Monday Morning Mentions: Dec 21st, 2020

With all the talk about the latest developments regarding the COVID-19 vaccine, there seems to be more questions than answers in the minds of the general public. 

For myself, I have a fairly extensive range of clinical experience. I've worked in hospitals and clinics (among other places) since I was nineteen, but even I was fixated on one particular point: this vaccine seemed to make it to public use awfully quickly. 

The way I saw it, I felt like the companies involved in its development may have cut some corners in their efforts to get the vaccine out as soon as possible. It never even occurred to me to consider the sort of resources and manpower behind it. It was an "all hands on deck" sort of pursuit, and what it left us with was multiple options for a viable and effective vaccine. 

This edition of Monday Morning Mentions belongs to someone with whom I've spoken at length, in the past, and has recently received the COVID-19 vaccine himself. 

A couple of years ago, I interviewed former Cardinals, Mets, and Braves first baseman-outfielder Mark Hamilton, who was about to complete his medical degree and take the boards. Now he's an internal medicine resident and specialist in interventional radiology at Long Island Jewish Medical Center, based in New York. Dr. Hamilton studied neuroscience at Tulane University, in New Orleans, as an undergraduate. 

He was kind enough to once again share a bit of his time and insights, answering a few basic questions about the COVID-19 vaccine. 

Clinton Riddle: I was hoping to ask your thoughts on a few details that have concerned me about these vaccines. My first concern is the time it took to get them to the market. Does it seem to you that maybe these companies might have cut some corners in order to rush these out to people who badly need them? 

Dr. Mark Hamilton: No. I do not believe corners were cut. What we saw was an arms race. Vaccines, unfortunately, have been an extremely unprofitable endeavor in the past 30 years. The profitable endeavors have been the next drug for chronic conditions like hypertension. As such, high powered pharma companies have simply not prioritized vaccine research. This pandemic and the public and private money invested into developing a vaccine has changed that paradigm. 

Theses companies dropped everything they were doing and put all resources into development. It’s simply amazing what unlimited resources can do. 

The vaccine itself is extremely simple and something people have been wanting to do for years. The challenge was stabilizing it for delivery. The science is high-school level. They have since animal tested and human tested. And FDA Phase 1 and 2 tested. 

The only step that was skipped was Phase 3, which specifically takes time by design. I believe it to be safe, and its simplicity, to me, makes that even more likely. 

The vaccine itself is just a fat membrane around a completely naturally-occurring product. It causes the body to produce the protein from the virus that the neutralizing antibodies need to be produced against. Extremely precise. Guaranteed to give the outcome desired. 

Can I say what the vaccine impacts are ten years down the road? No. But I would expect much, and I will say that contracting COVID means the same genetic material from the vaccine enters your body anyway (just with the rest of the virus and risks that come with infection). 

CR: Interesting. So it stimulates the production of components of the immune response which will show an affinity to the proteins in the viral shell of this strain of COVID, thereby causing those vaccinated to develop antibodies?

Dr. H: Correct. It delivers the genetic code for a single protein that is on the virus and make your own cells make that single protein. Your body recognizes it as “non-self”, and attacks it.

That attack stimulates the immune systems and results in durable antibodies against that specific protein. So if you come in contact with the virus, your immune cells already know and have antibodies against the protein on the virus surface, thus preventing full-blown infection before it begins. 

CR: It sounds astoundingly simple.

Dr. H: And they specifically chose the protein that binds the virus to our cells. So now the virus cannot enter cells very well. It’s been a pipe dream for decades to do vaccines this way, but the development would cost billions and the result was simply not profitable enough to invest in it. Until now.

Incentivize Big Pharma, and they deliver.

CR: Amazing. Did this require protein sequencing to be carried out first, or is the surface protein of this strain of coronavirus similar enough to other forms of the virus?

Dr. H: Yes. Sequencing first. But that had been underway since the virus was identified. This surface protein is unique to COVID (SARS-COV2). But the virus is very similar to SARS from 2001. 

Reverse sequencing is easy. We’ve had that tech since the 1940-50s. 

CR: True but I thought it took a lot longer. I had no idea.

