17 March 2012: The day Fabrice Muamba’s heart stopped for 78 minutes

As football fans, we often get carried away by our passion for the beautiful game, making claims that it is the most important thing in our lives at various times. Everyone is aware of Bill Shankly’s famous quote about football being more serious than life and death and it is easy to get carried away in hyperbole when talking about a sport you love. However, every now and then an event comes along that reminds us that, for all the hype, football is essentially just a game played by 22 players for their enjoyment and ours. The current worldwide pandemic has been one such incident, revealing what is truly important as opposed to what is nice to have. At times like this it is good to take a moment’s pause and reflect on life’s true priorities. Sometimes the events that provoke such reflection are truly tragic, such as Hillsborough or the Bradford Fire. But sometimes the events do thankfully have a happy ending.

A recent example was the frightening collapse of Christian Eriksen during the recent Denmark against Finland witnessed by millions around the world in  real-time. For a few terrifying minutes, everyone held their collective breath  as the medics performed emergency CPR. Thankfully Eriksen’s heart restarted and he regained consciousness. But the event was a reminder of  the fragility of life as well as a reminder of a similar event that occurred nine years earlier.

That event occurred during the 2011/12 FA Cup competition at White Hart Lane on March 17, 2012. On a sunny afternoon in North London, Tottenham hosted Bolton Wanderers in the quarter-finals. At the time, Bolton were stuck in the relegation zone of the Premiership, struggling to avoid the drop, a  struggle they were to lose come the end of the season. Tottenham meanwhile were flying high in third, competing with rivals Arsenal and Chelsea for a Champions League place. For Bolton, this was an opportunity to put their league woes behind them and secure a place in the semi-finals of the FA Cup, a welcome distraction for players and fans alike.

The fourth round had seen Bolton defeat fellow Premiership side Swansea 2-1 before then travelling to the intimidating home of Championship side Millwall in the fifth round and securing a 2-0 victory. Tottenham had struggled meanwhile to get past third tier Stevenage in the fifth round and so Bolton could go into the tie feeling confident despite playing away. The game got off to a rapid start, with Gareth Bale scoring an own goal after just  six minutes before Kyle Walker then equalized another six minutes later. The game then settled and as half-time approached, it looked like both teams would enter the break tied.

On around 42 minutes, Bale was put through on the left hand side but could only cross into the side-netting. Although not caught on camera, as Bale made his run, one of the Bolton players suddenly collapsed to the floor near to the halfway line. The player concerned was central midfielder Fabrice Muamba.

Fabrice Ndala Muamba was born in the Democratic Republic of Congo in 1988 and at six watched his father flee to England to seek asylum. This was finally officially granted in 1999 after which Fabrice was able to join him. Although unable to speak English on arrival, Fabrice still went on to earn an impressive array of school academic results. 

Three years after coming to London, Fabrice joined the Arsenal youth system, before becoming a professional there.  After just two first team appearances, he joined Birmingham City on loan where he established himself as a regular starter in midfield and earned the Young Player of the Season award from fans. His move was made permanent in 2007 and he made 37 appearances before Birmingham suffered relegation from the Premiership.

The summer of 2008 saw him join Premiership Bolton and another impressive 2009/10 season saw him named Player of the Season by the Bolton local newspaper. His footballing talent also saw him represent England at U16, U17, U18, U19 and U21 levels from 2002 to 2011, including being in the England squad that was runner-up in the 2009 UEFA European Under-21 Championship. 

Going into the 2011/12 season, Fabrice Muamba had therefore built up a solid reputation as a skillful midfielder. Bolton kicked off the season with a 4-0 win at QPR, with Muamba scoring his only goal of that season, meaning that for a fleeting moment they actually stood top of the Premiership after just one game. But then reality kicked in as Bolton lost their next six games, placing them in the bottom five where they would remain all season. Up to the FA Cup quarter-final, Muamba was a regular starter, making 20 appearances.

