Friday, March 7, 2014

A Pioneer Passes

Baseball lost one of its most significant non-playing contributors yesterday when Dr. Frank Jobe, longtime medical adviser for the Los Angeles Dodgers and the original developer of what we know as Tommy John surgery, passed away at the age of 88. Dr. Jobe retired from his everyday practice in 2008, but remained on the Dodgers' payroll as an adviser through three ownership changes and several front office overhauls. He was honored by the Hall of Fame last summer for his work, although not given the plaque he deserves for saving countless careers and changing the game more than any other non-player except for Marvin Miller. His story, of course, is intertwined heavily with that of John himself, the pitcher who gambled on what at the time was a shoestring chance of saving his pitching career.

For the first century of professional baseball, pitchers who suffered a major arm injury were essentially done as players, no matter how famous. Think of Dizzy Dean altering his delivery after suffering a broken toe in 1937 and completely falling off the map at the age of 27. Or consider Sandy Koufax, who hung it up at the age of 30 after a six-year period of domination practically unequaled in the history of the sport. Imagine their careers (both Hall of Fame-worthy as is, by the way) with a leap in medical technology that allowed them to pitch longer into their careers.

Tommy John was a pretty good 31-year-old pitcher when his elbow gave out during the 1974 season. He was in his twelfth major league season, with a 2.97 career ERA (16% better than league average) in over 2000 innings. John didn't strike out a lot of guys (1273 in 2165 innings), but he also didn't walk too many (633). He had made one All-Star team, during the Year of the Pitcher (1968) when he had a 1.98 ERA (which was only good enough for fifth in the American League that year). He was a solid starter who was great as your third guy but not so good that you had to keep him on your team; by the time of the trade, he had been traded twice, from Cleveland to the White Sox and from there to the Dodgers.*

*The details: John signed with the Indians in 1961, and four years later they traded him with Tommie Agee and John Romano to Chicago as part of a three-team deal that netted Cleveland Cam Carreon (from Chicago) and Rocky Colavito (from Kansas City). KC got Mike Hershberger, Jim Landis, and Fred Talbot from the White Sox. John and Steve Huntz were shipped to Los Angeles by the White Sox for Dick Allen in 1971.

John was enjoying his best season since the mound was lowered when he blew out his elbow twenty-two starts into the 1974 season. He went to Jobe, desperate to try anything that might let him pitch again. So Dr. Jobe told him they could try an experimental procedure that involved taking a tendon from a cadaver and threading it through John's elbow in place of the torn ulnar collateral ligament, but warned John that the odds of success were probably about five percent. The pitcher agreed, knowing it was probably his only chance. The tendon that Dr. Jobe used for that first surgery is one that about 85% of people have, but that is mostly superfluous. If you hold your hand out with the palm up and make a fist, then curl it towards yourself, two tendons should raise up against your skin (although you may have to move your fingers individually to be sure of both). One of these flexor tendons became John's new UCL, and he sat out the rest of 1974 and all of 1975 recuperating.

When John returned to the Dodgers in 1976 at the age of 33, he made 31 starts and pitched 207 innings, winning the National League's Comeback Player of the Year Award from the Sporting News (back when the Sporting News still mattered). He struck even fewer people out (91) thanks to not even having a medium ball, let alone a fastball, but he knew how to pitch. in 1977 he was a marvel, finishing second in Cy Young voting to Steve Carlton thanks to his 20-7 record (which had as much to do with playing in front of the best team in the league as his pitching). The next year he made his second All-Star Game before signing with the Yankees as a free agent prior to the 1979 season, where he would make two more Midsummer Classics and again finish second for the Cy Young (to Mike Flanagan). All told, that cadaver tendon with the five percent chance of success gave Tommy John 2544 more innings across fourteen seasons; he pitched his last game (still as a starter!) at the age of 46. He currently stands at twentieth all-time in innings pitched with 4710 1/3 (almost 2000 ahead of active leader Mark Buehrle) and eighth in starts with an even 700 (Buehrle has 429).

That gamble by John and Dr. Jobe revolutionized baseball. Jobe taught the surgery to hundreds of future orthopedists, and now the surgery is so common at all levels of baseball (not to mention other sports; even javelin throwers get it - shout out to Wake Forest's pride and joy, Alan Susi!) that it seems weird when a pitcher hasn't gotten the zipper. Here's a short list of star pitchers who have undergone the procedure: John Smoltz, Mariano Rivera (although technically his ligament was repaired - by Dr. Jobe - rather than replaced), Kerry Wood, Chris Carpenter, Adam Wainwright, Eric Gagne, A.J. Burnett, Jose Rijo, Billy Wagner, Jamie Moyer, Stephen Strasburg, Jordan Zimmermann, Joe Nathan, Tim Hudson, and Matt Harvey. That's quite a roster, and it doesn't even account for a few position players who have had the same surgery, such as Shin-Soo Choo. And remember that five percent estimate of success? Today, Tommy John surgery has a 95% rate of success, with many guys coming back even better than before (much like John himself).

Dr. Jobe's first experimental procedure completely altered the sporting landscape, prolonging thousands of careers, not just in baseball, but in all sports. He was one of the most influential people in sports in the twentieth century, and he will be missed.