Dr. H: Not really. Sequencing like this is simple. We had the genetics sequences within one week of identifying the virus as novel. 

CR: Wow

Dr. H: Selecting a target and comparing it to prior viruses took a bit longer. But not that much time.

You just had to know what you were looking for. At first, in China, they had no idea what the hell was causing the infection. Took longer to identify the virus itself than sequence it and computer model it’s proteins.

CR: With its similarity to SARS c. 2001, was this an offshoot of that particular strain?

Dr. H: Hard to say. It’s a coronavirus. There are thousands of them. Only a few impact humans.

CR: True. Did they develop a vaccine for SARS? I can’t remember. Seemed like it barely touched us, comparatively.

Dr. H: No. Tried and failed. But they only tried conventional methods. Which are harder. More guess work. The big issue was figuring out mRNA delivery and stabilization. But like I said, before (COVID-19), it wasn’t profitable to figure that part out. Vaccines are not money makers. You get one shot, and then you're done. Hypertension drugs (for example) you take everyday for the rest of your life

CR: Makes one wonder how many diseases we could vaccinate against, if money weren't the primary impetus.

Dr. H: I feel this will open many doors. I hope, at least. But again, they won’t bother if it won’t make them money...a sad reality.

These companies can not only say they are the ones who solved the problem, but a crazy amount of public and private money was given to them to solve it. (They) demonstrated that they could do something others couldn’t. 

(For more information on vaccine development, human immunological response, and other details involved with the research and development of new treatments, a good place to start is Merck Online, which covers a broad range of medical topics. It's long been a go-to for young doctors and medical students, and most definitely an old favorite of mine. 

(Also, fda.gov released a fact sheet regarding the COVID-19 vaccine, and what prospective recipients need to know before receiving it. ) 

Player Interview: Evan Gattis, C, Rome Braves (Class A, South Atlantic League)

FEB 23rd, 2012-As a follow-up to my previous article on Evan Gattis, I asked him for some personal insight into the long, arduous path he traveled from his time as a troubled teen to All-Star catcher in the pro ranks. He was kind enough to oblige.

When you left baseball initially, what would you say was the greatest reason?

I felt like there was something more important I had to "figure out".

Did you feel that baseball had, more or less, become your whole life, and that it had somehow made you forget who you were as a person, apart from the game? That you had to remember who you were, in a sense?

Not so much the baseball part of it. I felt like there was something missing no matter how good I was at ball.

But I like that you (mention) "remember", because when people feel like themselves, it's an overwhelmingly familiar sense.

That's a very good answer. When you first hit the road, did you have an idea as to what you wanted to accomplish, or was it just a matter of getting away from the world you knew and learning a bit about life in general?

Well, I finished a semester of junior college when I was enrolled at Seminole State College (Oklahoma) and I was actually giving up the "spiritual search" initially, but later on I wanted to surround myself with people of common interest.

So you were driven to learn about yourself, as well as what life was really about?

Yeah, whatever the motivation the story for everyone is the same; for me it was for relief of depression. Some people lose a child, some people do outrageously courageous things and they don't know how they did it, some people go their whole life with a sense of lack and they know their death is approaching. It happens differently for everyone but it's the same dynamic. It's a search, it wasn't like a hobby. I wanted help.

I can certainly relate to that. I understand the impact that depression can have on both the life of the person suffering and the friends and family who care for that person. I've seen it both as a health care provider and as someone who's suffered from it, personally.

Right, it's hard on everyone. And who wants to be around a depressed person? And who wants to be depressed?

It's hard for a lot of people to understand, so I think they shy away from the subject. At what point did you feel like you had reached an understanding about what you were going through? Was there a moment of epiphany for you?

Many, in fact. It seemed to be a process. The endgame was in Santa Cruz. I knew I had nothing to look for, and it's funny; when you don't look you find (it). Not that you find anything, just that you don't have to look, because the search is exhausting.

Would you say your experiences on the road strengthened your desire to play baseball, or perhaps allowed you to enjoy the game more?

I appreciate it more. I can enjoy it full on, without wondering if there is something more important to be doing.

So your time away from the game was sort of a liberating experience for you, in many ways?

