Uncertainty surrounds Monday night's marquee matchup between the NFC North Division-leading Chicago Bears and the frontrunners in the West, the San Francisco 49ers.
Concussions have put the status of both starting quarterbacks in question while the Niners' head coach, Jim Harbaugh, was sent to the hospital last Thursday when doctors discovered he had an irregular heartbeat.
Harbaugh underwent what was described as a "minor procedure" and was back at work on Friday preparing for the Bears.
"They had to do a little procedure, cardiovert," Harbaugh said after getting back to work. "Get it back normal. It's amazing they can do a procedure like that."
Cardioversion is an electric shock that gets the heart back into a normal rhythm and Harbaugh said it wasn't the first time he's had to have something done to his heart.
"About 13 years ago, I had a cardio ablation for the same thing," the 49ers coach said. "An atrial flutter is what I have."
Assistant head coach and special teams coordinator Brad Seely handled the 49ers practice on Thursday and would have presumably been in line to run things if Harbaugh was unable to recover quick enough for Monday night but the coach is ready to go against the organization he played seven of his 14 NFL seasons for.
"If you're a football player, it's a game you live for. If you're not, it's another day at the office," Harbaugh said. "I hope it's everything they live for."
On the field San Francisco's Alex Smith was belted twice in last Sunday's 24-24 tie with St. Louis, ultimately exiting the game in the second quarter after suffering blurred vision.
Smith did enough to pass the NFL's ImPACT testing protocol and was able to practice in a limited fashion by Thursday. He reportedly planned on playing Monday night but ESPN has reported that Smith did not pass a final concussion test and was not medically cleared to play.
"Contact, obviously, I think (is) the final straw," Smith said after practice last Thursday. "But yeah, I was able to go out there. Had the black jersey on me, which is a little redundant, seeing as how we don't get hit in practice, but yeah, felt good out there."
The Bears' Jay Cutler, however, isn't doing as well after being walloped during a helmet-to-helmet collision with Houston linebacker Tim Dobbins late in the first half of the team's 13-6 loss to the Texans on Nov. 11.
Dobbins was fined $30,000 earlier this week for the hit and Cutler has been ruled out of Monday's game.
On paper Chicago seems a little better prepared to withstand the loss of its starting quarterback since veteran Jason Campbell is the caddy for the Bears while untested but super athletic Colin Kaepernick is Smith's backup for San Francisco.
Campbell, who has significant starting experience in previous stops with Washington and Oakland, was unable to lead Chicago on a game-tying drive in the waning moments of its loss to Houston, however.
A steady rain and two play-making defenses made points hard to come by in that one. Houston and Chicago combined for six turnovers in the opening 30 minutes, with the Texans forcing four of them.
Campbell connected on 11-of-19 throws for 94 yards against the Texans while Matt Forte ran for 39 yards on 16 carries.
"We're 7-2," Bears coach Lovie Smith said. "We're going to get ready for San Francisco. We have an extra day to get ready for them. There's a lot of football left to go."
Two normally trustworthy kickers misfired in overtime and the end result was the NFL's first tie in nearly four years during the Niners last game
Both David Akers and Greg Zuerlein both missed field goals in overtime as San Francisco and St. Louis Rams played to NFL's first tie since Nov. 16, 2008 when the Philadelphia Eagles and Cincinnati Bengals finished their contest knotted at 13-13.
Akers, who sent the game into overtime with a 33-yard field goal with three seconds remaining in regulation, sailed his kick wide left from 41 yards out midway through the extra session.
Zuerlein initially nailed a 53-yard attempt on St. Louis' ensuing series, but a delay of game penalty was called. The rookie kicker, who split the uprights from 60 yards away earlier in the year, pushed it right from 58 yards out.
Smith was 7-of-8 for 72 yards and a touchdown before exiting the contest with the concussion. Kaepernick came on and threw for 117 yards on 11-of-17 efficiency and added 66 yards on the ground for San Francisco, which had won four of its previous four games coming in.
"The way I feel it was a good football game, it was a hard fought game, it came out even," Harbaugh said.
The 49ers hold a slim 31-29-1 edge in their all-time series with the Bears, including a 21-12 advantage at home. This game also marks the fourth matchup between the two clubs on Monday Night Football, and the first since 1991.
WHAT TO WATCH FOR
Two of the NFL's top defenses are probably licking their chops thinking about playing against backup quarterbacks.
San Francisco leads the NFL, allowing 127 points (14.1 per game) and Chicago ranks second with 133 points allowed (14.8 per game).
The 49ers also rank in the top three in the NFC in all three defensive yardage categories: total yards per game (292.1, first), passing yards per game (196.8, third) and rushing yards per game (95.3, third). The Bears, meanwhile, rank second in the NFC in rushing defense (92.3) and third in total defense (307.3), but lead the NFL with a mind-boggling 30 takeaways, including 19 interceptions and seven interception-return touchdowns.
Everything hinges on who starts at quarterback. A second-round pick out of Nevada in the 2011 draft, Kaepernick was pedestrian against the Rams in the first extended action of his NFL career. His athleticism and ability to extend plays is always a concern but a smart, opportunistic defense like Chicago's tends to give quarterbacks like Kaepernick a ton to trouble.
Kaepernick is approaching as if he will start against the Bears but it's pretty clear San Francisco will need Smith to navigate a Bears defense which makes its living generating turnovers and turning them into points.
"I feel good," Smith said. "It's really not up to me though. It'd be a better question for the doctors. They have a lot of stuff they're looking at. I'm not really sure what my answers are even telling them. They're checking my symptoms, things like that. I feel good."
If Kaepernick has to play expect the Niners to rely heavily on running back Frank Gore, who generally plays very well against the Bears, amassing 215 yards and a touchdown on just 37 carries in his past two games against Chicago.
"Chicago's a good team," Niners tight end Vernon Davis said. "They have a lot of talent. I know that we'll be ready."
Campbell has much more experience but certainly won't have it easy against San Francisco's defense, which has been putting big time pressure on opposing QBs lately, recording eight sacks and numerous hurries over its past three encounters.
This will be an extremely tough game to prepare for on both sides with all the uncertainty. Smith seemed to be on target to give it a go but that's cloudy now while Cutler will have to sit things out. Meanwhile, Harbaugh's heart issue had to affect the 49ers' preparation at least a bit.
All that said, the fact that Chicago's backup signal-caller is the more seasoned option should be enough to help the Bears sneak out of the Bay Area with a close win.
Sports Network Predicted Outcome: Bears 17, 49ers 14