Major League Baseball? What does that have to do with Alabama, or quite specifically, Birmingham? When you look at the 30 teams that play in the Majors, Atlanta, which hosts the Braves about 150 miles away, is the closest Major League city.
But when you look at a different type of map -- the one that shows where countless baseball players have gone over the last 20-plus years to have their careers prolonged, and even completely resurrected in some cases -- Birmingham has a big proverbial star on it to indicate it as a capital for the national pastime.
For Birmingham is where renowned sports orthopedist Dr. James Andrews has called home since 1986. When a baseball player is seriously injured -- particularly if it's a shoulder or elbow malady -- he'll often forego a more central location and get on a plane to see Andrews.
Not that Andrews thought it would turn out quite like this when he traded in his pole vault -- he was the SEC champion in that sport during his days at Louisiana State University -- for scrubs.
"That was never my ambition," said Andrews. "If you try to plan something like that it never works."
At 66 years old, the man is still -- according to those he works with and those he works on -- at the very top of his game.
"He's the best there is," said Blue Jays center fielder Vernon Wells, who had left labrum surgery from Andrews last September. "You start talking to other doctors that are around now and they've all seemed to study under him. When I got there, he was a good ol' Southern boy. He has a great sense of humor. He looked at my shoulder and told me what we were going to do. He was like, 'You'll be fine in a few months and you'll be ready to go.' I believed every word that he said."
Andrews has the track record to back up his talk, which comes in the form of a comforting southern drawl. Not that he is ever boastful around patients, co-workers or reporters. If anything, Andrews is exceedingly humble, good-natured and comforting, three things which have endeared him to his countless patients.
"The first thing is, if you're still talking about what you did yesterday, you're not doing much today," said Andrews. "The second thing is that this is not an 'I' situation here, it's a 'we' situation. 'We' makes 'I' stronger and that's sort of how we think. One person can't do any of this. The third thing is, even though I just had a birthday a week ago, I'm still learning and listening, I'm still trying to figure out what we do next."
If Andrews -- whose practice comes complete with a biomechanics center and a rehab facility -- never performed another surgery, his legacy would be secure.
Andrews is in the Alabama Sports Hall of Fame. His non-profit American Sports Medicine Institute is a uniquely innovative organization dedicated to researching and educating injury prevention, particularly for youth players, as well as proper mechanics. In June, Andrews will be officially inducted into the Louisiana Hall of Fame. Perhaps some day, there could even be a spot for Andrews in Cooperstown, N.Y., where one national baseball writer opined last year that Andrews should have a plaque. That's a point that could pick up steam in the coming years.
Baseball players have the means to see any sports doctor in the world. So why is it that so many of them -- from Roger Clemens to Bo Jackson to John Smoltz to Kerry Wood, just to name a small few -- have come to Birmingham for repairs and advice and continue to do so?
"He's very honest with you," said Yankees catcher Jorge Posada. "He's up front, and he doesn't fool around. He tells you what is wrong with you and how you can fix it. Every doctor is pretty much like that, but [Andrews] tells you how it is and you believe him. You let him know what's going on, and he's good at what he does."
"He's seen the most," said Smoltz. "It's like that argument about whether you go with the old pilot or the young pilot. I'm going with the old pilot because he's seen it all."
Smoltz is one of the many Andrews success stories. Prior to the 2000 season, Andrews performed Tommy John elbow ligament replacement surgery -- a procedure in which the ulnar collateral ligament is reconstructed with the insertion of a tendon from somewhere else on the body -- on Smoltz. By 2002, Smoltz was healthy enough to save 55 games. In fact, Smoltz sent Andrews an autographed picture from that 55th save as a gesture of appreciation.
Throughout the halls of where Andrews sees patients, there are similar posters from other athletes all over the place.
This is a man who hasn't just performed sports surgeries -- he's helped revolutionize them.
How it all started
Though Andrews operates on players from virtually every sport -- the National Football League is another major institution his name is a fixture in -- his work in baseball is probably what he's known most for.
Ironically, it was basically by coincidence that Andrews got involved with baseball players.
