Overthinking It: What Happens When Starters Get Sick

Earlier this year, 28-year-old pitcher Paul Phillips of the Atlantic League Somerset Patriots was scheduled to start a game against the Camden Riversharks. Phillips, who was drafted by the Blue Jays in 2005 and bounced around Toronto’s and Tampa Bay’s systems until last season, entered that game with a league-leading 1.76 ERA. Phillips was Somerset’s ace, if the Atlantic League has aces. But Phillips wasn’t feeling well.

He pitched anyway. And predictably, he pitched poorly. He lasted three innings and threw 93 pitches, allowing four walks and five runs. When asked to comment on his subpar start, Phillips said:

I had a little bit of a stomach bug before the game, but it’s no excuse not to throw strikes. I gave it what I had. I just didn’t have a lot.

A couple months before that Phillips start, I was scheduled to attend a BP book tour event at the Politics & Prose Bookstore in DC. BP book tour events are a lot of fun, at P&P in particular, and I wanted to be there. Unlike Phillips, I didn’t have to do anything more strenuous than stay upright. But like Phillips, I woke up with a bit of a stomach bug. And after a few brief and disastrous forays from my bed, I scratched myself from the book event. When asked to comment, I said something that sounded like

MUUAARGGHHHH

and didn’t move for the rest of the day.   

Think back to the last time you were sick. Really sick, not just the sniffles. Your main concern was where the closest bathroom was, or how long until you could lie down, or whether your next sudden motion would be the one that made you lose your last meal. Now imagine that while you were wondering all of those things, you also had to stand on a field in front of thousands of people and face major-league hitters who were feeling just fine.

Of all the impressive things baseball players do—and they do a lot of impressive things—starting while sick might be one of the most impressive. It is not, however, the most dramatic. You can’t imagine Ken Burns chronicling Chris Perez throwing up on the mound (twice!) or Chan Ho Park discussing his diarrhea the way you can, say, Kirk Gibson hobbling around the bases or Curt Schilling starting with a bloody sock. Playing through pain is heroic. Playing through a virus that won’t last that long is either unnoticeable, or funny, or so gross that you can’t watch it without feeling sick yourself. But going purely by degree of difficulty, injuries and illnesses probably aren’t all that different. I’m going to disagree with Paul Phillips. A stomach bug seems like an excellent excuse for not throwing strikes.

Anything Atlantic League pitchers can do, major-league pitchers can do better. So it’s not surprising that a number of major-league pitchers have pulled a Paul Phillips this season. In fact, we’ve had a flurry of sick starts in the last few weeks. What follows probably isn’t an exhaustive list, and it obviously doesn’t include any pitchers who kept quiet about their illness.* But it’s enough to give us some idea of what we should expect when a pitcher plays baseball despite being at death’s door. (Note: after an agonizing review process, I decided not to include a Yu Darvish start from May with a tenuous link to a stomach virus. And for the purposes of this article, I wasn’t interested in position players. Position players get sick too, but sick starters are the stars.)

*Although, really, if you make a start when you’re sick, why wouldn’t you say something? Either you have an excuse for pitching poorly, or you look even more like a boss for pitching well. And either way, you get points for competitiveness.

August 8th, Rangers vs. Red Sox
Sick starter: Matt Harrison
Pitching line: 4 2/3 IP, 8 H, 5 R, 4 ER, 3 BB, 3 K, 1 HR
ERA on the day/on the season: 7.71/3.31
Fastball velo on the day/on the season: 94.1/93.0
Team result: 10-9 win
How Harrison looked:

Game story description of sickness: “flu virus,” “stomach virus”
Pitcher statement about sickness: None that I could find. Poor Matt Harrison. No one even asked if he was okay. 🙁
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “He’s under the weather a little bit, but he still went out there and left it all on the mound. He gave us everything he had. He took the ball and battled.”
Other comments: Harrison probably wasn’t all that sick compared to some of this season’s other sick starters. Still, the Dallas Morning News reported that he needed IV fluids following the start, so he was sick enough to qualify for the list. IV fluids are a staple of sick starters. If you weren’t tied to an IV bag immediately after the end of your outing, you must have been faking for sympathy points.

