Behind the scenes of Alex Smith’s horrifying injury saga as he ponders NFL return

It is heartwarming. It is touching. It is inspiring. It is also jarring and gut-wrenching.

The gripping E:60 documentary, entitled “Project 11,” on Redskins quarterback Alex Smith’s arduous recovery from his broken right leg takes the viewers behind the scenes of the gruesome 2018 injury, how dangerous it got in the days that followed — Smith needed 17 surgeries in all and nearly lost his leg — and his long road back to what he still hopes is a return to the field one day.

“Football might not be out of the question,” he says during the show that will be televised Friday night by ESPN and was viewed by The Post. “Can I go play quarterback again? Can I push it that far?”

The piece gives insight into Smith the person, tough and determined. It tracks him from a young age, as an under-recruited quarterback who blossomed into a huge star at Utah. It includes cameos from Urban Meyer, Patrick Mahomes, Andy Reid, JJ Watt, and Jim Harbaugh and details the former No. 1 overall pick’s rough start in the NFL, losing his job with the 49ers to Colin Kaepernick and with the Chiefs to Mahomes after successful seasons at both stops. Then comes the difficult-to-watch injury 10 games into the two-time Pro Bowler’s first year with the then-first place Redskins.

It shows how bad it got for him after suffering a spiral and compound fracture of his right tibia and a fractured right fibula in a loss to the Texans on Nov. 18, 2018. He was sacked by Watt and Kareem Jackson, and his leg was destroyed, part of it hanging in the wrong direction, bone breaking through the skin.

Alex Smith NFL leg injuryAlex SmithThe Washington Post via Getty Images

Initially, the hope was he would only be in the hospital a few days, after getting the fractures operated on and three metal plates placed in his leg. But Smith developed bacteria in the blood in his leg, his temperature spiked and his blood pressure dropped. Parts of the leg became black, made up of dead skin and infected muscle tissue. It was created by necrotizing fasciitis, also known as flesh-eating bacteria.

“I couldn’t fathom seeing this in a war movie,” his wife, Elizabeth, said.

He developed sepsis, a life-threatening condition caused by the body’s poor response to infection. The dead skin and infected muscle tissue had to be removed through a procedure known as debridement because it cannot regenerate and would allow the infection to spread. He had four different kinds of bacteria that were ravaging the leg. As doctors opened up the leg, they found infections up to his thigh, leading to eight different debridement removals. By then, his leg was a skeleton of its former self, virtually nothing but bone between the knee and ankle on one side.

“Maybe cutting off your leg is the best thing?” the 35-year-old Smith wondered.

Alex Smith in July 2019Alex Smith in July 2019The Washington Post via Getty Im

It was either that or salvage it by taking muscle tissue from other parts of his body – like his right calf muscle and quadricep muscle from his other thigh, along with some overlying skin — and transplanting them into the leg, which they opted to do. At the time, he was told he wouldn’t be able to lift up his ankle or foot again. After initially feeling despondent, wallowing in self-pity, Smith grew optimistic.

One night, sitting up in bed with his wife, he told her: “You know what? It’s going to be OK. … Do you know how many people would love to trade positions with me? … Do you know the things and the blessings that we have? And we have can’t take it for granted.”

Fifty-nine days after the injury, Smith was able to finally go home. His leg was placed in a metal bracing apparatus and he needed a walker to get around. He couldn’t do anything on his own. A month later, his medical team arranged for him to visit the Center for the Intrepid, a medical rehabilitation center for United States servicemen and women. Several patients were without limbs.

“Very, very humbling,” he said. “You certainly didn’t see anybody feeling sorry for themselves.”

The documentary follows his lengthy rehab, from throwing his first pass while on one knee to getting the metal apparatus off and being able to walk on his own after a metal rod was placed in his tibia, and picking up steam in his training, surprising doctors with how far he had come. It concludes with him playing with his children, even sprinting and showing little signs of any limitations, determined to return to the field for one last shot.

“I’m anxious for the next steps, what I have left in front of me, where the road ends,” he said. “I mean, there are so many people who put so much into it. I’m feeling pretty good about the rest of my life, regardless of what happens with football.”

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