The Old Man and the See

Dick Sisler was an All-Star outfielder for the 1950 Philadelphia Phillies known as “The Whiz Kids”, propelling them into the World Series against the Yankees with a dramatic 10th inning home run against the Brooklyn Dodgers in Ebbets Field. He was personal friends with the author Ernest Hemingway, who immortalized him in The Old Man and the Sea: “In the other league, between Brooklyn and Philadelphia, I must take Brooklyn. But, then I think of Dick Sisler and those great drives in the old park.”

In the baseball world at large, however, Sisler’s calling card was that he was the eldest son of George Sisler. Gorgeous George, as he was known, was on track to be an even better ballplayer than Ty Cobb.

From Sisler’s SABR bio: “Sisler batted over .300 nine consecutive times, including two seasons in which he batted better than .400, making him one of only two players in American League history (the other was Ty Cobb) to post multiple .400 batting marks. Though Sisler’s greatest feats occurred in the years immediately following the end of the Deadball Era, by 1919 he had already established himself as one of the game’s top young stars, placing in the top three in batting average every year from 1917 to 1919, and leading the league with 45 stolen bases in 1918. That year one writer declared that Sisler possessed ‘dazzling ability of the Cobbesque type. He is just as fast, showy, and sensational, very nearly if not quite as good as a natural hitter, as fast in speed of foot, an even better fielder, and gifted with a versatility Cobb himself might envy.'”

But at the height of his career, tragedy struck. After his historic 1922 season during which he hit .420, Sisler missed the entire 1923 season with a severe sinus infection that apparently impaired his optic nerve, plaguing him with chronic headaches and double vision. Here’s a photo from an internet grab that illustrates something akin to what might have happened. It is a photograph of a patient showing isolated left abducens palsy (left upper panel), accompanied by a basal CT scan showing a left sphenoid sinusitis. Three weeks after the start of therapy, the abducens palsy resolved (left lower panel) and CT scan showed complete resolution of the sphenoid sinusitis (right lower panel). Unfortunately 100 years ago neither this imaging nor therapeutic pharmaceuticals or neuro-optometric rehabilitative therapy was available that would have hastened Sisler’s recovery.
Photograph of the patient showing isolated left abducens palsy (left upper panel). Basal CT showing left sphenoid sinusitis (right upper panel). Three weeks after the start of therapy, the abducens palsy resolved (left lower panel) and CT showed complete resolution of the sphenoid sinusitis (right lower panel).

Our colleague, Dr. David Goss from Indiana University School of Optometry and a SABR member since 1993, wrote a beautiful article delving into the nature of Sisler’s vision woes in more detail. It is titled George Sisler: A Close Look at Vision Problems that Derailed Him. Dr. Goss writes:

“In April 1923, Sisler was reported to have been hospitalized for surgery for an ‘inflamed ethmoid sinus.’ Exact details of the sinus surgery are lacking. Most likely, the procedure was designed to create an opening in the affected sinus to allow the contents of the sinus to drain. However, Sisler’s diplopia did not resolve until almost a year later, providing clues to what the cause of his diplopia might have been.

If the sinusitis and diplopia are in fact related (as physicians at the time assumed), two possible major mechanisms for Sisler’s diplopia come to the fore. Both are based on the assumption that the sinus infection spread beyond the confines of the infected sinus.

The first major possibility is that sinusitis produced an expansile infected mass within one of the sinuses adjacent to the orbit and that this mass either expanded the sinus or broke through the wall of the sinus to compress either a cranial nerve or an extraocular muscle. in Sisler’s case, the ethmoid sinus (located between the eyes) was reported to be infected, so that the mass would presumably have arisen within that particular sinus. Such a mass arising within the sinus can be uninfected (a mucocele) or infected (a mucopyocele). The report that the ethmoid sinus was infected suggests that it was a mucopyocele. However, successful decompression of such a mass should have produced improvement in Sisler’s diplopia within the course of a few days or weeks. To the contrary, the records indicate that Sisler’s diplopia was not resolved for almost a year, making it unlikely that the mass was a mucopyocele.

The second major possibility is that the infection could have spread from within the sinus into the adjacent orbit. Two possible mechanisms for such spread would be osteomyelitis (infection spreading to involve the bony wall of the orbit) or spread of infection through small openings in the wall without infection of the wall itself. Because the cranial nerves that control the extraocular muscles have a course that comes close to the walls of the ethmoid sinuses, infection extending beyond the orbital wall could produce inflammation of those nerves and impair their ability to control the extraocular muscles. Alternatively, osteomyelitis of the sinus wall may have directly caused inflammation of the extraocular muscles, which could become scarred as a result, their motion thereby becoming limited for a prolonged period. Again, the duration of Sisler’s diplopia is helpful in trying to deduce its cause. A yearlong delay in recovery from a cranial neuropathy (if the infection had been adequately treated by surgery) would be unusually long. Therefore, excluding other causes as unlikely, we arrive at the conclusion that the most likely cause of Sisler’s diplopia was not damage to one of the cranial nerves but rather prolonged inflammation of one of the extraocular muscles.”

This story comes to the fore now because of a marvelous new book about Jackie Robinson written by Kostya Kennedy.

True: The Four Seasons of Jackie Robinson ebook by Kostya Kennedy

Branch Rickey’s involvement in spearheading Robinson’s historic rise to the major leagues is legendary but long before that, he was George Sisler’s muse as his baseball coach at the University of Michigan. Wherever Rickey would go, Sisler would soon follow. On page 95, Kennedy makes note of Sisler’s vision problems that ultimately derailed his professional career. But Branch Rickey would come to rely on George Sisler as a scout, an evaluator, a learned eye, and a batting instructor. Of their time together in Vero Beach, during the spring training prior to Jackie Robinson’s major league debut, Kennedy writes: “He watched Jackie closely in batting practice, and they worked together, hitting off a tee. Sisler helped Robinson to keep square in his stance an instant longer, helped to eliminate Robinson’s tendency to lunge. Robinson became more patient on pitches off the plate, and more aggressive on pitches he could drive. Sisler would clap once sharply when he saw something he like: ‘Just like that, Jackie! Just like that!'”.

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