The stadium lights blazed, the crowd roared, and thensilence. On a chilly Monday night in Cincinnati, Buffalo Bills safety Damar Hamlin rose to make a routine tackle. The hit looked ordinary, but what followed was anything but. Hamlin stood, took two steps, and crumpled to the turf. His heart had stopped. Trainers rushed in, performing CPR as the nation watched in horror. This wasn’t just a game anymore; it was a fight for life.
Key Moments in the Incident
- Hamlin collapsed after a chestimpact tackle during the first quarter.
- CPR was administered for nine minutes on the field.
- He was intubated and transported in critical condition.
- His uncle reported fluid buildup in the lungs, prompting proning.
- The game was postponed, a rare NFL decision prioritizing player safety.
In that moment, the fragility of human existence collided with the raw intensity of professional football. Medical staff worked with frantic precision, restarting Hamlin’s heart on the field before rushing him to the University of Cincinnati Medical Center. There, a lesserknown but lifesaving technique called proning became part of his care. It’s a practice that turns patients onto their stomachs to help them breatheand it sparked a global conversation about hope, science, and survival.
1. What Happened to Damar Hamlin: A HeartStopping Moment
Imagine the scene: 65,000 fans, millions more on TV, and then the unthinkable. Hamlin, a 24yearold in peak physical condition, absorbed a blow to the chest at exactly the wrong millisecond. This rare phenomenon, known as commotio cordis, can disrupt the heart’s electrical rhythm if impact occurs during a vulnerable 20millisecond window in the cardiac cycle. His heart stopped. The stadium fell eerily quiet as medical personnel fought to bring him back.
Immediate Medical Response
- CPR started within seconds of collapse.
- An AED was used to restore heart rhythm.
- Hamlin was given oxygen and sedated en route to the hospital.
- CT scans ruled out brain injury; focus shifted to lungs.
- Family updates emphasized “trending upwards” within 48 hours.
Hamlin’s uncle, Dorrian Glenn, later shared that his nephew “basically died on the field and they brought him back to life.” Resuscitated oncenot twice, as early reports suggestedHamlin was sedated, intubated, and placed on a ventilator. Doctors faced a new challenge: fluid flooding his lungs, a common aftermath of cardiac arrest. That’s when they turned him onto his stomach. Proning had begun, and with it, a quiet miracle unfolded in the ICU.
2. Cardiac Arrest vs. Heart Attack: Understanding the Difference
Most people confuse cardiac arrest with a heart attack, but they’re distinct crises. A heart attack is a circulation problemblocked arteries starve the heart of blood. Cardiac arrest is an electrical malfunctionthe heart’s rhythm goes haywire and it stops pumping. Hamlin didn’t have a heart attack; his heart simply quit due to blunt trauma. Without immediate CPR, survival drops 10% per minute. He got help instantly.
Critical Distinctions
- Heart attack: Blocked blood flow, chest pain, gradual onset.
- Cardiac arrest: Sudden rhythm failure, instant collapse, no pulse.
- Survival rate without CPR: Less than 10% outside hospitals.
- Hamlin’s case: Commotio cordis suspected, not coronary disease.
- NFL protocol: AEDs and medical teams at every game saved him.
In the ICU, doctors treated the aftermath. When the heart fails, even briefly, blood backs up into the lungs, causing pulmonary edemafluid where air should be. This makes oxygenation nearly impossible. For Hamlin, still sedated on a ventilator, every breath mattered. Proning wasn’t a gimmick; it was physiology in action, redistributing pressure and fluid to give his lungs a fighting chance.
3. The Buffalo Community Rallies: Love in Crisis
Buffalo knows hardship. A mass shooting at a Tops supermarket claimed 10 lives in May 2022. A historic blizzard just weeks before Hamlin’s collapse buried the city in snow and took 47 lives. Yet when Damar fell, Western New York responded with fierce love. Prayer vigils filled churches. Fans left flowers at Highmark Stadium. A toy drive Hamlin started for kids in his hometown of McKees Rocks, Pennsylvania, explodedraising over $6 million in days.
Acts of Unity
- Toy drive surged from $2,500 goal to $6 million+.
- Fans held signs: “Pray for Damar” outside the hospital.
