The Arm (2 page)

H
E DIDN'T WANT A PIECE
of the dead guy holding his elbow together. That's all he asked.

Todd Coffey had resigned himself to spending the next year learning how to throw a baseball again. He had accepted the mind-numbing rehabilitation process after tearing his ulnar collateral ligament, the two-inch elastic band that had prevented the upper and lower bones of his right arm from flying apart when he pitched. He simply couldn't stomach the new ligament coming from someplace other than his own body. “I think about it as a used car that has 40,000 miles on it,” Coffey said. “You don't know what the previous 40,000 miles were like. I don't know what it's been through.”

He had spent his entire adulthood in baseball. Got married, had kids, fought his way to the major leagues, made his first million and a few more, played the hero and the goat. Now his elbow had popped, and it was fix it or be done. He was used to binary
outcomes after spending nearly half his life as a relief pitcher. Ball or strike. Win or loss. Save the game or blow it. He knew nothing else. He didn't want to know anything else. And here he was, at thirty-one, with that career, that life, at risk, and the doctor wanted to reconstruct his elbow with a dead man's tissue because Coffey's own body didn't have any to spare.

On July 17, 2012, Coffey slid into an MRI tube at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. The next day he was scheduled to undergo Tommy John surgery, the procedure that revolutionized baseball in 1974, when Dr. Frank Jobe used a tendon from the wrist of John, a left-handed pitcher, to replace his torn elbow ligament. At the time, Jobe said it had a 1 percent chance of success. In the forty years since, the procedure has saved nearly one thousand professional players' careers, including that of Todd Coffey. It had given Coffey everything, and now it was threatening to take it away. Coffey was a well-traveled reliever, having bounced from Cincinnati to Milwaukee to Washington to Los Angeles, and now to Dr. Neal ElAttrache's operating room.

Nobody needs a pitcher with arm problems, not when there are kids in the minor leagues who throw harder and come cheaper. While Coffey wanted again to be among the 80 percent whose careers Tommy John surgery saves, a second procedure poses far more risks. Revisions, as they're called, aren't nearly as successful. Compound that with the possibility of foreign tissue mending Coffey's elbow and a ripped tendon in his forearm that required repair, too, and even ElAttrache warned this was no typical sew and go.

“This,” he said, “is the toughest Tommy John I've ever done.”

Were it up to ElAttrache, he would've skipped the MRI and gone straight to an allograft, the technical name for a tissue transplant from a cadaver. Coffey insisted, so the MRI machine growled and confirmed what ElAttrache had thought: maybe, just maybe, there would be sufficient tendon in his left leg for a graft. It probably wasn't twelve centimeters, the minimal length
needed, and the scar tissue from the previous surgery might have compromised its integrity. Discouraged, Coffey asked ElAttrache to cut into his leg and poke around for something better anyway. Coffey would know only when he awoke from the anesthesia whether he might join the short list of major leaguers striking out batters with an elbow not entirely his.

On the morning of the surgery, Coffey was supposed to arrive at seven thirty. He showed up a half hour early at Kerlan-Jobe with his wife, Jennifer, and his mother-in-law, Cathy Singer. Palm trees swayed in front of the five-story building plopped in the middle of West LA. Celebrities and athletes and everyday people mingle daily in the third-floor waiting room, burying their heads in magazines and smartphones before appointments with ElAttrache. Coffey plopped into an old chair and started to fill out paperwork. The signatures seemed endless. Coffey didn't bother reading the documents. His eyes drooped. He hadn't slept very well. Stan Conte, a trainer for Coffey's team, the Los Angeles Dodgers, slipped into the room and pulled Jennifer aside.

“How is Todd?” Conte asked.

“He kept saying he didn't want to have surgery,” she said.

Coffey didn't know what to feel. His livelihood mocked him. It wasn't just the allograft. Jennifer, his second wife, was five months pregnant with their first child, and Coffey wanted to come back in twelve months whereas the doctors said it was going to take eighteen, and, God, was the rehab brutal, and what if the surgery didn't go well and kept him from even trying to come back, which didn't happen much, but maybe it would happen to him. And the dead guy. Please, Doc, not the dead guy.

He buried his head in the papers, looped his signature, tried not to listen.

“Time to go,” a nurse said.

