In Honor of the Three Greatest Words in the English Language

Pitchers—And—Catchers.

George Vecsey probably said it best.

Just say it out loud, the mantra that gets some of us through the winter.
Pitchers and catchers, pitchers and catchers.

Like NPR republishing Susan Stamberg's cranberry relish recipe each Thanksgiving or every dance school performing The Nutcracker each December, Sensible Medicine needs traditions. So, in honor of the start of spring training, when pitchers and catchers report for duty, I repost Friday Reflection #15: Of Medicine, Baseball and Other Distractions.

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RM is a 72-year-old man who comes to the office for routine follow-up of spinal stenosis, hypertension, and peripheral vascular disease. It is March. He answers my question, “How are you doing?” with a question. “Do you think the Cubs have a chance this year?”

I spend a lot of time thinking about medicine: at work, on the way to work, and on the way home. I have to admit, I also think about it at home. There are, of course, other interests that fill my time: music, art, travel, collecting, reading, ceramics. Medicine and these “extracurricular activities” exist separately for me; the extracurriculars are necessary distractions, or escapes, to keep my mind wandering. Sure, I think I’m a better doctor because I do things that take my mind off medicine, but I don’t give much thought to the similarities between my vocation and my diversions.

Baseball, however, may have some similarities. Bobby Scott, MD seems to be succeeding in making a whole Substack about them!

I’ve loved baseball for as long as I can remember. I still have the woolen New York Mets uniform that my father gave me when I was born in 1967. I was obsessed with the sport long before I began telling people, “I want to be a doctor when I grow up.” I remember graphing my favorite player’s wins, losses, and ERAs on a single sheet of graph paper with multiple colored pencils. I can still hear my father’s exasperated, “If you spent as much time on your actual math homework as you do on those graphs…”

My relationships with medicine and baseball have mirrored one another. I played baseball at a time I gave only passing thoughts to a career in medicine. I became an observer of baseball when I became an active participant in medicine. Someday I’ll just observe both.

Neither medicine nor baseball can be mastered. Both take a whole lot of time even to approach proficiency. I was deep into my medical career when the time I’d spent in the hospital surpassed the time I’d spent on ball fields. Nobody wants to play baseball or practice medicine in front of an audience until they have gotten pretty good. I remember games when I was more worried about the spectators than about the opposing pitcher. I also remember being videotaped interviewing a patient in medical school, more concerned about my classmates watching the video than about what the patient was telling me. (True story, I completely missed the fact that the patient was floridly psychotic).

Baseball and medicine have conveniently complementary schedules: medicine takes up my days and baseball, primarily Cubs radio broadcasts, my evenings. This conveniently overlooks the reality of occasional night call or glances at televised highlights on patients’ TVs during morning rounds.

The pace of general internal medicine and baseball has a lot in common. Cases and games unfold slowly over time, and what happens in the early innings affects what happens later. Surprise endings are common. I dread the bad ones.

Baseball and medicine are physical activities. General medicine may not be orthopedic surgery, but I sometimes leave the office physically exhausted. More than that, however, they are both activities of the mind. No elaboration is needed for medicine, but one need only review the careers of Rick Ankiel or Steve Sax, careers upended by the yips, to recognize the cognitive side of baseball.

Medicine and baseball are collaborative tasks. Success in either requires great teammates. Specialists and generalists are necessary and valued in both. I often think of my go-to electrophysiology colleague when a team puts in a speedy pinch runner at the top of the ninth.

Baseball and medicine lend themselves to hero worship; the people you idolize even when they are no longer in or on the field. I still think of Tom Seaver, the great Mets pitcher and my boyhood hero, or Don Mattingly, the most human of great players, when I listen to games. When I do teaching rounds, Jeremiah Barondess, an old-school internist at my medical school, leaps to mind.

I love listening to stories about baseball and medicine. In baseball, these often come from great players recounting episodes from their career—I’ve probably listened to Bob Gibson interviewed on NPR’s Fresh Air a half dozen times. Even my former teammates recounting games charms me. In medicine, stories are cases. Sure, I learn something from listening to a colleague describe a case, but I also enjoy the narrative arc of a clinical vignette. Not surprisingly, I sprinkle books about baseball and medicine into my “pleasure reading.” Do No Harm, The Bronx Zoo, Diary of Our Fatal Illness, and Game Six are some of my favorites.¹

Neither medicine nor baseball is perfect. Both continue to struggle mightily with diversity. I do think, however, that both have done a bit better than our society at large with this issue. Some of my heroes in both fields — Jackie Robinson, who broke the color barrier; Curt Flood, who challenged the reserve clause; James Bowman, a giant at my own institution; and Beatrix Hamburg, who managed to be an idol for my father and me — distinguished themselves in these struggles.

Like most loves, medicine and baseball occasionally disappoint me. I wish medicine progressed faster, and I wish baseball would stop feeling the need to change. I wish money influenced both less.

I have tried to pass my passion for medicine and baseball on to my children. There are few things I like more than playing catch with them or answering one of their medically adjacent questions. I have had no success kindling interest in a career in medicine. At least they will listen to and attend games with me.

I look forward to going to work each day and, during the summer, tuning in to games at night. I know I would enjoy both more if I worried less about the outcomes. But, maybe, that’s another important similarity.

1. I just finished the book Why We Love Baseball. I can absolutely recommend it. I listened to the audiobook, which I think made it even better — Joe Posnanski telling me great stories. If the chapter about the Kerry Woods’ 20 strike out game doesn’t send shivers up your spine…