Dr. Jonathan Gelber's book
Tiger Woods's Back and Tommy John's Elbow: Injuries & Tragedies That Transformed Careers, Sports, and Society packs
a lot of interesting information into less than 200 pages. Dr. Gelber
begins with the legend of the "Cobra Effect," which is an example of the
sociological concept of unintended consequences: as the story goes, an
Indian Raj sought to curb the presence of cobras in his territory by
offering a bounty for dead cobra skins--but the unintended consequence
was that his citizens bred cobras in order to kill them for the bounty,
and then after the Raj canceled the bounty the breeders set these cobras
loose in the countryside since there was no longer any value for
killing the cobras.
There are many examples of the
"Cobra Effect" in Dr. Gelber's book, and here is one to whet your
appetite to read about the rest of them.
It is well known
that L.A. Dodgers' pitcher Sandy Koufax retired in 1966 at age 30 to
prevent permanent damage to his left (pitching) elbow. Dr. Robert
Kerlan, the Dodgers' team doctor, diagnosed Koufax with arthritis, the
result of years of trauma to Koufax' elbow. A few years after Koufax
retired, Dr. Kerlan partnered with Dr. Frank Jobe to form the
Kerlan-Jobe Clinic, which later became world-famous for treating
athletes from a variety of sports.
In 1974, Tommy
John--then a pitcher for the Chicago White Sox--suffered an elbow
destabilization injury that Dr. Gelber suggests was similar to the one
that had eventually forced Koufax to retire. Dr. Jobe, consulting with
hand surgeon Dr. Herbert Stark, decided to perform a radical new
surgery, taking a tendon from John's forearm and carefully threading it
through John's elbow to stabilize the joint. John went on to win more
games after undergoing the procedure than he had won before, and the
operation is now known as Tommy John surgery.
The
"Cobra Effect" here is that Tommy John surgery has gone from being a
radical solution to an injury that threatened to end a pitcher's career
to a procedure that has become commonplace among young pitchers, many of
whom undergo the surgery not to cure injury but based on the false
belief that the surgery inherently increases performance levels. As a
result of this,
Tommy John has publicly stated his opposition to how prevalent his namesake surgery has become among young athletes,
noting that over half of such surgeries are performed on patients who
are between 15-19 years old, and that one in seven of those kids will
never fully recover.
Other "Cobra Effect" stories examined
by Dr. Gelber include Magic Johnson and HIV, Lyle Alzado and steroids,
Len Bias and drug abuse/mandatory minimum sentencing, Hank Gathers and
athlete screening for underlying health issues, Ayrton Senna/Dale
Earnhardt and race car safety issues, Duk-koo Kim and efforts to make
boxing safer, Tom Brady and measures to protect the quarterback from
injury, plus Tiger Woods' back injury and the use/abuse of opioid
drugs.
This book is thought-provoking, and I
recommend it with just two caveats: (1) The existence of a "Cobra
Effect" is suggested but not conclusively proven in some of the examples
and (2) the book would be even better if it had been lengthier so that
some of the issues raised could be discussed in more depth.
