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The seriousness of Tom Brady’s 2018 playoff thumb injury revealed in ‘The Dynasty’

Author Jeff Benedict explores the greatest contemporary sports dynasty of our time, the New England Patriots, in his upcoming book “The Dynasty,” which releases Tuesday. This excerpt is from Chapter 42, “Threading the Needle,” which highlights QB Tom Brady’s hand injury leading into the Jan. 21, 2018, AFC Championship game.

On the Wednesday before the AFC Championship game against the Jacksonville Jaguars, the Patriots were practicing outside in the bitter cold. On a routine play, Brady handed the ball off to running back Rex Burkhead. In the exchange, the ball jammed back into Brady’s thumb, hyperextending it with such force that the skin at the base of the thumb split open. With blood gushing, Brady let out a yell and rushed off the field, clutching his hand. Burkhead and his teammates looked on in stunned silence.

Minutes later, Dr. Matthew Leibman’s cell phone rang. Leibman was the hand and wrist surgeon for the Patriots, Red Sox, and Bruins. He was having lunch outside Boston when Patriots assistant trainer Joe Van Allen reached him.

Van Allen was frantic. “Matt, we need you at the stadium right now,” he said. “Brady hurt his hand. It’s bad. It’s bleeding.”

“What happened?” Leibman said.

Van Allen quickly explained that Brady’s thumb had somehow gotten jammed and bent backward during a handoff. “There’s a pretty big laceration,” he said.

“Is it his throwing hand?” Leibman said.

Van Allen said he’d text a picture.

Leibman hung up. Seconds later, the image was on his phone. It looked as though Brady’s hand had been slashed by a blade. The base of his thumb was split wide open. The laceration was gaping.

Tom Brady examines his injured thumb before the 2018 AFC Championship Game against the Jaguars.Getty Images

“Holy s–t!” Leibman said to himself.

In 99 percent of the cases where a hyperextended thumb results in a gaping laceration, there is also a fracture or dislocation involved. And the underlying ligaments and tendons are inevitably damaged as well.

Confident that Brady needed surgery, he called Van Allen back. “Does Tom just want to meet me at the hospital?” Leibman said. “Because we may go straight to the OR.”

Van Allen said that the team really wanted him to evaluate Brady at the stadium. “Get here as quick as you can,” Van Allen said.

“I’m on my way,” Leibman said. “Give me fifteen minutes.”

Leibman flew down the highway, confident that if he got pulled over all he’d have to do was tell the police officer, “Brady’s bleeding and waiting for me.” His bigger concern was the unnerving proposition of what he was about to do: operate on the throwing hand of the greatest quarterback of all time on the cusp of the AFC Championship game.

Distraught and awaiting the results of his X-ray, Brady lay on a stretcher in the medical treatment room at Gillette Stadium, his right arm outstretched, his hand wrapped in a towel. He feared his career was over, and his eyes welled up.

Alex Guerrero stood next to Brady’s head. Guerrero was worried, but he tried to comfort Brady.

Scowling, Belichick stood off to Brady’s side, next to trainer Jim Whalen.

Dr. Mark Price, the team’s head doctor and chief orthopedic surgeon, stood opposite Belichick to Brady’s right.

The room was eerily silent when Dr. Leibman entered.

“Hi, everybody,” Leibman said. “How’s everybody doing?”

No one responded.

“The good news is I just looked at the X-rays and they’re clean,” Leibman said. “There’s no fracture and there appears to be no dislocation.”

Still no one spoke.

Leibman sat down on a stool beside Brady and explained that he needed to examine his hand. Leibman removed the towel and looked at the wound. It was deep enough that he could see down to the bone and tendon. Brady grimaced as Leibman gently touched his thumb.

“It looks like the ligaments and the bone and the tendons are structurally intact,” Liebman told Brady. Leibman turned to Belichick and the trainer. “I’m very surprised. Normally with a laceration like this, the bones get pulled in a way that they either break or you tear a ligament.” The tension in the room remained palpable.

This is a hyperextension loading injury causing a skin burst. The fact that there’s no fracture or dislocation is amazing. — Dr. Matthew Leibman

“Guys, you don’t understand,” Leibman said. “This is a hyperextension loading injury causing a skin burst. The fact that there’s no fracture or dislocation is amazing.”

Leibman explained how rare it is to see someone endure such a high-energy injury without damage to the bone or dislocation. With all the hype about Brady’s pliability thanks to the TB12 Method, Leibman figured he’d lighten the mood by referencing it. Looking at Guerrero, he said, “I guess it’s because Tom’s thumb is so …” Then he glanced at Belichick and figured pliable wasn’t the best word choice. “Flexible,” he said.

