Tagged: Oakland A’s

Troubled Waters

Much has been discussed about the ‘premature’ shutdown of Stephen Strasburg, as the Nationals head into the last month of the regular season with a commanding lead over the Atlanta Braves for the top spot in the NL East. I won’t inundate you with links for the thoughts, and opinions of many who have weighed in on the matter; a bit of googling or 30 seconds of listening in to the sports talk radio show of your liking will give you all of the fodder you need to keep abreast of the situation. In the end, the decision to keep Strasburg at what many consider to be a pedestrian 160ish innings for the season, postseason be damned, rests with but a handful of people; those people will continue to toe the company line, and say that this decision was done with the best of intentions, not only for Strasburg, but for the collective futures of those affiliated with the Nationals.

While Mike Rizzo, Davey Johnson, and in some respects, super agent Scott Boras bear the brunt of the decision-making, and the vitriol revolving around ending Strasburg’s season, there remains one other person implicated, with of an opinion that bears enough weight to be considered in full, and the only man of this brain trust that has experienced the mental and physical dilemmas that predicate the decision to shut down Washington’s ace.

Steve McCatty, more than most, can and will vouch for the need for a franchise to protect the arms of their pitchers, not only as a pitching coach, but also as someone who wishes to prevent history repeating itself – his own.

While known now as the no-nonsense mustachioed pitching coach, and a man who has nurtured and re-energized the careers of many a Nats pitcher, he himself was a pitcher, and one who enjoyed success, albeit fleetingly.

A member of the Oakland A’s in the late 1970’s/early 1980’s, during the reign of Billy Martin, McCatty was part of a feared starting rotation that embodied, and fell victim to, BillyBall.

The early 80’s provided a renaissance of sorts for Oakland baseball, and McCatty was an integral part of this rejuvenation. As much joy as the early ’70s A’s teams brought the East Bay in the form of 3 World Series titles from 1972-74, the late 1970’s brought as much anguish, culminating in a harrowing 54-108 record in the ’79 season. However, as with any managerial changing of the guard, and of a philosophy, growing pains will prevail, and prevail they did under the helm of Martin.

The ’79 season gave way to a hopeful 83-79 1980 season, which then brought a great, albeit shortened 1981 season for the A’s, not only due to a player’s strike, but a poor showing in the American League Championship Series, seeing the A’s being swept by the New York Yankees.

Coinciding with this resurgence of winning in Oakland came the progress and apex of McCatty’s pitching prowess. Aside from a handful of innings in 1977 and 1978, Cat’s career didn’t really take off until the ’79 season, which saw him jump from 75 innings pitched in the majors and minors in ’78 to 205.2 innings pitched between Oakland, and AAA Ogden in ’79. Ending the ’79 season with a 11-12 record, good for 19% of the A’s win total that year, McCatty’s innings saw about a 175% increase from 1978. Just looking at his MLB numbers for those two years, Cat saw an 828% increase in workload. Take into consideration the Nationals policy for increasing a pitcher’s workload during the formative years, and the numbers further astound.

While his workload increase from ’79 to 1980 was a more tolerable 7%, and more inline with the natural progression of a young starter maturing into his role as a top flight starter, the wear and tear that BillyBall brought to the arms of the A’s was starting to show. However, McCatty soldiered on, and was rewarded with a fantastic 1981 season, which saw the A’s take the AL West, and McCatty go 14-7, good for a second place finish in AL Cy Young Award voting. He did this to the tune of 185.1 innings pitched, which at first glance, isn’t that much. However, given the strike shortened season, this is deceiving. Were it not for the strike, McCatty was on pace for a 20 win season, with around 250 innings pitched, assuming a typical starter making 30 starts in a season.

That’s not all that was impressive about his 1981 season. For ’81, Cat averaged over 8 innings PER START, with an astounding 16 of his 22 starts completed.

*16* complete games, with two of his starts seeing him go 10 innings.

This was par for the course for Oakland pitchers under the BillyBall philosophy, and it served them well…for two years.

As the calendar turned over to a new year and baseball season, the A’s saw their good fortunes of 1981 fizzle away in 1982 – a 68-94 record, and arm injuries to the starters signified the beginning of the end. As his fastball velocity went down, so did McCatty’s innings. Acknowledging pitching through pain most of those halcyon years, and those following them, Cat became nothing more than a junkballer after 1981, getting by on changing speeds, and veteran guile, his once mighty fastball all but a memory, post 1981.

In the end, McCatty’s promising career careened to a halt in 1986, spending most of his remaining years and innings as a reliever, and mop up man, his days of almost Cy Young caliber dominance exactly that – days past. No one remembers who came in second, and that point is driven home when it’s your middle reliever holding that uncrowned achievement.

Time heals all wounds, and to this day, Steve McCatty doesn’t speak ill of how Billy Martin used him, or the rest of the pitching staff during his days as a Oakland Athletic. He was paid to pitch, and that’s exactly what he did, to the detriment of the team in the end, and to the detriment of his arm, and baseball legacy.

