Damar Hamlin

Holy crap.  Scariest thing I've ever witnessed in a football game.  Collapsed immediately after getting up following a tackle.  Had CPR administered for 10 minutes.

Puts life into perspective.  Tomorrow is promised to no one.  Praying he's okay.

Stay safe and stay grateful.

 

One of the scariest sports moments I’ve seen, especially with how sudden it was following the end of the play. 
 

Glad they called the game. Can’t imagine forcing either team back onto the field after witnessing that, and heart goes out to the Bills family and Hamlin’s - everyone seemed distraught and heartbroken on the sidelines. 24 years old man, absolutely crazy - praying he pulls through.

 

Wild to see live. General consensus I've seen floating around seems to be that it's a freak occurrence of him taking a hit to the chest at the exact right moment that was able to stop/disrupt his heart, which I think it's more likely for him to have been struck by lightening if that's the case. I wonder whether the low likelihood of it happening again in that instance would mean he'll be able to return to play or if this was a career ender for him. Prayers for a rapid recovery whatever the outcome.

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Way out of my head with the medical possibilities here but how did he go without a beating heart for 9 full minutes and two days later he is awake, cognitively in tact, speaking, writing, moving his limbs etc.? This is like a biblical times type of miracle on display. He was dead bro and then revived - rescuers need some type of medal for their fast work. Wow

 
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Preface: This is going to be an extremely long comment, so be warned if you choose to dive in. I've been following this situation profusely over the past 72 hours, and want to give the WSO community some good information. Any evidence that I have is not firsthand, and I am NOT a licensed medical professional. The content here is only what has been reported from trusted media sources, and I'll attempt to deliver it in a factual and non-speculative way. All the evidence I've witnessed in my life supporting these claims is purely anecdotal and has not been reviewed by any medical professional. This seems silly to add to a finance forum comment, but I want to be thorough. 

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Not a doctor, but witnessed a situation like this before and have some anecdotal knowledge of the fact - my sister is a cardiothoracic surgeon in her final year of fellowship. You can bet that she was my first ping when I was asking about this. 

This all comes down to timing. The first seconds matter the most, followed by the first minutes, then hours. A series of events have to go completely right to survive this, much less make a 'good recovery' (as generally indicated by a positive neurological response and/or functioning brain activity). His optimistic outlook is largely thanks to the influx of medical personnel within twenty steps reach of him at any given moment - a cardiac event isn't good for anybody, but if you're gonna have one, then I recommend doing it in an NFL stadium. You're in pretty much one of the most ideal scenarios. 

So, let's break down the timeline if we can. We've watched the video of the hit, and it's been more-or-less confirmed that Hamlin suffered what's called "commotio cordis", which is an extremely rare phenomenon due to direct impact with the heart. When I say 'extremely rare', I mean nearly inconceivable. We're talking billionths of a percent here; you'd win the PowerBall and get struck by lightning on the drive home before you'd need to worry about this. The chances are so slim, that the medical community a) rarely reports about this type of event, and b) does not have a 'preventative' solution for it - again, the chances are so slim that it's just not something the average Joe needs to prepare for.

Now, his 'downtime' was indeed nine minutes. That's how long they were performing CPR, which is needed when the individual cannot sustain a pulse on their own. There are some general misconceptions (myself included, prior to learning this a couple of years ago) that the lack of a beating heart (and thus, a pulse) is what directly causes death in these kinds of cases. Now, that's half-true: the heart failing to beat is a surefire way to ensure someone isn't ever waking up, but the reason for that actually is all in the brain. The heart continues the circulation of blood throughout the body and transports the main element needed for functional brain activity: oxygen. It really all comes down to oxygen. Within minutes of oxygen depravation, brain cells will begin to PERMANENTLY die - this is known as cerebral hypoxia. It varies person-to-person, but the general notion is that the longer your downtime, the bleaker the outlook will be.

Now, don't get me wrong - nine minutes is a LONG time. Especially when you're in this realm. But, you may be surprised to learn that it's actually not THAT long regarding average CPR durations. My sister and I were discussing this earlier yesterday, and she's discussed her tenure in this as a former EMT and Nurse Practitioner. Often, CPR can be done on patients for 20-25 minutes with an eventual resuscitation. Once you hit this range, your odds of survival become exceptionally slim, and many are pronounced deceased before hitting this mark, but it can be relative for a lot of people. In addition, I'd like to comment that just because he was being resuscitated for nine minutes does not mean his brain was completely deprived of oxygen for nine minutes - his resuscitation was twofold:

  • CPR: Used to keep blood pumping while the heart is stopped, in order to properly deliver oxygen to the brain. The blood is pumped by the chest compressions, while oxygen is delivered by breathing into the person's airway - you all have seen this on training videos, TV/movies, and nearly everywhere. 
  • AED: These things are everywhere - if you're in a public place, there's probably one within a hundred or so feet of you. This is an electronic device that delivers a shockwave through the body and is designed to physically restart the heart via an electric current. After my father had a heart attack a couple of years ago, I invested in one for our house if God forbid anything similar were to happen to me or my wife. 