Yes, that was the whole point: liberation!

Now I'd like to ask you about your experiences with rehab, if you're comfortable with talking about that.

Yeah. I was 17 and terrified of failing a drug test for pot, and I didn't want to be a "mess up".

So it was an easy decision for you?

It kind of happened fast and I was depressed. Seemed like a good decision.

Certainly seems like it worked out for you. Last question: was rehab particularly tough for you, or did you get through it without much much difficulty?

It wasn't tough and kind of refreshing. It wasn't the happiest of places, but it was good to talk to people.

All Roads Lead To Rome For Star Catcher...Eventually

"My whole worth as a person was as a baseball player. If I failed at that, where would I be?"

-Evan Gattis, on explaining the pressures which lead to his 4-year hiatus from baseball.

FEB 19^th, 2012-It goes without saying that most ball players, if given the option, would like to advance their careers as quickly as possible.

They don't plan to take their time, don't want to spend too long in the low minors, and they want to get at it as soon as possible. Most players, that is.

Sometimes, however, Life has other plans. Evan Gattis can tell you a thing or two about that.

First stop: Texas A&M, at which point our pal Life decided to deal Evan a heavy blow, one which would affect the next 4+ years of his life. In situations like this, I prefer to let the player himself explain things for himself. Suffice it to say that he slipped off the rails, if only temporarily. He was just a kid, and a kid with what must have seemed like the weight of the world on his shoulders. He did what he could to cope, as we all do. The Aggies were not in his future, as it turned out.

Next stop: Seminole State College in Oklahoma. There, he suffered a knee injury and hit the wall, turning his back on baseball. That was the end of the story, as far as the game is concerned. Evan had a much more important and far more serious game ahead of him. There were moments when his anger and frustration were too much to bear. No different than most any other young man, anywhere in the world. His real problem lay with how he coped with that anger. For a short time, he ran. 

After that, he was nearly everywhere but a ball field. Colorado, Wyoming, New Mexico, California, all the while searching for answers, searching for himself, finding little in the process.

By the time he made it to San Francisco, he was living (if you can call it that) in his truck. A truck with a broken starter. The story is that he was trailing an area spiritualist looking for (you guessed it) answers. And surprisingly, that's where he found them. Well, one anyway. The one that mattered the most, for him. 

The spiritualist offered this gem: Calm down. Relax. Chill.

And go figure, that was THE answer for Evan Gattis. Take it easy. For whatever reason, it worked.

By this time, he had been away from the game for 4 years. Four. A phone call to his stepbrother Drew Kendrick, at the time playing for UT-Permian Basin, fixed that little problem. Well, it gave him a push start towards fixing things. It helped that UT-PB's coach remembered him from his high school playing days.

Kendrick knew what they were getting. The balls he hit, they had that “sound”. You know it if you hear it; the acoustic difference between a .22 and a 12-gauge. Scouts will tell you that “the sound” gets their attention, every time.

It didn't take long before the Atlanta Braves heard the sound, as well, and drafted him in the 23^rd round of the 2010 Draft. By the looks of things, he might have been a real bargain. Especially when you consider the path he traveled in order to make it to Class A Rome; all the jobs, all the driving, all the searching, looking for Evan the man, running from Evan the ball player.

Turns out, he found him in California. A lot farther from home, but much closer to his heart than baseball in the Sally League turned out to be.

Which is as it should be. 

The Book On...Atlanta (NL) Pitchers, 2007

Scouting the Braves Pitchers

By

Clinton Riddle

Feb 28th, 2007-Once a paragon of pitching power, the Braves have as many questions as answers in 2007. Much will depend upon Mike Hampton's comeback from elbow surgery in 2005, as well as Tim Hudson's return to form and John Smoltz's comtinued excellence at age 39. Lefty Chuck James will need to build on last year's solid performance, and Tanyon Sturtze should be ready before May is out. If the rotation can fall together, and that is a rather big "if", then the Braves could be a force to reckon with.

