Cook Returns From Nightmare Experience
By Jack Etkin
DENVER—Around the start of spring training, Aaron Cook will throw off a mound for the first time since Aug. 7. That was when the run of success that led the Rockies to believe Cook was finally realizing his front-of-the-rotation potential took a dire and sudden swerve.
Cook was coming off a complete game—the Rockies' only nine-inning complete game all season—when he took the mound that August night against Cincinnati. He had pitched at least seven innings in each of his previous four starts and had gone 3-1, 1.96 in his last five outings.
The Rockies are committed to developing their own pitchers, certainly their own starters, a process that most definitely includes Cook, 26. Before his setback, Cook had come to fully trust his hard sinker, confident he could attack hitters with the pitch and throw it for strikes.
Everything went haywire against the Reds, when Cook faced 10 batters, yielded five hits and left in the third inning. His velocity plummeted and was barely above 80 mph. Warming up, Cook felt dizzy and short of breath, symptoms that continued during the game for horrifying reasons.
Cook had blood clots in both lungs. He could have died on the mound. That's not the sensationalist analysis of a layman but the realistic assessment of the Rockies medical staff. Indeed, when Cook was taken to a Denver hospital and the grave diagnosis was made, a shocked Cook listened as the morbid ramifications of a pulmonary embolism, as blood clots in the lung are called, were explained.
"I had a doctor and a paramedic tell me, 'I don't know how you're still alive,' " Cook says.
Cook's wife, Holly, suffers from asthma. She was surprised that in the days leading up to that fateful Aug. 7 start, Cook asked what it's like having a breathing disorder. And the night before that start, Holly says her husband "woke up in the middle of the night, catching his breath and said something again about asthma."
Less than 24 hours later, after watching Cook leave his start early, Holly next saw him wearing a hospital gown and hooked up to a host of devices.
"He went from this healthy young athlete to looking like this science experiment," Holly says. "It's kind of scary. By the time I got to the hospital, they had him in a room, connected to some wires. They were going to town, and I had both the kids with me."
The kids are Alexis, 7, and Elijah, who turned 1 on Dec. 1. Soon after Cook was taken to the hospital, he thought of his family, his mind wandering into areas of uncertainty and finality that were overwhelming.
"I was thinking there's a chance I might not see my family again," Cook says, "see Holly and Alexis and Elijah, might not have a chance to see his first birthday. That's really when I started to break down, when I started to realize this is life threatening. I started to think, 'Holly's father died when she was 15.' All these things start racing through your head so fast. 'What's going to happen? And if something does happen, who's going to take care of them? Will he ever know who his dad is?' "
The clots originated in Cook's right shoulder, constricting the flow of blood from that area. They were caused by his first rib pressing against his collarbone. Other players, such as Rangers veteran Kenny Rogers and Rangers farmhand John Hudgins, have suffered from what is called thoracic outlet syndrome (TOS) but none endured the life-threatening situation Cook did when those clots traveled to the lungs.
On Sept. 10, Cook underwent a lengthy, delicate operation that left him with two scars and one surgical keepsake: a small bone that looks like a table scrap, about four inches long and slightly curved. It is virtually all of Cook's first rib, a lethal piece of bone that was removed in an eight-hour operation by Robert Thompson, a vascular surgeon at Barnes-Jewish Hospital in St. Louis.
Rockies trainer Keith Dugger was there, watching from above and taking pictures as Thompson and an assistant made two horizontal incisions, leaving Cook with a scar 5-6 inches and about even with his right shoulder. Not far below it is a second scar about 3-4 inches. The doctors removed most of Cook's first thoracic rib, along with a sizeable buildup of scar tissue around the veins in his shoulder and two muscles on the right side of his neck, all of which were trapping veins and restricting blood flow.
"I've seen hundreds of surgeries," Dugger says, "but I've never seen anything that, one, had taken that long, and, two, how detailed they had to be. It's an area that most doctors are afraid to even inject in, and they're cutting things out.
