Two years ago, playing in the high altitude of Denver could have killed Pittsburgh Steelers safety Ryan Clark(notes). Instead, it cost him surgeries that took his spleen and gall bladder, and the loss of an additional 35 pounds due to medical complications.

On Monday night, Pittsburgh returns to the Denver altitude for the first time since that scare. And amazingly, Clark is considering playing in the game, despite still carrying a sickle-cell trait and another undisclosed medical condition that caused the initial crisis. Clark has gotten medical clearance to play in the game, but the question remains: should Pittsburgh even be letting him entertain the risk?

It’s a complicated question, and one that really can’t be answered by anyone outside of the Steelers, who are the only ones fully aware of his medical history, as well as the potential danger caused by Clark playing in altitude. While some veterans expressed sentiment against it, one NFC general manager said it’s not a risk his franchise would take.

“Speaking from ignorance and not knowing all the medical particulars, my personal feeling is if all the pre-existing conditions are the same for [Clark], and if this was something legitimately brought on by the altitude, I don’t know how he could be allowed to play,” the general manager said. “But again, I don’t have the information in front of me that they do, so take it for what it’s worth. But to me, if you’re talking about the same scenario [as two years ago] from a health standpoint, even if that previous [health scare] was a freak thing, it’s got to be seen as a risk. If the altitude had a severe impact once, what’s to say it won’t again? Why take a chance?”

Clark’s previous illness ensued after playing in a 31-28 loss to Denver on Oct. 21, 2007. He became ill following the game, after complications with the sickle-cell trait in his blood prevented parts of his spleen from receiving oxygen. As doctors struggled to determine the problem, he was forced to have emergency surgery to remove his spleen. A few weeks later, his gallbladder had to be removed as well. Throughout the ordeal, he lost 35 pounds and his once-chiseled 205-pound physique atrophied, causing him to miss the remainder of the season. Along the way, doctors told Clark that about 1 percent of those afflicted with the sickle-cell trait in his blood react adversely to high stress and exertion in extreme altitude.

At last year’s Super Bowl, Clark related to Yahoo! Sports how the experience gave him pause about his football career, and how close his life came to changing dramatically.

“I thought about my daughter a lot,” Clark said. “You want to be there for her. You want to be able to pick her up and play with her. My football career became really secondary when I thought about that. My wife, my family, that is what was important.”

Clark has refused to discuss his decision to play this week with reporters, and Steelers coach Mike Tomlin has said that the two will come to an agreement on the decision later this week. However, it was something that was already on Clark’s mind at the Super Bowl.

“I’m supposed to be OK,” he said. “We actually play in Denver [in 2009], so that will be something to think about, whether or not I can play there. The sickle-cell [trait] and the [altitude] are only supposed to hurt certain things like those organs [the spleen and gall bladder] so they say I should be OK. They think it can’t hurt me now that those have been taken out. But, you know, it will be something to think about with my family.”

Even if Clark and his family decide he should play Monday, there is a chance the Steelers will deactivate him. Tomlin said he’s reserving the right to overrule Clark if he feels it’s in his best interests.

“His physical health, his well-being, of course, is paramount,” Tomlin said Monday. “We’re going to attempt to do what’s right. We’re going to weigh all our options and we’re going to come to a decision at some point later this week.”

Clark isn’t the only player with the sickle-cell trait. Steelers wideout Santonio Holmes(notes) has it, too, as well as many other NFL players. However, Holmes falls into the 99-precent who aren’t impacted by altitude issues. And he apparently doesn’t have the other undisclosed medical-condition that exacerbated Clark’s medical issues. Whatever the case, Tomlin reiterated what Clark said at last season’s Super Bowl: that the player has received medical clearance to play, and that doctors don’t expect any recurring issues.

But even with that clearance, it’s something that has weighed on the mind of his teammates. Both safety Troy Polamalu(notes) and wideout Hines Ward(notes) expressed some concern after watching Clark struggle through his previous scare.

“If it were me, no, I wouldn’t go,” Ward told the Pittsburgh Post-Gazette. “… I know he wants to be out there but life is way more precious than football. When football ends, you can still go on and have a productive life. What Ryan went through the last time he was there, to see him lose his spleen and to come to find out it was because of the Denver trip … if it were me, I wouldn’t play. It’s not even a question. But I can’t speak for somebody else. I don’t know how he and his family feel about the situation.”

Another factor to consider is potential legal issues if something catastrophic were to occur a second time. And while that’s a rather cold side issue in the whole affair, it’s something that most NFL teams would be forced to consider

“The legal end of it has to be part of your process,” the NFC general manager said. “I think there’s that whole idea of doubt. If something happened, the question is ‘If there was a scintilla of doubt in your mind, why put him out there?’ … I think there is a locker room element, too. You want to keep in mind the way players would view it, and how a team handles a health thing is always on players’ minds. They pay attention.

“That’s a lot of [consternation] for one regular season game.”

And that might be why it’s best to simply deactivate Clark in this case. While he’s got his medical clearance, doctors can’t clear a conscience. If anything were to happen, no matter how unlikely, the Steelers would be putting themselves in a precarious spot. Not only from the standpoint of public perception, but perhaps from their own players, too.

In this scenario, it’s better to stick with the overly safe approach and risk losing a little edge on the field than to go the other way and risk losing so much more.

 

Props: Yahoo sports