Damar Hamlin had a simple question when he woke up Wednesday night in the intensive care unit at University of Cincinnati Medical Center, two days after he collapsed in cardiac arrest during the Buffalo Bills-Cincinnati Bengals football game Monday night.
“You won,” a trauma team member told him. “You’ve won the game of life.”
The Buffalo Bills safety, weary and heavily medicated, had to ask the question in writing because he still needed support from the breathing tube in his throat.
NFL Nation and its legion of fans could finally take a breath Thursday afternoon, when a pair of doctors who helped save his life shared the most significant details yet about his injury, efforts to save him and where they cautiously hope things will go from here for the Pittsburgh native drafted in 2021 by this season’s playoff-bound Buffalo Bills.
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National Football League Commissioner Roger Goodell canceled the game after Hamlin, 24, fell into cardiac arrest following a tackle late in the first quarter of the highly anticipated “Monday Night Football” game, at Paycor Stadium in Cincinnati.
He remained in the surgical and trauma ICU on Thursday, but has made “substantial improvement in his condition over the past 24 hours,” said Dr. Timothy Pritts, chief of general surgery and vice chair for clinical operations at UC Health.
Pritts and Dr. William Knight IV, professor in the Department of Emergency Medicine at the University of Cincinnati College of Medicine and director of the hospital’s emergency medicine program, described Hamlin as alert and aware. They said he remained on a breathing tube and has communicated in writing since he regained consciousness.
“This marks a good turning point in his ongoing care,” said Pritts, also a professor in the Department of Surgery at the University of Cincinnati medical school.
Hamlin has been able to follow commands since he emerged from efforts to cool his body after he was revived from cardiac arrest and taken to UC Medical Center, about five miles from Paycor Stadium.
He “expressed surprise that he had … not been with the world for two days,” Pritts said.
The doctor said they were pleased with neurological and vascular tests conducted on the Bills safety since the tragedy began.
It appears “all cylinders are firing within his brain,” Pritts said.
Still, the doctors said, Hamlin has significant progress to make.
“It’s been a long and difficult road for the last three days…, Knight said Thursday afternoon.
Hamlin went into cardiac arrest at 8:55 pm Monday as he tackled Bengals receiver Tee Higgins from the front, right side. The angle brought Higgins’ helmet into direct contact with the left side of Hamlin’s chest as the two fell to the ground. Hamlin stood for a second before his knees buckled. He fell backward, landing on his back and the back of his own helmet.
Staff trainers and doctors with both the Bills and Bengals – including four who also work at UC Medical Center – sprang into action with a well-designed protocol.
Dr. Tom White, the Bills’ team internist, started CPR. An automated external defibrillator (AED) was used to readjust his heart rhythm on the field, which likely was knocked off its electrical track during the hit.
Bills teammates, many in tears and in prayer, shielded the rescue efforts from view, with Bengals players and staff following suit in the moments to come.
The on-field medical team was in communication with Pritts and the hospital trauma team before Hamlin was taken by ambulance at 9:25 pm
Both doctors lauded the quick care Hamlin received on the field and on the way to the hospital Monday night. They said Hamlin received one round of CPR and was administered one round of defibrillation on the Paycor Stadium field after he collapsed Monday night.
“That allowed for a very immediate resuscitation on the field,” Knight said of the Bills medical staff, which quickly recognized the impact of what they witnessed.
“We cannot credit their team enough…,” he said. “There are injuries occasionally that happen on sports fields, be it football or others, but it is incredibly rare to have something be this serious that happens like that and be quickly recognized.
Hamlin also was intubated on the field, Knight said, and health screenings intensified after Pritts and members of the trauma and emergency teams admitted him at the hospital.
The UC doctors on Thursday addressed speculation that Hamlin suffered an episode of commotio cordis, which can cause cardiac arrest when the electrical system in the heart malfunctions because of a sudden blow. The rare injury can cause cardiac arrest in even the healthiest of people.
Pritts and Knight said UC specialists have yet to find any signs of previous heart damage, though tests are continuing.
“We do not have definitive answers … at this time,” Knight said.
The focus for Hamlin remains on the day-to-day.
Both doctors emphasized that it is too soon to project Hamlin’s long-term recovery. Pritts and Knight said UC specialists have yet to find any signs of previous heart damage, though tests are continuing.
“The best outcome would be back to who he was before this all happened,” Knight said.
The doctors said the reason they were able to talk about Hamlin’s good neurological function, not just his life, is because of “immediate and good and high-quality CPR, and immediate access to defibrillation.”
Cardiac arrest is caused when the electrical system in the heart malfunctions and the heart stops. It can be caused by almost any heart condition, including a heart attack, which is a blockage in a coronary artery.
In rare cases, a sharp, sudden blow to the heart can cause cardiac arrest.
The heart needs an electrical system to tell cardiac muscle cells when to contract, first in the upper chambers, then in the lower.
It only takes a fraction of a second for the heart to go dangerously out of rhythm, a process called ventricular fibrillation, said Dr. Anne B. Curtisa SUNY distinguished professor in the Department of Medicine at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences who was not involved in the player’s treatment.
Typically, the heartbeat works at 60 to 100 beats per minute at rest, a bit lower during sleep and up to 150 beats a minute during exercise.
“In order for a blow to the chest to cause somebody’s heart to fibrillate, and then potentially kill them, it has to be a precisely located blow to the lower left chest, right over the heart itself, and precisely badly timed,” Curtis said earlier this week. “The window that’s been studied says it’s a 30-millisecond window. Think how small that is.”
Word of Hamlin’s progress since the Monday night on-field tragedy brought relief to his teammates Thursday, including fellow Bills defensive back Dane Jackson, a fellow University of Pittsburgh football alum.
After learning Hamlin asked who won the Bills-Bengals game, Jackson said at a press conference, “I mean, I really wouldn’t expect him to ask anything else, honestly… He’s a true warrior, he’s a fighter. He’s always gonna come out with some type of a joke…I know the 1st thing he’ll say to me when he gets back is something crazy”.
Medical vigilance continues as Hamlin works to mend. If progress continues as hoped, chances are he may be able to watch the next Bills game, at least from a hospital bed on TV, a Sunday contest against the New England Patriots.
“There are many, many steps still ahead of him,” Pritts said. “From our standpoint, we would like to see him continue to improve, to be completely breathing on his own. And then … ready to be discharged from the hospital. So those are the immediate next steps.
“His family has been with him at his bedside as have members of the Buffalo Bills organization, really, since this all began,” the doctor added, “and we really want to get him home to them. And so those will be the immediate next steps. And then we’ll talk about potential plans for the future.”
The family and treatment team have felt the power of prayer, hugs and good wishes that surround Hamlin’s latest journey, Knight said, and have been keenly aware of the chord it struck among those aware of it worldwide – as well as in Cincinnatti, where there have been vigils on the medical center grounds and cards and posters from well-wishers hanging inside medical center.
“It doesn’t take long to look outside and see the lights, the blue and the red around the city of Cincinnati,” he said. “The support from local restaurants, the support from the fans, and just people who are concerned. So yes, it’s been very powerful.”
Buffalo News reporters Katherine Fitzgerald and Jay Skurski contributed to this story.