Rubby De La Rosa on Tuesday joins what Guerra calls "the brotherhood" of pitchers who have had their elbows rebuilt through a procedure invented by longtime Dodgers surgeon Frank Jobe to save the career of former Dodgers pitcher Tommy John. Jobe didn't know it at the time, but he also saved the careers of Guerra, Kuo and hundreds of others with a procedure that revolutionized sports medicine and, some say, should earn Jobe entry to Baseball's Hall of Fame.
Jobe has insisted that the elbow is actually stronger after the operation than before, and pitchers like Eric Gagne, who won a Cy Young Award after the operation, wouldn't argue.
There is nothing for a pitcher that is lucky about tearing the ulnar collateral ligament, which holds the elbow in place, but at least De La Rosa has special resources from which to draw, like Guerra and Kuo. He'll have a rehab partner in Carlos Monasterios, who underwent Tommy John surgery last month.
De La Rosa's injury was suffered Sunday on a pitch in the third inning. He felt a sharp pain on a fastball but kept pitching. Three pitches later, he threw a 99-mph fastball. He pitched a fourth inning before coming out. The pain led to an MRI that confirmed the initial suspicions. He said he's a little bit afraid of what lies ahead.
Kuo remembers the first time his elbow blew out. It was 2000, he was 19, the first Taiwanese player signed by a Major League franchise. It was his debut game for Class A San Bernardino. He struck out seven of the 10 batters he faced. But on a pitch to that 10th batter, Kuo's ligament ruptured. Of course, he continued to strike out the batter.
"I knew right away something was wrong," said Kuo. "I threw two more pitches, and the inning was over. But it hurt. I didn't know anything about Tommy John. When they told me about it, I started to pay attention. They explained the rehab and the only way to get better was with surgery, and I came back stronger.
"Now, Tommy John, everybody has it and you come back stronger. I've got two of them. Rubby might come back throwing 105."
Although Kuo now deals with anxiety disorder, the Tommy John operations restored his fastball to the mid-90s, and he even earned a trip to the All-Star Game last year. And Guerra is 9-for-9 in saves for the Dodgers in a season that started in Double-A. That's quite a ride from a Class A game with Columbus six years ago, when his elbow blew out.
"I felt it on one pitch, an 0-1 fastball, and it popped," recalled Guerra. "I got the ball back from the catcher; I knew something was wrong. I threw the next pitch, 0-2, and it just came out and hit the guy, and I called the training staff to the mound.
"I had a complete tear. At first, they thought it was partial, and I could have rehabilitated. But at my age, I figured the best thing to do was operate and fix it right. When they got in there, they found it was a complete tear."
So Guerra reported to Vero Beach, Fla., where the Dodgers rehabbed their injured players at the time, and he came upon Kuo, the poster boy for Tommy John surgeries.
"It's almost like a brotherhood," Guerra said of those that have undergone the procedure. "We're like family members. I talked to Rubby and let him know it's a process, and it's more mental than physical. You'll have aches and pains, and you won't know what they mean. You just have to fight through it. I got a hold of him when I heard, and we had a good conversation and continued it during batting practice in the outfield. I feel for him. It's tough to go through.
"I think Rubby appreciates all that. He's just starting his journey. It's tough to understand what it's like to wake up in a sling, when you make your living as a pitcher. Surgery is always scary, no matter who you are or where you're at in your career. But the operation has become almost low-risk, high-reward. It's the right way to go. He seems very confident. I was worried he'd be upset or sad. He's confident, eager to get going. You want to see that. It's a big task."
De La Rosa's operation -- to be performed by arm specialist Dr. James Andrews in Florida on Tuesday -- involves harvesting a non-essential tendon from the opposite wrist, or a leg, that is used to replace the torn ligament. The new ligament is tied in a figure-eight pattern through holes drilled into the ulna and humerus bones that form the elbow.
Jobe, no longer practicing but still a Dodgers special advisor to the chairman, said he invented the procedure only after John didn't respond to traditional therapy and refused to retire. At the time, said Jobe, sports surgeries of any type were rare.
"I suggested he take up golf," Jobe recalled in an earlier interview. "He said to come up with something. I knew I could fix it, but I didn't know if the body would invade the elbow with blood vessels. The chance of success was pretty poor. I didn't have much faith in it. I watched every start of his carefully, but I waited several years before trying another. I thought it might be a fluke. Now, it's done by all the doctors."
Jobe was a medical supply sergeant in the Army's 101st Airborne Division during World War II and was one of the soldiers encircled at Bastogne, Belgium, during the Battle of the Bulge. He studied at Loma Linda University in California and completed his residency at USC County Hospital.
He began working with the Dodgers in 1964 and served as the club's orthopaedic doctor for 40 years. In 1965, Jobe partnered on a handshake with the first team physician in Los Angeles Dodgers history, Dr. Robert Kerlan, to open the Southwestern Orthopaedic Medical Group, which would later be named the Kerlan-Jobe Orthopaedic Clinic in 1985.