First, the good news: Damar Hamlin remains alive after one of the scariest moments in NFL history. After collapsing on the field in Cincinnati from what was later determined to be cardiac arrest, first responders got his heart and breathing restored on the field before transporting him to the University of Cincinnati Medical Center.

The bad news is that Hamlin is still in critical condition and under sedation, but this looked last night that it would turn out worse:

Damar Hamlin suffered a cardiac arrest following a hit in our game versus the Bengals. His heartbeat was restored on the field and he was transferred to the UC Medical Center for further testing and treatment. He is currently sedated and listed in critical condition.

— Buffalo Bills (@BuffaloBills) January 3, 2023

Hamlin, 24, went down after making a tackle on Cincinnati’s Tee Higgins with 5:58 remaining in the first quarter. He got up and took a few steps after making the hit before collapsing.

As Hamlin collapsed at 8:55 p.m. local time, the response on the field was immediate and hurried. Bills medical personnel rushed onto the field, stabilizing his head and neck. Doctors instantly called for a stretcher from the Bengals’ sideline and rushed it onto the field. Response from Hamlin’s Bills teammates was also immediate. …

The safety was lifted off the ground in a stretcher after being worked on for 15 minutes, leaving the field at approximately 9:10 p.m. ET. As he was loaded into the ambulance, all his teammates had a mile-long stare, trying to process what had happened to Hamlin. He was taken from Paycor Stadium to University of Cincinnati Medical Center around 9:25 p.m.

The game was temporarily suspended for more than 30 minutes before the decision was made to postpone. There was no word on whether the game would be rescheduled.

To say that no one’s seen anything like this may be a cliché, but it’s true. We have seen devastating hits on the field with tragic consequences before. I remember watching Daryl Stingley get leveled by Jack Tatum and becoming a quadriplegic, a hit that forced the NFL to finally take its first steps toward penalizing dangerous techniques and thinking through player-safety issues on the field. That hit didn’t stop the game, however, perhaps because the violence of the hit made the result seem a little more rational, even if just as devastating.

This hit, however, doesn’t seem like anything out of the ordinary. Out of respect for the Hamlin family and his Bills teammates, I’ll refrain from showing the clip, although it’s pretty widely available if you look for it. Hamlin showed good technique in squaring up on a Bengals ballcarrier, who also showed good technique in keeping his facemask up while driving through Hamlin’s torso. It’s a kind of collision that happens in every game, maybe even a dozen times within a game. Nothing about this looked unsafe until Hamlin collapsed backward lifelessly a couple of seconds after getting up.

That makes this awful outcome much more unsettling. The NFL’s first reported instinct to return to play misread the room, although perhaps understandably considering the normal routine around serious and severe injuries. The players on both teams balked, and the league rightfully reconsidered with a postponement. That creates complications for the league, to which we’ll return in a moment, but those are a lower priority to understanding what exactly took place.

We know that Hamlin had a cardiac arrest, and that seems linked to the hit to the chest he took, but we don’t know why or how. Speculation on sports media and Twitter last night was that it was a form of commotio cordis, a kind of cardiac arrest that can happen with healthy people after a traumatic strike to the chest. WFAA brought on a doctor this morning to give a brief explanation:

Just to be clear, we don’t know that this is a case of commotio cordis. It fits the circumstances, but it might be that Hamlin had an undiagnosed problem with his heart, too. We won’t know more before the doctors can explain it to his family, and then to the extent this gets shared with the league and with fans. All we can do at the moment is pray that Hamlin recovers.

What about the league? Last night, they belatedly reached the correct conclusion, although it reportedly took a player revolt to do so. Unfortunately, the road ahead looks murky. Hits like the Tatum-Stingley incident make it easy to address the risk through policy. Nothing about this play was dirty or even bad technique, though. If this turns out to be commotio cordis, it will be a freak occurrence that no amount of policy can address, unless the league is willing to transform its entire platform to flag football. The best argument for shrugging it off is that it hasn’t happened before in over a century of competitive football at any major level, or so we think. (Are we sure about that?) Even so, it will be a very long time before anyone forgets what happened to Hamlin, especially the men on the field who put themselves at risk in every play.

Least importantly: what does the league do about this game? It had significant playoff implications, and next weekend the regular season ends. Trying to play another game in between heightens all the risk factors for the players. I’d bet that the league just simply cancels this game with no penalty to either team and let the chips fall where they may on playoff seeding based on the records as they stand. There’s no better option at hand.

Finally, keep praying for Hamlin and his family, friends, and colleagues. If people want to do more, it turns out that the young athlete started a crowdfunding effort a couple of years ago to buy toys for underprivileged children, a charity he began even before Hamlin got drafted by the Bills. Since his cardiac arrest, Hamlin has raised $3 million from people wanting to show their support for him and his family in the immediate aftermath of his collapse:

Fans also showed their support by pouring millions of dollars into a charity that Hamlin started in 2020, shortly before he was picked in the sixth round of the 2021 NFL draft.

“As I embark on my journey to the NFL, I will never forget where I come from and I am committed to using my platform to positively impact the community that raised me,” Hamlin wrote on the foundation’s GoFundMe page.

The Chasing M Foundation was running a campaign to purchase toys for children in affected by the pandemic in McKees Rocks, Pa., where he grew up.

A cached version of the GoFundMe page shows that before Hamlin’s collapse, the foundation had raised a little over $2,900.

As of 8 a.m. on Tuesday, the fundraiser topped over $3.3 million in donations, 135,000% more than its goal. Thousands of fans across NFL teams shared words of support on the page, which GoFundMe verified on Twitter.

Hamlin’s true heart has nothing wrong with it. Let’s hope and pray his physical heart matches up at the end of this incident.