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Washington Football Team QB Alex Smith's comeback from nearly losing his leg

If you are looking for strength and character in the nation's capital these days, look no further than the story of Alex Smith. Nearly three years ago, the Washington quarterback suffered a crippling injury that almost led to the amputation of his right leg. It would have been a brutal end to the long career of a man who was once the first overall draft pick in the NFL and a three time pro-bowler. Instead, as we first reported last January, Smith defied expectations by rehab-ing the way injured special forces do. Tonight, a look back at one of the greatest comebacks in sports history. 

It all began on November 18, 2018, when Alex Smith led Washington as quarterback against the Houston Texans and pass rushers, Kareem Jackson and JJ Watt, crashed through his offensive line.

Alex Smith

Alex Smith: It was one of those plays as a quarterback, you know, "Okay, they got us--" you know, "Secure the football and-- and just kinda get down.

Alex Smith:  I immediately knew that it was broken.

Norah O'Donnell: You could see it or you felt it? 

Alex Smith: The visual was the most alarming thing, for me to look down and know that my leg was broken, it wasn't straight-- bending in a place it shouldn't bend.

Dr. Robin West: Alex isn't a guy who goes down a lot. I had never run on the field for him.

Dr. Robin West was the Washington Football Team's head physician. Last season was her 18th in the NFL.

Dr. Robin West: And I realized quickly that the injury was-- was severe when I got out there.

Norah O'Donnell: Just so that people understand, what is a compound spiral fracture?

Dr. Robin West: He had a fracture that extended from his ankle joint up to his knee joint. So, it spiraled all the way up the tibia, and then he had a piece of bone sticking out of his skin.

Norah O'Donnell: How often do injuries like this happen in football?

Dr. Robin West: Like this? No. Very, very rarely.

  Dr. Robin West

After watching from the stands, Alex Smith's wife, Elizabeth, rushed down to be with her husband. 

Norah O'Donnell: Do you remember what he said to you in the ambulance?

Elizabeth Smith: Yes. He wanted me to pull the game up on my phone. He wanted to know the score, he wanted to know how the offense was doing. He was not even worried about his leg whatsoever. He was worried about his team.

A team of orthopedic trauma surgeons was waiting to operate at Inova Fairfax Hospital in Virginia. They put Smith's leg back together with three plates and 28 screws and pins.

After surgery the X-rays looked good, but what Dr. West and her colleagues could not see was bacteria, she thinks from Washington's football field, had infected the open wound on Smith's leg.

Alex Smith: There in those couple days after is when it-- it, you know, quickly-- quickly got sideways.

Elizabeth Smith: His blood pressure's dropping, his fever was skyrocketing. And that's when I knew it was a lot worse than we ever anticipated.

Not many diagnoses sound worse than necrotizing fasciitis, more commonly known as flesh-eating bacteria. As the infection ravaged Smith's leg, his body reacted by developing stage-two sepsis, a dangerous condition that can damage organs and lead to death.

Norah O'Donnell: And his infection just keeps getting worse. What's going through your mind?

Elizabeth Smith: I'm obviously more worried about his life. He is septic. And, you know, you hear all these staggering numbers on when people go septic. 

  Elizabeth Smith

At one point, Elizabeth Smith asked to speak to Dr. West privately. His medical team was already considering the amputation of her husband's right leg.

Dr. Robin West: She said just-- just to get rid of it. "I just want him to live and walk out of here." So, we talked to his family and his father had a similar view. And then we went to Alex. But he said, "Do what you can to save my leg. Do anything you can to save it."

Smith underwent eight operations in ten days to carefully remove all the dead or infected tissue.

Norah O'Donnell: What did Alex Smith's leg look like?

Dr. Robin West: Bone, basically. All he had was his calf muscle and his tibia and his fibula.

Alex Smith: We were in the hospital approximately a month. They had to remove quite a bit of muscle and tissue from my lower leg-- in order to-- to get the infection under control. 

