Damar Hamlin is alert and asking questions, doctors say

"Did we win?"

It was the first question Buffalo Bills safety Damar Hamlin asked upon regaining consciousness after going into cardiac arrest during Monday night's game against the Cincinnati Bengals, his physicians said Thursday.

"The answer is yes," Dr. Timothy Pritts, division chief of general surgery at the University of Cincinnati Medical Center, told Hamlin. "You won the game of life."

Hamlin, 24, remains in intensive care on a ventilator and is unable to speak, Pritts said, but he is communicating by writing on a clipboard.

During a news briefing Thursday, Hamlin's doctors said his recovery includes other promising signs that his brain is functioning, such as moving his feet and squeezing the hands of his doctors and family members.

"It appears all the cylinders are firing," Pritts said.

Buffalo coach Sean McDermott and quarterback Josh Allen told reporters that word of Hamlin's improvement was a massive lift for team spirits.

"We heard that news this morning, and there’s nothing that could have been told to us to bring our day down," Allen said. 

"We’re extremely happy for him and his family. We just want to love up on him the next chance we get. I don't know when it's going to be, if we get to see him anytime soon, but it’s going to be awesome.”

Hamlin's collapse, watched by millions, occurred just after he tackled a Bengals receiver. It appeared that the receiver's shoulder struck Hamlin in the chest.

It remains unclear what exactly caused Hamlin's cardiac arrest. One possibility is a phenomenon called "commotio cordis."

"Commotio cordis is an incredibly rare event," Dr. William Knight, professor in the Department of Emergency Medicine at the University of Cincinnati College of Medicine, said Thursday. "It's a diagnosis of exclusion," meaning other conditions have to be ruled out before it can be determined definitively.

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"It is on the list of considerations," Knight said.

Pritts and Knight declined to specify the type of tests Hamlin has been given.

What is commotio cordis?

Normally, the heart pumps oxygen-rich blood throughout the body about every second. There is a rhythm to the process, keeping the blood flowing at a healthy pace. But every time the heart beats, there is a tiny moment — less than a fifth of a second — that makes it vulnerable to the force of a projectile that can lead to a chaotic and potentially deadly heart rhythm.

It is in this exact moment, experts say, that a blow to the chest in the exact right place can launch an otherwise healthy person into cardiac arrest. The heart’s electrical system malfunctions, and the heartbeat rhythm goes haywire.

It is too early, Hamlin's doctors say, to determine whether he might return to professional football.

For now, Knight said doctors were trying to wean Hamlin off the ventilator to start breathing on his own.

"He still has a little ways to go in terms of liberation from the ventilator," said Knight. "I think that that's going to be our focus right now in terms of helping him to recover, liberate, continue to get stronger and rehabilitate."

There is a concern that Hamlin may have inhaled fluid or blood, potentially causing problems with lung function.

The next few days are crucial in confirming that Hamlin can breathe on his own.

"The best outcome would be back to who he was before this all happened," Knight said. This means "getting him to the way he was at 8 o’clock on Monday evening."

Earlier Thursday, the Bills tweeted that "Damar has shown remarkable improvement over the past 24 hours. While still critically ill, he has demonstrated that he appears to be neurologically intact."

The Bills' statement was "a really good sign," said Dr. Todd Rice, director of the medical intensive care unit at Vanderbilt University Medical Center in Nashville, Tennessee, who has not been involved in Hamlin's care. By this point, doctors are looking for any indication that the patient’s neurological function remains intact, Rice said.

Thursday morning, Hamlin's teammate Kaiir Elam said in a tweet, "Our boy is doing better, awake and showing more signs of improvement."

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