The siren song of taking your horse and using him in a maximal fashion each start is alluring, but the rocks off of the shore of championships, and the glory bestowed upon those who achieve it, are too craggy to navigate without an unfailing compass of knowledge, which is lacking when it comes to the handling of post Tommy John surgery hurlers.

The Nationals have not been there yet, to set foot on the sandy beaches of World Series glory, but the shore is in their sights for the first time in their voyage as DC’s team. There is much to be said about being in the always troubling position of being the one who sets a precedent, be it successful, or a warning to others to not follow in their footsteps; this is the position that the Nationals find themselves in, and their every move along their course to the postseason without Stephen Strasburg is being eyed with hawk-like acuity by others.

The desire to be first is all-encompassing, but it should not be at the cost of the livelihood of any player, and his long-term health, and his career. Steve McCatty has tread those waters before, and drowned in the vortex of winning now, at all costs, all hands and arms on deck.

One can only hope that his career provides enough of a warning to Washington to stay true to the course they have set out on, as the siren sings on.

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HDIB? Neuroscience Grand Rounds: Epidural Hematoma

So by now many/most of you have seen the Brandon McCarthy incident that occurred during Wednesday’s game against the Los Angeles Angels of Anaheim, the Inland Empire, Barstow, and High Desert of Kern and LA Counties, and parts of San Diego. Scary stuff, life threatening stuff. Stuff of nightmares, and stuff that conjures up flashbacks to Juan Nicasio, even Ray Chapman.

As a neuroscientist by trade, I feel compelled to have a teaching moment, and hopefully shed some light on the medical aspects of the incident, in hopes of arming folks with a little extra knowledge of this type of injury, and perhaps add some additional gravity to the situation, while also alleviating some of the mystery, and concern over the epidural hematoma Brandon sustained.

Excuse me while I change into my white coat — mine’s flannel lined, and super comfy.

Ahh, that’s better; gotta love the LL Bean Health Care catalog.

While he didn’t quite dodge the ball coming off of Erick Aybar‘s bat, McCarthy did dodge a huge bullet in terms of his long-term health; he was quickly seen, and the physicians involved with his initial care did him a great service by getting a CT scan of his head. With the help of my crack staff of interns here at HDIB?, here’s a ‘nice’ CT image of what an epidural hematoma looks like:

Guhhhh

See the bright white crescent on the left? That’s the hematoma, which is simply an area of blood that has pooled outside of blood vessels due to trauma. As you can image, a baseball to the noggin at over 120 miles per hour will create enough trauma for the tiny capillaries and vessels of the head to get a little leaky, shall we say. For this type of injury, the blood pools between the tough, layered outer covering of the brain – collectively called the dura – and the skull. As more blood seeps out of blood vessels, the greater the pooling between the dura, and skull. More pooling, more intracranial pressure – the skull doesn’t have much ‘give’, as you can imagine, to flex against the swelling – which in turn, pushes the hematoma into the brain.

From here, the brain gets smooshed (medical term there, folks), and depending upon which part of the brain gets smooshed the most, you can see a number of symptoms, arising from what that smooshed brain area is responsible for – language, vision, movement, what have you. More severe hematomas can smoosh all the way down to more basic areas of brain that are responsible for things like, say, breathing. This can happen over a matter of hours, or a matter of days, which is why the CT scan, as well as keeping a person with this in the hospital for observation, is a crucial aspect of diagnosis, and treatment of this injury.

OK, my impromptu neurosurgery residents, what do we need to do, and how do we do it. Yes, you with all of the tattoos, playing Fruit Ninja on your phone – whatcha got?

…reduce intracranial pressure is the first step? Excellent! What’s a quick, and mildly barbaric way to do that?

You, the one with the bowtie, picking your earwax and smelling it, you’re up.

… a craniotomy? What you lack in social skills, you add in sheer neuroscience genius. While you are correct in wanting to do this, there are other methods of reducing the pressure from the hematoma, but the craniotomy is arguably the quickest, and most thorough way to get this resolved.

OK, so off we go to the OR to drill a hole in poor Brandon’s skull, to ‘evacuate’ the hematoma, and reduce that brain smooshing. You can find more in-depth information about the procedure here.

There we have it, in a nutshell – for those scoring at home, it’s a Brazil nut. While a somewhat common injury, especially in falls, and car accidents, it’s exceedingly rare within the realm of baseball injuries. McCarthy’s prognosis is quite good, given the speed in which the medical staff treated this, from the team trainer, down to the neurosurgeon.

Isn’t neuroscience great?

The answer is yes. Yes it is.

…and even more awesome is that Brandon is going to be OK, and hopefully back on the mound soon, albeit not this season, I would imagine.

I hope you enjoyed my teaching moment, and that it adds to your enjoyment of the game, and to your amazement of the human body, at rest, and in motion.

Is Brandon McCarthy awesome?

Yes. Yes he is. And with the help of modern medicine, he will continue to be.