Former Utah QB Alex Smith opens up about gruesome leg injury in ESPN special 
By Sean Walker, KSL.com | Posted - May 1, 2020 at 8:37 p.m.

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SALT LAKE CITY — Former University of Utah quarterback Alex Smith couldn’t walk without assistance.

He had no idea if his football career was over.

But after one of the most vicious hits taken by an NFL quarterback in more than three decades, he was just grateful — to be alive, to have his leg, and to have a supportive family by him every painful step of a medical episode he couldn’t help but wish was over.

And on Friday evening, he shared his story with the world.

The former No. 1 overall draft pick who will be inducted into Utah’s latest Hall of Fame class this fall finally broke his silence about an injury that has kept him out of the NFL for nearly two years — and nearly ended his life, he revealed in an ESPN long-form project titled "Project 11," directed by Daniel Lindberg.

From his star-studded career at Utah to his early struggles in the NFL with the San Francisco 49ers, and a career renaissance with the Kansas City Chiefs, Smith’s rise in The Shield was chronicled by the award-winning ESPN special projects bureau.

Then, in March 2018, at the age of 33, Smith signed a four-year extension worth more than $90 million with the Washington Redskins. Through ups, downs and everything in between, Alex Smith and his family were back on the upswing.

In one collision during a regular-season game against the Houston Texans on Nov. 18, 2018, Smith’s career — and even his life — changed.

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The injury was gruesome, drawing many NFL fans’ immediate comparisons to Joe Theismann following a career-ending compound fracture after a tackle by Lawrence Taylor in 1985.

"I remember the play. I remember pre-snap, making a protecting adjustment. It was a pressure look," Smith told ESPN. "To look down and to see your leg crooked, bending where it shouldn’t bend, was an unusual site.

"Immediately, I remember thinking, ‘My season’s over,’" Smith added. "It got pretty painful at that point."

The diagnosis revealed the worst: a compound tibial fracture, an open wound, and necessary emergency surgery in nearby Fairfax, Virginia. He had three plates inserted into his leg, two in the tibia and one to repair another break in his fibula.

But it was even worse than that. It was even worse than doctors initially anticipated and repaired. Smith had a fever and extremely low blood pressure — initial signs of infection — and doctors ordered tests to determine if the leg was septic.

"It was black. I mean, the blisters were huge," Smith’s wife, Elizabeth, told ESPN. "I couldn’t fathom seeing it in a war movie."

Bacteria had infected Smith’s leg, which was fully necrotic and filled with dead tissue. Saving his leg became preferable, but optional; doctors resorted to immediate life-saving measures. By the time they finished cleaning out all the necrotic tissue, Smith was missing vast portions of muscle from the knee to his ankle.

“Now we’ve got this lower leg that’s ravaged and deformed,” Smith’s father, Doug, recalled in the documentary, which shows the extent of the injuries in gorey detail. “We’re not even sure we could keep it. Maybe we shouldn’t.”

The Smiths elected to try to salvage his limb, and doctors transferred portions of his calf muscle and the opposite quadriceps to the damaged leg. The initial surgery was a success, but it left him clearly weakened.

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He was alive. He had his leg. But his football career? That was far from a certainty.

"I was upset. I was pissed off," Smith told ESPN. "You’re getting a little bit into a why-me-how-did-this-happen? mentality."

Rehabilitation wouldn’t come through NFL physicians, physical therapists and athletic trainers. The Smiths needed an even higher level of expertise.

"As the doctors explained it, he no longer had a sports injury," Elizabeth told ESPN. "He had what was more comparable to a military injury. He had a blast injury."

Thanks to a group of specialists at a military hospital in San Antonio and nearly 20 distinct surgeries, Smith began his rehab. He started to feel more like himself. He even started to feel like an elite-level quarterback — or at least, an elite-level human being.

"Having gone through everything, I feel really good about where I am. Optimistic. Hopeful," Smith told ESPN.

"I’m anxious for the next steps, of what I have left in front of me … So many people have put so much into it. I feel pretty good about the rest of my life, regardless of what happens with football."

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Sean Walker wrote:

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ESPN's Alex Smith documentary pulls no punches in showing a gruesome injury -- and courageous recovery
 By MICHAEL PHILLIPS
Richmond Times-Dispatch
Apr 29, 2020

It’s clear from the subject matter that a documentary about Alex Smith, the Redskins quarterback who suffered one of the most gruesome injuries in football history, is going to contain some graphic footage.

Still, try as you might, it is impossible to fully brace yourself for the impact of seeing, on screen, just what Smith’s leg looked like after undergoing surgery to repair multiple fractures sustained in a 2018 game.

That visual, about 35 minutes into ESPN’s excellent “Project 11” documentary, kicks off a series of images, each somehow more gruesome and stomach churning than the last, as doctors race to save his leg.

This is no circus sideshow, though. The images are crucial to the telling of Smith’s story, which was put in the capable hands of ESPN reporter Stephania Bell.

The physical pain is accompanied by emotional pain, as Smith’s wife, Elizabeth, discusses with a physician whether the leg should be amputated.

The hour-long program, which airs Friday night at 7:30 p.m, is ESPN at its very best — using its access, and trust with athletes, to take us places we’d never go otherwise. Bell said Smith wanted to make sure his story was told as authentically as possible.

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“Part of the authenticity of the piece was people really understanding where he had to come from and how bad it got,” Bell said. “I think the only way you can really appreciate that is to see the pictures. And Alex wanted to share that. It’s tough for the viewing audience, you know not everybody will want to see those things. That’s why there are graphic warnings. But it’s important to convey just how bad off he was.”

The first half of the program is devoted to Smith’s rise from lightly recruited quarterback to NFL star, building up to his trade to Washington and the injury.

While longtime fans will appreciate seeing home videos and other archival footage, it’s the rehab scenes that set this program apart. Smith has been mostly private since the injury, making “Project 11” all the more revelatory.

We learn that he had a portion of his quad muscle from his working leg transferred to the other, and that he went to The Center for the Intrepid, a military rehab facility in San Antonio, to receive post-surgical care.

Mostly, though, we learn just how dire things got once the wound was infected (it was exposed on the football field), and Smith’s body entered sepsis.

“I will never, ever forget this, as the surgeons walked out, they said, ‘We’re in life-saving mode now. And leg-saving mode, but it’s in that order,’” Smith’s mother, Pam, said in the film.

From there, Smith gradually works his way back to being able to walk, a triumph that was not a given when Bell started the project in early 2019.

Smith has even grander goals and continues to work out at Redskins Park regularly, but it’s clear from the film that how far he’s come is already an amazing achievement.

Bell said attending multiple rehab sessions and appointments with Smith, she was struck by how he threw himself fully into his recovery, even learning the medical terms the doctors were using.

She said some patients are content to be told what to do, but Smith wanted to learn the why.

“I don’t really know if there’s anyone else who has the same outcome with this injury and the consequences of it,” she said. “Alex is one of the most determined, driven people I’ve ever met, but in the most quiet and humble way.”

Bell also credited Elizabeth with keeping him well cared for at home, even as she raised the couple’s children.

“In the early days, she had to process everything,” Bell said. “He wasn’t coherent.”

Just as “Hard Knocks” gave viewers a peek into NFL meeting rooms, “Project 11” gives a look at a place that’s equally familiar to many of the league’s players, the rehab room.



The league would probably rather fans not see this side of the sport, but that makes the documentary all the more important. It also humanizes Smith, who millions of people will be rooting for after seeing his incredible perspective and unmatched drive throughout his recovery.

Michael Phillips wrote: