Crowds gathered to support college and professional sport teams the last four weeks of 2022. We watched the World Cup, college invitational basketball tournaments, college football bowl games, and a race for NFL playoffs. The excitement stirred by such events is intense enough to make sports fans sit for 8-12 hours watching games. Of course, cardiologists can’t sit 30-60 minutes without getting up. Our natural tendency is to keep moving. Patients reporting to the emergency department or our clinics after this degree of inactivity would heighten the clinician’s suspicion of deep venous thrombosis, pulmonary emboli, gouty attacks, gastric reflux, diabetic hyperglycemia, and the notorious alcohol binging prevalent during this season.
A nurse, respiratory therapist, or physician working during a Monday night football game would likely hear both cheers and shouts of anger coming from patient rooms. Unit secretaries often report occasional elevated heart rates on our telemetry monitor. We have even seen patients with unstable angina develop worsening angina. The heightened emotional excitement applies to the players, coaches and spectators watching that 12-inch spherical shaped ball being caught, carried and chased.
As the new year of 2023 unfolded, fans were devastated and humbled by an unusual tragic event that sent shockwaves nationally and worldwide. Millions of people watched as a young football player collapsed due to sudden cardiac death. Damar Hamlin of the Buffalo Bills had just made a tackle, stood up momentarily, and then collapsed. My husband, who was watching the game and shocked by what had just happened, beckoned me to the television to witness what he had already seen. What I saw was a scene that takes place daily in hospitals – commotion around a cardiac resuscitation. This was not a scene that was normal on the football field. In Damar Hamlin’s case, the game came to a halt, and the medical team members were surrounded by a human wall for privacy. Players on both teams were in shock, tearful and prayerful that this young man would recover. The first responders were quick in giving a lifesaving shock to the chest with the Automated External Defibrillator (AED) and in carrying out our usual advanced cardiovascular life support (ACLS) protocols. Damar was taken to the hospital for further aggressive care. A diverse group of players followed him there, hugging and supporting one another as they prayed fervently for the fallen football player’s full recovery. The team of first responders, including Emergency Medical Technicians (EMTs), performed their jobs to intubate, provide CPR and travel to the hospital. At the hospital, Damar was handed off to a team of medical professionals who provided aggressive medical care. In short, both professionals and civilians pitched in to help.
The medical community kept its composure in taking care of Damar, the high-profile patient, in much the same way that we would handle anyone experiencing sudden death or any other serious health issues. I texted my mentee, Dr. Jared Vaughan (now an ED resident with an interest in sports medicine in Ohio). I asked him if he attended the game. He had not. The two of us agreed that the presentation resembled a board question where the answer to the scenario was commotio cordis. Jared completed medical school at UMMC and was a leader in encouraging diversity within the field of medicine. While black males comprise 58% of the players in the National Football league, less than 5% of active physicians are African American. The AAMC has begun a drive to alter the course of medical care by encouraging more African American males to join the ranks of physicians. The NFL has certainly changed during my lifetime as far as team member diversity goes. The field of medicine can do the same, simply by adjusting its focus on education. There is much to gain in doing so, considering that the average playing career in the NFL is 3.3 years (Christina Gough, Statista 2023). Physicians practice for 40+ years. The life of a strong football player is more fragile than we can imagine.
Commotio cordis is an uncommon cause of death, although young athletes collapse and die annually on basketball courts, soccer fields, baseball fields and football fields. The more common cause of death of the young athlete is related to an underlying structural problem such as hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, coronary anomalies, etc. Trauma to Damar Hamlin’s chest was the likely cause of his resulting ventricular fibrillation.
Damar Hamlin is a blessed man to have had a team of medical professionals taking care of him and the country praying for him. His first form of communication after upon waking from the trauma was via paper and pen, “Did we win?” Dr. Timothy Pitts answered, “Yes. You won Damar. You won the game of life.”
Lives are turned around in seconds with myocardial infarction, pulmonary emboli, strokes, accidents, cancer diagnosis, gunshot wounds, car accidents, and so forth. Our commitment is to treat each patient as if the world is watching us care for a Damar Hamlin. After all, we have made a pledge to teach and encourage others to join the field of medicine. If we are not true to our pledge in this regard, what will our communities think about our promises in other areas?
Over the years, our churches, schools and activity areas have been encouraged to utilize an Automated External Defibrillator (AED). Airports are stocked with AEDs. Make sure your favorite local team has an AED. If one is not within the team’s reach, get donations to purchase an AED and a blood pressure cuff. These are lifesaving devices when used timely and could help others also win the “game of life.”