CC Sabathia and Me: After the Balloon Animals

CC Sabathia’s offseason heart procedure was more serious than some may have thought. (via Chris Ptacek)

News articles on CC Sabathia during spring training sometimes described what he had gone through this past offseason as a “heart scare.” That’s even what Sabathia called it on his podcast, “R2C2.” I beg to differ. Calling an arterial blockage that requires a doctor to intervene with a balloon angioplasty a “heart scare” is like calling a coma a “nap scare.” Sabathia was in real jeopardy. I should know; I just had the same procedure.

I am much older than CC Sabathia, but I wasn’t always. In fact, I used to be younger than Don Mattingly. Donnie Baseball was a JFK baby, born on April 20, 1961 as the Bay of Pigs invasion was going disastrously wrong. I was a Tricky Dick baby, born in 1970 as the Beatles were breaking up and the Vietnam War dragged on. With his great bat control, legitimately clutch hitting, and great glove, Mattingly was the first player to capture my imagination and make me a fully committed baseball fan. I recall lying on my childhood bed, staring at the back of a Mattingly 1985 Topps card, and comparing our birthdays. He was 23; I was 13. The future extended out before us both, unlimited—which is to say that the final reckoning was far enough away that we could pretend it was unlimited.

Many years have passed since then. Mattingly didn’t make the Hall of Fame and neither did I. That is not to say that I regret the way it has gone. There are words and deeds I would take back given a second chance, but I wouldn’t want to be 13 again. The ensuing years have brought my brilliant wife, my beautiful, intelligent children, and the opportunity to write stories like this one, my heart’s desire from an even earlier age. And yet, in many ways I am frozen in that place. My willfully bundling up an ever-present sense of mortality with Mattingly’s age and mine, and pushing both off to a hazy, forever far-away horizon remains characteristic of a man who needs to be in denial to function. I exist here, in 2019, but I also exist there, clinging to false hope. This bifurcated existence has taught me that emotional time isn’t a straight line. At best, it’s a singularity in which all moments take place at once. At worst, it is a line, but one bent like a paperclip, curving you past the person you were before and in some incalculable percentage still are.

Baseball is the wrong game with which to hold off time. It forces you to become aware of certain inevitabilities. For example, airplanes are risky. Ken Hubbs, Thurman Munson, Roy Halladay, Cory Lidle, and Roberto Clemente would tell you if they could, but they can’t. Youth is also no protection against aggressive bacteria (Addie Joss), valve malfunction (Urban Shocker), blood clots (Harry Agganis), cancer (Danny Thompson), motor neuron disease (Lou Gehrig), severe depression (Willard Hershberger, and way too many others to list), misadventure drunk or sober (Ed Delahanty, Mike Sharperson, Jose Fernandez, Steve Olin and Tim Crews, Oscar Taveras), vehicular homicide (Nick Adenhart), and murderous gunplay (Lyman Bostock, Dernell Stenson). Oh, and also getting hit in the head with a pitch (Ray Chapman) or a player (Johnny Quigley). Life is not safe; you won’t escape it alive.

I would like to, though, as unrealistic as that is. That’s why this business of having a clogged-up heart is so troubling. You might say that as signs of incipient immortality go, it’s a bad leading indicator. It also should not be surprising: My genetic inheritance is of heavy heart disease. I’ve known that for a long time, particularly since my father started having symptoms in his 30s. His imminent death from a hypertensive stroke or a coronary was the running theme of my childhood, and there were many, many occasions in which a family outing ended in the ER, the Old Man having experienced chest pressure and shortness of breath in the Smithsonian Museum of Natural History, the Tropicana casino on the Boardwalk, or It’s a Small World at Disneyland. Lengthy experiments in medication and surgery ensued, as did weekend sojourns that extended well into the week because Pop had been held for observation.

Sometimes a heart attack is like being slammed in the chest by an elephant; you can’t miss it. They can also be virtually silent. It’s only once you’re off the ride that you realize the mildly painful fluttering you felt was part of your coronary muscle dying. As the song almost goes, it’s a small heart attack after all.

Try explaining this to skeptical attendance authorities, which I had to do well into college. “Sorry I missed class for a week, Miss Othmar. I was sitting by my dad’s bedside hoping his ashen pallor didn’t signify imminent death.” Once, when I told a college registrar I had to drop an undroppable class because I would be needed at home to assist my father in recovery from multiple bypass surgery, she replied, dripping with skepticism and disdain, “How do I know you’re not making all of that up?” and proceeded to mock me to nearby colleagues as “some kid” with a made-up excuse. That was one of the few times in my life I can recall becoming righteously, volcanically angry.