Alex Smith:  And then faced with the reality that, "Hey, we--" you know, "We-- we still might have to cut off your leg." And-- for me, that-- to hear those words-- hard to deal with as a professional athlete, and someone that-- that really-- I-- I mean, I think I took that for granted for so long- my body, my health. Yeah.

Norah O'Donnell: The most basic thing people take for granted.

Alex Smith: Yeah. No doubt. Just wondering, like, I mean, would I ever be able to go on walks with my wife? Would I ever be able to play with my kids? Crazy reality. So yeah really thankful to be here.

Surgeons covered Smith's bones so they would heal, partly by removing a portion of his left thigh muscle and placing it on his lower right leg.  

His leg was also fitted with a piece of hardware called an external fixator.

Alex Smith: It looks medieval, but it's really advanced orthopedics. And so I wear this metal cage that's bolted into and pinned into my leg, and it holds my leg and bone in place-- while it heals.

Norah O'Donnell: How long did you have to wear the fixator?

Alex Smith: Yeah, it was almost ten months I wore this bolted in my leg. It was a long process.

The Center for the Intrepid in San Antonio was specifically built to help Wounded Warriors through that process. Dr. West reached out to her friend Johnny Owens, who for ten years had been the center's chief physical therapist.

  Johnny Owens

Norah O'Donnell: Had you seen a lot of injuries that were similar to what Alex had?

Johnny Owens: I have. That was the hallmark injury of-- of the wars was these lower leg injuries from blast traumas, stepping on landmines.

Smith requested and received special permission from the Pentagon to visit and consult with the Center for the Intrepid's staff.

Johnny Owens: We saw hundreds of Alex Smiths come through this door with those type of injuries and-- and said, you're gonna be able to run. You're gonna be able to do all these type of things that-- that people told you you weren't gonna be able to do.

Dr. Joe Alderete is a West Point graduate and chief of orthopedic reconstructive surgery at the center. 

Dr. Joe Alderete: From the moment we-- we met, you could tell in the look behind his eyes that can be so many of my patients, either blast injury, roadside bomb, cancer.  That look is binary. It's "you will succeed" or "you will fail." And Alex had the look of success.

During Smith's first trip to the Center for the Intrepid just a few months after his injury, the ESPN program "E60" recorded a major milestone in his recovery. 

Norah O'Donnell: What happened when you tossed Alex a football for the first time?

Johnny Owens: Two things. He almost-- broke my ribs because I didn't catch the ball right. And second, there was that spark in his eye. It w-- it was so cool. I think it was like a light bulb went off.

Smith says he was humbled and inspired to be around service members, some with injuries similar to his own, who were not only running but returning to duty.

Alex Smith: The rest of the world was telling me, "Temp--" yeah, "Go be happy about the rest of your life and-- and hopefully you save your leg and-- and that'd be great. And, you know, whatever you can do beyond that is icing on the cake." And that was not the mentality down there--

Norah O'Donnell: At the Center for Intrepid--

Alex Smith: That was the exact opposite. That it's okay to dream about playing again. It was okay for-- for service men and women if they wanted to go back and try and serve, and to do triathlons, and-- and-- and be elite. To go chase it. And that--

Norah O'Donnell: No mental limitations.

Alex Smith: No. No.

Washington Football Team quarterback Alex Smith describes his NFL comeback 05:16

Through thousands of hours of physical therapy and with the help of various braces and orthotics, Smith would re-learn to walk, then run and eventually move like a quarterback again, sometimes with the help of his wife, Elizabeth. 

Alex Smith first threw a football as a toddler.  He says he always wanted to be a quarterback and despite being recruited by Harvard and Princeton chose to play football at the University of Utah.

After being selected by the 49ers as the first overall pick in the 2005 draft, ahead of quarterback Aaron Rodgers, Smith struggled with injuries and consistency, but after a move to Kansas City in 2013, played the best football of his career. Then the team drafted a young quarterback from Texas Tech.

