About 48 hours after he collapsed and went into cardiac arrest during a nationally televised NFL game, Buffalo Bills safety Damar Hamlin awoke for the first time Wednesday night. Unable to speak because of a tube that is helping him breathe, he scribbled a note on a piece of paper on a clipboard.

“Did we win?” Hamlin asked his bedside nurse.

“The answer is yes, Damar, you won. You won the game of life,” Dr. Timothy Pritts said Thursday afternoon at a news conference in Cincinnati, paraphrasing the response of one of his medical partners.

Hamlin’s memorable question elicited a combination of joy and relief from the University of Cincinnati Medical Center team that is taking care of him. As Pritts said, “That tells us that it’s not only that the lights are on. We know that he’s home, and that it appears that all the cylinders are firing within his brain.”

Pritts and Dr. William Knight IV described Hamlin’s recovery as “fairly remarkable,” explaining that he appears to be neurologically sound, that his lungs have shown improvement and that he is able to move his hands and feet. While cautioning that Hamlin is still in critical condition and won’t be discharged until he can breathe on his own, Pritts said, “This marks a really good turning point in his ongoing care.”

That Hamlin is not just alive but alert and asking questions is a tribute to the medical personnel on site Monday night in Cincinnati. Pritts and Knight went out of their way to heap praise on the Bills' athletic training staff, admitting it’s “fair to say” the outcome could have been far more tragic had they not immediately recognized the gravity of the situation.

In the first quarter of Monday’s game between the Bills and Cincinnati Bengals, Hamlin took a lowered shoulder to the chest while tackling Cincinnati receiver Tee Higgins. Hamlin untangled himself, rose to his feet and adjusted his face mask before falling backward to the turf and laying there limp.

Bills medical staff sprinted from the sideline, assessed Hamlin’s condition and instantly called for the enactment of the NFL’s emergency action plan. An airway management physician and other emergency personnel were at Hamlin’s side in less than a minute, according to Knight, a crucially speedy response since when the heart stops beating, the brain no longer receives oxygen and can suffer significant damage in just minutes.

Knight said that Hamlin “initially had a pulse on the field and then lost it under the nose of the physicians and teams that were with him.” As distraught Bills teammates knelt around Hamlin and fought back tears, the second-year safety received “immediate bystander CPR” meant to imitate the pumping of the heart and restore the flow of blood to vital organs.

Medical personnel then successfully shocked Hamlin’s heart back into rhythm using a portable device called an automated external defibrillator. Moments later, Hamlin was taken via stretcher to a waiting ambulance, where Knight says a tube was inserted into his trachea to help him breathe.

Knight and Pritts described the response from the Bills' athletic training staff and independent physicians on site as “really, really outstanding work.” They said other professional sports franchises should study the care that Hamlin received so they’re just as prepared in case of a similar emergency.

“We can’t say enough about the quick actions of the Bills' training staff and the physicians who were on the field with getting to him, recognizing that this was a very serious situation and responding and saving his life,” Pritts said.

“And not just saving his life but his neurological functioning,” Knight interjected. “The reason why we’re talking about his recovery of neurologic function is the true critical importance of immediate and good and high quality CPR and immediate access to defibrillation.”

It’s no accident that the medical personnel on site in Cincinnati functioned so promptly and cohesively. Before the start of each season, every NFL team is required to design and rehearse an emergency action plan to follow in instances of severe trauma.

An hour before kickoff of every NFL game, team medical personnel and independent physicians assigned to the game are required to meet on the field to introduce themselves to each other and to go over in-game player health and safety procedures. They review the location of emergency equipment such as the defibrillator used to resuscitate Hamlin. They also designate which physician will serve as the leader in case of a cardiac arrest during the game.

Among the heroes on Monday night was Bills assistant athletic trainer Denny Kellington. Sports Illustrated’s Albert Breer tweeted Thursday that Kellington was “absolutely vital” in administering CPR to Hamlin.

Speculation from medical experts has been that Hamlin’s violent collision with Higgins may have been the cause of his sudden cardiac arrest. Very rarely, a hard blow to the chest can cause a potentially fatal disruption of heart rhythm known as commotio cordis.

Knight said Hamlin must undergo further testing to rule out more common conditions before he would be willing to declare commotio cordis the cause of the cardiac arrest.

“Is it on the list of considerations? It is,” Knight said. “But there are many other things we need to work through before a final cause can be defined.”

On Thursday, the cause of Hamlin’s sudden cardiac arrest wasn’t foremost on his loved ones’ minds. They were grateful that he was awake and alert, that he was able to grip their hands, that he was able to answer their questions with a shake of his head or a scribble of his pen.

With Hamlin awake, his family and caretakers were finally able to tell him about the nationwide outpouring of support he has received since his collapse. NFL fans have donated in droves to a foundation that Hamlin established in December 2020 to give back to children in the Pittsburgh-area community where he grew up.

The goal of Hamlin’s GoFundMe initially was to raise $2,500 for a holiday toy drive at his mom’s daycare center in McKees Rock, Pennsylvania. As of Thursday evening, the donation tally exceeded $7.5 million.

Said Pritts with a chuckle: “We’ve relayed that there’s going to be a lot of toys for him to buy when he recovers from all of this and we’re all looking forward to that.”