When the Republic of Ireland’s backroom staff went into the Mater Hospital to visit Shane Duffy, the restrictions of the intensive care unit meant they could only go in to see the teenager in pairs.
When Dr Alan Byrne and physio Ciaran Murray took their turn, the 18-year-old's initial reaction was to apologise. “I hope I wasn't too much trouble,” he said.
Byrne smiles as he recounts the story. “That's typical of Shane,” says the team doctor. “We joked about a few things.”
There was no time for messing on Friday evening, though. Duffy's situation was so grave that team surgeon Professor John O'Byrne believed the Everton youngster was going to die before he could even make it to the Mater, as an ambulance hared from Gannon Park in Malahide towards the city centre.
Duffy was losing blood at an alarming rate. In medical terms he lost 20 units — there were 3.6 units that leaked into his abdomen from a damaged artery in his liver. Put simply, he lost two thirds of the blood in his body, and the bleeding was so rapid it was a struggle to compensate for it.
“You can't replace the loss of fluid and blood,” explained Byrne. “He had lines going in everywhere trying to maintain his blood pressure.”
The Derry lad suffered a laceration of his liver — a hole in the left hepatic artery, to be precise — in the first half of the training match with Gerry Smith's junior side, when goalkeeper Adrian Walsh accidentally caught him in the chest with his knees while collecting a set piece. A shocked Walsh has since admitted he thought that Duffy was severely winded — which was the instantaneous reaction of those present at the behind closed doors training fixture.
When Byrne came on to treat the player, he sensed there was something unusual going on within 30 seconds, although he could never have anticipated the scale of it at that juncture.
The lanky centre back required oxygen on the pitch and the initial fears were related to possible cardiac complications.
“Then I noticed a bruise under his lower abdomen where your liver is,” said Byrne. “I knew we were in trouble. His pulse was ok, and I listened to his heart and lungs. I knew we needed to get to hospital quickly.”
It was a frantic journey, with O'Byrne on the phone to Byrne to relay worrying updates. Between them, they made contact with the hospital who were able to make preparations for his arrival. Ex-Meath footballer Gerry McEntee, an expert in liver issues, was brought in to perform emergency surgery. When Duffy entered A&E, he ‘crashed' again, to the verge of death's door.
“When you describe when someone crashes, it's when your blood pressure drops profusely,” explained Byrne.
“The blood was pouring in one way and it's leaking out the other. It's hard to know what actually happened but you have to assume an increased loss.
“We don't know what happened but there was a sudden drop in his blood pressure and he very nearly arrested.”
McEntee and his team took over from there and eventually managed to stabilise his condition. Before midnight, the good news was relayed to Duffy's parents and Republic boss Giovanni Trapattoni and his assistant Marco Tardelli — who left the St Patrick's Athletic/Bohemians game early when they realised the highly rated defender had taken a turn for the worse — that the patient would survive.
He was moved from intensive care yesterday to the high dependency unit and he was even able to sit up and read a newspaper. It's possible he could be discharged on Friday or Saturday, but it's unknown territory from here.
Certainly, it's anticipated he will make a full recovery, while it's difficult to put a time scale on something which is so unprecedented. The Everton medical staff travelled over immediately and were as baffled as the FAI team.
“It is similar to what you would see from high velocity blunt trauma road traffic accidents,” explained Byrne.
The Merseyside club were quick to offer support, with chairman Bill Kenwright in constant contact with Byrne, and manager David Moyes also on the phone from the United States.
“Shane was very frightened,” acknowledged Byrne. “He thought he was going to die actually.”
Trapattoni was in tears when he spoke about the drama, and Tardelli followed up by speaking of the strong sense of relief.
“It was a big emotion when I met his father because I have a son the same age as Shane,” he said. “The players are very sad because Shane is a good boy. It was very scary and he (his father) was very upset. He didn't know what was happening.”