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Thursday, May 30, 2013
Updated: June 2, 11:52 AM ET
David Cooper: Medical marvel

By Jerry Crasnick
ESPN.com

The career-ending injury can be a bolt from the blue or a relentless series of setbacks that make a player throw up his hands and cry "uncle." For Corey Koskie and Mike Matheny, the end came in the form of lingering concussion problems. Brandon Webb spent the better part of four years flirting with comebacks before persistent shoulder issues forced him to retire in February.

For others, the ending comes in a flash. Dave Dravecky broke his arm throwing a pitch. Bryce Florie was done, for all practical purposes, after taking a line drive off the face in 2000. And James Rodney Richard never threw another pitch in the majors after suffering a stroke at age 30.

David Cooper traveled a mysterious middle ground in his brush with baseball mortality. In the span of a few months, the former Toronto prospect was listed as day to day with a back injury, then given indications that he might never play again. He visited numerous doctors in a seemingly futile search for answers and was released by the Blue Jays in March before an innovative surgery helped restore his health and start him on the road to recovery. At age 26, he is now a firm believer in medical miracles.

David Cooper
During Cooper's surgery on April 3, a herniated thoracic disk was removed and his spine was reinforced with a titanium plate and two titanium screws that fused the T-7 and T-8 vertebrae.

"I don't ever wish this experience on anybody," Cooper said. "But I feel like I was put here at the right time. If this happens to anyone else -- whether it's an athlete or not -- they can have a solution so they don't have to live a life filled with pain."

Things were looking up late last summer for Cooper, the 17th overall pick in the 2008 MLB draft out of UC Berkeley. He was coming off a monster season with Toronto's Triple-A Las Vegas club, and the Jays were ready to give him a shot at winning the first-base job with the big club. Scouts were skeptical that Cooper would ever hit with prototypical corner infielder power. But Lyle Overbay, James Loney and other first basemen with similar skill sets have enjoyed successful careers. And for those who dream big, there's always the Mark Grace model.

But it's hard to swing the bat with authority when the slightest twist of your torso is enough to make you cry out in agony.

In a game against Detroit on Aug. 22, 2012, Cooper laced a line drive to right field for a hit off Anibal Sanchez. Jeff Baker retrieved the ball quickly and relayed it to second baseman Omar Infante, who fired to Prince Fielder as Cooper recovered from losing his footing and lunged back into first base to beat the tag.

When Cooper watches the video, he sees himself breathing heavily, through gritted teeth, as Toronto broadcaster Buck Martinez describes the play that just unfolded. It's the quintessential out-of-body experience.

"I looked at it a couple of times," Cooper said. "It's kind of weird. The adrenaline was flowing, and it took about 30 seconds to a minute for me to feel anything. Then it was pretty painful after that. It was a very sharp, stabbing pain, and I couldn't take a deep breath. It was hard to stand up tall, and I had no ability to twist [my body]."

David Cooper
Cooper felt a "sharp, stabbing pain'' in his back after diving into first base to avoid this Prince Fielder tag on Aug. 22, 2012.

The Blue Jays pronounced Cooper day to day with a jammed neck and upper-back spasms, but the ensuing weeks and months brought only setbacks and disappointment. An MRI in September revealed the presence of a herniated thoracic disk that was compressing his spinal cord, and rest was prescribed. But when Cooper tried to swing a bat in January, the persistent pain told him something was seriously out of whack.

Several doctors told him his best option might be to wait in hopes that the damaged disk would eventually retract and take the pressure off his spinal cord. Or he could try Plan B and visit Dr. Curtis Dickman, a Phoenix-based neurosurgeon with a track record for healing people in his predicament.

With a single phone call, Cooper found the man who became his guardian angel and baseball savior. Nine months after the initial onslaught of bad news, a surgically repaired Cooper is working out in Phoenix with an eye on playing later this season or at the very least resuming his career in 2014.

Who knows? Before this ordeal is through, he might be the Tommy John of back surgeries.

Career-saving surgery

Herniated disks are relatively common, but the vast majority occur in the lumbar region, in the lower spine. The next most common disk herniations are located in the cervical region, in the neck. In both cases, doctors typically go in through the neck or low back to make the necessary repairs.

Cooper was among the unfortunate 1 to 2 percent of back patients to suffer from a herniated disk in the thoracic region, in the chest cavity. That complicates matters considerably, since the thoracic spine is surrounded by the rib cage. When a herniated thoracic disk compresses the front of the spinal cord, it requires a surgeon to enter through the front of the chest rather than the back.

Herniated Thoracic Disk
In this artist's illustration, which is similar to David Cooper's injury, a herniated disk (the pear-shaped gray object) is pressing against the spinal cord (shown in pink).

The open surgical procedure, known as a thoracotomy, sounds like something out of a medieval torture chamber or the Mel Gibson movie "Braveheart." It requires an 18-inch incision in the chest wall and the removal of a rib, which allows the surgeon to pry open the chest cavity to gain access to the damaged disk. The long-term fallout can be severe, from pneumonia to chronic pain to lung complications and extended recovery periods.

When Cooper listened to doctors describe the procedure, it seemed almost "surreal." The only sliver of hope came when several specialists -- including Dr. Robert Watkins, the renowned California spine surgeon -- steered him in Dickman's direction.

