Late last month, I was talking with one of our Managing Editors (Henry Druschel) about some things related to our weekly podcast. Somehow the conversation shifted, and I learned that one of the writers recently brought on (Mark Davidson) is a recipient of Tommy John surgery. To me, this was awesome news. Having gone through the surgery myself on August 1st, 2016, I had been mulling ideas about how I wanted to write about it, and how I wanted to approach this topic. I immediately shot off a message to Mark, and that was the best thing I could’ve possibly done. We started talking about our injuries and our recovery; and then Mark asked me a question. "How has it affected your mental state?"
To be completely honest, I was not prepared for what I went through in the months preceding and following the surgery. Though I am only 20 years old, that period contained some of the lowest points in my life, mentally. At the time, I had no clue that others who had gone through this surgery have struggled in the same way, if not worse. But the more I talked with Mark, the more I realized that I was not alone in the way I had dealt with TJS and recovery. That’s when we came up with the idea for this project: to speak to as many recipients of TJS as possible about how they dealt with the mental struggles associated with the surgery. Not all of those that participate in this project have completed rehab, and I think the wide range of perspectives will help provide a look at how TJS recipients feel at the different stages of recovery.
My goals for this project are twofold. The first is that I want players who are about to get the surgery to be able to look at these responses and see what others have gone through and experienced. I don’t want to necessarily scare them away from the surgery, but I hope that it can help better educate people about what they can expect, based on what others have dealt with. Second, I want people who have gone through the process of TJS to be able to look at the stories of others, and realize that they aren’t alone in their struggles; that most of us deal with some type of mental anguish, or an identity crisis, at some point in the surgery timeline.
If you have had Tommy John surgery and would like to participate, feel free to email me at firstname.lastname@example.org, or DM me on Twitter (@ShawnBrody) to let me know. I thought the most fitting way to kick this off would be to publish Mark’s story, so here it is, presented in a Q&A format. I hope that it is as insightful for you as it was for me. I would also like to thank Mark for taking the time to share his story, in addition to helping me get this project off the ground. Without him, this would not have been possible.
Shawn Brody: When were you told of your injury, what level of baseball were you at, and how old were you?
Mark Davidson: I was a freshman at Cal State Fullerton and it was in the fall of ‘03, so I was 18. Now, at 31, it seems like I was a veritable baby.
SB: Did you know before you had the surgery that something was wrong?
MD: So I fear this answer might end up long-winded, but I see the backstory to my surgery as crucial to the struggles I had post-op. Looking back with the information we have now, that 15% of people are born without a UCL (Ulnar Collateral Ligament), and that it serves no real evolutionary purpose, it wouldn’t surprise me to learn that I had a weak UCL to begin with because, while it might sound like an exaggeration, I remember being 8 years old and riding home from practice with my elbow throbbing. I thought about telling my parents, but I had cried when they signed me up to play little league because I was terrified that I wasn’t going to be any good, so I thought they might assume I was just trying to get out of going. So, I settled on the pain being a byproduct of growing so rapidly.
It flared up again in my final year of little league. I was 11, and the pain was pretty severe. That definitely set off some bells for me, but I knew if I could just make it through the end of the season, then the tournament of champions, and finally all-stars, I could rest it by playing other sports.
Between little league and high school ball, I was playing on high-profile travel ball teams, which seems ridiculous to say about kids that are barely teenagers, but that’s the way it is. During those travel ball seasons, I’d periodically have to skip a start or two (or more) because of my elbow. I saw a doctor but I think because of my age he wasn’t overly thorough in his examination, which is probably a stark contrast to how a balky elbow in a 13-year-old is handled today. At some point before high school, the pain got so bad that I finally worked up the courage to tell my parents that I wanted to quit. It was met with hesitance, as I expected it would be, and when they asked what I would do in place of baseball, I had guitar in the school band and drama as my extra-curricular activities of choice. I knew I would miss baseball, but I was very serious about stopping; my elbow and I were burnt out.
For better or worse, my parents were more worried than I was about how much I would miss it, which, as a parent now, I think is a completely fair thought to have. They also saw me excelling at something and didn’t want me to not follow it a bit further. So their intentions were mostly good, but I believe they also felt some sort of reflected prestige would be robbed from them if I stopped pitching – a notion that was later confirmed to me by my mom. I cried a lot during that conversation because it was sad to admit and frustrating that they didn’t honor my decision. I haplessly agreed to keep playing, but it felt like I’d sacrificed some of my autonomy.
