Photo credit: Angelica Alzona/GMG

Welcome to Meat Sack, a guide to sports-related body horror. Today’s column is about exsanguination.

When I first saw the video, what struck me most is how abruptly it happened. Prior to watching it, I had some preconceived notions about what a bleed of that magnitude would look like, based on years of watching cinematic special effects and poorly shot surgical videos. An elder millennial in possession of more curiosity than is probably healthy, I was a rotten.com baby. As such, I came of age on the Internet through pictures of human bathtub soup and the aftermath of suicidal violence, and have always had a hard time looking away. The compelling revulsion I feel when I hear such footage is available, the internal conflict over whether or not to watch it, the wave of nausea and regret that hits when all my mirror neurons start firing, these are things I’m used to feeling on my journey as an Internet Citizen and Curious Human. These are the things lead led me to Clint Malarchuk.

I imagined it Hollywood-style, with some hose-like action. Which is to say, I was expecting a spurt. But there was no such geyser. One second it was a hockey game; the next, three pints worth of crimson is splashed across the ice. (For what it’s worth, the average human body contains about eight pints of blood.)

It was Wednesday, March 22, 1989. The Buffalo Sabres were up early, 1-0 against the St. Louis Blues in the first period. A 23-year-old rookie for the Blues, Steve Tuttle, charged the net with the Sabres Uwe Krupp coming up right behind him. A flurry of action and Krupp pulled Tuttle down, a motion that sent Krupp into goalie Malarchuk, skates first.

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Krupp’s skate went into Malarchuk’s neck.

The skate sliced through his jugular vein, as well as some neck muscle. In most instances, an injury of this type is a death sentence. And in Malarchuk’s case, he most certainly thought it was, referring to it as “the first time I should have died.

If you’ve ever stood up too quickly and gotten dizzy, then you’ve felt something akin to the early physical sensation of bleeding out. When a person stands abruptly, blood pressure drops because the pull of gravity causes blood to drain from the head faster than it is replaced. To compensate, the body sends out a message for the heart to beat faster and for vessels to tighten up, thus boosting blood pressure and getting the right amount of blood to the the brain. It’s that momentary deficit of blood in the head that causes light-headedness.

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A body without insufficient blood volume is ill-equipped to meet the demands of the head and the heart, leading to dizziness, confusion, loss of vision, and, as hypovolemia proceeds toward hypovolemic shock, an ominous cooling of the skin. Without enough plasma, there’s not enough sodium to keep the body’s electrics firing smoothly, The heartbeat stutters, becoming thready, fluttering along. I don’t know what technically comes first, total darkness or the excruciating sensation of cardiac arrest, but either way, this is the end from exsanguination.

In researching the process of exsanguination, I found a public eager to rank it on a scale of unpleasantness, as if the worst part about dying wasn’t the end result, but the process by which you got there. Please spare me this rhetoric; if Malarchuk had died on the ice, his ultimate end and the reaction of those around him would have been no less peaceful than if he’d been disemboweled.

When Malarchuk was injured, he knew he had three minutes to live. Players were vomiting on the ice, fans passing out, the referee screaming for a stretcher, screaming that he was bleeding out. But Malarchuk knew there wasn’t time. He had to get off the ice immediately, before his mother, who always tuned in from home, could watch her son die on live television.

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The team’s trainer, Jim Pizzutelli, agreed. As he told the Chicago Tribune two days after the accident, he was nonplussed and immediately ready to help. “I was in Vietnam. I`ve seen blood before,” he said. The former combat engineer acted immediately. Whereas years ago Pizzutelli had been medevaced to safety next to the corpse of a soldier who’d been decapitated by a sheet-metal hut, today he was pinching shut an artery as a horrified stadium of fans watched him escort the somehow-still-upright player from the ice.

Pizzutelli and the doctors and the surgeon who carefully sewed in over 300 stitches saved Malarchuk’s life. The veins on the cut side, the right side, had to be surgically closed, but surgeons told him that the other side of the neck would compensate. Malarchuk was back at work in 10 days.

It would be easy to stop the piece here, A brush with death, a happy ending. I could put a bow on this and frame it as a testament to resilience and the adaptability of the human body, but trauma is never has clean edges. Here, as in so many stories of survival, the real horror of the Clint Malarchuk story is what happens next.

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I don’t mean the horror of the direct aftermath, as gruesome as it was. The way the game restarted once it became clear that Malarchuk was going to pull through. His replacement, Jacques Cloutier, playing in a frozen pool of blood for the rest of the game. Pizzutelli, locking himself in an office alone for hours in his blood-soaked socks, refusing to talk to anyone.

When I talk about the horror of the aftermath, I mean a wasteland of post-traumatic stress disorder that left a bullet lodged behind Malarchuk’s eye. The extent of the therapy he received in the wake of his trauma was to stand on the ice with Pizzutelli and marvel at his luck, just two days after he almost died there.

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Imagine that the worst thing to ever happen to you was so bad that it sits outside the purview of sensitivity; that is, so awful and rare that it is the stuff of popcorn horror films and cold sweat nightmares. Fans from opposing teams made throat-slash gestures at Malarchuk while he played. Despite this, playing hockey also provided him a reprieve from his demons: alcoholism, insomnia, and chronic depression. His first suicide attempt was in 1992, when he stopped his heart with pills and whisky. The second time, he shot himself through the chin in front of his wife. The bullet is still lodged behind his forehead, but the incident led to him seeking intensive treatment, treatment that saved his life as dramatically as it was saved on that fateful day in 1989.

Malachuk has since completed comprehensive treatment and is open about the pain he suffered in hopes to reach others who may be struggling with PTSD and other mental health issues. It’s a happy enough ending to a horror story, the worst of which are always true.