Incredibly, despite hypertension that regularly hit 200/100 and so many bypasses that he no longer has the available space to receive any more of them, my father is still here to read these words. Perhaps that’s why I’ve been so complacent. Don’t misunderstand—each time I saw my father hooked up to pumps and wires, trying to get back on his feet after his sternum was sawed through, I changed my lifestyle. The first time, I stopped eating red meat forever. The second time, I eighty-sixed fried foods. The third time, I tossed pizza—a food I love enough that I could eat it at least once a day every day—almost completely out of my life; it became a one-slice-a-year treat. I figured, if you don’t want your arteries to fill up with life-threatening goo, don’t feed them life-threatening goo.

This was a misconception on my part: Arterial plaque results not just from one’s diet, but due to other factors, such as genetics and lifestyle. Sabathia suggests this reality. He’s an athlete. His proportions are unorthodox, but even if we accord a good deal of his poundage to that large frame and the musculature born of a lifetime of athletic work, the (unforgiving, draconian) body mass index would argue a 6-foot-6 adult male should be closer to 210 pounds than to 300. We don’t know if he eats three cheeseburgers a day. He has alluded to a family history of heart disease. We do know that he gets his running in. “My cardio,” he said, “has always been up … I’ve always been able to do cardio.”

In that, Sabathia was one up on me. Because of indolence, I failed in some crucial respects. I am not good at exercise. I never have been. I am bookish by nature and wasn’t brought up to athletic endeavor. The neighborhood kids were more about stealing my bicycle and trying to run me over with it than playing catch. Quick-twitch reflexes—in fact, reflexes of any kind—are as much absent from my genetic package as heart disease is part of it. As I hit my early teens, I finally found some friends who wanted to throw a baseball or see how many consecutive times we could pass a frisbee without dropping it. Eventually we got up some sandlot baseball games, but it was too late; I would always be catcher-first base-designated hitter material. As Casey Stengel said, anything you can’t do well and don’t enjoy, you generally fall behind in. I don’t enjoy physical exertion. I’m not good at physical exertion. I fell behind.

I also developed a weird paranoia about exercising to the point that I get winded. Watch a baseball player run out a triple or an inside-the-park home run. Even the ones in the best of shape (that is, not Bartolo Colon) will be panting after running a 360-foot sprint. It doesn’t mean they’re about to die. That’s the good exertion, the “feel the burn” exertion that makes you healthier. I have a hard time conceptualizing that when it comes to my own body. I start to question whether the exertion is a strain on my heart. Then I experience chest pain—I have since my first year of college. Doctors always said they were not real, an artefact of anxiety. For a while, maybe they were.

CC Sabathia is a unique pitcher, one who has always been difficult to project because of his unusual stature. Combine Sabathia’s 6-foot-6 height and his (official) 300 pounds and you have Baseball Megatherium, a specimen who is very hard to comprehend even as he’s standing before you.

Sabathia’s first team, the Cleveland Indians, handled him fairly gently early on; he crossed the 200-inning boundary just once before he turned 26. The kid gloves came off after that, though, as Sabathia reached the high-paid mercenary phase of his career: Between workload and his precocious arrival in the majors at 20, Sabathia finished his age-30 season with the 35th-most major league innings of any pitcher at that age. That doesn’t sound like much, but that list includes Deadball-era greats like Walter Johnson and Christy Mathewson, unfettered hurlers who died decades before any human being had even conceived of the words “pitch count.” If one considers only the postwar era, Sabathia had thrown the 18th-most innings. Restrict the pool to the last 30 years, the era in which modern bullpen usage evolved, and Sabathia had pitched the second-most innings, trailing Felix Hernandez by about 50 innings.

At the time, it was difficult to know how all those innings would affect Sabathia, because no other pitcher in baseball history resembles him. According to Baseball-Reference’s similarity scores, the pitcher who bears the greatest statistical resemblance to Sabathia is his former teammate, Andy Pettitte. At 6-foot-5, Pettitte could stand nearly eye-to-eye with Sabathia, but at 235 pounds, his silhouette was far slimmer. Stand Pettitte next to Sabathia and they spelled out a friendly, “HI,” with Pettitte the I to Sabathia’s broad H. In all of baseball history, there have been 279 pitchers Sabathia’s height or taller who have thrown at least 10 innings in the major leagues. There has been just one other pitcher, the recent Reds and Rays reliever Jumbo Brown, who would even admit to being 300 pounds. Only two others would concede they weigh as much as 290. Bartolo Colon registered at 285, which seems like a polite fib; even so, he was much shorter and therefore rounder than Sabathia.

