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If Alex Smith, the quarterback of the Washington Football Team, needed any reassurance that his right leg would hold up after two years and 17 surgeries out of the game, he got it fairly quickly. Some 700 days after a sack by J.J. Watt left him with a compound spiral fracture in his right leg, and one of the most gruesome injuries in NFL history, he returned to play—and was promptly sacked by Defensive Player of the Year Aaron Donald.
Though the leg had been repaired successfully—with 28 screws and three plates—the journey had been long, complex, and pretty terrifying. At one point, his leg was infected with flesh-eating bacteria called necrotizing fasciitis. Smith then developed sepsis, a complication of an infection that occurs when a body’s immune response damages its own tissues, which left him with two options: amputate his leg, or have a series of surgeries to try to save it. Neither option was good, and neither left Smith, a former number one overall pick, much chance of playing football again.
But with the help of rehab specialists at the Center for the Intrepid, where veterans who have suffered blast wounds are treated for similar injuries, Smith improbably made his way all the way back onto Washington’s roster, as the third-string QB. (He says the team didn’t expect or want him back.) By the end of the season, he’d become the starter, won five of six starts, and led the team to the playoffs.
For all that, Smith brought home the NFL’s Comeback Player of the Year award a few weeks ago. (Duh.) He spoke with GQ to talk about the decision to keep his leg, the reasons he decided to play football again, and the chances we’ll see him on the field again in 2021.
Why play football again this year?
That's the big question. Why? Why would I do that? Just go be happy with the rest of your life kind of thing. I think two things. Like I said, it was so long that I had these huge doubts about ever playing with my kids again, ever being a normal person. You really think about everyday life things, like getting up to the bathroom in the middle of the night, showering, being able to golf again, go on walks, hiking, you name it, skiing, mountain biking. Can I do anything?
It did have to do with the military. Their involvement in my rehab, being the foremost experts on lower limb injuries in the world and the rehab that I was doing, and trying to get back to an elite level. But, really, also the mindset. King of just daring me. And they were the first ones in a rehab session, really early on, to put a football in my hands. Johnny Owens was the PT, and was really involved in my plan coming back. He put a football in my hand.
I hadn't touched a football and I had kind of been bitter towards football because I'm like, I was playing this stupid game and [the injury] happened. I remember how good it felt to play catch, how good it felt to have a football in my hand. I'd been playing catch my whole life, and how natural it felt. My rehab was better. I just enjoyed doing rehab with a football in my hand: Give me the football to see if I can do this. I started thinking about playing quarterback more.
It really did energize me. It started to become this thing, to put this crazy thing out there. I knew if I never achieved it, my life would be better. I would be able to do more. I was going to take my rehab further than I would if I had just settled on being able to stand or golf. I know I'm ancient and old in football terms, being 36, but I was like, "Man, I got the rest of my life. I got young kids. There's all these things I want to go do that I've dreamed about doing outside of football." I knew football as a vehicle to go try to do this crazy, ambitious thing. I knew, even if I don't get there, I'll be better for it and I won't have any regret that I just settled, that I was happy with just golfing. And I love to golf, so I don't mean that in any bad way.
In the back of my head, I never thought it was actually going to happen. I put this crazy thing out there and was like, let's see if I can go get it. Really, a big part of me was skeptical, like, that's not going to happen anyway, I'm going to hit the wall before I get there. It was really scary when I finally got the clearance right before camp from all the doctors. I got this big round of imaging done, and all the doctors—all the military doctors, all my doctors here in DC—were like, "You're good to go." I never thought I'd hear those words. They were like, "If you want to play football again, you can do it."
I assume you were talking to the Washington Football Team throughout that process? Were they surprised to hear that you were ready to go?
They were. They never thought I was coming back. No one there. I did all my rehab outside of the building. They do ACLs and stuff like that. But walking in with what I had, it's like you got three eyes.
So what was their response?
So there was a very small group of people that actually thought that I could do this. I think the rest of the world either doubted me, or they patronized me. "Yeah, that's really nice that you're trying." When I decided to come back, I definitely threw a wrench in the team's plan. They didn't see it, didn't want me there, didn't want me to be a part of it, didn't want me to be on the team, the roster, didn't want to give me a chance. Mind you, it was a whole new regime, they came in, I'm like the leftovers and I'm hurt and I'm this liability. Heck no, they didn't want me there. At that point, as you can imagine, everything I'd been through, I couldn't have cared less about all that. [laughs] Whether you like it or not, I'm giving this a go at this point.
And so you convinced them.