During my freshman year, after basketball season gave way to baseball, my arm felt pretty damn good. I was throwing 82–87 and it kind of hit me that this was something I had to do. Despite the fact that 82–87 is pretty much on par with Jered Weaver, that doesn’t sound so outstanding with today’s velocity readings, even from a 14-year-old; but other people, and even myself, were enamored with it. After my sophomore year, my baseball coach convinced me that I didn’t have any future in basketball and that I needed to focus on baseball.
The problem was that without basketball, and with an uptick in summer tournaments and showcases, the pain in my elbow was back and my velocity gains plateaued. This was especially frustrating because some kids were catching up with my velocity and the goal I had set to reach triple digits before the end of high school seemed further out of reach. But 89–94 with a splitter and a decent-ish slider was enough to give me plenty of college offers to choose from and I committed to Fullerton not long after July 1st between my junior and senior years.
The next summer, when interest from major league teams didn’t line up with what I felt I was worth, and my scouting report cited a problematic arm action, I took it pretty hard and set out that summer hitting the squat rack and running in the pool daily. I was in the mid-90s consistently that summer and got up to 96, but then had elbow soreness near the end of summer ball. When I got to Fullerton, I remained sidelined for several weeks before starting to throw, and when I finally got on the mound in my first scrimmage, my velo readings were down into the mid-80s. That’s when I went and got the MRI and found out kind of what I’d suspected for a long time – that my UCL was torn.
SB: How bad was the tear?
MD: It was a 3rd degree sprain, which means it was a complete tear.
SB: What was it like to be told you needed Tommy John, and what was your initial reaction?
MD: I was surprised at how straightforward the doctor’s delivery was. "You can either have the surgery or never pitch again." But the news itself wasn’t necessarily a revelation. I looked around the room at my parents and the doctors and was like, "I don’t really have an ideal place to hang up my cleats, so yeah, I’ll do the surgery." My doctor, Tadashi Funahashi, had that plastic smile doctors have to convey optimism as he described the procedure. At that point, protocol dictated a second opinion, so I was sent, with my imaging, to Dr. Jobe in Los Angeles. Of course, he concurred, and I remember feeling very unfortunate to have the same bad news delivered to me twice when I felt once was enough.
SB: What emotions did you struggle with following the surgery?
MD: A lot of guilt, shame, and anger.
When I got to Cal State Fullerton I was aiming to start one of the weekend games. In talking with the pitching coach, Dave Serrano, leading up to my time there, I got the impression that’s what they expected as well. To go from feeling like an integral part of a plan to feeling like a forgotten piece on the roster was brutal. In reality, no one had forgotten about me, but from my perspective I had failed to deliver on my end of the deal and I carried a lot of guilt over that. That guilt ultimately changed the perception I had of myself, and how I thought I looked in my coaches’ and teammates’ eyes. That’s an important distinction to make, because while my coaches and teammates probably saw a young kid trying to stay positive who was going to rehab and working his ass off in conditioning, I perceived myself as a nuisance taking up time that could be used to work with players who were going to perform that season. That was probably a miscalculation on my part.
I don’t know if there’s a discernible connection between how we view ourselves and how others actually perceive us, but I think there is one, because when I was feeling like I was forgotten, I was upset, and I found myself attracting conversations with other disgruntled players, players that didn’t have a clearly defined role or who were just going to be a bench player. These guys were facing their own baseball mortality, too, which I was empathetic towards initially, but ended up developing a strange superiority over them when they would ultimately reveal that they believed their situation was the fault of the coaches, who were failing to see their brilliance. They weren’t playing because of skill, whereas I couldn’t play because of injury, and that provided me comfort at the expense of their grief. I think any time we realize a new depth to our darkness, it’s natural to be a bit shocked, and I was ashamed, and because I didn’t know how to process this, it led to a lot of anger.
SB: How did it affect your mental state; what was your biggest mental struggle?
MD: I’m having a hard time not quoting Yoda, so let me get it out of my system: "Fear leads to anger. Anger leads to hate. Hate leads to suffering."
It was very exhausting. I didn’t know what a healthy outlet was for everything that I was feeling, so I tried hiding it all, which ended up being a full-time gig. Trying to convince everyone around me (and maybe even myself) that I was okay became a crisis. It showed me that what I perceived to be the only acceptable version of myself contradicted who I really was at the time. I was only 18 years old, and my life had been pretty uneventful up to this point, charmed even, and I was very satisfied being a goofy, happy-go-lucky kid. The constant contradiction between that and what I felt like inside was a source of suffering for me.
The hassle of having to get to physical therapy at Kaiser Permanente three times per week on top of baseball practice and school was pretty draining, too. I’d always maintained a busy schedule, but it’s easier to keep a positive outlook when your work yields consistent results; the rehab process, however, as you know, does not. And I was beginning to feel anxious over the looming idea that my end goal, pitching, was at least year away, and there was no guarantee even of that.
