Fluke Injuries and Living With Risk
Reminders of the fragility of existence
I probably gave a guy a concussion in a pick-up basketball game last week.
He was (embarrassingly) on my team, and came up to set a high screen for me. The guy defending him was going to hedge hard enough to keep me from driving, so I pulled up from behind the screen to take a long jump shot. On the way down after the shot, my elbow hit the top of his head.
He doubled over right away, and I said “Oh, shit, I’m sorry, man.” He said “Nah, nah, I’m OK,” then started to jog to the defensive end. Which lasted for about four stumbling steps drifting diagonally to his right, then he collapsed.
One of the other players was right there, and caught him before he hit the ground. We found a towel to put under his head, and made him lie still for a bit, until he felt more stable. We helped him up, and he walked off to a chair on the sidelines. He’ll be out of the game for at least the next week or two.
Then we picked up a guy who was jogging laps in the gym next door, and finished out the game1.
This is the kind of thing that happens from time to time. Not all that often— it’s a faculty/staff/student basketball game, so not the highest level of competitive intensity— but occasionally. I’ve been the guy lying on the floor waiting for my head to clear a few times in the twenty-odd years I’ve been playing here. It felt a bit different last week, though, in the wake of the Damar Hamlin injury in last week’s Monday Night Football game.
If you’re not a sports fan and also live in a remote cabin where your only contact with the outside world is a printed copy of this Substack delivered to you by carrier pigeon, Hamlin is a defensive player on the Buffalo Bills who made a fairly routine-looking tackle early on in a game against the Cincinnati Bengals. He got up immediately, took a couple steps, then collapsed in a heap. Medical staff rushed out, and had to perform CPR for several minutes to get his heart re-started; he spent the next several days unconscious in an ICU.
The latest word at the time when I’m first typing this (on Friday morning, with the intention of posting Monday) is that he’s regained consciousness, and while he’s still got a lot of recovery ahead, he’s probably past the worst danger. I don’t know that there has been any definitive determination as to what caused his collapse, or that one will ever be announced to the public. The most likely causes are all kind of random and flukey— a subtle heart defect of a type that doesn’t show up clearly until it leads to a catastrophic failure, or the condition called “commotio cordis,” where a physical blow to the wrong region of the chest at the wrong point in the cycle of a heartbeat can cause the heart to just… stop. This doesn’t happen often— that linked article calls it “so rare that it is hard to get reliable information on the number of occurrences”— but it’s definitely a Thing that I was aware of, and one of the first things I thought of when I heard about the Hamlin situation.
Hamlin’s injury unleashed an entirely predictable tsunami of Takes on social media, starting with an immediate outcry over the league’s failure to instantly call off the rest of the game, and continuing on into the week. A lot of these were lightly retouched versions of arguments about head injuries in football, calling into question the whole morality of watching such a violent game in which players are putting their bodies and even lives at risk. Some of these are good and interesting— I liked the conversation with Domonique Foxworth on Ryen Russillo’s podcast quite a bit— a lot of them are… not.
This particular incident seems like an uneasy fit for a broader “Is it moral to play football?” conversation, because of the inherently flukey nature of the event. This wasn’t a case of something that could only happen because football is a disturbingly violent game, because the tackle that caused it just wasn’t that bad. This was just incredibly bad luck, something that could happen in almost any sport. I was aware of commotio cordis as a Thing because this comes up every few years in the context of sports other than football— I’ve seen a number of tragic stories about high-school lacrosse players dropping dead after an errant pass to the chest, or baseball players killed by a ball that took a bad hop. The rare(-ish) heart defects that are the other most likely explanation also make their presence devastatingly known in a bunch of different sporting contexts— there are famous examples of basketball players dropping dead on the court from unsuspected heart issues, and I’m old enough to remember jogging booster Jim Fixx dying during a run (providing fodder for any number of jokes in poor taste).
