By now, most baseball fans know the story of Tommy John surgery. In 1974, John -- a solid pitcher for a decade -- blew out his elbow while pitching for Los Angeles against the Montreal Expos. “Blew out his elbow” is not a medical term, of course, but there was no need for medical terms when it came to pitchers in 1974. Once a pitcher tore the ulnar collateral ligament in his pitching arm, he was finished. That was exactly what Tommy John had done.

In John’s case, though, a pioneer was watching. Frank Jobe grew up in North Carolina, became interested in medicine while serving as a medical supplies supply sergeant in the army during World War II (and while watching doctors patch up soldiers during the Battle of the Bulge), served as a family doctor until his interests turned toward orthopedics. When he saw John’s elbow pop, he was the Dodgers orthopedic doctor. And he had this wild idea about replacing John’s torn elbow ligament with a healthy one already in his body.

Jobe famously gave John a 100-to-1 chance of ever pitching again. John eagerly took those odds; a one-percent chance is, after all, better than zero. As it turned out, the odds were much better than 100-to-1. John came back and pitched better with the new ligament than he had with the old. And a baseball revolution began. The list of pitchers who have had their careers saved by Tommy John surgery is mind-boggling -- there is a movement to put Dr. Frank Jobe in the Baseball Hall of Fame, and certainly there are few who have impacted the game more.

That’s the obvious story to recount today, one day after Frank Jobe died at the age of 88. But there’s another Frank Jobe story I discovered while writing The Machine that is, perhaps, just as telling about the man. Gary Nolan was a brilliant young pitcher. Few remember him that way, but Nolan was a phenom in the same class as Bob Feller or Dwight Gooden. He was 18 years old when he made his first start in the big leagues -- he and Feller are the only two pitchers in baseball history to strike out 10 or more big league batters in a game before they turned 19 years old. Nolan as an 18/19 year old had a lower ERA, better WHIP, more strikeouts and fewer walks than the National League Rookie of the Year -- a pretty fair pitcher named Tom Seaver.

“Don’t be scared,” Feller had told the kid that first year. “Make them scared of you.”

Not long after that, Nolan’s arm began to hurt. It was this sharp pain that made him wince with every throw. He couldn’t stay out there. He made just 22 starts his second year, 15 his third. But what hurt even more was this: Nobody believed him. Doctors had looked at his arm in the primitive way that doctors looked at arms in those days, and they found nothing wrong. Of course doctors didn’t KNOW that they were looking at arms in primitive ways, so they felt sure that there was nothing wrong ... except in Gary Nolan’s head.

“Pitchers have to throw with pain,” his Reds manager Sparky Anderson told him. “Bob Gibson says every pitch he’s ever thrown cut him like a knife. You gotta pitch with pain, kid.”

This cut harder than the jolting pain in his arm. The Reds -- this included doctors, management but, more painfully, his teammates -- thought he simply wasn’t tough enough. Rub a little dirt on it. Grit your teeth and bear it. Pitch through the pain. He tried because that’s what was expected. He pitched 250 agonizing innings in 1970, 244 more in 1971. He grew so used to the sharp pain, that he simply came to think of it as normal. In 1972 he was having a poor-man’s version of the legendary season Steve Carlton was having in Philadelphia.

At the end of July:

Nolan: 14-6, 1.71 ERA, 152 innings, 78 strikeouts, 28 walks, .228 batting average against. Carlton: 15-6, 2.37 ERA, 205 innings, 208 strikeouts, 54 walks, .206 batting average against.

And then the pain climbed to a higher plane. It was too much. He couldn’t handle it. The reporters asked him how much it hurt. “Enough to make you cry,” he said. Teammates rolled their eyes. Letters to the editor in the Cincinnati papers questioned his manhood.

“When’s Nolan going to pitch again?” reporters asked Sparky Anderson.

“Hell, I don’t know. Ask him,” Sparky barked angrily.

It was at this time that the Reds did one of the most bizarre things a baseball team has ever done. Reds executive Dick Wagner called Nolan and said they had figured out a way to fix his arm. They were sending Nolan to ... a dentist. Yeah. A dentist. Some crackpot dentist had reached the Reds with the message that Nolan’s arm problems were clearly the result of an abscessed tooth. Nolan actually went to the dentist. The dentist actually pulled a tooth. This really happened, not in the Dark Ages but in 1972. It’s probably lucky that the Dentist didn’t pull out leeches. The pain, strangely, did not go away. Nolan pitched two games in 1973 and he did not pitch at all in 1974. His career seemed over. And he felt dead.

Then, in desperation, Nolan went to see Frank Jobe, orthopedic doctor for the Reds’ biggest rivals, the Dodgers. The Reds, of course, were opposed to this ... but Nolan had reached the desperate point where he would try anything. He, like every other pitcher in baseball, had heard Jobe was different from other doctors. The first thing Nolan noticed was that Jobe took an X-Ray of Nolan’s shoulder from a different angle. This was new. And because of that, Jobe found what every other doctor had missed -- a one-inch bone spur floating around in Nolan’s shoulder and slicing him every single time he threw a baseball.

Finding the bone spur and getting rid of it, of course, are two different things ... but Jobe thought removing it was considerably less complicated than replacing Tommy John’s torn elbow ligament. The Reds, of course, were opposed to the surgery. They thought he could pitch through the pain. It really is staggering how disposable baseball players were to teams in those days. Jobe performed the surgery. And Nolan -- though he could never be as brilliant as he was at 19 -- no longer felt the pain and he came back to the Big Red Machine and won 15 games in 1975, another 15 in 1976 for two of the greatest teams in baseball history.

But the extraordinary thing is how Gary Nolan looks back not at the career-saving surgery itself but at something entirely different. He looks back and sees the kindness of Frank Jobe. For six or seven years, Nolan had been treated as something less than a man. He’d had his pain mocked and his toughness doubted. He’d been told again and again and again that the agony was all in his head, that it was his duty to pitch through it, and this false aura of fragility had come to define him in the eyes of American baseball fans.

Then, this soft-spoken doctor from North Carolina came back from the X-Rays and pointed at the source of all that pain -- there it was, as real as a swing and miss strikeout.

“I have no idea how you pitched in that sort of pain,” Frank Jobe said to him. “You must have been in agony.”

Thirty-five years later, Gary Nolan could still recite those two sentences, word-for-word.

Gary Nolan Surgery

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