If you spend enough time in certain circles in Los Angeles, you might get the impression that the most popular person in town is Neal ElAttrache. Officially, ElAttrache is an orthopedic surgeon at the Cedars-Sinai Kerlan-Jobe Institute for sports medicine. Unofficially, there are people who regard him as a village miracle man. One of his patients, for instance, is Vasiliy Lomachenko, one of the best boxers in the world. After his wins, he likes to credit God. In a bout in 2018, he threw a combination of punches that yanked his right shoulder out of its socket. It hurt so badly that he bit through his mouth guard. “For a long time, I wondered if I could box again at the same level,” Lomachenko told me. He went to ElAttrache. The doctor operated on the shoulder, then undertook the more delicate work of helping Lomachenko rebuild trust in his arm. ElAttrache would take him out for lunch and counsel him on what punches to throw and when. Lomachenko won his second match back by knockout, a right hook to the skull. Afterward, he didn’t thank God. He thanked ElAttrache.
ElAttrache sees patients in a multi-story office building near LAX. After business hours, by phone, a stream of athletes and the otherwise famous or wealthy seek ElAttrache’s advice for free. He treats shoulders, elbows, knees, Achilles tendons, and the big muscles. Most surgeons are known for one specialty operation; ElAttrache’s fellow-surgeons consider him among the best in the world at many. “There’s very few of the upper-level-athlete injuries that we’re not going to be somehow involved in,” ElAttrache told me. “Over time, it’s gotten to be, just, a lot.” One week this spring, his off-the-books consultations included an N.B.A. star in the playoffs, a future W.N.B.A. Hall of Famer, an ace pitcher and an All-Star infielder, a star quarterback and a receiver, a Grand Slam-winning tennis player, a World Cup-winning women’s-soccer player, a prominent actor, at least one billionaire, several fringe-level athletes, and a high-ranking member of a Middle Eastern royal family. This was a fairly slow week. The Jets quarterback Aaron Rodgers, a close friend, was texting ElAttrache videos of exercises that he was doing for his left Achilles, which ElAttrache had repaired in September. Rodgers had just had dinner at ElAttrache’s house with Sean McVay, the coach of the Rams, who considers ElAttrache a father figure. ElAttrache is the team physician for the Rams and the Dodgers, but one of his nurses said, “Lately, we’ve been joking that he’s the team doctor for all the teams.” (Only patients who consented to the presence of a reporter have been named.)
Athletes seeing ElAttrache often find themselves, quite suddenly, at a low point in their careers, maybe their lives. Many have described their bond with ElAttrache as a singular relationship. “It was the first time I ever felt, in the football business, someone being completely honest with me,” the receiver Odell Beckham, Jr., told me. ElAttrache often becomes a fixture in his patients’ lives. He did Tom Brady’s knee surgery in 2008, then regularly flew to Boston during the rehab. Brady now considers him a best friend. ElAttrache was one of Kobe Bryant’s few confidants. Rob Pelinka, Bryant’s longtime agent, told me, “When those types of individuals meet one another, they just know. That was his guy.” Surgery is perhaps the only time a superstar must relinquish control completely to someone else. Bryant once spent the night before a shoulder surgery shooting around at the private basketball court of Patrick Soon-Shiong, the owner of the Los Angeles Times. “My wife was screaming at him, saying, ‘Kobe, what are you doing?’ ” Soon-Shiong once recalled. “He says, ‘It’s broken. Neal’s going to fix it tomorrow anyway.’ ”
ElAttrache likes to host patients and friends at his house near Benedict Canyon, above Beverly Hills, for Cuban cigars and Pappy Van Winkle bourbon. “My practice, it’s almost like a continuum,” he told me. “There’s no beginning to the day, there’s no end of the day. I guess it’s very personal.” Sensitive conversations happen within the confines of doctor-patient confidentiality. A friend who spends time with ElAttrache, Brady, and Stephen Curry said, “They share, you might even say, their soul with him.” Walker Buehler, a pitcher for the Dodgers who often dines at ElAttrache’s house, sometimes with other eminences, told me, “The funny part about that whole thing is, everyone who’s there wants to talk to Dr. ElAttrache more than anything.”