The physical therapy also brought physical pain. Working out at the gym is fun, or at least yields a good type of pain and consistent results, but breaking down the scar tissue was not that. Our bodies are incredible in how fast they can heal, and so the scar tissue builds up quickly. It’s a weird sensation having your arm straightened by weights or by a therapist, because fear and pain receptors are very resistant to it. So, the physical pain of therapy combined with the emotional struggles of recovery made for a complicated rehabilitation because they tended to exacerbate each other. Amazing as our minds and bodies are, sometimes correlations are made between pain and emotions and that can lead to depression.
SB: Did you become depressed?
MD: Without a doubt.
SB: Did you seek out medical help for depression?
MD: Eventually, but it was a couple years after surgery.
I wish talk therapy or anger management was considered a part of the rehabilitation process. I definitely would’ve benefited from it. I didn’t have the right tools to get through the process. I had severely overestimated my ability to frame things positively, and grossly underestimated how arduous and draining the rehab process would be.
By the time I sought out professional help I’d spiraled pretty far down the rabbit hole – I was self-medicating and getting into fights. And the process of getting help is a hit-or miss-experience, so it can feel like yet another obstacle when you’re just starting out. Besides one-on-one talk therapy I test-ran a couple antidepressants before settling on the same medication I take today - shout out to Celexa!
But beyond that, when I started to focus on myself, I caught a glimpse of the multitude of layers I was going to have to work through, and that realization initially made things worse. So, to cope, in conjunction with my anti-depressants, I started anti-anxiety and attention deficit disorder medications (a lot of my teachers would feel vindicated to hear this). I attended several outpatient group programs at Kaiser: one for generalized depression, one for anxiety, and one that taught me about cognitive therapy.
Cognitive therapy was the best thing for me because it allowed me to identify a lot of negative thinking patterns and then challenge them, giving me a tool I could use without burdening another person. It’s tedious because it involves a lot of writing. What you do is you make three columns: the first column is the negative thought, the second column labels what kind of thought it is, and the third column you use to come up with an alternative thought. Our brain supposedly has 50-70 thousand thoughts per day and a lot of mine were negative, so I have dozens of notebooks filled with cognitive therapy from several years of work.
Maybe that seems insane, but to give you an idea of where I was at: the surgery had not worked, so obviously there was no more baseball. I was trying to figure out what my college degree would be, and I was taking (mostly) jobs I didn’t want to do: at movie theaters, restaurants, furniture stores, retail stores, grocery stores, as a special needs assistant, and more. I list so many occupations because I wasn’t holding down jobs very long, because I was mired in negative thoughts. I felt like I’d wasted all of my potential because I couldn’t think of what I had to offer besides baseball. I had carried over that cast off and forgotten sensibility I developed during my Tommy John rehab, and had probably started believing those things, and my defense mechanisms became withdrawal and anger – two things that are not acceptable in a professional atmosphere.
I was so down on myself that I’d begun to isolate from a lot of friends. I stopped going to the practices for the band I was in (Sharks Ate Rickey), and basically made every textbook-wrong decision for trying to deal with depression. I knew my friends were frustrated with me, and that added to the list of people I felt I’d disappointed to that point: my parents, coaches, teammates, and friends. I started to wear that as part of my identity.
There were some nights when I would go to the park and contemplate the idea that I wanted to die. I never had a plan, but I knew that I should take those thoughts seriously, so one night I 5150’d myself. A 5150 is like a voluntary, but also mandatory, stay in a hospital for several days. At first I regretted the decision because despite my willingness to cooperate, protocol dictates that they escort a 5150 patient from the emergency room to the facility in an ambulance while strapping them down to a gurney.
I get emotional thinking about that ride now. The hospital was scary. I don’t know what I’m allowed to talk about from my time there, but it was a smack in the face for sure. Talking to some of the people in there who were suffering from PTSD or trying to detox from heroin puts my woes in perspective. Not that mine weren’t valid, but it helped me understand where I was battered by circumstance and where I was complicit.
In a weird way, it was also like a vacation. Granted, there were strict mealtimes and bedtimes, but only having to be in charge of my own thought processes and focus on my moods really helped me focus on that path a little more. I was granted early release and that’s when I started to hit the cognitive therapy really hard.
