In the midst of a game, an athlete is concentrating winning, focusing all of his energy on the action. One of the furthest things from his mind is the chance of dying on the playing field.

However, this chance became a disturbing reality March 17 in Ithaca, when Cornell lacrosse co-captain George Boiardi passed away after being struck on the sternum with the ball. A senior defenseman, Boiardi was attempting to stop a shot on goal by Binghamton’s Nate Kerstein with roughly two and a half minutes left in the game. The impact caused Boiardi to collapse on the field, and he was pronounced dead at Cayuga Medical Center a few hours later. Though incidents of this magnitude are not frequent, they certainly send a shock through the athletic world.

“I’m sure it effects some of the kids,” Yale men’s lacrosse head coach Andy Shay said. “We knew George — it’s a sad day for lacrosse, a sad time for lacrosse — it hits close to home.”

Along with the sadness that follows an occurrence of this nature, there is also the fear of witnessing a fellow athlete undergo a fatal accident. While Boiardi’s cause of death is not certain — no autopsy has been performed — some medical personnel suspect that it was commotio cordis, an incident so rare that between 1998 and 2002, it occured in just 128 sports cases — both recreational and organized. Commotio cordis occurs due to a bizarre combination of events. In Boiardi’s case, the ball hit his chest at the exact moment of the cardiac cycle’s repolarization. It is not the force of the impact that causes death, but the timing of it.

“There are cases that show the bizarre nature of this entity,” Yale Sport’s Medicine physician Dr. Barry Goldberg said. “Like the case of a mother throwing a whiffle ball to her son in the driveway and hitting him in the chest, causing his death — commotio cordis most of the time is a low impact injury, and not a high impact injury. In baseball, you have a higher incidence of creating ventricular fibrillation when a ball is shot at 30 to 50 miles per hour than 70 to 80 miles per hour.”

Perhaps one of the most frightening things about this type of injury is the virtual inability to prevent it. Lacrosse rules do not require that chest protectors be worn, but extra padding will not necessarily help, Goldberg said. There has not been any research to prove that chest guards decrease athletes’ risk of commotio cordis, though more individual teams are requiring players to wear them. Eli lacrosse defensemen currently wear chest protection, but Yale will soon instate a rule that requires all players to wear it.

In addition, defibrillators, unless used immediately after impact, will often not be effective. A defibrillator was used on Boiardi, but to no avail.

“In most instances you have five to six minutes to defibrillate the heart to reestablish regular rhythm,” Goldberg said. “In commotio cordis, you only have three to five minutes to defibrillate somebody. That’s why the overall mortality with commotio cordis is in the neighborhood of 90 percent.”

As chest protectors only go so far and defibrillators do not always help in these cases, at some point there is nothing to do to ensure that players do not incur such traumas.

“I think in the nature of sports there’s going to be some risk at whatever level,” Harvard’s Director of Athletic Communications Chuck Sullivan said. “What happened with [Boiardi] was as much of a freak accident as could be. You can go over preventative measures all day, but I’m not sure that’s going to have an effect when fate or chance interjects itself.”

Chance certainly seemed to be the cause of the tragedy on Schoellkopf Field. And because the incident can be attributed to chance, coaches and players alike recognize that while things like this may shake a team, the only thing to do is to continue playing.

“Coaches are trying to teach kids to play as cleanly as possible to prevent injury,” Yale women’s ice hockey head coach Hilary Witt said. “Accidents happen and I think [what happened at Cornell] was a freak accident, which is really unfortunate. But it’s certainly not something you go out there thinking about all the time, but it’s something that’s in the back of your head.”

Lacrosse players, though certainly affected by the tragedy, plan to continue playing as they played before.

“It’s a scarier reality when you think about it outside of practice, but it’s not going to change how any of us play,” midfielder Dave Levy ’07 said.

The Yale squad, which is set to face Cornell on Saturday, will be wearing Boiardi’s jersey number — 21 — on their helmets in memoriam of the talented athlete, with whom many Elis have played. Nevertheless, as Levy said, the accident will not minimize the Bulldogs’ aggression on the field, though it will definitely be in the back of the minds of players, coaches and spectators alike.

“Every time someone gets hit with a ball, I think about it,” Shay said. “Absolutely every time. We have portable defibrillator on the field should something happen. It’s something we’re definitely aware of and fearful of — it’s a pretty scary situation. I witnessed a friend paralyze himself by hitting someone, and every time someone hits somebody I’m worried. But with any sport you need to expect some potential for injury.”

Shay recalled that an injury of this sort has only happened in lacrosse four times over the past four years — the 1999 incident at University of Massachusetts in particular garnered a great amount of media attention. But so far, no incidents of this sort have ever occurred at Yale, nor has Dr. Goldberg had to deal with a death in his 20-plus year career.

“I haven’t heard of that happening here at Yale,” Witt said. “And, God willing, that never will happen here.”