengals wide receiver Tee Higgins had made a catch, and Hamlin tackled him. Higgins led with his shoulder and hit Hamlin in the chest — a hard hit, but nothing unusual in the context of a football game. Hamlin quickly got up after the tackle and was on his feet for about three seconds — and then after wobbling for a moment, suddenly fell backward to the ground, seeming to surprise the players around him — such as the Bengals’ Joe Mixon.

And then the world of sports, which had looked forward to a high-stakes matchup between two playoff teams with two of the game’s most skilled quarterbacks, suddenly had to readjust its priorities. Who won the game didn’t really matter — in the end, it’s just a game.

Everyone told each other not to speculate, but people want answers when something shocking and frightening happens, and those with some experience in cardiology pointed to a phenomenon called Commotio Cordis.

Commotio Cordis refers to the sudden arrhythmic death caused by a low/mild chest wall impact. Commotio Cordis is seen mostly in athletes between the ages of 8 and 18 who are partaking in sports with projectiles such as baseballs, hockey pucks, or lacrosse balls. These projectiles can strike the athletes in the middle of the chest with a low impact but enough to cause the heart to enter an arrhythmia. Martial arts is a sport in which a strike of a hand can also cause the heart to change its rhythm. Without immediate CPR and defibrillation, the prognosis of commotio cordis is not very good. This condition is extremely dangerous with rare survival.

That assessment comes from the University of Connecticut’s Korey Stringer Institute, which has its own tragic tie to the NFL; in August 2001, Korey Stringer, a Minnesota Vikings offensive lineman, passed away from exertional heat stroke.

An NIH report notes that Commotio Cordis is likely to occur when the impact arrives at a particular moment in the heart rhythm.

The contact occurs during ventricular repolarization, specifically during the upstroke of the T-wave before its peak. If the impact occurs later than this, it is more likely to result in a transient complete heart block, left bundle branch block, or ST-segment elevation. While this period occupies only about 1 percent of the cardiac cycle, the relative proportion is increased with increasing heart rate, as may occur during exercise.

As noted above, Commotio Cordis is rare in general, and even rarer in grown men.

Damar Hamlin is a 24-year-old professional athlete and at the pinnacle of human health by the measures we can see. If Hamlin’s cardiac arrest was indeed Commotio Cordis, it is just the extraordinarily unfortunate circumstance of Higgins’s shoulder hitting Hamlin in just the right spot while Hamlin’s heart was in that particularly vulnerable part of the heartbeat cycle.

The Monday Night Football broadcast crew on ESPN adjusted fairly well in difficult circumstances. The horrific injury threw Joe Buck, Troy Aikman, Suzy Kolber, Adam Schefter, Booger McFarland — and then Ryan Clark and Scott Van Pelt — into one of the toughest tasks in broadcast journalism: live coverage of a breaking news story where details were scant. Everyone was tuning in, looking for answers, hungering for some sign of hope or assurance that things will turn out okay. But the hospital and team weren’t giving updates, and the broadcast team could tell the game would not resume long before the official word came from the league.

To hear the NFL tell it, Commissioner Roger Goodell and the league never expected the teams to retake the field and continue the game after Hamlin was taken to the hospital. But there was a widely reported rumor last night that the league expected the teams to get back on the field and continue the game after a five-minute warmup period. The rumor spurred more than a little social-media rage that the league could be so callous to expect players to go out and play a game, just minutes after watching their teammate and friend receive CPR for ten minutes, not knowing if he would live or die. (It is worth noting that, as of this writing, while Hamlin is in a level-one trauma center and getting the best care available, he is not out of the woods.)

Considering how bad it looks, Goodell will likely insist until the day he dies that he never expected the teams to retake the field, and the hour-long delay in suspending the game for the night was just routine procedure. But many fans will never believe him. The NFL is near the apex of American wealth, fame, and power, and it is in the entertainment business, and that can warp a man’s judgment.

There’s a darkly funny line in the movie Concussion, where one doctor tries to explain to his colleague the cultural power of the NFL, calling it “a corporation that has 20 million people on a weekly basis craving their product the same way they crave food. The NFL owns a day of the week, the same day the Church used to own. Now it’s theirs. They’re very big.”

A few folks have wondered if, once Hamlin’s condition has stabilized and we know he’ll be okay, the game can be continued or replayed, and if so, how. There is just one more week in the regular season, and both the Bills and Bengals have already qualified for the playoffs. In the early morning hours, the Bills players and staff returned to Buffalo; they’re going to need, at minimum, a couple of days before they can refocus on football. The playoffs are scheduled to start on Saturday, January 14. Right now, it seems likely that 30 of the NFL’s 32 teams will play a 17-game schedule, and the Bills and Bengals will play only 16 games, and that awkward imbalance will have to do. Put an asterisk in the record books, and chalk it up to extraordinary and unavoidable circumstances.

Last night also brought a lot of the idiotic usual suspects out of the woodwork to contend that Hamlin’s collapse had nothing to do with the impact to the chest he had suffered moments earlier and was some sort of delayed — I guess really delayed — serious reaction to the Covid-19 vaccine.

At some point, those who speculate that every health problem of every celebrity or public figure is a reaction to a Covid vaccine whose supposed dangers the whole wide world is covering up will become akin to those who attribute all world events to aliens or lizard people. As the saying goes, you can’t reason a man out of a position he didn’t reason himself into. These people will use words such as “medical evidence,” but they’re clearly not interested in that. They choose to live in an alternate world of dark conspiracies, shadowy secrets, brainwashed “sheeple,” and themselves: the bold, rebellious heroes of their own narrative. It is a faith-based argument meant for a faith-based audience.

Speaking of faith-based, I can’t help but notice that modern America is a secular society, with more than a little sneering and eye-rolling at organized religion.

And then something like this happens, and the word “pray” comes out of so many mouths.

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