I’d improved some by augmenting my cognitive therapy with anger management and my meds, but my depression was still treatment resistant, so I talked with my parents about other options and I was fortunate that they supported me in going through TMS. It’s called Transcranial Magnetic Stimulation, and as the name states it utilizes magnets to stimulate parts of the brain to get them to work differently, or more ideally. I would go in and sit in this giant, reclining, medical chair and they’d place a magnetic coil near the front left part of my head and for 30 - 45 minutes, the coil would pulsate electrical currents into my brain. At best, it was uncomfortable; at worst, tear-inducingly painful. But I can’t deny that, when coupled with talk therapy, it was very effective for me.
That was three years ago, and I’ve done maintenance to help combat the return of depression, but I’m pretty okay now. I mean, I’m better than okay... but my goal is always to be okay. I’ve been able to cut my intake of medicines from 160 mg of antidepressants to 40; my anti-anxiety from 1.5 mg daily to 0.25 mg, and my ADD medicine from 40mg to 10mg. I’m very thankful to my family, my doctors, and myself for working so hard to get me to where I am today.
SB: Did you self-medicate?
MD: Oh, constantly. I had never even taken a sip of alcohol leading up to my surgery, but I’d also never experienced such a strong desire to escape my reality. I think a couple months after my surgery I drank for the first time and smoked pot for the first time, too, and experimented with almost anything I could find after that – I just wanted a way out of my reality.
But by far and away the substance that has had the longest lasting negative effects on my psyche was steroids. In the summer of 2004, things were not going well in my rehab; it hurt to throw, basic physical therapy was still more painful than it should have been, and it was starting to creep into my head that I might have to go back to the doctor and see what was wrong. When Fullerton offered to re-up my scholarship, I declined. The opinion I had on my elbow had tipped to the point where I believed it was not going to heal and I couldn’t risk the guilt of accepting another year of a scholarship.
I poked around at different junior colleges and ultimately decided on Orange Coast College. Talking to some of the players I knew, I had expressed some of my fears and a lot of the players started to reveal to me that they were taking steroids to help with injuries (or performance). I ended up with a referral to a physical therapist who could then advise me on whether or not I should take steroids. Now did I ever think he was going to tell me, "no, stick it out, setbacks are common"? No – I’d already abandoned a straight edge lifestyle months before, and I wanted something that would provide a quick fix.
I got on an anabolic called decabol. It was magic and it was terrifying. The benefits were pretty immediate. I could do physical therapy with no problem and the duration and intensity of my strength training destroyed any notion of a ceiling I had. The effects, however, were also visibly noticeable, as I went from 6’-6", 220 lbs to 265 by the end of the three-month cycle. I learned quickly how to maneuver the creepy, weird world of steroids. If my physical therapist at Kaiser asked about the sudden, rapid improvements and size gain it was because I was finally feeling healthy enough to put in the work and I had a new diet. When I showed up at Orange Coast College, I said that I finally was able to pack on the muscle to my frame that I needed to if I was going to get back to doing what I wanted.
Looking back, I can’t pretend like anyone else was responsible for my decision to take steroids, but the pressure I felt to get healthy was tremendous. I felt that not only was I trying to get healthy for myself, but for all the people that had told me that this was something I should see through. The pressure eased off as I started to gain more positive reactions in regards to my progress and appearance, which I knew was in direct opposition to the reaction I would’ve received had I been honest about my elbow. I think from this viewpoint, I feel like an extreme version of a steroid sympathizer – I can’t imagine the pressures of being a major league baseball player.
But I’d be remiss if I didn’t speak truthfully about the benefits of steroids. From my experience, the benefits cannot be embellished. At this point I had moved to throwing off of the mound and my velocity was creeping back up, but my elbow still had stabbing pains. The way I saw it, I was done, but I kept showing up and going through the motions because I had no idea what else to do at that point. I would’ve been terrified to not have baseball. Up until this point, it was clear that at both programs, at a Division 1 college and at a JUCO, that my role was as a pitcher. I had good but not great high school numbers as a hitter. I hit 3 home runs my senior year and was somewhere in the .350 range, but the guys that go on to hit in college are the 8–10 HR guys who hit over .400. But one day we had pitcher’s batting practice and I hit a ball on a fly into the parking lot across the street from our field – clear over the net that was set up to protect a busy, six lane street.
This display had the coaches pencil me in as the designated hitter for the next two preseason exhibition games against local JUCO’s and I had 5 hits in 10 PA; a double, a single, and two home runs. It was almost unfathomable how easy it was. But this was just a year away from the Mitchell Report investigations starting, and Barry Bonds was coming off an incredible year at age 39; in other words, murmurs had truly turned into screams about PED use. On top of that, the toll on my psyche was frightening. I was constantly angry and I was paranoid. Not just paranoid that people would find out, but paranoid to the extent that I was imagining that people were saying things about me behind my back. So, while it would’ve been easy to continue to obtain and take steroids, I’m so happy I had a moment of clarity and stopped. After those two games and one final bullpen, I never went back.
