As he lay in his hospital bed following emergency, life-saving surgery, former University of Houston cornerback D.J. Hayden thought his career was over.
"I thought I'd never play football again," he told The Morning Journal's Jeff Schudel at the NFL Scouting Combine.
It's difficult to put into words just how incredible Hayden's story really is. As Schudel describes, a knee to the chest during practice tore Hayden's inferior vena cava (IVC)—the largest vein in the human body, one that is responsible for bringing blood from the lower body back to the heart. The resulting massive internal bleeding immediately threatened his life.
The nature of the injury is astounding enough. The events that followed are even more so.
In order for Hayden to live through the ordeal, recover as he did and be drafted in the first round five months later, nothing could go wrong.
Eight days before the draft, Andrea Kremer of NFL.com described the sequence of events that needed to take place. The first hero? University of Houston athletic trainer Mike O'Shea:
O'Shea was the first responder on the field and the first domino to fall. His decisions set off a chain of events that saved Hayden's life. And why did he do what he did, never having been in that situation before? He followed his gut instincts.
Medical staffs are trained to look for certain red flags that signal something may be seriously wrong. As Kremer writes, those red flags quickly announced themselves:
Hayden still couldn't breathe well; he felt cold and had started shivering. He was losing blood but didn't know it. Suddenly, his left eye went black, and all he could see were stars.
In other words, following the hit, Hayden entered a state of shock due to massive internal bleeding. Low blood flow to his skin and muscles prevented Hayden from burning fuel to create heat, causing him to shiver. Decreased flow to the brain led to his vision changes.
O'Shea recognized the severity of the situation and called an ambulance. The ambulance took the quickly deteriorating Hayden to Dr. Ron Albarado of the Memorial Hermann Texas Trauma Institute. Without the quick actions of Albarado and his team, Hayden would have soon entered a downward spiral out of which he could never have climbed.
As Kremer reports, Albarado opened Hayden up and found the expected internal bleeding. Yet even in surgery, the nature of the injury initially remained a mystery—Albarado could not readily find the source of bleeding.
"We found blood, did not find a liver injury, did not find a spleen injury," he said.
As they are abdominal organs that are relatively unprotected from blunt injury, Albarado correctly suspected the spleen or liver as the source of the bleeding.
Then, Albarado looked higher up—in Hayden's chest.
"The main blood vessel, the vena cava, bringing blood from the lower extremities back to the heart, was nearly completely torn off the back of the heart," Albarado told Kremer.
In some people, the IVC can reach a diameter of over an inch. That's a one-inch-wide pipeline of blood streaming into the abdomen and chest with each heartbeat.
With such rapid bleeding, a delay of minutes could cost Hayden his life. Doctors needed to act quickly, and the only treatment for a torn IVC is the immediate surgical repair of the vessel. To do so, they performed a thoracotomy—they cracked open his chest.
According to Kremer, a fountain of blood greeted Albarado. He needed to place his hands directly on Hayden's IVC to stem the tide and buy time for Hayden to receive what eventually amounted to enough blood transfusions to supply three healthy adults. It bled that fast.
Sewing the IVC back in place on the heart proved an immensely difficult task. Kremer explains: "Albarado likened repairing the vena cava to sewing together wet toilet paper; every time he would put a suture in, it would practically disintegrate."
After hours of tireless work, the repair ultimately proved successful, but the question still remained: Was the damage already done?
In hemorrhagic shock, poor blood flow to organs like the kidney and brain causes damage. Sometimes, that damage is permanent. Kidney cells die and no longer clean the blood, and low cerebral blood flow causes strokes.
Often, it takes time to know whether damage took place. If it did, it takes even more time to know its severity and whether it is permanent.
Worst of all? Hayden—once among the elite of all elite athletes—could no longer perform the simplest movements without experiencing blinding pain due to the surgery.
The situation took its toll. Tormented by the possible looming end of a career for which he worked and trained tirelessly for years, Hayden's spirits were understandably low. He recalled, via Kremer:
Why do I have to go through so much pain, why do I have to? Just, why me? Why? That was the lowest point. I was scared every time my heart would beat fast. I got nervous because I thought, like, the vein was gonna tear again.
Yet with the resolve that only the most determined can muster, Hayden pushed through. Day by day, he kept his eyes on the big picture.
The psychological toll that serious, life-threatening injury or disease can take on patients is often forgotten by those on the outside looking in. Nevertheless, given the fact that he clocked a 4.40 40-yard dash time just four months after nearly dying, it seems Hayden had no interest in giving up (h/t Rob Rang, TheSportsXChange/CBSSports.com).
Due to that, heads started to turn once again, and slowly but surely, Hayden made his way up NFL draft boards. Hope rekindled. All it takes is one.
Then came Thursday night.
With what is sure to go down as one of the most famous utterances by Roger Goodell in NFL draft history, the Raiders took their chances on the walking medical marvel that is Hayden.
Everyone watching couldn't help but smile.
Sure, there was some shock and disbelief. After all, is it a smart move from a football standpoint?
Maybe, maybe not. In fact, some teams might not have been willing to draft Hayden at all due to his history, let alone take him in the first round.
In the end, it pales in comparison to what is really important, as injury stories end sadly all too often.
A freak hit here. Lost agility there. Players traded. Players released. Concussions. Head injuries.
Sometimes, it seems like it doesn't end.
Yet, this time, an athlete ignored the medical textbooks and proved everyone wrong. O'Shea, Albarado and everyone in between are true heroes, and Hayden's story may one day go down as one of the most unlikely triumphs of medical acumen and quick action in the history of football.
Nevertheless, nothing is more important than the drive and resolve Hayden showed following his injury. He beat insurmountable odds and realized his football dreams mere months after nearly dying.
In other words, well, the kid's got heart.
Dave Siebert is a medical writer for Bleacher Report. He will join the University of Washington as a resident physician in June. Medical information discussed above is based on his own knowledge.
Follow Dave on Twitter for more sports, medicine and sports medicine.