So, that was the first ten minutes or so. Everything I've mentioned above - the first ten minutes, that's it. Everything was done exceptionally fast and efficiently, which I directly believe resulted in the good news we got today. The next part of the sequencing is the immediate hours that come following the initial event - from ambulance to final ICU. From what I have read (unconfirmed, someone please feel free to correct me), EMTs will generally NOT take a patient in an ambulance if a heartbeat isn't established, which seemed to be the case here. I also saw how the ambulance waited in the parking lot of the stadium in excess of ten minutes, which was either a great sign or a terrible one. Since then, we've learned it's a great one. The ambulance ride to the hospital will consist of EMTs taking vitals, providing ventilation (either intubated or oxygen mask, depending on the severity), using stimulating boosters such as epinephrine, and a multitude of other things to ensure one thing: the patient arrives to the hospital alive. I've seen many posts (not here, but you know... the internet) criticizing EMT response both with Hamlin and unrelated cases when in reality the EMTs just exist to provide the first-responder actions and the transport. After that, it's all up to the doctors. 

Speaking of doctors, now we've arrived at the ER. This is the entry port of the hospital, where Hamlin was triaged, evaluated, and fitted into permanent hospital conditions. As I mentioned above, at this point he is doing as well as he possibly can. He's survived the first minutes, but the next major hump is getting through that 12-24 hour mark - the condition level at this point is most likely listed as 'critical', which just means that he could fall right back into stage zero at any given point. I think a lot of people (again, myself included prior to learning about this kind of stuff) believe that if your heart is pumping, you're 'alive'. As much as I like the sentiment, not how it works. Hamlin was now in one of the following unconscious states, as they're often mistakenly used interchangeably. It's honestly unfortunate that I know all of this, but for those of you who have read a comment I made about a year ago, you will know that I lost my best friend in a car accident nearly twelve years ago. He went through variable states of unconsciousness - there are generally four types, which I'll list below:

  • Coma (non-induced): An automatic shutdown system of the body to preserve only the most critical aspects. Think of it as a person who is asleep, but cannot physically be wakened by any stimulus. The brain gives this order to the rest of the body in its hypothesized 'final moment', even if it's only temporary. 
  • Coma (medically-induced): Very similar to the above, however, the brain hasn't given the rest of the body the order yet, or doctors are attempting to prolong the state before the body wakes itself back up to encourage resting and recovery. This is primarily a reversible condition, it's kind of similar to general anesthesia. 
  • Persistent vegetative state (PVS): This generally stems from a non-induced coma when the body does not have the basic brain functions to wake itself back up. As a general rule of thumb, a person is moved from a 'coma' term to a 'PVS' term after continued unresponsiveness for 2-3 weeks. At this point, the outlook is extremely severe and it is unlikely that the individual will ever regain total or even a nominal amount of consciousness. Certain lobes of the brain could be permanently dead, but the brainstem is still alive - allowing a small amount of neurological function. It's very unlikely that the person knows who they are, where they are, or has normal reactions to any of their five sense. 
  • Brain death: This is final. Often confused with a PVS, but there's no going back. In this case, the brainstem is dead. The 'person' may be kept 'alive' by machines that will pump their heart and ensure blood flow, but every ounce of who they were is gone. They will 100% never move, never wake up, never do anything. In some countries, this person may be classified as legally dead. To be classified as brain-dead, an individual will need several different tests to be performed by more than a dozen doctors, all of whom must unanimously agree that there is zero chance of recovery. At this point, the decision is usually given to the family to turn off life support machines. 

Okay, so if you've read this far, know that I'll try to wrap it up. Shortly after arrival, Hamlin was put into a medically-induced coma to allow his body to completely rest and recover. A key staple of the MIC is that it's used primarily to reduce brain swelling, which happens as cerebral hypoxia takes effect, causing further damage. From the timeline here, this leads me to believe that there was little-to-no brain swelling that occurred - FANTASTIC news. Patients who experience this are often intentionally kept in their comas for up to a week or more. When you are in a totally unconscious state, it's not guaranteed that your own body will have the capacity to perform basic life operations on its own - breathing, pulse rate, etc. We now know that if this was the case, it was for an extremely short period of time. 

Now, let's fast-forward to today (01/06), and what we know:

  • Hamlin's breathing tube was fully removed after we learned that it was only providing 50% oxygen. He can now breathe on his own. 
  • He is 'neurologically intact', as indicated by his awareness of the world around him, and his exceptional Zoom call with his teammates. 
  • McDermott has testified to media outlets that Hamlin is in good spirits, and looks forward to recovery.

Now, to turn directly to your question: it's a combo of what I said above and the unknown. There are plenty of factors that still remain to be seen, and these kinds of injuries vary between person-to-person. But being a healthy young man with a stellar first-response team around him, access to exceptional care and treatment, quick-paced thinking, and just a little bit of luck, I feel safe to hypothesize that Damar Hamlin is gonna be alright. I'm not a particularly religious dude, but I thank God that this young man still appears to have his entire life in front of him. There will be roadblocks to maneuver, hurdles to jump over, and barriers to break through, but if anyone can do it I know that it will be this guy. 

On a final personal note, I would like to say that I am overjoyed at not only this young man's recovery but seeing the reaction from the football community. I honestly cannot remember the last time that so many people joined together in support of a communal cause - it sounds like an obvious thing to do, but the NFL has become increasingly toxic over the past couple of years. Just nice to see everyone together. If you've stuck around this long, thanks for reading. Hope you get something out of it!

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Once again, I am NOT a licensed medical professional and am only attempting to reiterate factual, non-speculative information that I have read from trusted sources. I hope you all have enjoyed reading and gained some new information. I won't lie, I did in fact spend probably thirty minutes writing this comment, but it's important to reiterate properly. Thanks for reading!

 

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