During his orthopedic residency at Tulane University, Andrews had a great desire to work with the late Dr. Jack Hughston, who was a prominent sports orthopedist at that time. He got that wish after going to Columbus, Ga., and personally asking Hughston for some hands-on experience.
When Andrews was out of medical school and ready to work full-time, he went back with Dr. Hughston. Inevitably, many of the colleges in the South would send carloads of athletes to see Hughston.
After a while, a trend formed. Hughston would work on all the wounded legs of the football players. The baseball players? He'd send them to a back room and tell Andrews to try to figure out what was wrong with their arms. At the time, in 1973, there was barely any knowledge of how to fix shoulder and elbow ailments.
"So I'd have to go back and look at five or six of them at a time," said Andrews. "It was real hard to figure out a baseball player's shoulder. 'Well, my shoulder hurts. Why does it hurt?' We didn't have a clue. I figured out after a while that if I was going to have to see all these upper extremity things, shoulders mainly, that I better figure out something about them."
Around that same time, the advent of arthroscopic surgery for athletes occurred. A household term to sports followers and players now, Andrews helped turn it into an art form.
"We didn't have MRIs, all we had was X-rays in the examination back in those days," said Andrews. "So I started scoping shoulders in baseball players and that's where I started learning what was going on with baseball players. The arthroscope helped me figure out the shoulder. There weren't many people doing it."
Aside from the many shoulder scopes he has done through the years, Andrews was the very first doctor to do an elbow arthroscopy.
Though Dr. Frank Jobe of California was the pioneer of Tommy John surgery by operating on, yes, Tommy John, in 1974, Andrews studied that procedure intently. Andrews traveled to the West Coast to examine Jobe in action and took the success of that particular type of surgery to another level. Andrews has done more than 3,000 Tommy John surgeries on amateur and pro players of all different ages throughout his career. It isn't abnormal these days for a pitcher to throw harder after Tommy John surgery than before.
Then there was the whole matter of Andrews deciding to take part in the ownership of a Double-A baseball team in Columbus. The team's owners were running out of money and they were going to either fold or leave town. To Andrews, who was just starting to learn how to fix baseball players and was serving as the team's physician, losing the Columbus Astros would have been a tough blow.
So he did something about it.
"I got George McCloskey, who was our head physical therapist with Dr. Hughston, and he and I bought the team," said Andrews. "It's embarrassing, but it was probably the best investment I ever made. We borrowed $40,000 from a local bank and that's what we bought the franchise for."
Nearly a decade later -- once Andrews decided to open his own practice in Birmingham -- he and McCloskey sold the Columbus Astros for a cool price of about $1 million. But you can't put a price on all the invaluable experience Andrews gained by examining and repairing all those Minor Leaguers.
His reputation developed to the point where a young pitcher named Roger Clemens -- in his second season with the Red Sox back in 1985 -- went to Andrews to see what was wrong with his shoulder. An arthroscopy followed, and so did a Cy Young Award and a Most Valuable Player trophy, both of which Clemens won in 1986.
From there, a doctor's reputation that had already been solid was on the way to stardom.
Not long after Andrews operated on Clemens, he moved to Birmingham. And that was when players from around Major League Baseball began flocking to see him.
There were routine cleanups and monumental achievements. When Jimmy Key -- an Alabama native -- went to visit Andrews after tearing his rotator cuff in 1995, the prognosis was grim. No pitcher had ever come back from a full rotator cuff tear.
But Andrews changed that with a procedure so successful on Key that the lefty won the clinching Game 6 for the Yankees in the 1996 World Series.
There are other watershed moments that Andrews remembers, such as the night Al Leiter flew with him to Birmingham immediately after the Blue Jays beat the Braves in Game 6 of the 1992 World Series. Leiter couldn't pitch in that World Series because his arm was a mess. His psyche was even worse.
"I had operated on him twice, on his shoulder," said Andrews. "Couldn't get well. He was still sore. He was on the plane flying back home with us that night. I had operated on his brother, who had played for Baltimore. I had done all of Al's surgeries. He was saying, 'I can't play, I'm going to have to go back home and work on the wharf.' He had tears in his eyes coming home with us that night. I brought him back home and operated on him the next day here."
