X-rays were ordered. Robert Kerlan, the noted orthopedic surgeon and team doctor, took one look at the film and pronounced the bad news: traumatic arthritis. A diagnosis without a cure. Arthritis is an acute inflammation of a joint, usually associated with old age. Pitch by pitch, season by season, the cartilage in Koufax's elbow was breaking down. His arm was old even if he wasn't.
Kerlan knew the long-term prospects weren't good. Pitching is trauma. The human elbow may be one of God's great inventions, but He didn't anticipate a major league fastball during those first seven days. Maximum stress occurs just as a pitcher cocks his arm and begins to accelerate it forward. In that instant the elbow is subjected to what doctors call "maximum load," as two contrary forces, momentum and inertia, converge on the joint. It causes ligaments to stretch like saltwater taffy on a hot summer day.
Today arthroscopic surgery allows professional athletes and middle-aged golfers like Koufax to recover in a fraction of the time they once needed. Dr. Frank Jobe, Kerlan's partner and successor, performed the first elbow reconstruction in 1974, less than a decade after Koufax retired. Tommy John, the surgical pioneer, returned to baseball and pitched for another 14 years. Jobe says, "If you had said to Dr. Kerlan, 'Why does [Koufax's] arm hurt?' he'd say, 'Because he throws so hard.' That's true. What he didn't know was that [Koufax] threw hard enough to stretch a ligament. It wasn't torn, but it was stretched enough to allow two bony surfaces to rub together. It must have just killed him."
Koufax scoffs at such reports. "My heroism is greatly overstated," he'll say. On occasion he's been known to admit, "Maybe I just didn't want to think about how bad it was."
March is the crudest month for pitchers: when rested arms renew the annual struggle for controlled velocity. Today pitch counts and early outings are meticulously monitored. Pitching a complete game in spring training is unthinkable, even without an arthritic arm. But on March 30, 1965, Koufax did just that. The next morning his roommate, Dick Tracewski, was at the sink shaving when Koufax walked in. "He says, 'Look at this.' The elbow was black. And it was swollen. From the elbow to the armpit it looked like a bruise. It was a black, angry hemorrhage. It was an angry arm, an angry elbow. And all he says is, 'Roomie, look at this.' "
Quickly but quietly, Koufax returned to Los Angeles to see Kerlan, who told him he'd be lucky to pitch once a week. Eventually, and irrevocably, he would lose full use of his arm. Koufax told the doctor, "I'm trusting you to keep me going. I'm also going to trust you to say when you think I should quit." They mapped out a schedule for the '65 season that called for him to pitch every five days, which would have meant starting only 34 games instead of his usual 41. Koufax promised Kerlan he'd quit throwing between starts, no small concession for a man who routinely dragged Tracewski out of bed in the middle of the night in order to go throw.
Palliatives were all that medicine had to offer: cortisone shots in the joint, Empirin with codeine for the pain (which he took every night and sometimes during the fifth inning) and Butazolidin, an anti-inflammatory prescribed for broken-down thoroughbreds, so poisonous to humans that it was taken off the market in the '70s. It had one major side effect. "It killed a few people," Jobe says.
Koufax didn't think twice. He rejoined the Dodgers in Washington, D.C., in early April, where they were scheduled to play an exhibition game. He made headlines tossing a ball on the sidelines. SANDY PLAYS CATCH! one read the next day. He was wondered at and wondered about. No one knew what to expect, least of all him. He pitched three innings in his first outing the next day, striking out five of the 10 men he faced. Doug Camilli, his old catcher, was the last of them. He popped up. "Sore arm, my eye," Camilli yelled as he trotted back to the Senators' dugout.
Koufax regularly used a salve called Capsolin, derived from red-hot chili peppers grown in China, to mask his pain. Players called it the "atomic balm"—thick, gooey stuff that is no longer marketed in the United States. Most pitchers diluted it with cold cream or Vaseline. Koufax used it straight, gobs of it. Nobe Kawano, the Dodgers' clubhouse man, always made sure he washed Koufax's laundry separately. But once, when the Dodgers donated used jerseys to a local Little League team, the lucky kid who got number 32 ran off the field screaming, "I'm on fire!" He wasn't the only one. Lou Johnson wore one of Koufax's sweatshirts one cold night in Pittsburgh. First he began to sweat. Then his skin blistered. Then he threw up.
If heat was Koufax's salve, ice was his salvation. They didn't have ice packs then; they just plunged your arm in a bucket of ice and waited for frostbite to set in. Trainers fashioned a rubber sleeve for him out of an inner rube—the height of medical technology—that was later donated to the Hall of Fame.