- Rival Bengals fans donated in droves.
- NFL players wore “Love for Damar” shirts in warmups.
- Local restaurants delivered meals to Hamlin’s family.
Teammates wept openly. Dion Dawkins, the Bills’ offensive tackle, said the incident “immediately breaks you down into prayer.” Strangers became family. The GoFundMe, originally set for $2,500, became a symbol of collective hope. In a city that’s endured so much, Hamlin’s fight reminded everyone that resilience isn’t just survivingit’s lifting each other up when the weight feels unbearable.
4. Proning Explained: Why Turning Patients Saves Lives
Proning isn’t new, but it’s not widely understood outside ICUs. The technique involves carefully rolling a sedated, ventilated patient from back to belly. It sounds simpleuntil you realize a team of six to eight nurses, doctors, and respiratory therapists is needed to move someone safely without dislodging tubes or lines. For Hamlin, this maneuver helped drain fluid from his lungs and opened airways compressed by gravity.
Core Benefits of Proning
- Reduces pressure on posterior lung tissue.
- Improves ventilationperfusion matching.
- Lowers mortality in severe ARDS by up to 50% if done early.
- Requires 12–16 hours daily for maximum effect.
- Used in ICUs since the 1970s, surged during COVID19.
The science is elegant. When you lie on your back, your heart and abdominal organs press down on the lungs. Fluid pools in the back, where most lung tissue lives. Flip the patient, and gravity pulls fluid forward, away from the largest, healthiest lung segments. More alveolithose tiny air sacscan inflate. More oxygen reaches the blood. It’s not a cure, but it buys time for healing.
5. The Physiology Behind Proning: Gravity as Medicine
Your lungs aren’t symmetrical. The back (posterior) has more volume than the front (anterior). In the supine positionlying on your backfluid settles in the back, squishing alveoli. The heart, sitting atop the lungs, adds weight. Abdominal organs push up from below. It’s a compression sandwich. No wonder oxygenation fails in critical illness.
Mechanisms at Work
- Decreases dorsal lung compression.
- Redistributes pulmonary blood flow.
- Enhances alveolar recruitment.
- Reduces ventilatorinduced lung injury.
- Improves functional residual capacity (FRC).
Now flip the patient prone. The heart rests on the sternum, not the lungs. Abdominal pressure shifts to the mattress. Fluid drains forward, compressing only a small, less vital lung area. The large posterior lungsnow on topexpand freely. Blood flow, which always favors the back, now meets wideopen airways. Ventilation and perfusion align. Oxygen surges. It’s physiology rewritten by gravity.
6. ARDS and Fluid in the Lungs: Hamlin’s Hidden Battle
After cardiac arrest, the heart’s pumping failure causes backlogblood seeps into the lungs. This is pulmonary edema, a hallmark of Acute Respiratory Distress Syndrome (ARDS) when severe. Alveoli drown. Oxygen can’t cross into the bloodstream. Ventilators push air in, but it’s like blowing into a wet sponge. Hamlin’s doctors saw this on Xrays: white, cloudy lungs where black air should be.
ARDS Triggers and Impact
- Cardiac arrest → pulmonary edema.
- Pneumonia, COVID19, trauma also cause ARDS.
- Mortality without intervention: 40–60%.
- Proning must start within 48 hours for best results.
- Hamlin’s youth and fitness aided recovery potential.
Proning became his lifeline. By improving oxygen levels, it reduced the work his heart had to do. Every percentage point of saturation mattered. Studies show early proning in ARDS cuts death rates nearly in half. For a young athlete with everything to live for, this wasn’t experimentalit was evidencebased hope in action.
7. The Prone Positioning Procedure: Precision in Motion
Proning isn’t casual. It’s a choreographed ballet in the ICU. The patient is sedated, paralyzed if needed, and fully monitored. LinesIVs, arterial, ventilatorare secured. A team counts to three. In one smooth motion, the patient is rolled facedown onto pillows supporting the chest and pelvis. Arms are positioned like a swimmer midstroke. Every two hours, skin is checked. After 12–16 hours, they flip back.
Steps in Safe Proning
- Assemble 6–8 trained staff members.
- Secure all lines and tubes with tape.