In ElAttrache’s office, his staff keeps a whiteboard listing patients and examination rooms. Sometimes a person will point to it and say something like “This is Ryan Seacrest’s friend.” Scores of framed autographed photos and notes from patients line the walls: Alex Morgan (“Thinking back to the World Cup, I was only able to get through it playing every game because of you”), Leonardo DiCaprio (“Can’t thank you enough for my new knee”). Charlize Theron told me, “I run into people all the time on my movie sets: ‘Oh, Neal did this for me!’ ”
In his younger years, ElAttrache could have passed for a star on “General Hospital.” He has intense green eyes, a prominent chin, and an imposing chest. As a freshman at Notre Dame, he won the school’s light-heavyweight boxing championship. Now sixty-four, he effuses a certain Dos Equis-man masculinity. Ringo Starr told me that he consulted ElAttrache in 2002. “He was there with the intake form, doing it himself,” Starr said. “Name? Age? I just burst out laughing, because it looked like Elvis was doing the name check.” Starr’s shoulders were in bad shape. “I was going to some homeopathic people in England,” he said. “One guy even injected O3 into me. Woo-ooh. Anyway, none of it worked.” A family member suggested ElAttrache, who found bone spurs that no one else had seen, and operated successfully. Starr had been distressed that he couldn’t lift his arms to flash peace signs onstage. “And now!” he said, demonstrating for me triumphantly. After the surgery, ElAttrache stayed with Starr and his wife, Barbara, at their house in Surrey. Starr and ElAttrache have attended each other’s birthday parties. Last year, Barbara got hurt in a riding accident, and ElAttrache treated her as well. “She’s doing good!” Starr said.
One day recently, the whiteboard said “Patiño, Room 11.” This was Luis Patiño, a friendly twenty-four-year-old Colombian pitcher for the San Diego Padres, who’d complained of arm pain. “I felt a tingly feeling in my elbow every time I threw,” he told me. Patiño wore ripped jeans and shiny Jordans. He sat on an examination bench, eyes wide, swinging his legs off the edge.
ElAttrache walked in wearing a white coat over a blue blazer. He has a regal nose, which can make him appear imperious when he looks down, though he rarely does. “If I’m delivering bad news, I’m at their level or lower,” he told me of his patients. He sat next to Patiño on the bench and patted his knee. (“It immediately makes someone feel like they’re being protected.”) He pulled up MRI scans on a computer and talked Patiño through the images. ElAttrache saw damage at the top of the ulnar collateral ligament, or U.C.L., a two-inch band that holds the upper and lower arm together. ElAttrache prefers to avoid surgery. They discussed Patiño’s pitching repertoire. Then Patiño removed his shirt so that ElAttrache could test his range of motion. Below his right shoulder, Patiño had a tattoo that said “TRUST NO ONE.” ElAttrache later told me, “His tattoo may say that, but I promise you, by the time I operate on him, I could tell him I’m going to do whatever crazy thing I’d want to do and he’ll let me do it.”
Thirty minutes had gone by. A team trainer, who occasionally helped translate, said, “He’s asking if he’s gonna get surgery.”
ElAttrache was facing Patiño from a stool, which he’d positioned down low. “I think he needs it,” he said. “Do you think you need it?”
Patiño laughed. “If you have a knife now, I’m ready,” he said.
Very few things exist that haven’t, at some point, injured a baseball player. Players have got hurt putting on shirts, putting on pants, taking off shirts, taking off pants, washing dishes, and eating a doughnut. At least nine players since 1985 have missed games after a painful sneeze. For decades, sports medicine was little help. Not that long ago, pitchers had teeth pulled to treat their arms. Players played until their bodies broke. Years of pitching mangled Sandy Koufax’s arm so severely that his tailor had to shorten his left sleeve. He retired at thirty. Mickey Mantle, as a parlor trick, would twist his bum kneecap around, “as if opening a pickle jar,” his biographer Jane Leavy wrote. The strongest and fastest athletes tended to destroy their own bodies; the survivors remained small and slow. There was a time when many N.F.L. linemen were, on average, built like Jimmy Kimmel.