"The third time, I don't know what I did to get him well, but he got well and he made $50-60 million since then. That was probably the biggest comeback thing in baseball that I had ever seen, to come back and have that longevity after all of that."
A year later, Leiter earned a win in relief in the 1993 World Series, helping the Blue Jays win the second of their back-to-back titles. By 1997, Leiter was an elite starter, helping the Florida Marlins win the World Series. He helped the Mets win the National League pennant in 2000. And Leiter's arm held up so well that he pitched until 2005, some 13 years after he had confided to Andrews that he thought his career might be over.
Key and Leiter were far from the only lefty starters whose careers Andrews helped resuscitate. There have been 17 perfect games in Major League history. No. 14 was by Kenny Rogers in 1994 while David Wells twirled No. 15 in 1998. Both perfectos came after Andrews had them on the operating table for major procedures on their shoulders and elbows. In fact, Rogers had his Tommy John surgery performed by Andrews in 1987. Twenty-one years later, he is still going strong.
"We know the nature of the business," Rogers said. "But in my state, I was semi-young. I talked to him a little bit, and he'll reassure you. A lot of them are good that way. They'll reassure you that it's not a major thing, it's not a big deal. He's fixed so many of them already. He'll say, 'This is what I think is going on,' and that he can fix it."
Of course, not all the surgeries are full-fledged success stories. Jose Rijo came to Birmingham again and again and again, but couldn't find long-term comfort. That still troubles Andrews.
"I finally did get him back, but I never really did get him back to where he should have been," said Andrews.
Of course, it didn't help that Rijo went against doctor's orders and started throwing three months after Tommy John surgery. That was roughly six months ahead of schedule, and Andrews can now only shake his head as to why Rijo was stalled in his return to the mound.
Then, there was the matter of the two-sport athletic marvel named Bo Jackson, an Alabama native that Andrews had been acquainted with ever since high school. On January 13, 1991, Jackson's pro football career was halted by a hip injury in a playoff game. The condition degenerated so much that Jackson eventually needed a hip replacement, which Andrews performed. The agreement Jackson made with Andrews was that the injury was only for quality of life, and he would not attempt to play baseball again.
"I went through all different kinds of gyrations with him; I had a big flip board with all the different types of hips and all the problems and it was the most education I've ever done for a patient," said Andrews. "He promised me when he was having his hip done, that he wouldn't play again. Putting a hip in a young guy like that, he couldn't walk. He said, 'I'm doing it for three reasons. Number one is the pain, number two is not to limp and number three is to be able to take my two boys fishing.' That was agreed. No baseball, no sports. He woke up in recovery and the first thing he said was, 'man, my hip feels good. I'm going to Spring Training.' "
As it turns out, Jackson made a near miracle comeback, hitting 16 homers for the White Sox in 1993 and 13 more for the Angels in '94 before finally calling it quits.
No end in sight
Perhaps Andrews will retire at some point. But he's not planning on it any time soon. In fact, he just opened up the Andrews Institute, which is a state of the art, multi-faceted facility in Pensacola, Fla., that he travels to every Friday. And his Birmingham practice will move into a new and improved building this fall.
"He's actually busier than he's ever been, I think," said Dr. John Richardson, who performed a quadruple bypass on Andrews following a heart attack two years ago. "And he really ought to be. He's got more blood going to his heart than he's had in a long time. When he got back, he got back full speed. He's doing more I know, traveling and going to all these things, meetings, doing as many cases as he's ever had."
It is an energy that is infectious within the walls of where Andrews works.
"You'll get to see a 66-year-old guy who's got more energy than your children," said Dr. Jeff Dugas, who was a member of Andrews' fellowship program nearly a decade ago before settling into a full-time job in which he gets to work side-by-side with the master. "I'm telling you, he is go, go, go, all the time. He gets it all done. He's a great role model. Everything he does, he does it right."
Though Andrews has several hobbies -- including yacht racing, golfing and hunting -- not to mention a wife, six children and three grandchildren, his job consumes him.
"It's going to be hard to get off the merry-go-round if I ever do retire," said Andrews. "That's why I built that facility down in Pensacola, so I can go down and administrate and watch that place grow. Got some more work to do here first, though."
Ian Browne is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.