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How Tommy John Surgery Got Its Name May Surprise You

On April 21, 2007, the professional baseball season was well underway. I was not yet the Yankees doctor, but I was spending the morning with a retired Yankee player. Weeks earlier, I had invited my mentor, teacher, and inventor of Tommy John Surgery, Dr. Frank Jobe to our New York Orthopedic Hospital Alumni Biennial Meeting as a special guest. Our Biennial medical meeting is a gathering of the brightest orthopedic surgeons and alumni of our surgery training program. This year’s meeting was historic with Dr. Jobe scheduled to speak on Tommy John Surgery. Leading up to the meeting however, Dr. Jobe developed incapacitating back pain from spinal stenosis and required surgery on his own spine. Unable to come to the meeting, rather than simply cancel, he called Tommy John and asked him if he would fill in. John came to our medical center with tremendous enthusiasm and upon walking into the lecture hall, he expressed how was excited he was to “pinch-hit” for his friend and surgeon Dr. Frank Jobe.

I began the meeting by giving a lecture on how to diagnose UCL injuries and perform Tommy John Surgery. It was truly an honor to discuss advancements in Tommy John Surgery with Tommy John himself present. I then introduced Tommy John to the stage and showed the audience a few slides that outlined his career achievements. John stepped up to the lectern with no notes or slides and began speaking. “I first hurt my elbow when I was 13 years of age when changing from Little League to Babe Ruth League. The mound-to-home distance increased from 45 feet to 60 feet. With my elbow hurt, I played first base for a while. I really became a pitcher in high school.”

“Everyone remembers what they were doing when JFK was shot on November 22, 1963. I was getting my first elbow cortisone injection. Early that week, I had thrown a shutout and the next morning could not move my arm.” What many people do not know is that John had excessive amounts of elbow cortisone injections, “Between November 22, 1963, to July 14, 1974, I probably had over 40 cortisone injections….!”

John explained to us that any pitcher who experienced elbow pain at that time immediately became extremely concerned about their career. “I don’t recall a pitcher in the 60s or 70s who had surgery and came back. In 1972, I slid into home plate and jammed my left elbow. Dr. Jobe diagnosed me with loose chips and recommended surgical removal. I did not know if surgery was the right choice so I called my dad.” John explained that he needed reassurance from his dad that surgery was the best next step. Jobe cleaned out the chips and repaired his flexor tendon.

In Spring training 1973 John felt good but was not throwing well. Everyone was asking him including players and eventually players’ wives — is your arm ok? The trainers told him his arm was ok. But John explained to our audience of orthopedic surgeons that no one can tell you if your arm is fine. The only person is you. You need to get confident on your own. So he took 6 baseballs out of Dodger town, threw for 1 hour, and threw as hard as he could with a catcher. Then the next day — he got a catcher and threw curve balls as hard as he could.

Tommy John (left) and Dr. Frank Jobe, inventor of Tommy John Surgery

Midseason, 1974, Tommy John’s record of 13–3 included five complete games and three shutouts and was the best in baseball that season. In a game against the Expos, John found himself working out of trouble and attempted a sinker to produce a double play. Upon executing the pitch, he felt a searing pain in his elbow. He attempted another pitch that flew awkwardly into the stands and walked off the mound to seek attention from training staff and Dr. Frank Jobe. Without MRI technology available at that time, Dr. Frank Jobe diagnosed John with an elbow ulnar collateral ligament tear, solely based on a physical examination and stress view x-rays. Jobe put John’s arm in a cast for four weeks, hoping for the UCL to heal. The injury quickly declared itself as not healed when John experienced pain with his return to light throwing. Unable to pitch, and unwilling to give up, John instructed Jobe to surgically fix his elbow. The challenge for Jobe and John was that a surgical solution was nonexistent at the time. When Jobe explained to John that he did not have a surgical solution for him — John instructed him to “make something up”.

Jobe came up with a plan.

John asked, “What are we gonna do?” and Jobe replied, “I don’t know. I will get others in the room to help figure it out.” Herb Stark, Lew Yocum, to help guide him. “I told him — If you do your job, I will do my job.”

