Alex Smith’s comeback: Inside the fight to save the QB’s leg and life

On Nov. 18, 2018, Washington quarterback Alex Smith was injured in the third quarter of a Week 11 game against the Houston Texans. The injury was severe. This is a first-person account, from Smith’s wife, Elizabeth, to ESPN’s Stephania Bell, of the untold story of what happened next. This piece originally published on May 1, 2020. Smith was released by Washington on March 5, 2021, and is now a free agent.

Warning: This story contains graphic images.

“Our first priority is we’re going to save his life. And then we’re going to do our best to save his leg. And anything beyond that is a miracle.”

Alex isn’t Alex anymore.

It’s been 57 hours since my husband was carted off the field with a compound fracture in his right leg in a Week 11 game, but now it’s Wednesday at midnight and he’s not just an injured football player — he’s the patient who’s drifting in and out of consciousness as doctors try to figure out what’s wrong. Of course, I just want to talk to Alex. But he’s … he’s not there.

They’re thinking he has a blood clot, a pulmonary embolism. Then we’re doing a cardiogram. Throughout the night, it’s test after test after test. Alex’s fever is through the roof. His blood pressure is dropping.

Everyone — the nurses, the doctors — every person is in this room and can hear me asking, “Is everything going to be OK?” They are saying, “We just need to find the root of the problem.”

Finally, we learn he has an infection.

The doctors are telling me, “He’s septic. It’s in his blood. But we don’t know what type of infection it is.”

Dr. Steve Malekzadeh, one of Alex’s trauma surgeons, comes in early the next morning. It’s Thursday, Thanksgiving Day. He would tell us later he came in because he couldn’t sleep. He knew something was off. He unwraps the bandages from Alex’s leg, even though it had been unwrapped just a few hours before. At that time, it looked normal, at least as normal as post-surgical fracture sites look.

But now his leg is black. The blisters are huge. It’s clear the infection is in his leg. It’s something I couldn’t fathom seeing in a war movie, only now it’s my husband. It’s my worst nightmare.

Dr. Malekzadeh says, “We have to go back. We have to take him into surgery again.”

Alex’s parents are there. The Redskins were in Texas playing the Cowboys that day, but Dr. Robin West, the head team physician, flew back from Dallas to join in on the surgery. I couldn’t even tell you how long it was, but it felt like we were waiting for an eternity.

The doctors finally walk in, and they look defeated. Like they had opened Pandora’s box. “He has a bad infection,” they say. “There was colonization of the bacteria all through his soft tissue. We removed a big portion of the anterior compartment.”