A Hardball Times Update
Goodbye for now.

In December, Ken Rosenthal of the Athletic reported that Sabathia, by now 38, had experienced “symptoms of acid reflux and heartburn”—that is, chest pain that is ambiguous enough that you might dismiss it as gas—“and noticed that he was sweating more quickly than usual while riding an exercise bike.”

“I just didn’t feel right,” Sabathia told the New York Times. “I know myself. I try to listen to my body.” On his podcast, he added, “Deep down I knew it wasn’t my stomach… I knew I didn’t have acid reflux… If this is acid reflux, what the fuck?”

He underwent a stress test. That test revealed an arterial blockage, and he underwent an angioplasty on December 11. The procedure, as well as recovery from knee surgery, caused a slight delay to the start of his season, but since returning on April 13 he’s logged a 2.66 ERA in 20.1 innings; life goes on. Publicly, at least, he doesn’t worry about things the way I do.

Ten years ago, when I was still in my late 30s, I chattered about chest pains long enough that I finally got a doctor to take me seriously. I was given a stress test, essentially a supervised trip on a treadmill bookended by scans of the heart. By observing how blood flows through one’s arteries before and after exercise, doctors can infer the existence of plaque. I failed; they saw something.

I was then sent for a cardiac catheterization, in which a thin tube (the eponymous catheter) is inserted through the wrist or the groin and threaded up to the heart. A number of actions can then be performed. If a blockage is found, it’s circus time! The doctor inflates a tiny balloon that crushes the blockage. The balloon is withdrawn and a small wire tube, a stent, may be inserted to keep the now-open artery from closing again (imagine the shoring timbers in a mine).

It’s a world of weird coincidences: My first catheterization was performed by a close relative of Joe Torre’s. He saw serious occlusion of the circumflex artery, but not enough to perform an angioplasty. I was put on a high dose of cholesterol-reducing statins and told not to worry about it. I kept up a low-fat diet, except for the odd dessert at birthday parties, weddings, graduations, anniversaries, business lunches, non-business lunches, and, well, whenever someone would give me the excuse. I exercised intermittently. I lost weight. I took antidepressants and other drugs and gained it back and then some. There is a lot of blame to go around, in terms of the intersection of one’s bad habits, inertia, other medical conditions, and genes. In the end, saying, “It’s not (wholly) my fault!” doesn’t change anything. Last month I failed another stress test, then underwent another catheterization. This time there wasn’t one blockage; there were several. One was ballooned out of existence. The rest remain, ticking time bombs.

All those years eating dry salads, wasted.

I was awake throughout the angioplasty, my heart beating on a deluxe flat-screen monitor that overhung the surgical table. The doctor yelled at me. A lot. He asked me if I had kids, if I wanted to see them grow up. If I did, he said, I had to change. It is hard now, in the aftermath, to know that little coil of wire is inside me, and not to think about what is taking place with every beat of my heart, the quick trip to the grave with which I was threatened.

Sabathia’s stress test had an even more frightening result: His left anterior descending artery was 90 percent occluded. You might survive a heart attack inflicted by a blockage of the circumflex. They call a full blockage of the left descending anterior “the widowmaker.” Sabathia and I have this much more in common: He was shaken by his diagnosis. “It was tough to process the first, like, three or four days,” he said on “R2C2.” “Doctor told me if I’d have got on a plane to go to London, I wouldn’t have made it back.”

Sabathia, at least externally, has always been the same, by which I mean he’s not waxed and waned and waxed again as I have. Even in his Cleveland days, he carried a substantial gut. He shaved a couple of stone in 2012, but, feeling like the subtracted mass led to lower velocity, put it back on again. That bay window doesn’t necessarily indicate sloth or the aforementioned three cheeseburgers; it too can be genetic. Some of Sabathia’s waistline may have been an indirect result of the drinking problem for which Sabathia sought treatment in 2015—booze likes to convert to belly fat. Regardless of the cause, a spare tire correlates to increased risk of heart disease. I have it too; reflecting the lingering influence of an ancient Judy Blume novel, I fantasize about being flensed.