"When you come down by your clavicle, by your throat and you just go a little bit to the right, you have your jugular (vein) there, you have your subclavian artery. All these nerve endings there that they just clean around. And to cut one of those nerves the wrong way . . ."
Before the operation, Cook and Holly met with Thompson for about 90 minutes. He gave them a detailed description of what would transpire, summing up with a reference that had nothing to do with anatomy.
"The last thing he said was, 'You're going to feel like a truck hit you when you come out of surgery,' " Cook says. "He said, 'Actually, I had a girl volleyball player I did the surgery on. She said: When I got out, I felt I got hit by a train.' "
In the first few days after surgery, Cook says he was "crying in pain." Fluid in his lungs contributed to chest spasms and made breathing difficult. The day after the operation, Cook says he was getting aggravated with a nurse who wanted him to get up and walk.
"She said, 'Honey, we need you to get up and walk around,' " Cook says. "I was being calm up until that time. But she was making me do things that were hurting, and I couldn't do. I don't think I can wish this surgery on my worst enemy. That's how much pain I was in."
The Rockies drafted Cook, 26, in the second round in 1998 out of Hamilton (Ohio) High near Cincinnati, which is where Cook went for rehabilitation following his surgery to strengthen his shoulder blade.
He has been long-tossing but will report to spring training about one month behind the other Rockies pitchers. Following time in their extended spring training program and, most likely, four rehabilitation starts, the Rockies expect Cook to rejoin them in May.
"I'm looking forward to getting back out there and playing at the same level," Cook says. "From everything that we can see and tell, there's no reason why I shouldn't be able to play at that level. It's just a matter of going through the rehab and taking my time and being patient."
Cook is very much a part of the Rockies' plans. They paid dearly for the $172 million free agent plunge in December 2000 that netted Mike Hampton and Denny Neagle. They combined to go 40-51, 5.66 for the Rockies.
Instead, the Rockies' emphasis is on developing their pitchers, particularly starters. Cook is part of that process, along with former first-round picks Jason Jennings, 26, who was arbitration eligible for the first time and signed a two-year, $7 million contract this winter, and lefthander Jeff Francis, 24. Lefthander Joe Kennedy, 25, didn't begin his career with the Rockies, but he re-established it with them last year after being acquired in a trade with the Devil Rays. Shawn Chacon, 27, Colorado's third-round pick in 1996, is returning to the rotation. Then there's Jamey Wright, 30, another former first-round pick of the Rockies, who was vastly improved last year in his second tour with them.
"We recognize that signing and developing our own starters is something that we have to be able to do as an organization," O'Dowd says. "It's easier to educate them on the process of Coors Field and what stats are important and what they'll get paid for, what kind of mindset and attitude they'll have to develop."
Kennedy was proof that the Rockies can acquire a young pitcher who has struggled and have him adjust to the harsh reality of Coors Field. And older free agent pitchers such as Shawn Estes and Darren Oliver, who re-signed with the Rockies this winter, are proof that Colorado can successfully bottom fish in the free agency market.
"And we'll continue that," O'Dowd says, "but certainly the core is going to have to be developed from within."
By May, the Rockies hope Cook is ready to assert himself again as part of that core. Meanwhile, spring training draws near, a time of anticipation for all players. It's that way with Cook, but with subtle differences after his ordeal.
In 2003, the Rockies handed him their No. 4 starter's job before he even showed up in spring training in Tucson, and Cook stumbled that season. Last year, he began the season at Triple-A Colorado Springs, where he made seven starts and went 3-1, 2.74 before being recalled May 17 by the Rockies.
This year Cook knows he's bound for extended spring and has no chance to break camp with the Rockies. But something will be rekindled when he reports to Tucson, something wonderful, as usual, but now something altered.
"I'm definitely looking forward to getting back out there and getting back in a baseball atmosphere," Cook says. "That's part of what I'm made up to do. But at the same time, I think I'm a little more relaxed and calm this year. Because I know what I've been through and at the same time, baseball isn't life and I'm really blessed to be here."
Jack Etkin is the national baseball writer for the Rocky Mountain News.