Belichick glared at Brady.

No one smiled.

The only thing Brady cared about was whether he had a shot at playing on Sunday. Leibman explained the realities of the situation: The game was four days away. Brady’s hand needed surgery. After the procedure, skin takes a good eight to 10 days to seal. If Brady were to fall on his hand or get hit on his thumb during that period, the surgical wound would blow open.

A discussion ensued about things they could do to protect his hand.

Dr. Price chimed in that another Patriots player had previously played in a game after getting stitches for a hand laceration. To Belichick, the situation wasn’t comparable.

“Tom’s the quarterback,” he groused.

“We’ll have to take it day by day and make a game-time decision on Sunday,” Leibman told everyone.

Without saying a word to Brady, Belichick left the room. Whalen followed. Guerrero stayed with Brady while Leibman performed the procedure. Dr. Price assisted.

Telling himself, This is just another hand, Leibman prepared to operate on Brady by numbing his thumb with numerous injections. Then Leibman irrigated the area around the bone and tendon, removing any grass or dirt particles from the wound. When it came time to realign Brady’s skin and sew him up, Leibman told Brady he was going to use a larger caliber of thread than he would ordinarily use, since he knew the plan was to try to enable Brady to play in four days. For extra strength, he also used 25 sutures sewn in a crisscross pattern for maximum support.

After the procedure, Leibman dressed Brady’s hand and applied a splint. Then he looked at Brady and Guerrero. “Right now, the concern is that the thumb is going to get very swollen and painful,” he told him. “So you can’t do any of your massage. You can’t do any of your mobilization. We want to immobilize. Whatever you do, don’t remove the splint.”

Brady figured his season was over.

Leibman arranged for him to have an MRI later in the day just so he could be sure that there was no underlying damage to the joint.

As Leibman prepared to leave, Rex Burkhead entered the room with tears in his eyes.

“It’s not your fault,” Brady told him.

Burkhead was inconsolable.

“Don’t worry,” Brady told him as he put an arm around him. “I love you.”

Tom Brady led the Patriots to a win over the Jaguars in the 2018 AFC Championship Game despite playing with a significant thumb injury that required 25 stitches.AP

After Burkhead left, offensive coordinator Josh McDaniels and backup quarterback Brian Hoyer entered.

Dr. Price gave McDaniels the prognosis.

McDaniels turned to Hoyer and said, “You better get f—kin’ ready.”

At 3:18 p.m., the Patriots announced: “Tom Brady is with our medical staff and will not be available to the media today.”

Belichick was notorious for remaining tight-lipped about player injuries. In this instance, it was particularly critical to keep a lid on Brady’s situation. On the outside chance that Brady played on Sunday, Belichick didn’t want the Jaguars to realize that he was vulnerable, especially in his throwing hand.

By 6:00 p.m., longtime Patriots beat writer Karen Guregian tweeted, “Tom Brady jammed his throwing hand at practice after accidentally being run into, according to a source. X-ray showed no structural damage.” Thirty minutes later, NFL Insider Ian Rapoport tweeted, “This is my understanding, as well. Sounds manageable.”

By evening, ESPN’s Mike Reiss tweeted, “Source close to Brady: ‘Hand should be OK.’ ” And the Boston Herald reported that Brady was expected to play on Sunday “barring an unexpected setback.”

On Thursday morning, Dr. Leibman reviewed Brady’s MRI. It confirmed that the bone hadn’t been broken and that the ligaments were intact. However, the imaging revealed swelling at the joint or base of the thumb, indicating that the scope of the injury went beyond a bad laceration. Leibman drove to Brady’s home later that morning to discuss the MRI. When he arrived, he found Brady had ignored his instructions: the splint had been removed, and Brady was gripping a football. And Guerrero was with him.

“I think I’m okay,” Brady told Leibman.

“Listen, Tom,” Leibman said. “We need to let this rest. We don’t have that many days.” Exasperated, Leibman then looked at Guerrero. It was absolutely critical, he said, that Brady wear the splint and keep his thumb immobilized. “Don’t mess with it,” he said.

“Matt, don’t worry,” Guerrero told him. “We got it.”

That afternoon, Brady attended practice in full pads, but he didn’t participate. His teammates told reporters Brady “looked good.” When he skipped his media session again, however, speculation mounted that his injury might be more serious than had originally been thought. “It’s not a big deal at all,” insisted Stephen A. Smith on ESPN. “It’s a waste of time. It’s a bogus story.”

