Tuesday, February 19, 2008

Schill Out

Nobody has a greater vested interest in Curt Schilling's baseball career than...Curt Schilling. In a very real sense, Schilling's dilemma resembles what in medicine was called 'risk contracts'. As a patient you would ask yourself are you better off if the physician (and the entire entourage) caring for you gets paid for what they do, or what they do not.

Are you better off getting some riskier elective surgery or taking medical treatment? The answer is, as always, it depends...on many factors.

The Red Sox, with Schilling under contract, would like to extract some value (public relations aside) from Schilling's ability to pitch, whenever and whatever that might be. If Schilling needs (and has surgery) the presumption is that the Red Sox get nothing from the righthander this season. Ergo, a conflict arises, what is good for Schilling over the remainder of his career (whatever the duration) or what is good for the Red Sox now. Is this a 'zero sum' game, or is everyone likely to be unhappy? If Schilling were 32 years old and had three years left on a deal, would the recommendation be the same or different?

What is medically right (if that is known) is not always the same as what is expedient. Physicians and patients usually do not live in a world of black and white, but grey and greyer. Should I stop drug A so I can have surgery, realizing that stopping the medication alters the overall risk equation. If the risk equation is overwhelmingly on your side, you still can lose through chance.

I cared for a patient eons ago when I was in the service who was scheduled for a risky, and major surgery that was canceled at the last minute for an emergency case. The patient left in tears, physically and emotionally prepared to accept that risk that day. The surgery happened the next week...and the patient died during the operation. That was irony for me.

I don't have the smallest claim on knowing what is 'right' for Curt Schilling, but I do favor him having the authority and the accountability of making that decision. I'm sure that Red Sox and MLB policy dictates not only a second opinion but probably an arbitration procedure. Of course, sometimes life gets in the way of our best plans.

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