Despite all his sporting interests, however, Kerlan remains most devoted to medicine, particularly now that he cannot be sure how long his ailment will let him carry on actively. Already he has restricted his surgery to very special cases, and the slack has been taken up by Jobe, one of two younger men Kerlan has taken into his office.
Working side by side with Kerlan, Jobe has become an all-out disciple. "I think Bob is a genius," Jobe says. "His superiority as a doctor is in his head. It's the ability to evaluate a situation and come up with a good judgment. You can't really get that out of books; it's something that you have or don't have. As Bob says. 'You can teach a chimpanzee how to do a surgical operation, but it's knowing when to do one that's important.' You could say he didn't perform a great operation on Koufax, but he kept him pitching by being very sensitive to the needs of that elbow and taking care of it with little things. He's that way with his regular patients just as much as he is with athletes."
Kerlan believes that "the major impact on my career" was made by Dr. Vernon Thompson, one of his professors at USC. "He was a very conservative orthopedist." Kerlan explains, "and I am also very conservative due to his teaching. He was a strong advocate of finding out what the natural process of any orthopedic problem is. In other words, what would happen if you didn't do anything. Thompson impressed one thing on me: you're an orthopedic physician first and an orthopedic surgeon second. Sure, the surgery itself is important, but it's only one of the things."
His experiences with injured athletes have led Kerlan to think more and more in terms of preventive measures or what he calls "the area of prophylaxis." As an example, he cites the Texas A&M football coach who discovered that a lot of knee injuries result from players getting their heel cleats caught in the turf and how he minimized these injuries by designing a shoe with two soccer cleats in the heel. Kerlan himself has designed some basketball pants with pockets in the rear for inserting small plastic shields that protect the sacroiliac joint when a player falls on his behind. The players haven't accepted them yet, largely for esthetic reasons.
The conservative approach to medicine is most apparent in Kerlan's attitude toward drugs. "I don't believe in giving stimulants to athletes," he says emphatically. "Dexedrine and medications like that are meant to get them real high for a particular game, and I don't believe in that. On the other hand, we use anti-inflammatory medication all the time. If we're treating an athlete who is bothered because he has a chronic or an acute strain which has then caused swelling or pain, then it's rather routine. We use Butazolidin on Baylor and West and Chamberlain. This is to treat them so they can play in a normal manner. It isn't used to stimulate them or build them up for one contest and then not used for a lesser game.
"There is an application of this to the problem of horses," Kerlan adds. "Drugs like Butazolidin and indocin are anti-flammatory agents, not painkillers. If an animal is having pain because there is an inflamed joint or an inflamed tendon or an inflamed muscle, these medications treat the symptom, not just eliminate the pain."
Kerlan anticipates the day when athletic medicine will become a legitimate offshoot of orthopedics. Discussing this notion, he says, "I see a lot of young residents at the hospital who are interested in learning more about this, and their formal training doesn't include much of it at present. Fellowships could be set up under individuals who have been doing this for some time, and just as the subspecialty of hand surgery developed from orthopedics, I'm sure that a subspecialty in athletic injuries will develop. There are more and more orthopedic meetings set aside for just this subject, and they're very well attended."
As Kerlan points out, the problem of athletic injuries is no longer confined to the more violent participation at the high school, college and professional level. The ailments of those people are now shared by Little Leaguers as well as the middle-aged weekend overdoers with a passion for fitness or, at least, an urge to look reasonably young and healthy. "The aging process does cause some loss of elasticity of the soft tissues," Kerlan warns, "and if the tissue isn't quite as elastic it's much easier to get an injury to it. A typical example of that is the number of torn Achilles' tendons you see in the older people who play games that require quick stopping and starting—tennis, paddle tennis, handball and the like."
Conservative as he may be, Kerlan used pills on one occasion that caused his sportsmanship, if not his ethics, to come under serious indictment. That was during the 1967 World Series in Boston. Kerlan had gone there with Bavasi, with whom he has developed one of the closest friendships of his later years. They and their wives often take holiday trips together, and when Bavasi moved to San Diego as president of the new National League franchise there, he made Kerlan a director of the club. (Kerlan has since resigned his post with the Dodgers.)
Prior to the Boston excursion, Mrs. Bavasi warned Kerlan that her husband was a very raucous snorer. Bavasi takes the story from there. "We got to our suite and to bed early, and Bob said, 'Here, I'll give you a pill that will put you to sleep right away, and you won't snore.' So I took two of the pills and stayed up all night, never got a wink of sleep. I found out the next morning he had given me some pills to keep me awake so that I wouldn't snore. Very funny!"