Betances entered the Yankees’ 7-3 victory in the eighth and opened his outing with a strike. From there, he unraveled. Betances walked Yan Gomes on six pitches, and then he nearly drilled Francisco Lindor in both the helmet and the belt buckle on the way to walking him in four pitches. Up the dugout steps skipped Manager Joe Girardi to retrieve Betances.

“The first pitch was good,” Betances said. “After that, I felt like I was just a little too amped up. I just got to be able to control myself. I got the first guy on, and I felt a little out of whack. I felt like I had a lot of energy out there. I just got to be able to dial it down a little bit.”

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Betances was remarkably cool afterward as a handful of reporters gathered around him. An ice pack around his shoulder, Betances calmly answered every question. He felt “100 percent,” physically, he said. He was “yanking pitches,” and “I got to be able to control myself a little better.” He was “trying to stay positive.” He insisted he was not dealing with doubt.

Betances noted he pitched well in an adrenaline-pumping situation in Cleveland, throwing two scoreless extra innings of Game 2 before the Indians got to him, but “being at home, the crowd was live,” he said.

Tommy Kahnle cleaned up Betances’s mess, so his Game 4 meltdown had no immediate repercussions. But the blowup signaled the resurfacing of a recurring problem. During one stretch from late June through early July, Betances walked 11 of 22 batters he faced over a span of five outings. On July 5, he faced five hitters and walked four.

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Betances seemed to solve his issues — he walked none in five of his final seven appearances this season, and he dominated in the 11th and 12th in Game 2. On Monday night, though, he had to have given Girardi pause about whether he could use Betances in Game 5.

“I know I can help this team out,” Betances said. “I just got to forget about this one and try to stay positive.”

Betances’s performance placed Girardi in a tough spot. If he does not use Betances, the Yankees’ bullpen cannot reach its highest level. If he does call on him, he risks getting Betances on one of his bad days and watching his season end in a hail of wild pitches.

“I feel confident for Wednesday,” Betances said. But after Game 4, it seems hard to fathom that the Yankees could place any confidence, much less the fate of their season, in him.