Well yeah. I mean, they tried to put me on PUP [Physically Unable to Perform] for two weeks, then they tried to IR me. I felt like I still hadn't had my fair shake at that point. I wanted to see if I could play quarterback and play football, and I feel like I hadn't been given that opportunity yet to find that out. It’s like getting this close to the end line of a marathon and they're telling you that you can't finish the race. It’s like, fuck that. I'm finishing this thing. At least I'm going to see if I can. So, I’m thankful we worked through all that stuff but no, it wasn't like open arms coming back after two years. Like I said, new coaches, new faces, and I think I definitely surprised a lot of people that never thought I would even be trying it.
So when you go into your first game against the Rams this year, is there any part of you that's like, "What the... I didn't think I would be able to do this, this is crazy”?
Oh, sure. I honestly never thought it would happen. I never, never thought it would happen. Then obviously, towards the end, it became more of a reality. That week was the first week I even dressed. I’d just gotten bumped up from third string to backup, and boom, sure enough, I'm playing. It was a ton of emotions. A ton of dread and terror, and really wondering what was going to happen when I go out there and get tackled. Also just the crazy excitement and rush and exhilaration of being able to play football again.
And then gigantic Aaron Donald hops on your back.
I don't think I've ever been tackled like that in my entire career, ever playing football. It's so crazy that the first time I get tackled after all this is Aaron Donald jumping on my back. If there's any other way for me to know that my leg was strong enough, here's the perfect example. In hindsight, I'm thankful for it. I was able to put all the contact stuff behind me and I could really just move on to playing football again.
Did you look at your leg after that and be like, "Okay, we're good?”
There was a moment. I didn't know it was Aaron at the time, but I felt like it was in slow-mo. I'm like, "I have a D-lineman on my back right now." And I took a couple of small steps before I went down. There was a little pause when that happened, like, "I got a human on my back with this leg.” Turns out it was the three-time Defensive Player of the Year.
So after that, it sounds like you were a little more free. Do you still think about the leg playing? I know in the 60 Minutes piece, you said a lot of people are like, “I feel like your mom watching you play.” And I will say, it's scary watching you.
All my buddies, especially guys that I played with earlier in my career, all had told me that, like, "Dude, I just can't watch. I'm on pins and needles every time you're out there." I got to play one more time as a backup, and I felt really good playing, really natural, I didn't feel like I hesitated at all out there. I wasn't thinking about my leg. And then [it was] really, really eerie, for my first start, how good I felt, how comfortable I was out there. I kept thinking I would have more apprehension after everything that I'd been through and I felt like that would linger longer, but it really didn't. I really felt like it was like ripping a Band-Aid off. My wife would ask me and I'm like, "No, it's weird. I feel really good out there. I feel like I'm just playing football."
When you won Comeback Player of the Year, you ended your speech by saying, "Just live." I'm curious what you mean by that.
So it's a bit of a long story. When I was a young player, I struggled with anxiety and expectations and playing to please people. I felt like I had to justify my draft status. It consumed me and became this just downward cycle.
I've had some teammates, these crazy special teams guys. These guys run down on kickoffs—and this is back when they had walls [behind the end zone], and they were running through the walls. They were all backup linebackers. And they were nuts. They’d get all hyped up before the game in the locker room. I mean, you kind of go to a crazy place to go do that. I had two in particular that would always talk about living. They would always talk about, "Man, I'm going to live today." And they'd walk around and challenge you, like, "Are you going to live today?" And I'm this young quarterback and I'm like, "What the hell are you talking about?" [laughs]
I learned what that means, to just live. Being in the moment, making the most of the opportunities. And certainly what an opportunity it is to go out there on Sundays and play, to be like kids. That stuff's not going to last forever. We don't know when it's going to slip through our fingers. So it became something I would tell myself all the time: "Just live. Just go out there."
With the injury, it definitely made me buy into it even more because I spent so long not being able to do anything. Doubting what I would ever be able to do. My mind going down those dark paths and having a lot of negative self-talk. When I got to start rehabbing and I got to start doing more, [it became] a little bit more about flipping that mindset. Just live and enjoy the process, even when I got to just stand, how amazing that was. When I got to start to walk again. I got to do these activities that I wondered if I'd ever be able to do again. Really, for me, that reminder of the mindset and attitude, trying to live up to that one day at a time.
There's a fraternity of guys who have had traumatic leg injuries—I can think of Paul George or Gordon Hayward. Is there a tighter knit fraternity for something like this?
Well, there's a small group of guys that have had [fractured tibias] in sports. Paul George and Gordon Hayward, and then the big man for the Trailblazers, Josef Nurkic, just did it a couple years. But in football, it's Joe Theismann. That's it. Everybody knows about that, Lawrence Taylor breaking his leg. I was too young to actually remember that at all, but obviously I knew the story. I had no idea that when I broke my leg, it was 33 years to the day. It was almost on the same yard line. His was by a former Defensive Player of the Year, mine was [DPOY] J. J. Watt. Player of the Year. And Joe was there—Joe came to our game. Eerie similarities.