Coffey leaned over and gave Jennifer a kiss. She told him everything would be OK, and he wanted to believe her.

“I love you,” he said.

The nurse whisked him through a door and back to an operating room, where ElAttrache soon would join them. Todd Coffey's career was not dying, not there, not then. Neal ElAttrache promised he'd save it.

T
HE FIRST TIME TODD COFFEY'S
UCL blew, the surgeon tried to harvest the palmaris longus, a tendon in his right wrist, to tie the elbow back together. The tendon was too thin to stabilize the joint. He sliced open the other wrist. Same problem. So he went to Coffey's left leg and removed the gracilis, a hamstring tendon. It broke as the doctor tried to loop it through Coffey's elbow. One more cut yielded a fresh gracilis. Mercifully, it worked. Coffey made history on May 11, 2000: He was the first—and still the only—patient in the history of UCL reconstruction to go in for a surgery that entailed two cuts and leave with five scars.

Over his fourteen years in the game, Coffey had left behind an almost-unparalleled trail of apocryphal stories that were actually true. Like the time he asked the Arizona Diamondbacks' visiting clubhouse manager to make him a snack. He wanted peanut butter on one side, jelly on the other, two Reese's Peanut Butter Cups in the middle, all griddle-fried with butter. To this day, visiting players at Chase Field still can order the Todd Coffey Sandwich. His new teammates always wondered about the extra piece of luggage he hauled from city to city. The hard-shelled suitcase carried just one item: Coffey's baseball glove.

Justin Todd Coffey was born September 9, 1980, in Shelby, North Carolina. He stands six feet four, weighs approximately three hundred pounds, and has a shock of red hair with a beard to match. Fans know him best for his exuberant sprints from the bullpen to the pitcher's mound, during which many of those three hundred pounds gyrate in manners only physicists can explain, and which tens of thousands of YouTube viewers have enjoyed. For seven years, he clawed through the minor leagues: the
twelve-hour bus trips and fast-food dinners in bunk-ass towns for nothing pay and even less hope. Eventually, he found a role as a bullpen piece for the Cincinnati Reds, where he became a cult favorite. Although he is smarter than his goofy persona might suggest, Coffey fits the stereotype of a man playing a kids' game: he still drinks whole milk, watches
Star Trek
, and obsesses over Blood Bowl, a football-rugby hybrid dice game that involves painting figurines and having them disfigure one another.

Coffey's career had been far better than most, even if instability defined it. His career earnings totaled nearly $7 million as an average reliever for eight years. Cincinnati had released him on his birthday in 2008, and the Milwaukee Brewers and Washington Nationals subsequently let him walk via free agency, and his current Dodgers contract would expire at the end of 2012, leaving him jobless for the first time since a Reds executive tried to talk him out of signing as a seventeen-year-old. It was another of Coffey's odd stories. After Cincinnati chose him in the forty-first round of the 1998 draft, the team wanted to watch him pitch in junior college for a season and, if he looked good, sign him for a far more significant bonus before the next draft. To show their best intentions, the Reds asked area scout Steve Kring to pay Coffey a visit after the draft.

“I sent the scout into the house to go ahead and offer him a thousand dollars,” said DeJon Watson, the Reds' scouting director at the time. “There was no bonus. It was just the minor league contract. And he fucking accepted it! The scout's calling me from the house, freaking out. I said, ‘Did you explain to him we want him to go to college and give him more money later on?' And he said, ‘Yeah. He doesn't care.'”

Watson had already spent every dollar budgeted for the draft by his skinflint owner, Marge Schott, and did not want to draw her ire for dropping even a thousand dollars on a forty-first-round pick from North Carolina who threw 88 miles per hour. He started screaming at Kring.

“D,” Kring said, “Todd wants to talk to you on the phone.”

Watson figured he could convince Coffey to go to college. He sweet-talked his way into deals. Surely he could sweet-talk his way out of one. Watson told Coffey he was excited to have him in the Reds family and that everyone wanted to see him grow as a pitcher—in college. To which Coffey replied that he'd rather sign. Watson thought Coffey didn't understand. He did. He understood clearly. He just refused to listen. Coffey was signing his contract.

“And I promise you,” he said, “I'm gonna pitch in the big leagues.”