August 6th, Phillies vs. Braves
Sick starter: Vance Worley
Pitching line: 3 2/3 IP, 6 H, 4 R, 4 ER, 3 BB, 2 K, 0 HR
ERA on the day/on the season: 9.81/3.83
Fastball velo on the day/on the season: 89.82/90.5
Team result: 6-1 loss
How Worley looked:

Game story descriptions of sickness: “stomach ailment,” “stomach condition,” “stomach issues,” “upset stomach”
Pitcher statement about sickness: “Yeah, I felt like I was going to see Earl* a few times today. You know, I just couldn’t get it out. And then I went out there, and it seemed like every time I tried to let loose today, it didn’t go where I wanted. And neither did my stomach. Everything arm-wise felt fine. I came out with good action. It just wasn’t going where I wanted because I couldn’t control my stomach.”
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “Once he said he wanted to go, and he said he felt good enough to go, I was going to let him try.”
Comments: In the post-game interview, Worley said he “went out there with heart.” Someone asked him, essentially, whether he might have been better off showing a little less heart and letting someone else start instead. Worley said no, although he allowed that he would’ve liked it to go a little better.

*”See Earl” is what Worley actually said. Most newspaper transcriptions replaced “see Earl” with “[vomit]”. I like Worley’s way better.

July 31st, Orioles vs. Yankees
Sick starter: Chris Tillman
Pitching line: 5 IP, 8 H, 5 R, 4 ER, 0 BB, 3 K, 1 HR
ERA on the day/on the season: 7.20/2.38
Fastball velo on the day/on the season: 91.6/95.6
Team result: 11-5 win
How Tillman looked: 

Game story description of sickness: “flu-like symptoms,” “lethargic,” “weak,” “sick for days”
Pitcher statement about sickness: “I was kind of out there fighting stuff on the mound, just trying to get through.”
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “He obviously wasn’t feeling very good. He was pretty weak.”
Other comments: Bonus points for being on antibiotics.

July 29th, Rays vs. Angels
Sick starter: Jeremy Hellickson
Pitching line: 6 IP, 2 H, 0 R, 0 ER, 0 BB, 5 K, 0 HR
ERA on the day/on the season: 0.00/3.43
Fastball velo on the day/on the season: 92.6/91.8
Team result: 2-0 win
How Hellickson looked:

Game story description of sickness: â€‹"nauseous" 
Pitcher statement about sickness: “’First inning, I actually threw up on the mound,’ said Hellickson, who noted that he threw up ‘five or six times’ on the day. ‘Then I threw up in the dugout a couple of times…Got a little light-headed later in the game.’”
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “He was chalkier than a Des Moines winter. You could see that his face was a little bit red. It’s not easy when you’re ill to go out in that kind of heat and keep your wits about you.”
Comments: The first three pitchers on this list allowed a combined 14 runs in 13 1/3 innings in their sick starts. Hellickson’s was one of his best starts of the season. Few baseball feats are more badass than shutting out the AL’s best-hitting team for six innings with your own body rebelling against you.

After the game, Joel Peralta said, “Getting sick and pitching like he did, that says a lot.” In addition to being badass, sick starts are worth plenty of clubhouse points. If you throw up on the mound, compliments from teammates flow as freely as IV fluids.

In his next start, Hellickson—who presumably had made a full recovery—faced the Orioles, a far weaker offensive team than the Angels. He lasted four innings, giving up four runs and four walks.

July 15th, Red Sox vs. Rays
Sick starter: Josh Beckett
Pitching line: 6 IP, 8 H, 3 R, 3 ER, 2 BB, 7 K, 0 HR
ERA on the day/on the season: 4.50/4.97
Fastball velo on the day/on the season: 91.4/92.4
Team result: 7-3 win
How Beckett looked:

Game story description of sickness: â€‹"flu," "dizziness" 
Pitcher statement about sickness: "In between pitches it was borderline blackout periods."
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “He was a little dizzy. He’s going to be a little pissed off that I even said anything about it. I’m sorry I said anything about it. Can I put it back in the bottle?” 
Comments: Under the weather, on antibiotics, and he still made the start. Yet another example of the single-minded commitment to winning that has made Beckett so beloved in Boston.

May 25th-June 5th, Rangers vs. Blue Jays, Mariners, and Athletics
Sick starter: Derek Holland
Combined Pitching line: 14 1/3 IP, 20 H, 13 R, 13 ER, 5 BB, 13 K, 5 HR
ERA on the days/on the season: 8.16/5.18
Fastball velo on the days/on the season: 92.0/93.7
Team results: 14-3 win, 21-8 loss, 6-3 win
How Holland looked:

Game story description of sickness: “lingering stomach virus”
Pitcher statement about sickness: “I just want to be rid of this.”
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “He looked like a ghost last night.”
Other comments: Holland holds the distinction of making the most sick starts this season, stringing together three consecutive outings during a sick stretch that led to a stint on the DL for “left shoulder fatigue.” During that time, Holland dropped 15 pounds, lost several miles per hour from his fastball as his pitch counts climbed, was treated with antibiotics, and went 2-for-3 in IV fluids. The second of his three sick starts was the most disastrous: he went 1 2/3 and allowed eight runs against the Mariners, which equates to at least 12 against any other team.