SB: Did going through TJS cause you to resent, hate, or feel angry at the game of baseball?
MD: Yeah, definitely. I think at the college level you already are starting to feel, with the amount of hours it takes from you, an iota of what it’s like to turn the game into a career. Working that hard, but with your end goal so far away, I got frustrated that the game was going on without me. Of course, I knew it would, but to remain in such close proximity was very difficult. It wasn’t fun. I was happy for my teammates, but a part of me was always yearning to experience their success first hand. It’s probably cliché, but I felt like baseball had broken up with me.
By the end of the process, and after I walked away, I stayed away for a long time. I didn’t watch any baseball for almost 6 years. There is a huge gap in my baseball intake from 2005 through 2009. I randomly joined a fantasy league in 2010, though I don’t know why, but I remember that there were so many names I didn’t recognize. Some of the names that were unfamiliar to me – Ryan Zimmerman, Franklin Gutierrez – were guys coming off 6 WAR seasons in 2009. I realized I hadn’t watched a game since Boston won the World Series in 2004. That’s how far removed I’d been. I wanted nothing to do with baseball.
SB: How did the surgery change your perspective on the game?
MD: I mean my current view on the game is very different from when I played. I think when you’re immersed in the sport to the extent that I was, you tend to think about it in the vernacular you hear on the field, which consisted of like, eight phrases when I left the game. Now, at least for the past few years since I got into advanced metrics, the game is so much more beautiful than it’s ever been, even better than when I was a kid.
I think during my rehab process it was much more existential – like what are we doing out here playing this game? What is this game? Isn’t it a giant distraction? Should my education be free because I can throw a ball better than most people? I still can’t answer last one that with a firm, subjective yes because it’s ridiculous, but our society values it.
But yeah, while I thought it was kind of stupid during the rehabilitation, I don’t think I’d appreciate it as much as I do now without it.
SB: Did you feel alienated from your teammates?
MD: Interestingly, yeah, it was hard for me to feel like I was a part of the success they were having. I think I was jealous that they were healthy. I was frustrated by the fact that the only other guy who had Tommy John was a couple years older, was constantly injured, and was not very willing to talk about it. Though that was my fault for having unrealistic expectations about where I could receive empathy.
SB: What was your biggest fear in coming back from TJS?
MD: I think that it was the idea that if the surgery didn’t work, I’d finally have to face who I was without baseball. I’d spent years constructing an identity around baseball and cracks in that identity were just beginning to reveal how much I’d come to rely on the self-worth it brought me. That really started the war within myself.
More immediately, I suppose, there was a sense of panic about my "stuff" not being the same.
SB: Do you wish someone would’ve warned you about what it would be like? The frustration/depression/physical pain.
MD: Yes and no. I think it might have helped to have had that seed planted, but I think that, ultimately, I’d probably have experienced the same trajectory. It’s tough to say just how serious 18-year-old me would’ve taken such a warning. Though that doesn’t line up with my desire to warn pitchers about it now.
SB: What would you want to tell someone who’s about to have Tommy John?
MD: Well I wouldn’t want to tell them to expect the worst, but they should mull over all of the variables at play and seriously consider that it may not work out. If they can maintain their sights on the day they make it back to the mound as a beacon of hope and not something they deserve, I think it might be easier to focus on the daily struggles of physical therapy and whatever mental demons may beset them. And as far as those mental demons, please don’t be ashamed. If you need help, don’t expect it, seek it out. Don’t be afraid of appearing weak; sometimes true bravery comes from admitting you’re weak to begin with.
SB: Your scar: do you consider it a badge of honor, reminder of a sense of failure, or relic from a time of growth?
MD: (laughs) I love my scar now. Definitely a badge of honor and a relic from a time of growth. I don’t subscribe to the "everything happens for a reason" philosophy, but I can say that if I had never gotten hurt I wouldn’t have grown so much and I might not be who I am today – which is someone who I’ve learned to love.
. . .
Shawn Brody is a contributor for Beyond the Box Score producer of In Play, Pod(cast), and a pitcher recovering from Tommy John at Howard Payne University. He is a Junior majoring in Business Management with a minor in Computer Information Systems. You can follow him on Twitter @ShawnBrody or email him at Shawnbrody9@gmail.com
Mark Davidson is a Contributing Writer at Beyond the Box Score. You can send him bat flip gifs and follow him on Twitter @NtflixnRichHill.