Thursday, July 28, 2011

I'm not a doctor, I just play one on TV

The above title was allegedly overheard in the Red Sox locker room this weekend.

Alex Speier of reported today that the Red Sox are “very concerned” about the status of Clay Buchholz and his ailing back. What was once thought to be a muscle strain could now be something serious like a broken bone. Before we get into the nightmare scenario of John Lackey being one of the team’s three top starters in a playoff series, I want to look at what the hell is going on with the Red Sox medical staff. In chronological order:

2004: The Red Sox lose team physician William Morgan and hire Dr. Thomas Gill as team medical director. Morgan was the brilliant mind behind Curt Schilling’s bloody sock moment. He used tissue from a dead body to suture the tendons in place in Schilling’s ankle, a procedure that had never been done before, and allowed the pitcher to contribute to the first Red Sox championship in 86 years. Gill was the chief of the sports medicine division at Mass General so he carried with him an impressive pedigree.

2005: Signed injury reclamation project Wade Miller for less than market value with the hopes that their “All Star” medical staff can keep him healthy for the season. They do not. (He may not have stayed healthy for any team, but this becomes a trend with the Sox)

2006: Matt Clement is put on the DL for arm fatigue and then diagnosed with biceps tendinitis. His rehab progresses slowly and some people suggest he is afraid to come back to the team because he was hit in the head by a line drive earlier that year. He received arthroscopic surgery in September and it was found that he actually needed Tommy John surgery. He would never pitch in the majors again. (In fairness to the Sox, even Dr. James Andrews, King Tommy John, misdiagnosed this one, but it’s still another black mark as far as I’m concerned)

2008: The team re-signed an injured Schilling to a 1-year, $8M contract with the assumption that he would be back mid-season. Boston thought the best course of action for Schilling was to rehab his shoulder. Dr. Craig Morgan, who had operated on Schilling in 1995 while with the Phillies, proposed a revolutionary new surgery called biceps tenodesis that he and Schilling believed would guarantee his return prior to the All Star break. The club opposed the new surgery and elicited a third opinion from a Mets team physician who agreed with Dr. Gill. The rehab didn’t work and in June that year he had the surgery he wanted to have in the offseason. He never pitched again.

2008: Jed Lowrie injures his wrist in the minor leagues just before his major league debut. He plays the remainder of the season with intense pain and once the season is over is diagnosed with a fracture. He does not have surgery on the wrist until April, 2009. According to the team, he saw 6 hand specialists and it wasn’t until that 6th one that surgery was recommended.

2009: Signed injury reclamation project John Smoltz hoping to capitalize on an undervalued pitcher while their “All-Star” medical staff keeps him healthy for the season. They do not. (After only 8 ineffective and injury-plagued starts, he is shipped off to St. Louis where he posts a 40:9 strikeout to walk ratio down the stretch in 7 starts)

Now things start to get downright fucky

2010: The Red Sox sign Adrian Beltre to be their third baseman making Mike Lowell expendable. The team works out a trade with the Texas Rangers, but the Rangers pull out of the deal at the last minute. Reports are conflicted over which injury they pull out because of: his bad hip or his torn thumb ligament. Regardless, the team waits until December 30th to operate on the thumb and Lowell is unable to come back until the middle of Spring Training, which makes it impossible to establish trade value.

2010: Jacoby Ellsbury breaks his ribs in an April collision with Beltre. He returned a month later, but re-aggravated the injury making a diving catch. The initial diagnosis was a bruise and the team refused to provide an x-ray because they do not x-ray bruises. After finally convincing the team to do the x-ray, he was diagnosed with the broken ribs. After his return and re-injury, the team said he had a new broken rib in his back, but Ellsbury sought a second opinion from Dr. Lewis “Don’t Call me Dwight” Yocum who discounted this statement saying that the back rib was broken in the initial collision.

2010: Mike Cameron suffered a torn abdominal muscle early in the season. Sox doctors recommended he play through the pain until he could no longer handle it. After a few DL stints, he finally had surgery in August and was out the rest of the season. He played in 48 games. Would surgery earlier have spelled a late season return?

2010: Dustin Pedroia broke his foot on June 25th. After surgery, he surprisingly returned seven weeks later after being cleared to play by the team’s medical staff. He played 2 games and then had to go season ending surgery to insert a pin in the foot to repair it further. Despite the team getting a second opinion that their process was correct, Pedroia seemed skeptical of being cleared so early.

2011: Daisuke Matsuzaka goes on the DL for a sprained elbow ligament. The club says rest and rehab will be the optimal course and he should be back in a month. Dice-K seeks a second opinion from a Japanese doctor. Terry Francona tells the media that the pitcher will not need surgery to fix the issue. A few days later, they confirm that at the Japanese doctor’s recommendation he will undergo Tommy John surgery to fix his elbow, effectively ending his career with the Red Sox.

2011: After a number of really really really really really bad starts, John Lackey is placed on the DL for some mysterious elbow problem. When he returns about a month later, his results on the mound are mixed. This prompts some Sox officials to suggest that his elbow may still be injured and that surgery may be necessary. Lackey responds to these comments with disbelief, saying there is absolutely nothing wrong with his elbow.

2011: And now, the Buchholz ordeal.

So what’s really goin on here man? I think the Red Sox have the best interest of their players in mind at least in the short term. Ultimately everything they do is with an eye towards winning, so maybe the long term health of these guys is not their concern. However, there are a number of instances in here where a more proactive course of action should have gotten players ready quicker than what was actually done. What’s worse is that it appears the current staff is getting a bum rap among players. The only reason we know about a lot of these instances is because the players have been very vocal in their disagreements with Dr. Gill and his staff. This mismanagement, and poor PR play, may have a serious effect on future acquisitions. At its best, a strong medical staff can be a huge asset for a team in attracting talent and keeping that talent healthy. The Phoenix Suns, a different sport but a great example, boast the best medical team in basketball. They have been able to attract and maintain aging veterans like Steve Nash, Grant Hill and Shaquille O’Neal because they know that going to that team means a prolonged career. At its worst, like with the New York Mets and possibly the Red Sox, a bad or uncooperative group can turn players away and turn hefty long term investments (Dice-K, Lackey) into steaming piles of New Jersey. I don’t know if Dr. Gill is a bad doctor or if he is being strong-armed by Theo Epstein and Red Sox ownership like he was James Woods in Any Given Sunday. What I do know is that this current medical staff is being painted as the bad guy far too often and for the greater good of the team they should seriously be re-evaluated in the offseason. 

As for Buchholz specifically, I would not bet my life on his return this year. The team officially needs a new pitcher from a group of Erik Bedard, Rich Harden, Hiroki Kuroda, Scott Baker or maybe even Ubaldo Jimenez (just don’t trade Middlebrooks, Lavarnway, Iglesias, Reddick, Brentz or Jacobs please). Otherwise, get your bags of heroin ready because it is going to be a scary playoffs if John Lackey is pitching Game 3 of the ALDS.

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