May 25th, Twins vs. Tigers
Sick starter: Anthony Swarzak
Pitching line: 3.2 IP, 9 H, 6 R, 6 ER, 1 BB, 3 K, 0 HR
ERA on the day/on the season: 14.71/4.43
Fastball velo on the day/on the season: 90.7/93.2
Team result: 10-6 loss
How Swarzak looked:

Game story description of sickness: Very vague—nothing more specific than “Swarzak felt sick.” However, IV fluids were involved.
Pitcher statement about sickness: None. After the game, Swarzak sat at his locker with a thermometer in his mouth, periodically repeating, “Man, I sure could stand for some intravenous fluids right now” and moaning loudly whenever a reporter walked by, but no one went over to talk to him.
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “We needed a pitcher, we put him in there, and we took our shot. He didn’t have his mojo going.”
Other comments: Anthony Swarzak has a 5.74 ERA in 27 career starts. If he was also sick in the other 26 starts and just didn’t say anything, he might be better than we think.

May 13th, Mets vs. Marlins
Sick starter: Jon Niese
Pitching line: 6 IP, 5 H, 0 R, 0 ER, 3 BB, 4 K, 0 HR
ERA on the day/on the season: 0.00/3.82
Fastball velo on the day/on the season: 90.4/91.4
Team result: 8-4 loss
How Niese looked: â€‹Like he was faking for sympathy points.

Game story description of sickness: “flu,” “fever, body aches, a sore throat and a runny nose,” “he considered himself lucky he did not have the stomach bug that has hit a few teammates”
Pitcher statement about sickness: “The body aches were kind of gone. Now I’m just kind of congested, sore throat.”
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “Niese is a little sick.”
Other comments: “Usually, being sick kind of makes you focus more,” Niese said. I wish I would get sick the way Niese does.

April 5th, Dodgers vs. Padres
Sick starter: Clayton Kershaw
Pitching line: 3 IP, 2 H, 0 R, 0 ER, 1 BB, 3 K, 0 HR
ERA on the day/on the season: 0.00/2.88
Fastball velo on the day/on the season: 89.8/93.9
Team result: 5-3 win
How Kershaw looked: Exactly like he always looks. Scully: "You would never think that he has been sick. And I â€‹mean â€‹sick."
Game story description of sickness: “stomach virus”
Pitcher statement about sickness: None. Kershaw didn’t speak to reporters after the game, except to tell them that he felt too sick to speak to them.
Time he made a batter look bad while being about to barf:

Manager statement about sickness: “When he’s throwing fastballs at 88, 89, you know he’s not feeling good.”
Other comments: It would be fairer for hitters if Kershaw always had the flu. Chase Headley, who was hitting third for the Padres, said he was “wondering what was wrong.” Clayton Kershaw threw three shutout innings and struck out a batter per inning, and the hitters who couldn’t touch him still wondered what was wrong.

Kershaw’s teammates were impressed by his Opening Day effort. A.J. Ellis probably spoke for most of them when he said, “I didn’t expect him to start the game at all.” What they didn’t realize is that any pitcher will go to great lengths to pitch against the Padres. Unless you’re on life support, you always make your starts in Petco Park.

Game stories described Kershaw as “slumped over on the dugout steps” before the game and “lying down in the tunnel” after the game. Slumping and lying down are activities that any sick person can do. It’s the “getting up long enough to shut out a major-league team for three innings” that most people have trouble with.

So, what can we conclude from our survey of sick starters, if anything? Well, if they’re really sick, they’ll probably throw less hard, and they’ll probably pitch poorly (unless they’re Jeremy Hellickson, in which case the more often they throw up, the better they’ll be). It’s the trainers’ and manager’s job to decide whether a pitcher is so ill that he might harm himself further, or that the team would be better served by starting someone on short rest, burning the bullpen, or making a roster move. In some of the cases above, I suspect the sick starter’s team would have had a better chance to win if the manager had made one of those three choices, though on a couple of occasions, the team lucked out and won anyway.

Regardless of whether those starters should have been starting, though, the fact remains that they did. And that’s another thing that separates most of us from the people who make the major leagues. It’s not just that we lack the physical tools to do what they do when they’re healthy. It’s also that we lack the willpower to do what they do when they aren’t. When you or I would call in sick, watch re-runs, and plead for pity, sick starters pick themselves up and pitch to Albert Pujols. Pujols won’t take pity, and he’ll probably make them pay, but we can still honor their sacrifice. So the next time you celebrate the bloody sock, spare a thought for the upset stomach.