- Use slide sheets to reduce shear force.
- Position pillows under chest and pelvis.
- Monitor endtidal CO2 and oxygenation continuously.
For Hamlin, this cycle repeated daily. Nurses watched pressure alarms. Doctors tracked oxygen saturation. Each turn was a risktubes could kink, pressure sores could formbut the benefit outweighed the danger. It’s laborintensive, but in critical care, human hands and sharp eyes remain irreplaceable.
8. Even Healthy Lungs Benefit: What Proning Teaches Us
You don’t need ARDS to see proning’s effects. In healthy, awake people, lying prone increases functional residual capacitythe air left in your lungs after exhaling. The diaphragm moves differently. The heart shifts, freeing lung tissue. Breathing feels easier, especially for obese individuals or those with sleep apnea. Yoga’s “prone savasana” isn’t just relaxationit’s subtle physiology at play.
Physiological Shifts in Prone
- Increased FRC vs. supine position.
- Reduced diaphragmatic compression.
- Better secretion drainage.
- Lower work of breathing in obesity.
- No change in peak expiratory flow.
For intubated patients like Hamlin, the stakes are higher. Sedated, unable to cough, fluid builds fast. Proning helps clear secretions. It prevents ventilatorassociated pneumonia. It gives the lungs a break so inflammation can subside. Even in healthy lungs, the prone shift reveals how much posture shapes breathing.
9. Player Safety in the NFL: A Reckoning
Football is violence disguised as sport. Hamlin’s collapse exposed that truth. The NFL has improvedbetter helmets, concussion protocols, practice limitsbut commotio cordis remains a fluke risk. Chest protectors exist in youth lacrosse; why not football? After Hamlin, the league pledged reviews. Players spoke out. Dion Dawkins said, “This ain’t about football right now.” For once, the game took a backseat.
Safety Reforms Under Discussion
- Mandatory chest protectors for highrisk positions.
- Enhanced commotio cordis training for trainers.
- Expanded cardiac screening in predraft evals.
- Realtime ECG monitoring during games.
- Cultural shift: mental health days now standard.
The postponement of the BillsBengals game was unprecedented. Players refused to continue. Coaches supported them. The human toll outweighed playoff implications. Hamlin’s heartbeat became more important than any scoreboard. It was a turning pointa reminder that behind every jersey is a person with a family, a future, a life.
10. Hope, Science, and the Human Spirit
As Hamlin fought in the ICU, the world held its breath. His toy drive became a beacon. Strangers prayed in hospital chapels. Teammates visited, masks hiding tears. Doctors adjusted ventilators, timed proning sessions, watched oxygen levels climb. Each small victorywaking up, writing on a notepad, breathing on his ownwas a miracle built on science and love.
Signs of Recovery
- Wrote “Did we win?” on January 5.
- Removed from ventilator January 9.
- Transferred to Buffalo hospital January 9.
- Discharged home January 11.
- Cardiac testing ongoing; return to play uncertain.
Proning isn’t flashy. It’s not a drug or surgery. But it’s a testament to human ingenuityusing gravity, teamwork, and timing to cheat death. Hamlin’s story isn’t over. He woke up asking, “Who won the game?” Doctors laughed through tears: “You won, Damar. You won.” And in that moment, medicine, community, and sheer will converged into something greater than sport.
11. A Legacy of Resilience and Care
Damar Hamlin’s collapse was a tragedy. His survival is a triumph. Proning, CPR, community supporteach played a role. But the deepest lesson is human connection. In a divided world, millions united for one young man. His heartbeat restarted more than his own life; it reminded us that beneath pads and helmets, we’re all fragile, all fighting, all worthy of care.
Lasting Impact
- Over $9 million raised for Chasing M’s Foundation.
- Increased AED training in youth sports.
- Proning protocols updated in hospitals nationwide.
- Hamlin named NFLPA Community MVP.
- Inspiration for cardiac research funding.
As Hamlin heals, his foundation grows. Kids receive toys. Doctors refine protocols. Players wear his number in warmups. The NFL evolves. And somewhere, a nurse flips a patient prone, adjusts a pillow, and whispers, “Breathe.” Because that’s what medicine isscience in service of the human spirit. And that’s the real victory.
