A search for answers amid a life-and-death scramble on an NFL field

The Washington Post / Adam Kilgore, Ben Strauss, Mark Maske

10:54 JST, January 5, 2023

Shortly past the midway point of the first quarter, draped in the spectacle of Monday Night Football and the high stakes of a pivotal game between the Cincinnati Bengals and Buffalo Bills, Bengals quarterback Joe Burrow floated a short pass to wide receiver Tee Higgins. Higgins sprinted upfield as Damar Hamlin bolted from his safety position to make a tackle. Higgins’s helmet met Hamlin’s chest like a battering ram. It was a routine play, until it wasn’t. It was a game that mattered, and then it didn’t.

In the harrowing moments that followed on the Paycor Stadium turf, emergency physicians frantically pumped Hamlin’s chest to restart his heart. Hamlin was driven off the field in an ambulance as stricken teammates and opponents looked on with tears in their eyes and anguished horror on their faces.

A national television audience watched live on ESPN as the network pivoted from broadcasting a football game to covering a news story. During freighted phone calls between New York and Cincinnati, NFL executives determined how to proceed in a moment of medical catastrophe unprecedented even for a sport steeped in violence and physical suffering.

By Tuesday afternoon, Hamlin remained in critical condition after spending the night in the intensive care at University of Cincinnati Medical Center. The NFL announced the postponed game would not be resumed this week, and no decision had been reached on whether it would be concluded at all. This weekend’s slate, the last of regular season, will unfold as planned.

As Hamlin continues to fight for his life and the NFL’s machinery lurches ahead, the frantic hour between Hamlin’s injury and the postponement of the game will linger. It rattled the league and prompted support from all corners of the sports world. No one present had seen anything like it.

The Bengals-Bills meeting, a potentially decisive showdown for the AFC’s top playoff spot, began as one of the most anticipated games of the season – “a great night for the NFL and a great showcase for our hometown,” Bengals Owner Mike Brown said in a statement.

The Bengals led, 7-3, with 6 minutes, 12 seconds remaining in the first quarter when Burrow found Higgins on second and 3. After tackling Higgins following a 13-yard gain, Hamlin stood briefly, wobbled, then collapsed on his back. Bengals running back Joe Mixon pointed at Hamlin and waved toward the sideline. The whistle blew, and the game clock stopped. Buffalo’s training staff rushed onto the field at 8:55 p.m.

“Now another Bills player is down,” play-by-play announcer Joe Buck said on the ESPN broadcast. “That is Damar Hamlin, a big piece of this defense. Back after this.” The broadcast quickly cut to commercial, as it typically would following an injury.

Even by Tuesday evening, neither the league, nor teams nor any medical personnel had offered any update on Hamlin’s status or gone into detail about those frantic first few minutes after his injury. That has left the pictures and reports from the “Monday Night Football” telecast as the best available record of how those moments unfolded, as Hamlin lay on the ground, his life at risk.

After the first round of commercials, ESPN returned at 8:58, and viewers could see a stretcher on the field. The network showed a replay of the injury, before returning once more to commercial. By 9:01, the scenes on the field made clear the seriousness of Hamlin’s injury. An ambulance was on the field; Bills quarterback Josh Allen had his face buried in his hands; wide receiver Stefon Diggs paced around, visibly shaken. “There’s just nothing to say right now,” Buck said. “We’ll take another break and come back.”

At every stadium, the NFL creates an emergency action plan for serious on-field medical situations. At each game, an ambulance awaits inside the stadium. A physician specialized in airway management is on-site. A Level 1 trauma center is designated nearby. Medical staff rehearses the plan every year. Each crew knows who calls the ambulance on the field and when to summon the specific medical support.

An hour before kickoff, the medical staffs from both teams and independent medical personnel, more than 30 people total, gather for what is called the “60 Minute Meeting.” Led by the home team’s head physician, the meeting reviews stadium resources and provides a reminder of the closest hospital.

When trainers reached Hamlin, they saw a 24-year-old, world-class athlete in dire condition. He had suffered cardiac arrest. Players from both teams encircled Hamlin. Some walked away, shocked and unable to watch. Some knelt in prayer. Many cried.

Medical personnel unscrewed Hamlin’s face mask, gave him oxygen from a portable tank and administered CPR. They restored his heartbeat. They placed him on a stretcher.

At 9:04, sideline reporter Lisa Salters reported that Hamlin had been receiving treatment on the field but could not provide more details, the surrounding players obscuring her view. At 9:05, Buck informed the audience that CPR had been performed.

At 9:10, 15 minutes after he collapsed, the ambulance carrying Hamlin drove into the tunnel and out of view. Bills players gathered in prayer behind. Fans applauded. After his mother had joined him from the stands, Hamlin was driven to University of Cincinnati Medical Center, accompanied by police escort.