With his blood flow restored, Sabathia can pitch without fearing that he’ll die on the mound. But if it were me, I would never stop worrying. That’s the way I’m wired. Me, I too have been cleared: Even with those lingering blockages, I can type safely without fear of overexertion, except I worry about that too—and also walking, running, skipping, jumping, or eating anything except pan-seared salmon over brown rice. Looming in the future are now annualized stress tests, probably more stents, maybe even a bypass or seven. And no pizza, ever.

Here is what I have seen of my future via my father: When you have heart bypass surgery, your lungs fill with sludge. After, you need to cough it out so that infection doesn’t set in. Coughing, though, is the last thing you want to do because your chest is held together with staples. They give you a teddy bear to hug as you cough to keep your chest from flying apart. He’s like the Care Bear of Torture, a superior little bastard of a false ursine with a friendly little heart on his chest that mocks your dysfunctional one. Sabathia sounds upbeat now. He’d probably see the bear as a symbol of hope, and hand in hand they would romp through the Hundred Artery Wood.

I envy him. For him, the surgery was a liberation from pain, escape from a sword he hadn’t even known was dangling over him. I just see more danger. Maybe I’m a pessimist and he’s centered. Maybe he’s naively optimistic and I’m a realist. Either way, I wish I could be more like him. I wish I felt like I was closer to the beginning than to the end, still staring at that Don Mattingly baseball card in the spring of 1985, “Raspberry Beret” on the radio, and life an unwritten story brimming with such potential that the air crackled with ambient energy on a lazy Sunday.

At least Mattingly is okay. During his playing days, Mattingly was listed at an even six feet (this may have been very slightly generous) and 175 pounds. He might be 185 now. Maybe he’s been more disciplined than CC and me. Maybe he’s just been lucky. Maybe managing the Miami Marlins puts a man off his feed. If that’s the case, I wish they would let me manage the Marlins. As much as losing hurts, as frightening as dying is, I hate exercising more.

References and Resources

  • Baseball-Reference
  • The New York Times
  • Steven Goldman appears courtesy of some doctors and in spite of others.

Steven Goldman is the author of Forging Genius: The Making of Casey Stengel, the editor and coauthor of numerous other books including Mind Game, It Ain't Over 'Til It's Over, and Extra Innings: More Baseball Between the Numbers, and hosts The Infinite Inning baseball podcast. A former editor-in-chief of Baseball Prospectus, his writing on the game, its history, and sundry other topics have appeared in numerous publications. He resides in New Jersey, which is not nearly as bad as you've been told. Follow him on Twitter @GoStevenGoldman.
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Howard Megdalmember
5 years ago

Just a wonderful piece.

5 years ago

Great piece. Johnny Quigley?

5 years ago

I want you to know that after freeloading here for a few months I just paid for a membership because of your column. I can relate. Just over a year ago I had a cardiac calcium scan and scored 596. Zero is the ideal number. Mayo Clinic says that puts me in the highest risk category for an adverse cardiac event.

This was something of a shock as I’m 6’1″, 155 lbs. and fairly active. My cardiologist says I’m not that bad. Still, for 3-4 months I was afraid to do anything that required physical exertion for fear of a heart attack. It took a lot of effort but I finally started exercising again, cautiously and nervously at first, but now I get my heart pumping pretty good on my stationary bike. But it was hard to do, mentally and physically. At my age (64) muscles and conditioning are lost rapidly with inactivity.

Try doing some exercise, Steven. Start as slowly to keep your anxiety at a minimum. It won’t be easy but after a few weeks it will start to feel good. The heart is a muscle – we have to use it or lose it.

5 years ago

Good article. However, to not mislead those that are constantly misinformed about how fat is obtained and retained: A large amount of fat around the gut is always the result of calories in vs calories out. If your calories in are higher than calories burned, you will start to acquire extra, non-muscular weight. A large gut, without the fat, can have a few different causes. The majority of these are seen in very poor countries with little access to clean water or healthy food.

Although it was obviously not your intent, people should know that there is no magical substance that goes on in only heavy people’s bodies that keeps them from burning fat. It is only willpower that is required, and a simple mathematical equation in order to stay in shape and under a healthy body fat percentage. Some people have the ability and desire to keep this in order, some do not.

Getting and staying in relatively good shape, (say 15% body fat for males) is fairly easy and extremely rewarding. People should be reminded of the truth: Your body fat percentage is the single best indicator of your outlook for future health, genetic defects aside. If we care about being there for your children as we age, we can and should take the proper 15-60 minutes per day to work on our machinery. Stop looking for coincidences or excuses.

Vote down as your please, but the truth hurts.