Why Tommy John’s legacy will forever live on across baseballplaySC Featured: Billion Dollar Arms (8:06)Jeff Passan
When it came time to name what would become the single greatest triumph in the annals of sports medicine, Frank Jobe considered his options. Frequently, doctors simply attach their own surname to a surgery. That felt wrong to Jobe. He dreamed up the idea and executed it, sure, but without the diligence and drive and work put in by the patient, the procedure would have failed.
Thus was born Tommy John surgery, not just a feat of sports medicine but a victory for modern medicine period, the real-life version of Humpty Dumpty being put back together again. The procedure has saved thousands of baseball careers and rebuilt tens of thousands of elbows, a legacy destined to long outlive those instrumental in its existence.
When John died Saturday night at 83 following a 2024 bladder cancer diagnosis, the game didn’t just mourn the loss of a 288-game winner who threw more innings than all but 19 of the nearly 10,000 men who have pitched in Major League Baseball. John’s 26-season career, magnificent in a vacuum, was secondary to the Sept. 25, 1974, surgery that forever changed the game.
Over the course of more than five decades since Jobe reconstructed the ulnar collateral ligament in John’s pitching elbow using a palmaris longus tendon from the wrist, John carved out an almost-inconceivable place in baseball: alongside Babe Ruth and Jackie Robinson as the most consistently mentioned former players.
Obviously, Ruth and Robinson were better players and more important figures, both cultural touchstones whose stories exceeded the bounds of their sport. No other player, however, is part of the game’s modern discourse like John.
Every day during baseball season, and plenty in the offseason, Tommy John — always his first and last name together — is talked about, written about, bandied about. Every incident of tightness in the forearm. Every time there’s a twinge in the elbow. All of the vagaries inherent in pitching turned John’s name into something that evokes fear and triggers anxiety. Never did John shy away from this legacy or regret Jobe’s use of his name, beyond his go-to joke that “if I had any idea it would’ve been this big, I would’ve trademarked the surgery and had all those SOBs pay me.”
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He was paid instead in appreciation. In July 1974, John’s 12th major league season, he threw a sinker to Hal Breeden, felt a crackling sensation up his arm, immediately left the field and told Bill Buhler, the Los Angeles Dodgers’ athletic trainer, to “get Dr. Jobe.” Already considered among the foremost orthopedic surgeons in America, Jobe also happened to be the Dodgers’ team doctor. Because MRIs were still more than a half-decade from clinical usage, Jobe X-rayed John’s left elbow and diagnosed him with a torn UCL, the triangular ligament that holds together the upper (humerus) and lower (ulna) parts of the arm.
“We just told him to go home,” Jobe stated. “He was through playing baseball.”
At the same time, Jobe had been studying the use of the palmaris longus — a tendon with limited utility that 1 in 7 or so people don’t even have — in successful ankle surgeries for polio patients. When rest did nothing to restore John’s ability to throw, Jobe presented him with two choices: go back to his hometown of Terre Haute, Indiana, and sell cars, or play guinea pig. Jobe told him that a UCL reconstruction had a 1-in-100 chance of working. For John, those odds registered better than the alternative. And in truth, Jobe assessed a 90% likelihood of success. He just didn’t want to get John’s hopes up.
“Tommy,” Jobe stated, “I don’t know what I’m doing.”
“When a doctor admits he’s not a god, a deity, and he can f— up,” John stated, “that sold me.”
John’s belief ran into obstacles. For the first three months following the procedure, his left hand was reduced to a shriveled claw, the result of Jobe transposing the ulnar nerve from the inside of the elbow to the bottom. John underwent another surgery, in December 1974, to reposition the nerve. It worked.
Throughout the 1975 season, with no rehabilitation protocol in place, John did what Jobe had suggested and listened to his arm. By late summer, it was whispering sweet nothings to him. By Opening Day 1976, John was ready, and in the Dodgers’ fifth game he threw five innings with no incident. John’s elbow held up over more than 200 innings that season, including four complete games in his final seven starts.
And on it kept going. He was second in National League Cy Young Award voting in 1977. Second in American League Cy Young voting with the New York Yankees in 1979. More innings, wins and years on the mound after surgery than before. In total, 166 of his wins and 2,544⅔ of his 4,710⅓ career innings came after the procedure. He retired in 1989 at 46 years old.
Most MLB Seasons PlayedEven though Tommy John suffered a UCL injury in 1974, he played 26 seasons in Major League Baseball, which is tied for third in MLB history.
YearsPlayerSea.Tms1966-1993Nolan Ryan2741871-1997Cap Anson2731963-1989Tommy John2661884-1912Deacon McGuire2611ESPN ResearchExperimental surgeries can be tricky. The next seven players who underwent UCL reconstructions after John’s failed to pitch in the major leagues with their new elbows. There’s ample evidence to suggest the most successful Tommy John surgery was the first — and not just because it worked.Eventually, Jobe honed the procedure and, 12 years after pioneering Tommy John surgery, he wrote about it in The Journal of Bone and Joint Surgery. Other surgeons put their own flourishes on the procedure, and it became an area of expertise for doctors who recognized blown-out elbows were nothing new. Though Sandy Koufax’s arm issues that ended his career at 30 never were firmly diagnosed, Jobe believed he had a torn UCL.The careers of others who followed, meanwhile, found second and even third lives. John Smoltz doesn’t make the Hall of Fame without Dr. James Andrews mending his right elbow. Justin Verlander, whose elbow held up until his first procedure at 37, will be the second pitcher in Cooperstown with a 3-inch scar on the inside of his elbow. Chris Sale will follow him. Shohei Ohtani has had two Tommy Johns, as has Jacob deGrom. Tarik Skubal, Zack Wheeler, Max Fried — all members of the club. An estimated 40% of major league pitchers today have undergone UCL reconstruction.
By no means is Tommy John surgery foolproof. Some come back lesser versions of their presurgery selves. Others never return. More often than not, though, it works, and to the point where players have taken to shortening John’s name when discussing the procedure. Perhaps the three scariest words in the game: “He needs TJ.”
During induction week in 2013, the Hall of Fame recognized Jobe for his contributions to the game. John was in Cooperstown that day, thrilled to pay homage to the brains behind one of the most impactful moments in baseball history.
“We did a little surgery,” stated Jobe, who died in early 2014, “but the man did all the hard work.”
Jobe’s reverence for John never faded, nor did John’s mutual admiration. Last week, when he missed Old-Timers’ Day at Yankee Stadium, John asked the Yankees to distribute a letter on his behalf. In it, John thanked the team, the Steinbrenner family, the fans — and “Dr. Jobe, who saved my arm.” Countless things could have gone wrong on Sept. 25, 1974. The anchor holes into which Jobe drilled to weave the tendon in a figure eight could have cracked. The palmaris longus could have snapped. The rehabilitation could have gone sideways. Impediments abounded. John avoided them all.
Were Frank Jobe not so humble and deferential, Tommy John would have passed with a standard lament for a player who spent more than two decades in the majors. Instead, his death was felt in every corner of the game. He was the patient worthy of eponymy. And his name will echo ad infinitum because of it.
