The Boston Globe’s Alex Speier reports that Red Sox starter Chris Sale underwent Tommy John surgery in Los Angeles, performed by Dr. Neal ElAttrache. Sale missed the final month and a half of the 2019 season and was slow to start spring training this year due to an elbow issue. He was diagnosed with a flexor strain in his left elbow this month and initially tried to rehab it rather than undergo surgery. Tommy John surgery was unavoidable in the end, as he and the club opted for it a week and a half ago.
Under normal circumstances, Sale would have missed the entire 2020 season and a sizable chunk of the ’21 campaign as well. That will still be the case, though these are not normal circumstances anymore.
We are dealing with a global pandemic with coronavirus (COVID-19). Hospitals in the U.S. are already at maximum capacity with sick patients and overworked, underpaid staff. The nation is dealing with a shortage of medical supplies, namely PPE (personal protective equipment) such as face masks and respirators. In many states, nonessential surgeries are being suspended, though the definition of “nonessential” is nebulous, differing from state to state. Tommy John surgery, as important as it might be to Sale getting his career back on track, would be the very definition of nonessential, right?
The Red Sox agree. Chief baseball officer Chaim Bloom deemed Sale’s procedure elective, per The Globe’s Dan Shaughnessy. Bloom said it was “obviously something we’re mindful of,” adding that he wanted to make sure “we’re doing this in a way that doesn’t put any extra burden on the public health system.”
That athletes like Sale may still have these elective procedures performed in the middle of a pandemic underscores the disparity between the haves and the have-nots. The Utah Jazz came under fire earlier this month when they got 58 coronavirus tests while regular people across the country were dealing with a shortage of testing. If Sale can get Tommy John surgery, then Jeff from accounting can still get that nose job too, right?
Fittingly, Emma Baccellieri of Sports Illustrated examined the quandary, speaking to several medical ethicists. David Magnus, who is a professor of medicine and biomedical ethics at Stanford University and was a former chair of Stanford Hospital’s ethics committee said of Sale’s surgery, “At the present time, I don’t think there’s even a question that it would be inappropriate and should not be done in any areas that are hit hard by COVID.” Magnus added, “And I think it’s arguably a bad idea to do anywhere right now…. Even in areas where there have been no reported cases, or very few, and it hasn’t spread yet, that’s changing by the hour. Maybe right at this moment, they don’t need the space, or the personnel that would be involved in the procedure, but that can change so rapidly that I think it would be an irresponsible use of resources. Nobody should be doing this.”
As Baccellieri notes, there isn’t much overlap between the doctors performing these elective surgeries and the doctors who would treat COVID-19 patients. However, equipment is at a premium, specifically PPE. Additionally, the space taken up by elective surgery patients — hospital beds, operating rooms, etc. — could be used for more pressing matters, as could staff such as nurses. Hospitals like performing elective surgeries as they make considerable amounts of money off of them.
Obviously, Sale wants to get back to 100 percent as soon as possible, and the Red Sox want that just as much. But this is a time where professional sports needs to take a back seat in our lives in many ways, as sad as that is to say. Even if, legally, ElAttrache was in the clear to perform the procedure and Sale was in the clear to receive it, it was not ethically the right thing to do at the moment. The Red Sox and Sale should have made personal sacrifices, choosing to delay the surgery until the nation has adequately dealt with COVID-19 and we have mostly returned to normal.