First came the nausea.
Then the feeling of PTSD.
Next the holding of breath from snap to play’s end.
And now? Elizabeth Smith, the wife of Washington quarterback Alex Smith, has settled into the regular kind of dread, anxiety and worry that almost every NFL wife feels on game day.
“Now it’s the normal Sunday angst,” Elizabeth said this week in an interview with The Chronicle. “I guess it’s gotten a little easier.”
Alex Smith’s extraordinary journey — from severe football injury, possible death, probable limb amputation, grueling and lengthy rehabilitation to a return to the field as a starting NFL quarterback — is becoming the stuff of NFL lore.
But he’s not the only survivor in one of the most remarkable comebacks in sports history. Elizabeth, his partner every step of the way, doesn’t have a titanium rod in her leg, or mangled flesh from 18 surgeries. But she carries plenty of scars.
“She bore as much, if not more, of the brunt than I did,” Alex said. “I only worried about myself. I was so helpless.”
It was Elizabeth who, in November 2018, witnessed the compound fracture and mangled leg as her husband was close to unconsciousness on the field. It was Elizabeth who watched as he went into septic shock in the hospital and was told he might die. It was Elizabeth who had to initially speak with doctors and process the real possibility of amputation. It was Elizabeth who nursed Alex for months after his release.
“She had three small kids, a household, and a husband that needed hourly attention,” Alex said. “I couldn’t go to the bathroom by myself. I had to take medicine every hour. She was a wife. A nurse. She has more invested in this than anybody.”
And it is now Elizabeth who holds hands with her three young children as they watch their daddy play football again.
“I was not on board with this, for a long time,” she said. “First of all, a return wasn’t really plausible. But as he got closer and closer, when he was medically cleared to play, we had to sit down and have some long conversations.”
Throughout his rehabilitation, Alex didn’t want to be controlled by fear. He didn’t want to limit himself. He just tried keep moving forward, step by step.
“At first, it was so far off that everyone said, ‘Oh sure,’ just to appease me,” Alex said. “But then I was finally right on the doorstep. At that point, she was fully behind me.”
Suddenly, the next step was actually playing in the NFL again.
“It would have been selfish for me to hold him back,” Elizabeth said. “It took so much mentally, physically, emotionally to get to this point. He wanted to prove to himself that if he could do this, he could do anything.
“I couldn’t be the selfish one. He would have always regretted it.”
At first Alex was just happy to make the Washington roster. Nice story, right? But then starting quarterback Dwayne Haskins was benched and dropped to third on the depth chart, so Alex was elevated to No. 2 behind Kyle Allen.
On a wet day in October, Elizabeth and Hudson, 9, Hayes, 7 and Sloane, 5, were sitting in the stands in their ponchos at FedExField for the Rams game, and saw Alex come out of the tunnel in his uniform for the first time in almost two years.
“It was very emotional to see him walk out,” she said. “But I never thought he’d step into the game. When I realized Kyle was hurt, my heart sank.”
Allen was injured late in the second quarter, and Alex entered the game. On his third snap he was sacked by the league’s most ferocious pass-rusher, Aaron Donald.
“To say I had anxiety is quite the understatement,” Elizabeth said. “I really did think I was going to throw up.”
Allen returned to the starting job the next week but was injured again three weeks later in the first quarter against the Giants. Smith came into that game on Nov. 8 and has been the starter ever since.
Washington is a young team, in need of veteran leadership and with a coach in Ron Rivera who values character. In that way, it is an ideal fit for Alex, whose on-field contributions have always been complimented by his ability to teach, lead and model hard work.
The 5-7 team has won three in a row, including an upset Monday over the previously undefeated Steelers, and is surprisingly in the playoff hunt. Smith has taken 335 snaps in the past five weeks.
“It still seems surreal,” Elizabeth said. “If you had told me this in April, I would have said you were insane.”
Hayes and Sloane were too young to really remember their father playing, so they have new memories. With fans now prevented from most games, the family gathers around the television. On Monday, Elizabeth started to panic when she saw blood dripping down her husband’s leg until Hudson pointed out it was dad’s left leg, not the rebuilt right one still covered by a vulnerable flap of skin.
“That got me going for a second,” Elizabeth said.
As Alex’s story has gained momentum, his following has swelled. During his rehabilitation, he worked closely with the Center for the Intrepid, a San Antonio facility for service members with severe limb injuries, and he took inspiration from those veterans. Now he is providing inspiration for others who face adversity, either due to injury or some other kind of setback.
Dating to his difficult days as the 49ers’ starter, Smith has always been mentally tough.
“I know, as his wife, how hard Alex works at anything that’s in front of him,” Elizabeth said. “Throughout this, I think other people now realize the competitor he is. The spirit he has. The kind of man he is.”
Alex, who was drafted by the 49ers in 2005, has two years left on his contract. Everyone wants to know what happens next, including Elizabeth who, as the family organizer, has to plan. The family is building a “forever home” in Woodside and will plan to settle in the Bay Area whenever Alex’s career is over.
“I’m loving this right now, and living it week to week,” Alex said. “But when the season’s done I owe my wife the chance for some input.”
After all, Elizabeth carries scars, too.