Dickman, who works out of the Barrow Neurological Institute in Phoenix, is a true renaissance man. He's a writer, a painter, an Ironman triathlete, and a guitarist and saxophone player whose band, Crosstown Traffic, has helped raise more than $9 million for Arizona charities. He treated Billy Wagner when the former Astros closer took a Kelly Stinnett line drive off the head in 1998, and made national headlines in 2003 when he helped save an 18-year-old patient whose skull was ripped from his cervical spine in a gruesome automobile accident.

In the early 1990s, Dickman became a pioneer for his work with an endoscope, a medical device consisting of a long, thin tube with a light and a high-resolution camera that transmits surgical pictures to a TV screen. It's an imaging tool that provides illumination, magnification and visualization of the anatomy to allow for much less invasive forms of surgery. The endoscopic technique for treating thoracic disk herniations is called a thoracoscopy, or thoracoscopic microdiscectomy.

Dickman performs about 12 to 15 thoracic disk surgeries each year with the endoscope and has about 150 on his résumé. His initial consults with Cooper told him the ballplayer was a prime candidate for the procedure.

As Dickman explains, the spinal cord is normally shaped like an oval, and is surrounded by fluid that acts as a cushion and a buffer around the cord. But X-rays showed Cooper's spinal cord was shaped like a kidney. It was indented and deformed because of the pressure being placed on it by the herniated disk. In a worst-case scenario, Cooper faced the possibility of paralysis down the road.

"The pain was a sign there was something seriously wrong," Dickman said. "If the disk herniation persisted, it would not be safe for him to return to playing baseball professionally -- or to any type of exercise."

Dr. Curtis Dickman
Dr. Curtis Dickman performs about 12-15 thoracic disk surgeries with an endoscope each year.

Faced with three options -- the open thoracotomy, a sedentary existence with no baseball or the endoscopic surgery -- Cooper didn't need much time to think. "It was a no-brainer," he said.

On April 3, Cooper lay on his left side on an operating table in Phoenix and underwent a delicate four-hour endoscopic procedure. Dickman inserted a special breathing tube to block the air flow on one side of Cooper's chest cavity, temporarily deflating the lung and creating an empty space to give the surgeon room to work. He made small incisions between the ribs, and with the help of flexible plastic tubes called portals, removed the herniated disk material and reinforced the spine with some assorted hardware and bone grafts from Cooper's rib.

Cooper is now walking around with a titanium plate and two titanium screws that are 8 millimeters in diameter fusing the T-7 and T-8 vertebrae in his back. The plate and screws are connected with locking nuts. He is the proud owner of a bionic spine.

"Naturally I want to do everything perfectly for every single patient," Dickman said. "But knowing how much David had riding on this surgery, I was as vigilant as I could be to make sure everything was 100 percent perfect. The CAT scans and MRIs verify that everything was 100 percent perfect from a technical standpoint.

"It's hard to put a percentage on his recovery, since so many things go into it. But David certainly hopes -- and I hope -- that he'll return to a level where he's as good or better than he was before. We just have to let the healing process take its course and see what happens."

The road ahead

Cooper's biggest challenge at the moment is coping with boredom. He has remained in Phoenix for his rehab with his wife, Tamara, and for the first month after his surgery, the highlight of his day was going for a half-hour walk or pedaling away on a stationary bike. He received some good news two weeks ago when Dickman cleared him to begin upper-body weightlifting. Between workouts, Cooper spends his time playing video games, watching TV and waiting patiently for his fused spine to heal.

If things go according to plan, he will be ready to begin hard-core baseball activity in July. Maybe he'll swing a bat and take ground balls as part of an open audition for potential suitors. Or it's possible one team will jump to the front of the line, try to sign him and help oversee his rehab. Cooper is keeping an open mind about a possible return to Toronto, the only big league organization he's ever known.

It's been a heck of a whirlwind tour. Brodie Van Wagenen of CAA Sports, the agency that's represented Cooper since he was drafted, had a front-row seat for the emotional swings.

"It was really difficult to watch from an outsider's perspective -- to see David make the journey through the minors and break through the door at the big league level only to have it suddenly halted," Van Wagenen said. "It was even more difficult for David as a player. Then he went from a bleak diagnosis to a 180 turn because of Dr. Dickman and his procedure. It's pretty exciting."

Cooper just turned 26 in February, so he's still young enough to have a productive career. He is not the classic 30-40 homer slugger, but he did bat .364 with a .973 OPS in the hitter-friendly Pacific Coast League two years ago with that sweet left-handed stroke. As former Toronto manager John Farrell observed in 2012, it's a classic "low-maintenance" swing.

And Cooper doesn't lack for motivation. After seeing his career flash before his eyes, he is more driven than ever to succeed.

"I have every expectation to get back to where I was," he said. "I'm not doing this to go back to the minor leagues. If it happens, so be it. But that is not what my expectations are."

If it's possible to experience a career's worth of despair, anxiety, hope and exhilaration in nine months, Cooper knows the feeling. He has emerged from his ordeal, both literally and figuratively, with a spine of steel -- equally grateful for modern medicine and second chances.