On Friday morning, Boston radio and television stations reported that Brady got four stitches. The Patriots listed Brady as “questionable” for Sunday’s game on the team’s official injury report. Then Belichick held his weekly press conference. Asked about Brady’s status for Sunday, he said: “It’s Friday.”

A short while later, Brady entered the media room wearing a glove over his injured hand. The first question he faced was, “How’s your hand?”

“Not talking about it,” he said.

“Thumbs up or thumbs down for Sunday?” a reporter asked.

“We’ll see,” he said.

“What exactly happened on Wednesday?”

“I’m not talking about it.”

With Guerrero at his side, Brady went to the Patriots’ indoor practice facility known as “the bubble” and threw. The more he threw, the more he became convinced that he could play on Sunday.

When Brady told Leibman about his progress, Leibman told him: “Don’t throw! You don’t need to throw.”

“I was just testing it out,” Brady said.

“Stop testing it,” Leibman said. “We’ll test it on Sunday.”

The Jacksonville Jaguars were an upstart team trying to complete a Cinderella season. Loaded with young talent, the Jaguars’ defense was ranked No. 1 in the AFC. Six of its defensive players were Pro Bowlers. Days before Brady injured his thumb, CBS had asked actor John Malkovich to film a commercial teasing the game. In the commercial, standing in front of an orchestra at the New England Conservatory of Music, Malkovich tossed aside the script and told the director: “You’ve overcomplicated this story. This is one of the simplest, oldest stories there is.

“It is the story of David versus Goliath,” he continued, his voice rising in concert with the violins and bass strings. “The story of the mighty giant against the tiny underdog. And yet, what does football teach us? You always have a chance. Look at what … the Jaguars did only last weekend. … But now it’s against the Patriots. You are fighting a giant.

“They don’t have one Goliath,” Malkovich railed. “They are two Goliaths. Brady! Belichick! Relentlessly! THE MACHINE … STOMPS … ON! It’s that simple.”

But it wasn’t nearly that simple this time. Just four days after a surgery on his throwing thumb that took 25 stitches to close, Brady was compromised. He was also still in a lot of pain. On game day, Leibman could have given him a shot to numb up the area around the wound, but Brady declined, saying he didn’t want to do anything that would limit his feel for the ball. The Patriots, meanwhile, insisted that Leibman be on the sideline in the event that Brady split open his hand and treatment was required during the game.

About five minutes prior to kickoff, Brady walked into the medical training room adjacent to the locker room, where Leibman was laying out his instruments.

Startled, Leibman stopped what he was doing.

Brady closed the door behind him, drew the blinds, and took a seat on a stool. Then he rested his chin on the training table. Staring ahead with a diabolical gaze, he extended his arm across the table, opened his hand, and calmly said: “Will you trim the tails of the sutures? I don’t want them touching the ball.”

Bewildered, Leibman sat on a stool on the other side of the table and faced him. The game was about to start. Everyone else was already on the field.

“Tom, I don’t want to touch the sutures.”

Brady explained that he didn’t like the feel of the suture tails pushing against the bandage and pressing against the ball when he gripped it.

“Tom, my biggest concern is that the sutures are going to unravel and it’s going to split open.”

“I trust you,” Brady said.

“I really don’t want to touch them.”

“You need to do it.”

It was a negotiation that Leibman knew he was losing. He reached for a pair of suture scissors and peeled back the bandage over Brady’s wound.

“Tom, we really shouldn’t do this,” he said.

“No, you need to do it.”

There were two minutes to kickoff.

One by one, Leibman delicately snipped a millimeter off roughly twenty sutures on the exterior of the wound. Then he redressed Brady’s wound.

Brady stood and gripped his ball. It felt much better.

“Thanks, buddy,” he said.

“Good luck, Tom.”

Brady walked out, his cleats click-clacking as he headed to the field.

On the Patriots’ opening drive, Brady threw six passes and completed all of them. He ran the ball once and got popped. He also got sacked. On the sideline, Leibman winced, especially when one of Brady’s linemen helped him up by gripping his throwing hand and pulling him to his feet. But Brady never flinched.

After the Patriots took a 3–0 lead, the Jaguars’ defense shut them down, delivering one big hit after another. Then, with the Patriots trailing 14–3, Rob Gronkowski stretched out in an attempt to catch a pass and took a brutal helmet-to-helmet hit. The play drew a personal-foul penalty for unnecessary roughness. And Gronkowski suffered a concussion and was lost for the game. It was starting to appear that Goliath was going down.