If there’s a lesson to take away from this situation, it’s less about the moral status of football than it is about the fragility of life in general. Yes, playing football made it more likely that Hamlin would be subject to the kind of stresses that could lead to disaster, but at the same time, the man is an elite-level athlete in a much better position to survive such an event than 99.99% of the population. If this is evidence that football is too risky to allow than so is basically any athletic activity beyond jogging on a treadmill with a trained EMT on hand. Lacrosse and baseball are the reason I know about commotio cordis in the first place, so they’re clearly out, soccer has had a high-profile near-death, and as we saw at the top of this post, even basketball has its own share of risky collisions.
The human body is a fragile and ungainly thing, even when trained to the absolute highest level possible with the infrastructure of a multi-billion-dollar sports league, and access to the best medical care on offer. We walk around feeling like absolute masters of the world around us, but random weird shit could make any of us drop like a stone at more or less any moment. Playing sports means accepting a somewhat elevated level of risk into your life, sure, but there’s a level of risk inherent in living at all that we all have to bear.
And there’s also a message here about resilience. One of the more hyperbolic categories of Takes in the wake of the Hamlin injury was the call for the next week of games to be canceled, with some variants extending to a kind of incredulity that anyone would even think of continuing the season. In at least one case, I heard a commentator expressing doubt that a game should ever be restarted after an injury that resulted in a player leaving the field on a cart, even injuries far less serious than Hamlin’s.
I think the impulse here comes from a place that’s basically good, but carries it a bit too far. There certainly ought to be considerable deference given to the wishes of the players— forcing them to re-start a game against their will would be unconscionable. But at the same time, if the players who are the ones bearing the actual risks of playing want to continue, that’s absolutely their decision to make. (And between those extremes, I’m 100% on board with Foxworth’s attempting to use this as leverage in negotiating better compensation and benefits for players.) This is an area where the tenor of some well-intentioned commentary goes in a direction that comes off to me as deeply patronizing. It amounts to talking about players who might choose to continue as if they just don’t know enough to want the things that people watching from the stands or on television think they should want.
At the end of the day, the answer to “How can they possibly go on?” is the same as when that question is asked about any of the other terrible things that happen in life: They go on because it’s what people do. Random awful events take away people’s jobs, or houses, or friends and loved ones, and many of those people resume doing what they were doing before simply because the alternative seems worse. Not everyone, of course, and not in every situation, but by and large people are resilient, sometimes in ways that seem surprising from outside.
The usual counter here is a version of “It’s just a game:” an assertion that football just isn’t important enough to continue. But at some level, that’s not really a different argument than “Why are you rebuilding your house when you know that another hurricane could come along and destroy it again?” It doesn’t make sense when you’re not the person who is invested in that place or that career, but if it was your home or your livelihood, you would likely feel differently. It doesn’t surprise me in the least that most of the people who have dedicated their lives to building careers in football would receive Hamlin’s injury as a nasty shock, but still suit up and play the next week without much need for coercion.
We live— all of us— with the constant threat that everything we have might at any moment be taken away by a random, low-probability event. We try our best not to think about that, because it can become paralyzing to do so, but every now and then, something happens that reminds us of the fragility of existence in a terrible and dramatic fashion. Sometimes that demands a total halt, but other times, you get back up and keep playing the game, because there’s really nothing else to do.
This is a slightly risky post, since I’m going to hit publish and then be away from my computer for a good chunk of the day— I’m taking The Pip down to NYC to see Giannis Antetokounmpo (his favorite player) and the Milwaukeee Bucks play the Knicks in Madison Square Garden. I’m sure nothing can go wrong with this, though, so if you want more content in this vein, here’s a button:
And if you feel moved to respond to any of the above, and are willing to wait a long time for any potential reply from me, the comments will be open:
My team got smoked after the re-start, because the new guy wasn’t warmed up but isn’t the type to let that stop him taking a bunch of shots.
Not sure you and team did the right thing. He needed to see a doc. There could have been bad shit happening but not apparent for hours.