Jobe told John he had a chance 1 in 100 of returning to competitive baseball.

Tommy John (above) pitching for the Dodgers

Midseason, 1974, Tommy John’s record of 13–3 included five complete games and three shutouts and was the best in baseball that season. In a game against the Expos, John found himself working out of trouble and attempted a sinker to produce a double play. Upon executing the pitch, he felt a searing pain in his elbow. He attempted another pitch that flew awkwardly into the stands and walked off the mound to seek attention from training staff and Dr. Frank Jobe. Without MRI technology available at that time, Dr. Frank Jobe diagnosed John with an elbow ulnar collateral ligament tear, solely based on a physical examination and stress view x-rays. Jobe put John’s arm in a cast for four weeks, hoping for the UCL to heal. The injury quickly declared itself as not healed when John experienced pain with his return to light throwing. Unable to pitch, and unwilling to give up, John instructed Jobe to surgically fix his elbow. The challenge for Jobe and John was that a surgical solution was nonexistent at the time. When Jobe explained to John that he did not have a surgical solution for him — John instructed him to “make something up”.

Jobe came up with a plan.

John asked, “What are we gonna do?” and Jobe replied, “I don’t know. I will get others in the room to help figure it out.” Herb Stark, Lew Yocum, to help guide him. “I told him — If you do your job, I will do my job.”

Jobe told John he had a chance 1 in 100 of returning to competitive baseball.

Without MRI technology available, Dr. Frank Jobe diagnosed John with an elbow ulnar collateral ligament tear, solely based on a physical examination and stress view x-rays

Coming Back…

After two full years of rehabilitation, John resumed pitching. In the spring of 1976, John explained that he was called into the front office and told his next start would be his last start. He was upset but was not giving up. His last start would be in Houston which is a very difficult ballpark for a sinkerball pitcher. He quickly found himself in trouble. Men on base and in a 3–0 count, with current batter 3–0. Ferguson comes out to the mound and says “this may be your last hitter……ever! I suggest you throw fastballs.” John throws 4 seamers as hard as possible and manages to get a strikeout. He threw a 7 inning shutout with 2 hits.

Naturally, John asked, “Do I get another start”. Incredibly, over a span of 13 years…. John never missed another start.

Fourteen seasons and 164 wins later, John retired at age 46. Following John’s successful outcome, Jobe went on to directly help the careers of hundreds of pitchers with his surgery and, indirectly, with the surgeons he taught the procedure to who went on to perform the surgery. It is truly a medical wonder.

John explained that Jobe is a surgeon and a friend. “Why I love Dr. Jobe — he is humble.” Jobe had said over many years, “had I been a better doctor, I would have diagnosed Sandy Koufax” “I am not a great surgeon, I have great patients…. the patients make me look good.”

Tommy John Surgery Gets Its Name

Dr. Jobe chose not to perform any additional UCL reconstruction surgeries until after he fully understood the outcome of Tommy John. After John’s successful return, Dr. Jobe began offering it to other pitchers who had UCL injuries. Dr. Jobe was also an academic surgeon, meaning he would actively teach other surgeons. And many surgeons decided to spend a full year with him to observe and learn his unique skills (I was one of those surgeons!). His first published report of Tommy John Surgery was in The Journal of Bone and Joint Surgery in 1986. Jobe would refer to the surgery as “Ulnar collateral ligament reconstruction of the elbow using ipsilateral palmaris longus tendon graft”. He was repeating this mouthful of a description so often that he eventually began simplifying and would say — “the surgery I performed on Tommy John.” That then evolved to Tommy John Surgery. Players now even further simplify it as TJ surgery.

Historically, surgeons who invent procedures tend to name the surgeries after themselves, Dr. Jobe was happier having his surgical invention named after his patient.

Dr. Ahmad with his mentor, teacher, and inventor of Tommy John Surgery, Dr. Frank Jobe
Tommy John and Dr. Ahmad in 2007 at the New York Orthopedic Hospital Alumni Biennial Meeting
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