Sometimes the experts get it wrong. Just ask R. A. Dickey.
In 1996, Dickey was a first round pick of the Texas Rangers, with a signing bonus of $810,000 on the table. At 21, he was on the cover of Baseball America along with four other pitchers for the U.S. Olympic baseball team. It was a dream come true for an All-American boy from Tennessee.
Be careful what you wish for, kids!
The cover photo was seen by an orthopedist, who noticed something strange about the elbow of the young right hander. Alerted by the doctor, the Texas Rangers insisted on a medical exam. What they found stunned everyone: Dickey had no right ulnar collateral ligament. None. The main stabilizing force in the young man’s elbow simply didn’t exist. “The doctors said I shouldn’t have been able to turn a doorknob without feeling pain,” said Dickey. His ability to throw a pitch was a medical mystery.
Faster than you can say MRI, the $810,000 dollar offer was gone. The Rangers, convinced that he would never survive in the major leagues, reduced their offer to a consolation prize of $75,000. Dickey took the money, and proceeded on to the minor leagues where he pitched without pain, eventually switching to a knuckleball, which is to say that he is an enigma who tosses an enigma. On Wednesday May 19th, fourteen years after that magazine cover changed his life, Dickey took the mound for the N.Y. Mets (6 innings; 5 hits; 2 runs; no decision in a NY loss – not his fault. The Mets are a work in progress.).
Here’s my point: everything about Dickey’s career has confounded the experts. The baseball gurus said he would be a star; instead, he has been a journeyman pitcher, moving from club to club to find a job. The medical experts said he couldn’t possibly pitch; last year he played in 35 games for the Minnesota Twins. His first game with the Mets featured an inside the park homerun and a triple play, and still the strangest thing about the evening was R.A. Dickey, pitching in the major leagues at age 35.
As a genetic counselor, I thought a lot about his elbow watching that game (and as a Mets fan, believe me, it was a welcome distraction). How could all the medical experts be so wrong? At least in part, it’s because of that ascertainment issue: their experience was based on people who came to medical attention because they had pain. As a rule, we don’t test people without pain for missing elbow ligaments. Perhaps there are more R.A. Dickeys out there with no ulnar collateral ligaments, living their lives in ligament-less obscurity. We would never know.
But what if we did know? What if we knew when R.A. was 18, or 8, or 8 months old? What if we knew before he was born? That is the thing about making predictions; the only sure thing is that some of the time you will be wrong. “I’m sorry, Mr. and Mrs. Dickey,” we would say. “I understand that you love baseball, but the hard truth is that your son will never throw a ball or swing a bat. I know you may not be ready to hear this quite yet, but many of our parents report that their children very much enjoy soccer.”
OK, so it wouldn’t have been the end of the world. R.A. Dickey and I both know that baseball breaks your heart anyway, more often than not (shut up, Yankee fans). But it is a good story to remember, for those of us in the prediction-making racket. How many of you have seen patients that confound medical expectations? Perhaps you will share some of those stories here. It all goes to show you: sometimes you’re right, sometimes you’re wrong, and every once in a while, life throws you a knuckleball.
Lets Go Mets!