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Under the Knife

Truth is bad enough without jumping to conclusions

Posted: Thursday June 8, 2006 2:44PM; Updated: Thursday June 8, 2006 5:07PM
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By Will Carroll, BaseballProspectus.com

When I heard the Jason Grimsley story on Tuesday afternoon, the first thing that came to mind was ... no, the first is unprintable. The second thing that came to mind was, "Good people are going to get sucked into this." Logic escapes the performance-enhancement zone with perfect consistency. No one cares that some have been busted -- some twice or three times -- but everyone is told that Barry Bonds is baseball's Antichrist.

No one cares that more pitchers have tested positive than hitters since tests became public record -- and that even before, hitters weren't getting the advantages credited them. The home runs some tried to take away due to steroids might need a couple tacked on for the juiced-up pitchers they faced. "Give us more speculation!" the public cries. "Feed us a big name so we can wail and gnash our teeth. Feed us someone we once worshipped and let us melt down his Hall of Fame plaque as an offering to the sainted Ruth and Maris. If Barry Bonds used and Jason Grimsley used, then everyone in between must have used, right?"

Wrong. For every one of you who called for testing, you were right to do so. HGH (human growth hormone) and other recombinant versions of naturally occurring chemicals are the next shadow the game will confront, this time with no easy solution, no test on the horizon and no shady chemist to blame. My position, both before and after writing The Juice, was not strong enough, and I acknowledge that. But by calling for testing, you must then accept the results and only the results.

That leaves us with the moral gray areas, such as Grimsley's having not tested positive since results became public. It leaves some wondering if his miraculous comeback from Tommy John surgery wasn't so miraculous after all. I spoke with his surgeon, Tim Kremchek, this morning. Dr. Kremchek hadn't heard the news and was dumbfounded. "I don't prescribe [HGH], I don't recommend it, and I would never have one of my patients use it," he told me. It leaves us staring at the abyss of the nonanalytic positive or just throwing up our collective hands and handing over the wand to WADA. With the Grimsley case just beginning, and names -- in the words of Dan Patrick, "shocking names" -- hiding behind the black marker of Jeff Novitzky, we're only at the beginning of this story. Novitzky's pen is likely to get more use in the coming months, checking names off the list he's working from of implicated players with past positive tests and connections to the illegal use of performance-enhancing drugs.

We cannot jump to conclusions. We must remain grounded in fact and science rather than wild speculation. The truth is bad enough and getting worse.

Powered by a night at the ballpark with one of my heroes, SI's Peter King, on to the injuries:

• That didn't take long. The saga of Eric Gagne's elbow gets another chapter after he was shut down Thursday. Gagne had an MRI after he saw "significant" swelling in his elbow. The image showed inflammation around the ulnar nerve, which is a different nerve than the one he had removed earlier this year. The injury is potentially devastating and has many with the team shaking their heads, wondering how it could show up only after his major league re-emergence. I've had discussions with several pitching experts over the last few days about the mechanical differences between game and non-game situations. While the data show that there are no significant differences, I think it's the unmeasured game situations in which the variables change. Gagne is shut down indefinitely as the team tries to assess the cause of the inflammation and the best possible treatment.

• Bonds was once, not so long ago, where Albert Pujols is today. Now they have one more thing in common. Bonds is dealing with a "tweak" to his left oblique, just another bump, bruise or assorted ouchie keeping him off the field. Bonds is expected to get a couple of days off and have the injury re-evaluated. This is nowhere near as serious as the devastating injury to Pujols. While I seldom like or use the word "tweak," it seems in this case to be actually appropriate.

• When rehab assignments go long, it is seldom a good sign. For the Braves, keeping Brian McCann at Single A for a few more days is smart. The team is still concerned about how McCann's ankle will hold up when asked to handle a normal catcher's workload. Keeping him down an extra few days and pushing him a bit further will give them more information and hopefully prevent McCann from needing a return trip to the DL. More information is never a bad thing, so this rehab extension should be taken as a positive. Once he's back in the Braves' lineup, he should be there to stay.

• Sometimes it's not the most traumatic injuries that take the longest to heal. One data point there is the high-ankle sprain. It seldom has the dramatic wrenching event of a normal ankle sprain, yet it's one of the more painful and lingering injuries that occur in the game. Cliff Floyd is no stranger to ankle problems, so hearing that he suffered a high-ankle sprain on Wednesday isn't that surprising. That the Mets think Floyd will only miss a few days is surprising. Either this is one of the least-significant high-ankle sprains or Floyd's long history of problems has given him some sort of leg-saving laxity. The Mets think Floyd will be back in the lineup by early next week, but I'm not convinced.

Rich Harden is headed back to the DL, now with elbow problems in his pitching arm. Ken Rosenthal of FOX Sports is reporting that Harden had an MRI yesterday that showed a sprained ligament, likely the UCL. There's no immediate information from the always-cagey A's on the severity, but this is definitely a blow. If Harden needs Tommy John surgery, well, you know that song and dance.

• It's more than a simple setback for Darin Erstad. The bone chips in his ankle appear to have resurfaced, forcing the CF/1B to abandon his rehab assignment. Erstad returned to L.A. to have the ankle re-examined, but the team insists that the next option is not surgery. After two cortisone injections to an ankle that did not hold up under a normal week's workload, I'm not sure what the interim options are. The chances that Erstad will be able to avoid that surgery -- or at least delay it until the offseason -- are decreasing. Erstad's contract status complicates things.

• It was painful to see Chris Burke swing, miss and pop his left shoulder out again. The third time is apparently not the charm, as the third instance of dislocation/separation is now going to put Burke on a surgeon's table. Burke's chronic shoulder laxity is fixable, and several players -- Milwaukee's J.J. Hardy, for one -- have made comebacks from similar procedures. If surgery is performed, Burke is done for the season. Keep in mind that Burke came back from a similar injury in the minimum, so that possibility remains.

Quick Cuts: Derrek Lee will start swinging a bat over the weekend.... Jeff Nelson's career ends with surgery. That's too bad for anyone.... John Patterson had his first rehab start. He'll have one more before returning to the Nationals' rotation.... Rocco Baldelli is back after an extended rehab. Watch his running.... Kerry Wood may miss his Sunday start after having his shoulder re-checked.... A.J. Burnett has a couple of weeks left on the shelf, but Jays fans can look to the 23rd of June as the day they find out where their season is going.... Cliff Politte heads to the DL with a sore pitching shoulder. The one question the White Sox have unanswered is their bullpen.... Bill Mueller had surgery on his right knee but got no relief. He's headed to Dr. Richard Steadman for a second opinion.... David Wells is headed west for a second opinion on his injured knee. Some sources are telling me the verdict will determine whether or not Wells retires.

Will Carroll's Under the Knife appears 4-5 times a week throughout the season at Baseball Prospectus, updating readers on all things medical in the world of major league baseball. For injury reports, commentary and cutting-edge performance analysis, visit Baseball Prospectus on the web.

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