Smithsonian Delivers History And Innovation With Original Cast From First Tommy John Surgery

By Arthur L. Caplan & Lee H. Igel

A hunk of plaster wrapped in two black plastic bags has been sitting in a plastic bin in the attic of Tommy John’s house in California for nearly a half-century. The fascinating artifact—the original cast from the elbow surgery that informally bears his name—is about to be moved from its storage spot and shipped across the country to Washington, DC. Tommy John may not be in the Baseball Hall of Fame, but his cast is going into the collection of the Smithsonian Institution.

The former Major League Baseball pitcher decided to hang onto the cast, he recently said, “I guess because the guys signed it. The 1974 Dodgers. They were a good team.”

John was one of the most solid and reliable pitchers in Major League Baseball during a career that ran from 1963 to 1989. He won 288 games, including 46 shutouts, pitching for the Cleveland Indians, Chicago White Sox, Los Angeles Dodgers, New York Yankees, and California Angels. Whether the results of those performances are worthy of election to the Baseball Hall of Fame has been a point of contention among writers, historians, and fans since John’s name first appeared on ballots in 1995. To the people overseeing the millions of historical artifacts in the Smithsonian museum collections, however, there is no question about what to do with John’s arm cast.

In the middle of the 1974 season, John was pitching a game for the Dodgers when pain suddenly ran through his left, throwing arm. It was an unusual feeling, a kind he had never known before. He shook his arm to try to move the pain away and then threw another pitch. There was that same pain. It was enough to pull him from continuing in the game. As John made his way off the field toward the clubhouse, he asked for someone to “call Dr. Jobe.”

Frank Jobe, the Dodgers orthopedic surgeon, was already en route. He met John in the clubhouse and started an examination. But several team staff, players, and members of the media scurrying around made it too loud and busy a place to be as thorough as Jobe preferred. So, he advised John to meet at the hospital the following day for further examination.

At the ballpark the night before, Jobe was immediately concerned that John had sustained severe damage to an elbow ligament. At the hospital, an X-ray revealed there were no broken bones. But X-rays couldn’t detect whether ligaments had been torn; it would be a few more years until magnetic resonance imaging (MRI) would offer that type of precision. Jobe still strongly suspected a rupture of the ulnar collateral ligament in the elbow. He sent John to see Herbert Stark, a hand surgeon whose specialty might confirm it.

Almost immediately into the office visit, Stark confirmed Jobe’s diagnosis. By that point in his career, John had won a total of 124 professional games. The injury, though, was a career-ender.

But John was not yet ready to retire. So, as he shared with us in a recent conversation, he asked Jobe, “What would you do?”

Their conversations encouraged Jobe to invent a surgical procedure that could reconstruct the damage to the elbow. It would repair the torn ligament by harvesting a non-essential tendon—palmaris longus—from the non-throwing side wrist. The objective was to give the patient some use of his elbow: Jobe was mostly concerned about whether he could help John find a line of work to support his family.

In early autumn 1974, Jobe performed the surgery on John’s elbow. Soon after waking up from surgery, there was a test of the range of motion in the surgically-repaired elbow. When John bent it as much as he could, the arm was set in a cast.

Recovery and rehabilitation took 18 months. It required a program that no one had ever embarked on before because no one had ever undergone the surgery before. But John, with guidance from Jobe, figured “to do what I did when my arm was healthy.”

It also involved being on the lookout for tools that could improve what was already known to work. For example, while walking around the city during a Dodgers road trip to Montreal, John and a team trainer happened by a martial arts shop. They noticed an odd-looking device in the window, which they soon discovered was used to develop hand and finger strength. So, they purchased it and brought it back to the training room in Los Angeles.

One year and a day after the surgery, John resumed his playing career. Incredibly, he pitched 13 more seasons, never missing a start. Of his 288 career wins, 164 came after the operation.

John told us that he always had it in mind to return to pitching rather than find a new occupation. His focus, from the moment that he learned about the extent of his injury, was squarely on the question, “What do I need to do to get back to pitch?” And when Jobe first discussed the idea of the innovative surgery, John replied, “Dr. Jobe. If you do your job, I’ll do mine.”

Since then, the procedure, now known as “Tommy John Surgery,” has been improved upon. The recovery time has decreased and patients often return to action stronger than before they sustained the injury. The procedure has become so widely familiar across sports and society that, in 2019, Merriam-Webster added the term to its dictionary.

When John decided to keep the first arm cast all those years ago, he didn’t imagine the impact and influence that the surgery associated with it would have in the future. (In the weeks following the surgery, he would return to the hospital to have the casts replaced every few days.) In addition to the cast, John will also be donating an MRI of his elbow taken a decade ago during a medical checkup. The image highlights Jobe’s original work.

As to why the items will be going to the Smithsonian instead of the Baseball Hall of Fame, John quipped, “I called the Hall and asked, ‘Am I in the Hall?’ They said, ‘No.’ So, I thought, ‘How about the Smithsonian?’”

What is fascinating is that not only is a pioneering surgery being saved in a prominent museum, but that it is a reminder of what the future holds for potential markets in medical memorabilia and firsts. Private collectors and speculators who once went after baseball cards, rare maps, and paintings may soon enter a new world of trading in items of historic medical significance.

Tommy John and Dr. Jobe were pioneers in sports medicine. Museum directors are recognizing that fact. How long will it be before those trading in the NIL, NFTs, and historic items markets join them?