He reported to Billings, Montana, one of eight future major leaguers on the Reds' rookie-ball team. He didn't throw hard, not yet. He was awkward, Watson said, “like a big Baby Huey at the time. They teased the shit out of him. I felt so bad. Everybody rode him so hard.” Coffey stomached the jokes, kept improving, gaining velocity, fighting through his first Tommy John recovery, not just making it but staying. “It was something special about him,” said Watson, who later helped bring Coffey to Los Angeles, where he was an assistant general manager. “He said he was gonna pitch in the big leagues. And he kept his end of the bargain.”

Coffey loved pitching for the Dodgers. They had spent most of the first three months that season in first place. Dodger Stadium was paradise for pitchers. The sale of the team to a Magic Johnson–backed consortium invigorated the city. When Coffey came into the game in relief in the top of the eighth inning against Cincinnati with his team down 3–1 on July 2, 2012, he figured it would be just like his previous 460 appearances in the big leagues: throw sinkers and sliders, get ground-ball outs, head home. On Coffey's fifth pitch, a slider that plunked his former teammate Jay Bruce on the foot, he felt a twinge in his elbow. He shook his arm and thought little of it. Coffey bounced his next pitch in the dirt. His catcher, A. J. Ellis, visited the mound.

“Something doesn't look right,” he said.

“It feels fine,” Coffey said.

“You're not extending,” Ellis said.

“I will, I will,” Coffey said.

Three pitches later, Dodgers outfielder Elian Herrera misplayed a Todd Frazier hit into a triple. Manager Don Mattingly headed to the mound with the team's head trainer. Coffey threw a couple of warm-up pitches, and even though he shook his arm after each, he swore he was good, and they believed him.

Coffey struck out the next two hitters. He still has no idea how.

“Maybe adrenaline?” he said. “My elbow was done. And the tough thing is, in my case, it didn't hurt. I didn't have any pain. There's no swelling. It just felt like normal inflammation. My body is telling me: You can pitch.”

He gave up a hit on his next pitch, and Mattingly yanked him and sent him into the clubhouse so ElAttrache, the Dodgers' team physician, could examine him. Coffey is almost certain his elbow blew when he hit Bruce, meaning he fired sixteen pitches, most up around 92 miles per hour, with a UCL shredded for the second time.

An MRI the next day confirmed the tear. The misery of Tommy John surgery had struck Coffey again, as it would strike at least twenty more pitchers through the end of 2012. Even if his career in Los Angeles was done, Coffey promised to follow the Dodgers the rest of the season. He swore he would not forget them, no matter where he was or what he was doing.

Coffey needed just one favor before he left and went on to the rest of his career. He asked for Mitch Poole, the home clubhouse attendant, to wrap up his spikes. He wasn't going to waste a perfectly good pair of shoes, not when he planned on using them again.

T
HERE WAS BLOOD ON THE
floor of the stark-white Operating Room 2 at Kerlan-Jobe, and the surgery hadn't even started.
Coffey, who hated needles, had warned the staff about his elusive veins. “I've always been a hard stick,” he said. “My veins hide.” On the first attempt at inserting an IV in Coffey's arm, the vein blew and spurted crimson. It took three more tries before an IV worked.

Coffey breathed deeply. At least he wouldn't have to watch the rest. The nurse warned him he would feel some burning. Propofol, the creamy white sedative doctors call “milk of amnesia,” started to course through Coffey's body.

The door opened and ElAttrache walked in.

“Doc,” Coffey said. “This is some good shit.”

“We're going to get you taken care of,” ElAttrache said.

“Well, good luck,” Coffey said, drifting off to sleep. Once he was out, the medical team covered everything except his right arm with a sheet. ElAttrache first needed to assess the havoc. Years of damage can leave a pitcher's elbow looking like a grenade went off inside. ElAttrache started the scalpel above Coffey's first Tommy John scar on his upper arm, sliced over the elbow and ended beneath the bottom of the old scar—about twelve inches total, four inches longer than with a first-time UCL patient. He split the muscles around the elbow and used retractors to expose the UCL area—an inscrutable mess of red muscles blending into ligaments mingling with tendons camouflaging bones. ElAttrache needed to navigate the mess, and the first task called for someone even more specialized than him.