When Muamba collapsed, it was immediately apparent that something abnormal had occurred, as he fell without putting out his arms to break his fall. The first player to react was Rafael van der Vaart, who motioned to both the Bolton and Tottenham medical staff to rush on. Luckily there were five fully medical trained assistants pitchside. The physios quickly turned Muamba onto his side and as all around started to sense that something was seriously wrong, TV cameras pulled back their coverage so as not to distress viewers. Bolton fans started to chant his name as Bolton manager, Owen Coyle, sought more details from the sideline. 

As more time passed, some Bolton players started moving away from Muamba in obvious distress. The referee, the experienced Howard Webb, waved Coyle onto the field so he could join the medical staff, the crowd noise beginning to fade as they began to appreciate that something very serious was happening. 

The commentator now observed that it appeared that resuscitation efforts were occurring, reflected also by the shocked faces of several players including van der Vaart and Bolton’s Nigel Reo-Coker. Over 30,000 spectators were now close to silence, holding their breath in that horrible state of limbo of not knowing how serious the situation is. Howard Webb called some of the senior players together before then calling all the players off the field as Muamba was placed onto a stretcher. Seven minutes had elapsed since Muamba collapsed.

What had in fact occurred during those seven minutes is that Muamba had suffered a cardiac arrest. This is not to be confused with a heart attack; they are in fact different medical events. Cardiac arrests usually occur suddenly and without warning, as in this case, and are triggered by an electrical malfunction in the heart that can cause an irregular heartbeat. In that case, it can no longer pump enough blood, and therefore oxygen, to a person’s vital organs such as the brain and lungs. Unless medical treatment is administered swiftly, the victim will die within minutes. 

It is therefore essential to keep blood pumping and to restart the heart as swiftly as possible. Attempts to restart the heart are usually via defibrillator shocks, where an electric shock is administered to the chest using paddles. In the meantime, in order to keep blood pumping, cardiopulmonary resuscitation (CPR) needs to be applied through push-down hand compressions on the chest to mimic the beating of the heart. 

Luckily the medical staff at White Hart Lane were excellent and CPR was immediately administered. Applying CPR is no easy task, in that deep hand thrusts have to be made at around 80 per minute, and it is tiring and often needs to be tag-teamed. Muamba also received a number of defibrillator shocks on the pitch, as well as in the ambulance on the way to the hospital. 

While getting aid on the pitch, help included a consultant cardiologist named Andrew Deaner, who happened to be in attendance with his brothers as a fan and who persuaded stewards to allow him on when seeing that Muamba was being given CPR. Muamba was rushed to the London Chest Hospital on Dr Deaner’s recommendation, knowing the specialist equipment that they had, accompanied by Bolton manager Owen Coyle and club captain Kevin Davies. Twelve defibrillation shocks were administered during the trip, an exceptional amount for a human body to endure, especially as each shock (300-Joules) that fails to return the heart to normal decreases the chance of survival. Hospital staff finally managed to get Muamba’s heart to start beating on its own again. 

From the moment of collapse to the moment of his heart restarting, it transpired that Muamba’s heart had in fact stopped beating for 78 minutes. 

On the Monday following the game, Muamba regained consciousness against all expectations. Later that day he even expressed regret that his collapse had caused the game to be abandoned. By Tuesday he diagnosed himself as feeling fine; luckily the experts avowed him of that view and kept him in intensive care. He eventually stayed in hospital for one month, being discharged on April 16, having been fitted with an Implantable Cardioverter Defibrillator (ICD), a device able to perform defibrillation and pacing of the heart.

Following on from the abandoned game at Tottenham, football fans banded together to show support for Muamba and his recovery. Bolton’s first game following the incident was at home against Blackburn Rovers on March 24 and the whole stand raised cards to show Muamba’s name and number in an emotional display. Other fan-bases also displayed banners at games, such as Arsenal. After his discharge, Muamba was able to attend Bolton’s home Premiership game against Tottenham on May 2 and received a hugely emotional reception as he stepped out onto the pitch before the match. He was then invited back to White Hart Lane where he received a standing ovation from Tottenham fans as he strode to the spot where he had previously collapsed. Visibly moved to tears, he returned the thanks to the crowd, marking a beautiful example of how football can transcend rivalries.

