BehindTheMedspeak: Curt Schilling's in the wrong sport

The stoic Red Sox righthander belongs in hockey, what with his newly-acquired habit of getting stitches put into his right ankle before each pitching appearance.

I couldn't believe what I was seeing last Tuesday night when the Fox TV cameras repeatedly showed Schilling's bloody right ankle during his magnificent seven inning outing in Game 6 of the classic Red Sox-Yankees A.L.C.S.

But I was even more amazed when I read Jack Curry's story in yesterday's New York Times Sports section on what exactly's been going on with Schilling's ankle.

He has a dislocated right ankle tendon.

Its restraining sheath has been torn away, so Schilling's foot won't work properly.

He had to leave Game 1 of the A.L.C.S. after three innings when he injured the ankle while covering first base.

Most people didn't think he'd pitch again this season.

But Dr. William Morgan, the Red Sox team physician, had an idea: he thought he could suture the skin on the sides of Schilling's tendon down to the deep tissue under it, thus creating an artificial sheath to prevent the tendon from snapping against the bone.

He looked into the literature to see if there were other reports of this procedure, but found none.

So he tried it out on a cadaver, then performed the experimental operation on Monday, October 11, the day before Game 6.

He put in three stitches under local anesthesia, but one ripped away early in the game, resulting in the bleeding visible to TV viewers.

Morgan last Saturday performed the operation a second time on Schilling's right ankle, this time using four stitches to make the repair stronger.

After the game is over, Morgan removes the stitches and prescribes antibiotics to guard against possible infection.

Two thoughts:

1) If the series goes that far, Schilling's gonna need the Morgan procedure one more time - before Game 6

2) I'm certain that this surgical procedure will henceforth be termed
"Curt Schilling surgery" in the same way people refer to the now-routine tendon transfer procedure on a pitcher's throwing arm as "Tommy John surgery."

Hats off to Dr. William Morgan for creative thinking under pressure.

And hats off to Curt Schilling for being willing to undergo this procedure.

Remember, you're talking about one of the most valuable properties in baseball.

Schilling's scheduled to undergo reconstructive surgery on his ankle a few days after the World Series, with rehabilitation expected to last three months.

Here's the Times story.
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A Doctor Is Keeping Schilling in Stitches

Soon after Curt Schilling arrived at Fenway Park on Saturday afternoon, he found Dr. William Morgan, climbed onto a trainer's table and underwent the revolutionary medical procedure that should enable him to pitch for the Boston Red Sox in Game 2 of the World Series on Sunday night.

Morgan, the Red Sox' team physician, sutured the skin around the dislocated tendon in Schilling's right ankle down to the deep tissue to form an artificial sheath to prevent the tendon from snapping against the bone.

Morgan devised this remedy before Schilling's last start, and it was successful as he went from pitching like an unknown to resembling the same old ace against the Yankees.

When Morgan first thought of using this method to keep Schilling's tendon in place, he searched for similar case studies and found none.

Morgan practiced on a cadaver before trying it on Schilling the day before he won, 4-2, in Game 6 of the American League Championship Series on Tuesday.

Schilling kept the Red Sox breathing in that series, and everyone in Boston is breathing easier now because the hometown team is in the World Series and the chatty, overpowering pitcher is not worried anymore about the most analyzed ankle in New England.

"This was an absolutely last-gasp, brilliant idea" that the medical staff came up with, Schilling said.

"Because, had this not worked, I would not have been able to pitch Game 6. No way."

So, like a hockey player, Schilling will be stitched again to give him the flexibility and the power he needs to push off the rubber as he opposes the St. Louis Cardinals.

Schilling, who receives an anesthetic before Morgan begins working, said Morgan took about 20 or 30 minutes to finish the suturing.

He will receive another anesthetic Sunday shortly before his start.

Morgan used three sutures on Schilling's ankle Tuesday, but one ripped away and caused some bleeding that was visible on Schilling's white sock.

So Morgan told ESPN that he would use four sutures on Schilling's ankle on Saturday.

Schilling said Morgan removed the sutures after he left game Tuesday to help guard against possible infections.

Morgan prescribed antibiotics for the same reason.

"If something were to happen and they were to get infected, it would put my surgery back four, five or six weeks, and you're talking about missing spring training and the beginning of the season," said Schilling, who will most likely have reconstructive surgery on the ankle a few days after the World Series.

His rehabilitation is expected to last three months.

When Schilling was asked if it hurt when Morgan stitched him, he said: "What do you think? Does it hurt when you get poked in the eye?"

Schilling left Game 1 of the A.L.C.S. after three innings because of the pain in his ankle, and it seemed unlikely that he would be able to return in the series.

But the Red Sox continued searching for ways to get Schilling back on the mound, trying an ankle brace, investigating modified cleats and eventually settling on Morgan's groundbreaking procedure.

"There were a lot of scenarios we looked at, and one scenario was a last-ditch scenario with sutures," General Manager Theo Epstein said.

"Although it sounds extreme and we couldn't find a case of it being done before, it was not that risky."

Although reporters asked Manager Terry Francona about Schilling several times, the Red Sox did not reveal what they had done with him until after he pitched seven effective innings in Game 6.

"It's always nice to have some secrets in October," Epstein said.

If Schilling needs to make a second start against St. Louis in Games 5 or 6, Epstein said the Red Sox should be able to use the procedure one more time.

Schilling, a 21-game winner, is a crucial factor for the Red Sox and could be the difference between them winning, or failing to win, their first World Series title since 1918.

But Schilling emphasized that Morgan had already made a difference for the Red Sox.

When someone suggested that the players might give Morgan a full share of their postseason earnings, Schilling, who is thankful to still be pitching, explained how he offered lavish praise to Morgan.

"I asked him what the highest prize for medicine is," Schilling said.

"I guess they give out a Nobel Prize for medicine. I got to believe that he's on the ballot."