Norah O'Donnell: What's the name of that guy again who replaced you at Kansas City?

Alex Smith: Yeah. Don't know if you ever heard of him. Pretty good player.

Patrick Mahomes was the MVP of Super Bowl LIV, but spent 2017 as Alex Smith's backup and understudy.

Patrick Mahomes:  He didn't hold anything back from me. I mean, he taught me. That's just the type of person he was and that he is. And I'm… I attribute a lot of my success to him.

Alex Smith: I think the thing that jumps out to me-- from our relationship is from day one the mutual respect. And I think just, you know, what a good person he was.

Norah O'Donnell: How did you mentor him?

Alex Smith: I was gonna be a good teammate. I wasn't gonna be selfish. You know, I-- I signed up to play a team sport and was gonna do my part.

Last summer at the age of 36, after 17 surgeries and 20 months out of the game, Alex Smith was medically cleared to rejoin the Washington Football Team, despite the fact that his tibia bone was not yet 100% healed.

Norah O'Donnell: But after everything that you've gone through, why would you risk it?

Alex Smith:  I'm not crazy. I was-- I wasn't gonna do this if I didn't, you know, obviously hear from the experts.

Alex Smith: And so to hear finally from the experts that, "Okay, you can." For me, a bit of a gut check, you know.  Do I really wanna do this? Do I put myself out there, walk across those white lines potentially again in live action.

Norah O'Donnell:  Exhilarating or nerve-wracking?

Alex Smith: Both.

He wouldn't actually play in a game until week 5, when the starting quarterback got hurt against the Los Angeles Rams.

Three plays in, Smith was sacked by all-pro tackle Aaron Donald.  And then, he got right back up.  Watching on TV, while deployed in Iraq, was Dr. Joe Alderete.

  Dr. Joe Alderete

Dr. Joe Alderete: I was so proud of Alex-- sorry-- and-- and all that he had achieved.

Norah O'Donnell: You were emotional then watching that.

Dr. Joe Alderete: I was, I was totally blown away. I didn't know whether I w-- I wanted to cheer or throw up. It scared me to death, but I-- I just loved watching Alex achieve. 

Dr. Alderete says the only other patients he's seen achieve similar outcomes are the most elite U.S. Special Forces. 

Norah O'Donnell: So you've worked with almost 1,000 limb salvage patients. How many have been able to get back to the type of functionality that Alex Smith has?

Dr. Joe Alderete: Less than a dozen. Alex is my capstone patient of somebody who absolutely knocked it outta the park.

Smith went on to record a five and one record as a starter. Washington beat archrivals the Cowboys on Thanksgiving Day and in their next game, ruined the Steelers' undefeated season. 

The day after he helped Washington clinch the NFC East and a spot in the playoffs Smith was sore and needed some physical therapy. He had missed the prior two games because of a bone bruise, on yes, his salvaged right leg.

Washington's coaches kept him out of the playoff match-up against Tom Brady and Tampa Bay, which won the game. Afterward, the greatest of all time made it a point to pay his respects, to the triumph of Alex Smith's comeback.

Tom Brady after game against Washington:  Hey, so proud of you, bro. You're unbelievable, you know that? 

And despite the end of his season, the comeback might not have been over.

Alex Smith: This year has-- has only emboldened-- for me that I can-- you know, play at this level.  I feel like I've had a lot of people reach out to me-- saying they feel like my mom, you know, when I'm playing. And how concerned they are for me.

Elizabeth Smith: I understand people's apprehension. I have the same apprehensions. But I think it's bigger than football. That's what I tell people. It's not about the game. It's about what happened and getting back on your feet and dusting yourself off, no matter what the obstacle is. 

This past off-season, Alex Smith made the difficult decision to retire from the NFL. But he's not done with the game. This season he will work as a football analyst for ESPN.

Produced by Keith Sharman. Associate producer, Kate Morris. Field producer, Mark Hooper. Broadcast associate, Olivia Rinaldi. Edited by Sean Kelly.

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