So with the 49ers, you have great success, and then you get hurt and Colin Kaepernick comes in, and he plays great. You guys just miss winning a Super Bowl. You go to the Chiefs, you have consecutive All-Pro seasons, then Patrick Mahomes comes in. I can imagine in those situations, there could be a little bit of, "Why me?" And then the injury happens, and I imagine that has to also be like, "Why me?" Do you feel unlucky? How do you process those things?
So I guess to run through all of it, my first several years in San Fran were so bumpy and so rocky. I got drafted as the number one pick—we were the worst team in football the year before. It was a hard road out of it, and then finally we were out. I was playing decent football. And we finally turned a corner, made the NFC championship game, and then, the next year, the Super Bowl. So to get traded, I was a little bit bummed. I had finally worked through all that. I didn't leave, I didn't run. I stuck it out, and it finally turned. And then I missed my window. But also I felt like when I got traded, it was also this brand new opportunity.
[In 2013, when I got traded to] the Chiefs, they were the worst team in football. Andy Reid comes in and it was a little bit like, Here's my chance. I still feel like I have a lot of football ahead of me, and I'm going to go and run with this thing and go. And we did. We made the playoffs four out of five years, and I went to the Pro Bowl three of those years, won the division a few times, and just never got it done in the playoffs. And then obviously, we draft Patrick. That was my 13th year in the league. At that point, I didn't have much, "Why me?" I was like, "I got another year. I'm coming to Washington, I'm ready to go. I feel like I'm still reaching my potential, I just came off the best year in my career in year 13."
Never had [the “why me?”] through the broken leg. [But after I woke up], I was out of it for two weeks while they were doing all the infection hits, and then I had all these debridements where they were cutting the infection out of my leg. I remember coming to two weeks later, and it was my wife and doctors in the room, and they were explaining to me what was left in my leg. That things would never be the same and that I'm going to have permanent [damage]. They had to remove muscles and tendons and permanent things that I'll never get back. And I have two choices now: we can cut off your leg—and there were doctors advocating for that in the room from the team—or I could elect to have several more surgeries, and they're going to kind of Frankenstein my leg. They're going to take a muscle out of my lat or my leg or my quad on my other side and they're going to move it down. And these aren't guaranteed to work either. And we're going to try and save your leg, and if we do happen to save your leg, we don't know what kind of ability you're going to have at all, because you do have permanent muscle loss down there.
Faced with that, when I kind of came to, that's when I really got dark. It was like, "Why me? How did this happen?" I was playing football. And all of a sudden we’re talking about cutting off my leg. Or I've got this other option where they're going to cut out muscles from other parts of my body, put them down here in hopes of saving my leg, and if those work, I’ll still be, in my head, crippled for the rest of my life.
That was months and months of me in the hospital, and in a wheelchair, and in a walker, just thinking about that stuff. I couldn't do anything. I was helpless. Just like, my life's never going to be the same. Luckily, the surgeries worked and I got to keep my leg, but I still didn't know what I'd be able to do with it. It was this great big unknown. So that was when I was probably my darkest, for sure. Going back to: It was just football. I was just playing football.
And they took from your left quad, ultimately, to rebuild your right calf, right?
They wanted to take my lat and I was like, "Don't take my lat."
Because you needed to throw?
I'm like, my lat? My upper body? Now you’re going to make my upper body weaker? And so they ended up taking one of my quad muscles from my left leg. They literally cut the whole thing out, and then put it down there. Then they also had to turn my calf. So half of my calf on my right leg, they had to disconnect, and then they also turned that sideways.
My infection wasn't on the back of my leg, so I did get to keep my calf. Still, every time I see the plastic surgeon, I get after him. I remember not even knowing that was going to happen. I woke up and he's like, "Oh, we also had to take half your calf." And I'm like, "You didn't tell me that. That wasn't part of the deal." [laughs]
Do you have any more answers or thoughts on whether or not you're going to retire, or keep playing?
I'm still in this space where I have so many plans. I'm going to go snowboarding in two weeks. There's all these things I plan on doing. I felt like last year, just based on where my rehab was and then COVID, I didn't get to answer a lot of those. But I did get to go do football. I made a ton of gains through the year, and I still feel like I have more left to go gain. I still feel like there's stuff for me to go get out there, and get better.
But this offseason, there's a bunch I want to go do off the field. But football-wise, I got more left. I got more to get there too. So I really do really wanna get in the meat of this offseason and see where I'm at and push it. I want to push my body harder. I want to push my leg harder. The harder I push it, it does respond. So I kind of want to go do that. At some point, I'm obviously going to have to sit down with my wife and have a very real conversation and, do we want to do this? She deserves a ton of input. So we'll see.
This interview has been edited and condensed.
Originally Appeared on GQ