Tom Brady and Bill Belichick embrace after the Patriots’ win over the Jaguar in the 2018 AFC Championship Game.AP

In the second half, things didn’t improve for the Patriots. The Jaguars held a firm 20–10 lead with a little over twelve minutes remaining in the fourth quarter. All the Jaguars had to do was stop Brady one more time and muster a couple of first downs on offense to put the game away. But on the Patriots’ next possession, it took Brady less than four minutes to drive the length of the field, completing five passes, three of which went to Danny Amendola. The third one, a 9-yard touchdown strike, cut the lead to 20–17.

Two minutes later, the Jaguars punted. Then the Patriots punted. Then the Jaguars punted again. After a big return by Amendola, the Patriots had the ball on the Jaguars’ 30-yard line with 4:58 to play. Two minutes later, Brady zinged a spiral over the outstretched arms of two defenders on the goal line toward Amendola, who was streaking across the back of the end zone while being chased by two more defenders. Leaping while twisting his upper body backward against his forward momentum, he snatched the ball out of the air, managing to get his front foot down and then the toes of his second foot before falling out of bounds.

Gillette Stadium erupted. Brady’s pinpoint pass and Amendola’s acrobatic catch had given the Patriots a 24–20 lead. For the 11th time in a playoff game, Brady had orchestrated a game-winning drive in the fourth quarter or overtime. But this time he’d done it at age 40 with 25 sutures holding his thumb together. It was the kind of performance that would have been the defining moment for virtually any other quarterback. But for Brady, thanks in large part to the secrecy shrouding the magnitude of his injury, it would go down as just another one of many great feats.

As the final seconds on the game clock ticked down, Belichick triumphantly raised his arms on the sideline. Brady, with a black bandage on his throwing hand, simultaneously raised his arms. Despite injury, controversy, strife, media scrutiny, and another seemingly insurmountable fourth-quarter deficit, Belichick and Brady were headed to the Super Bowl for the eighth time.

With a blizzard of confetti raining down on Gillette Stadium, owner Robert Kraft made his way onto the field for yet another AFC Championship trophy presentation, on the 24th anniversary of the day he had purchased the team. Kraft was taking his franchise to the Super Bowl for an unprecedented ninth time.

As he took in the moment, Kraft looked at his sons and thought back to when he had sat with them in the stands in the 70s, dreaming about owning the team that he watched lose year after year. They’d come a long way. In the 24 years since he’d purchased the team, the Patriots had gone to the postseason 19 times and suffered just two losing seasons, the last one being way back in 2000. Kraft’s franchise was poised to win its sixth championship. Only legendary Chicago Bears owner George Halas had amassed six championships. But that was in the pre–Super Bowl era and it had taken Halas 40 years. If the Patriots won this time, Kraft would have caught up to him in about half the time.

In an on-the-field interview with CBS, Brady downplayed his injury. “I’ve had a lot worse,” he said. In the locker room, however, Brady tracked down Leibman, put his arms around him, and thanked him. “I thought this injury was going to be the end of my career,” Brady told him.

One by one, players thanked Leibman. Then Robert and Jonathan, Kraft’s sons, thanked Leibman. But Leibman deflected all of the credit back on Brady.

“I still don’t understand how he played,” Leibman said. “It doesn’t make any sense to me. He played with a surgical incision on his throwing thumb.”

In his postgame press conference, Belichick was asked to talk about Amendola.

“Danny’s a tremendous competitor,” he told the press. “Danny’s such a good football player. When you look up ‘good football player’ in the dictionary, his picture’s right there beside it. Doesn’t matter what it is. Fielding punts. Third down. Big play. Red area. Onside kick recovery. Whatever we need him to do. He’s just a tremendous player. Very instinctive. Tough. Great concentration. And made some big plays for us today.”

“Bill,” a reporter said, “just your thoughts on Tom Brady, all that went on outside the locker room, and throwing the way he did today.”

Belichick’s expression changed. “Yeah, well, what went on outside the locker room is all you guys,” he said. “So you could tell me all about that. Inside the locker room, everybody prepared for the game. Tom did a great job preparing. I thought we all competed today and made enough plays to win.”

“Bill, did anything have to change game-plan-wise because of Brady’s hand?” a reporter asked.

Exasperated, Belichick took a long pause. Shaking his head, he finally said, “Not that I’m aware of.”

“Can you just speak to the resourcefulness of Tom dealing with something like that midweek and then coming out and playing a huge game like that?” a reporter said.

“I mean, look,” Belichick said. “Tom did a great job and he’s a tough guy. We all know that. All right? But we’re not talking about open heart surgery here.”

From “The Dynasty” by Jeff Benedict. Copyright © 2020 by Rockspring Media, LLC. Reprinted by permission of Avid Reader Press, an Imprint of Simon & Schuster, Inc.