“From an emergency action plan perspective,” NFL executive vice president of communications, public affairs and policy Jeff Miller said, “things worked as designed with terrific collaboration by the team medical staff and the independent medical providers who are on-site there if something happens.”

As medical personnel fought for Hamlin’s life, NFL executives grappled with how to handle the remainder of the game.

NFL chief football administrative officer Dawn Aponte represented the league office at Paycor Stadium. After the ambulance left the field, Bengals Coach Zac Taylor and Bills Coach Sean McDermott convened with referee Shawn Smith. Remotely, executive vice president Troy Vincent triangulated communication with Aponte, Smith, NFL Players Association executive director DeMaurice Smith and league Commissioner Roger Goodell.

Shortly after the ambulance left the field, Buck told viewers that the game would restart after a five-minute warm-up period, based on information that had come from ESPN officiating analyst John Parry, according to a person with knowledge of the broadcast. During every Monday night game, Parry corresponds with the league’s officiating department about issues such as replay review decisions, then relays information to Buck and his analyst, Troy Aikman. But this decision had escalated beyond those with whom Parry typically communicates.

“They’re gonna try to continue to play this game,” Buck said at 9:13 p.m.

Despite Buck’s report, Vincent said later the league never considered restarting the game.

“Immediately, my player hat went on: How do you resume playing when such a traumatic event occurs in front of you in real time?” said Vincent, an NFL defensive back for 16 seasons. “And that’s the way we were thinking about it, the commissioner and I.”

Some players reverted to rituals that suggested they were preparing to play. Diggs, minutes after tears left streaks on his face, stood before teammates and delivered a fiery speech. Burrow made a few gentle tosses.

Buck noted on the broadcast that, despite going through those motions, players didn’t seem to be preparing in earnest. “Nobody’s out there really warming up,” he said. “Everybody’s just stagnant.”

Vincent said he and Goodell decided they wanted to “let the coaches and players breathe” as they mulled whether to restart the game. McDermott and Taylor met again with Smith, the referee, then returned to their teams. McDermott shouted, “locker room, locker room,” to his players.

At 9:18 p.m., Smith announced to the crowd the game had been temporarily suspended. Both teams left the field. Vincent said once the game was suspended, he stopped communicating with Smith and talked directly with McDermott and Taylor.

Vincent strongly denied the notion that the league had told players they had five minutes to warm up, calling it “ridiculous” and “insensitive” and saying he did not know where it came from. An assistant coach from one of the teams, who requested anonymity to discuss a sensitive matter, said no timetable for a restart was ever given to the coaching staffs and credited the head coaches for taking players off the field.

“Nothing was ever officially communicated like that,” the coach said. “I was up in the box, and we didn’t get much in the way of info. I think they were trying to figure out what to do, since it was so traumatic. And Sean and Zac, with input from players, decided to take teams to the locker room.”

On Tuesday, ESPN released a statement, backing Buck’s report.

“There was constant communication in real time between ESPN and league and game officials,” a network spokesman said. “As a result of that, we reported what we were told in the moment and immediately updated fans as new information was learned. This was an unprecedented, rapidly evolving circumstance.”

Once players found refuge in the locker room, the NFL continued deliberations. DeMaurice Smith, the NFLPA head, had communicated its desire to postpone the game. The decision, according to the NFL rule book, would fall to Goodell.

In an ESPN studio in New York at 9:19, analyst and former NFL player Booger McFarland called for the league to postpone the game. “I just don’t know how any of these players are able to play football tonight,” Aikman said on the air at 9:36 p.m.

After a 31/2-mile ambulance ride to the UC Medical Center, doctors intubated and sedated Hamlin. Though his vital signs returned to normal, Hamlin family friend Jordon Rooney said, doctors classified Hamlin as in critical condition.

At 9:54 p.m., Bills equipment staffers packed up gear and players began shaking hands and hugging in the corridor between locker rooms. At 10:01, the league announced the game had been postponed.

“Medical advice guided our decisions,” Aponte said. “We remained in constant communication, as Troy said, with both teams, with medical personnel, with the game officials, with ownership. And we made decisions that we believed to be in the best interests Damar’s status and the state of both teams’ players and staff.”

The Bills’ team plane returned home, although players were given the option to stay in Cincinnati. Diggs went to the hospital and, with the help of ESPN reporter Coley Harvey, talked his way into the medical center. Burrow and several teammates visited the hospital, too.

Fans at home could process what they had seen only through ESPN’s continuing coverage. On “SportsCenter,” following the postponement, former NFL safety Ryan Clark delivered a stream of eloquent and profound analysis, essentially improvised spoken essays. At one point, Clark ruminated on the bargain all NFL players must strike.

“Part of living this dream,” Clark said, “is putting your life at risk.”