Muamba later returned to that same spot of the pitch for an interview with Gary Lineker, the former Tottenham star striker and now TV presenter.  Again, Muamba was visibly upset, having difficulty in controlling his emotions as the interview began. He tearfully remarked that “this is where my dream was taken away from me” and it was obvious that he was struggling between the two feelings of sadness over never being able to play football again as well as gratitude that he has miraculously survived. Talking about the game, Muamba recalled that during the match he felt fine, before after missing a chance moving back into the midfield, after which he suddenly felt very dizzy and experienced double-vision before collapsing to the turf. There was no pain beforehand, just dizziness and then blackness. 

He recalled how both his father and brother were in the crowd, while his wife and son were at home watching on TV, and one cannot even start to imaginewhat they must have been going through as he lay there surrounded by medics. He did reveal that he had watched the footage twice since, the first time being with his mother and the second on his own to try and obtain some closure. The interview also showed a degree of survivor’s guilt in that Muamba was still trying to reconcile how he had survived such a long heart stoppage, although realizing that he had received amazing medical care from the first moment to the last.

Three months later, Muamba retired from professional football on the advice of his medical team. He had initially hoped to resume his playing career but subsequent discussions made him appreciate that the risk of such an action was too high.

Since retiring from the game, Muamba has continued to be active within the footballing world. He was part of the ITV’s coverage of the 2013 African Cup of Nations. He also studied for a BA in Sports Journalism at Staffordshire University, graduating with honours. The story of Fabrice Muamba’s survival is an extraordinary one and a testament to the level of medical support now present at all major sporting events. It should be stressed though that this is not the first time that such a collapse has happened during a football match and unfortunately fatalities have occurred. The most well-known of these are probably Marc-Vivien Foe in 2003 and Cheick Tiote in 2017. 

Marc-Vivien Foe was a Cameroonian midfielder who played for Lens, West Ham United, Lyon and Manchester City over nine years from 1994 to 2003. He was part of the Cameroon squad that went to the 1994 World Cup Finals in the USA, starting all three of their matches. By 1998 his skill had attracted interest from Manchester United but negotiations broke down after he broke his leg at Cameroon’s training camp, ahead of the 1998 World Cup. In 2003, Cameroon were participating in the FIFA Confederations Cup where Foe played in the wins against Brazil and Turkey that saw Cameroon qualify for a semi-final against Colombia. Tragically it was during that game that, like Muamba, Foe suddenly collapsed to the floor in the 72nd minute. Medics spent 45 minutes trying to restart his heart but to no avail. Signs of fatigue had been shown by Foe shortly before his collapse, which led to thoughts of substitution, but he had signaled a desire to play on.

Cheick Tiote meanwhile was an Ivorian defensive midfielder who played for Anderlecht and FC Twente before moving on to Newcastle United. During six and a half seasons at Newcastle, he only scored one goal, but that goal will always be immortalized by the Geordie faithful, being a 25 yard volley which saw Newcastle snatch a 4-4 draw from a home Premier League game against Arsenal in which they had trailed 4-0 at half-time. After that he eventually ended up playing for Beijing Enterprises in the Chinese League where, on June 5, 2017, he suffered a fatal cardiac arrest during training, aged 30.

Football is a game that many of us love and that holds great importance in our lives. It can supply us with a host of emotions from week to week, from elation due to a late winner to despair after a particularly harsh defeat. But it is overall just a game, played by 22 men on a pitch for both their enjoyment and ours. And while it is easy to throw around quotes joking about how crucial it is, in the grand scheme of things it is just entertainment and, as we have seen with recent events, even when football stops, life continues.  Stories such as that of Muamba’s incredible survival hopefully remind us all that the most important aspect of a football match is really that everyone involved both on and off the pitch experience an enjoyable time with family and friends and get home safely afterwards. The rest, as they say, is just gravy.