Team ERA-4.71
K/BB Ratio-2.06/1
IP/Start-5.74
Opp. BA-.279

Starters
John Smoltz, RHP
Future HOF
2006: 16-9, 3.49, 232 IP, 211 SO, 55 BB, .251 BAA
Just keeps on going, with no real signs of slowing down...Has been able to become a dominant closer relatively late in his career, then switch back to the rotation and pick right up where he left off...How many can say that?...FB reaches the high-90's still, but works around 93-94, along with a cutter, hard slider and splitter...cutter has late action, looks a lot like his slider but runs instead of breaks...Throws a curve to LHH, works in and out with ease...Splitter is only used occasionally...Has stayed in great shape and seems to have an even better feel for his stuff now than in years previous.

2007 Projection: 17-6, 3.65, 210 IP, 180 K, 65 BB

Tim Hudson, RHP
2006: 13-12, 4.86, 218 1/3 IP, 141 SO, 79 BB, .273 BAA
Big surprise, and not in a good way...Finally seemed to show his mortality last year, as his control became an issue...Classic sinker/slider pitcher...Heavy sinker at 92-94, curve, slider, CU and splitter...Aggressive with the curve to lefties, sinker bores in on RHH, splitter drops like a rock...Got a little fine around the plate in '06, and while his BB total wasn't terrible he was wild in the zone and paid for it...Should rebound without question this year, though he may be streaky at times with location at first.

2007 Projection: 15-8, 3.60, 200 IP, 155 SO, 55 BB
Mike Hampton, LHP
Comeback?
2006: DNP
Last healthy in 2005, his return from elbow surgery is vital to Atlanta's resurgence...Has athleticism going for him, along with a strong track record...In 2005 had FB around 88-90, good curve and plus CU...FB has natural tailing action which he throws away from RHH...Mostly away with everything, will go inside to LHH with curve...Hard to say what he's going to do this year, but assuming he's able to stay healthy he should be a solid #3...At 34, he doesn't have a lot of time to work with.

2007 Projection: 13-8, 4.25, 140 IP, 85 SO, 55 BB

Chuck James, LHP
One to Watch
2006: 11-4, 3.78, 119 IP, 91 SO, 47 BB, .232 BAA
Young lefty with a good idea of what he's doing on the mound...Good mechanics and arm action...FB tops out at 90, slider and CU...Throws CU with same arm speed as FB, adding to deception...Slider has better lateral movement than downward break...Should be able to continue development regardless of league batters' adjustments.

2007 projection: 14-7, 3.68, 175 IP, 125 SO, 70 BB

Kyle Davies, RHP
One to Watch
2006: 3-7, 8.38, 63 1/3 IP, 51 SO, 33 BB, .332 BAA
Is much better than numbers would indicate, as is often the case with young pitchers...FB in low-90's, curve and CU...Plus FB but gets up with it and gets hit hard because of it...If he can keep the fastball down and be more aggressive, as well as maintaining his plus change, he should develop into a solid #3 or a very good #4...Also needs to work on mechanics.

2007 projection: 10-11, 4.45, 135 IP, 110 SO, 55 BB

Relievers
Tyler Yates, RHP
FB up to high-90's, tough to handle when he's on...(to be continued)

Rafael Soriano, RHP
2006: 1-2, 2.25, 53 G, 60 IP, 44 H, 65 SO, 21 BB, .204 BAA
Power pitcher, 3/4 arm slot...FB up to mid 90's with movement low in the zone, slurvy slider and CU with 2-seam action...Could stand to separate speeds a bit more...Hit in head with line drive last August, could affect his game.

2007 projection: 2.50, 60 G, 65 IP, 55 H, 62 SO, 30 BB, .233 BAA

Oscar Villarreal, RHP
2006: 9-1, 3.61, 58 G, 92 1/3 IP, 93 H, 55 SO, 27 BB, .261 BAA
2.63 ERA after the AS break...Can be short man or middle reliever...Mid-90's FB, splitter-like CU that is in early stages, heavy sink on FB, late slider...Changes arm slot as well to keep hitters on their toes...Has problems with maintaining velocity in consecutive appearances.

2007 projection: 3.35, 54 G, 74 IP, 65 H, 50 SO, 33 BB, .245 BAA

As before, will add on as I am able.