In 1974, Tommy John, of the Dodgers, threw a pitch and, as he has recounted, “felt as if I had left my arm someplace else.” He’d shredded his U.C.L. Frank Jobe, the Dodgers’ team physician, performed an experimental operation. He drilled holes in two bones at the elbow and transplanted a tendon from John’s wrist, looping it in a figure eight through the eyelets as if hitching a boat to a mooring—a MacGyvered ligament. An earlier generation of doctors, operating on knees, had achieved moderate results, but Jobe’s procedure was a breakthrough. John, whose career had seemed over, returned better than before. The operation, now common, is known as Tommy John surgery.
About a decade later, ElAttrache entered medical residency at the University of Pittsburgh. Many of the big-shot surgeons were in the cardiothoracic department. ElAttrache was talented and ambitious, and was drawn to the department. He assisted on one of the first pediatric heart-and-lung transplants. There was a monthlong span when he slept at home just once. An older surgeon pulled him aside, hoping to give him some perspective. “We went through the I.C.U. that night,” ElAttrache said. “His message to me was ‘You know, six or seven of these kids are not getting out of here. Starting tomorrow, you’re going to come with me and talk to the families.’ ” ElAttrache went on, “My ego was so strong on one hand but fragile on the other. All I could see was fucking misery. And then I see that my orthopedic surgical colleagues are dealing with people that break, and you fix them, and they get back to being healthy and happy.”
“Once upon a midnight dreary, while I waited weak and weary, Over many a package of goods galore—While I nodded nearly napping, suddenly there came a tapping, As if Amazon gently rapping, rapping at my chamber door—But it’s a stupid bird and nothing more.”
Cartoon by Brooke Bourgeois
ElAttrache took a fellowship with Jobe and his clinic partner, Robert Kerlan, in Los Angeles. Jobe was a surgical artist. “It was a waltz, everything moved in a certain way,” James Bradley, the Steelers’ team physician, who worked with ElAttrache at Pittsburgh and at Kerlan-Jobe, told me. “Neal had that early on.” Kerlan, meanwhile, suffered from a debilitating form of arthritis, which eventually prevented him from performing surgery, but patients trusted nobody more. He was a creature of Los Angeles. He liked to bet the horses at Hollywood Park with his friends Fred Astaire and Burt Bacharach. “I remember one day Kerlan called up to the fellows’ room yelling and screaming,” ElAttrache said. “And so, of course, I come running down to his office. And Clint Eastwood and Bob Newhart are there, and Kerlan said, ‘I told you he was fast!’ ”
As sports doctors were becoming more effective, athletes were becoming more dependent. There were few high-level players in the nineties and two-thousands who didn’t visit James Andrews, an orthopedist then based in Birmingham, Alabama, who was one of ElAttrache’s mentors. Andrews treated Michael Jordan, Albert Pujols, Jack Nicklaus, and most of the Yankees’ cornerstones: Roger Clemens, Andy Pettitte, Bernie Williams, Jorge Posada, Mariano Rivera. Andrews flew in a Falcon 10 jet and had a yacht that competed for a spot in the America’s Cup. He told me that he would perform about a thousand surgeries per year.
No players have come to rely on surgery as much as pitchers. In the past twenty years, the average major-league fastball has become five miles an hour faster. For the U.C.L., speed destroys. ElAttrache has operated on elbows whose tissue resembled spaghetti. Today, more than a third of pitchers on major-league rosters have undergone Tommy John surgery. At the beginning of this season, more star pitchers were on the injured list than not. “Here’s the problem,” Andrews told me. “We’ve made it too good an operation. They’re not scared about blowing their ligament out, because they think it’s easily fixed.”
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