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Date: 2024-06-30
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# Neal ElAttrache, Doctor for Tom Brady and Leonardo DiCaprio
If you spend enough time in certain circles in Los Angeles, you might get the impression that the most popular person in town is Neal ElAttrache. Officially, ElAttrache is an orthopedic surgeon at the Cedars-Sinai Kerlan-Jobe Institute for sports medicine. Unofficially, there are people who regard him as a village miracle man. One of his patients, for instance, is Vasiliy Lomachenko, one of the best boxers in the world. After his wins, he likes to credit God. In a bout in 2018, he threw a combination of punches that yanked his right shoulder out of its socket. It hurt so badly that he bit through his mouth guard. “For a long time, I wondered if I could box again at the same level,” Lomachenko told me. He went to ElAttrache. The doctor operated on the shoulder, then undertook the more delicate work of helping Lomachenko rebuild trust in his arm. ElAttrache would take him out for lunch and counsel him on what punches to throw and when. Lomachenko won his second match back by knockout, a right hook to the skull. Afterward, he didnt thank God. He thanked ElAttrache.
ElAttrache sees patients in a multi-story office building near LAX. After business hours, by phone, a stream of athletes and the otherwise famous or wealthy seek ElAttraches advice for free. He treats shoulders, elbows, knees, Achilles tendons, and the big muscles. Most surgeons are known for one specialty operation; ElAttraches fellow-surgeons consider him among the best in the world at many. “Theres very few of the upper-level-athlete injuries that were not going to be somehow involved in,” ElAttrache told me. “Over time, its gotten to be, just, a lot.” One week this spring, his off-the-books consultations included an N.B.A. star in the playoffs, a future W.N.B.A. Hall of Famer, an ace pitcher and an All-Star infielder, a star quarterback and a receiver, a Grand Slam-winning tennis player, a World Cup-winning womens-soccer player, a prominent actor, at least one billionaire, several fringe-level athletes, and a high-ranking member of a Middle Eastern royal family. This was a fairly slow week. The Jets quarterback Aaron Rodgers, a close friend, was texting ElAttrache videos of exercises that he was doing for his left Achilles, which ElAttrache had repaired in September. Rodgers had just had dinner at ElAttraches house with Sean McVay, the coach of the Rams, who considers ElAttrache a father figure. ElAttrache is the team physician for the Rams and the Dodgers, but one of his nurses said, “Lately, weve been joking that hes the team doctor for all the teams.” (Only patients who consented to the presence of a reporter have been named.)
Athletes seeing ElAttrache often find themselves, quite suddenly, at a low point in their careers, maybe their lives. Many have described their bond with ElAttrache as a singular relationship. “It was the first time I ever felt, in the football business, someone being completely honest with me,” the receiver Odell Beckham, Jr., told me. ElAttrache often becomes a fixture in his patients lives. He did [Tom Bradys](https://www.newyorker.com/tag/tom-brady) knee surgery in 2008, then regularly flew to Boston during the rehab. Brady now considers him a best friend. ElAttrache was one of [Kobe Bryants](https://www.newyorker.com/tag/kobe-bryant) few confidants. Rob Pelinka, Bryants longtime agent, told me, “When those types of individuals meet one another, they just know. That was his guy.” Surgery is perhaps the only time a superstar must relinquish control completely to someone else. Bryant once spent the night before a shoulder surgery shooting around at the private basketball court of [Patrick Soon-Shiong](https://www.newyorker.com/magazine/2021/11/01/how-patrick-soon-shiong-made-his-fortune-before-buying-the-la-times), the owner of the Los Angeles *Times*. “My wife was screaming at him, saying, Kobe, what are you doing?’ ” Soon-Shiong once recalled. “He says, Its broken. Neals going to fix it tomorrow anyway.’ ”
ElAttrache likes to host patients and friends at his house near Benedict Canyon, above Beverly Hills, for Cuban cigars and Pappy Van Winkle bourbon. “My practice, its almost like a continuum,” he told me. “Theres no beginning to the day, theres no end of the day. I guess its very personal.” Sensitive conversations happen within the confines of doctor-patient confidentiality. A friend who spends time with ElAttrache, Brady, and [Stephen Curry](https://www.newyorker.com/tag/stephen-curry) said, “They share, you might even say, their soul with him.” Walker Buehler, a pitcher for the Dodgers who often dines at ElAttraches house, sometimes with other eminences, told me, “The funny part about that whole thing is, everyone whos there wants to talk to Dr. ElAttrache more than anything.”
In ElAttraches office, his staff keeps a whiteboard listing patients and examination rooms. Sometimes a person will point to it and say something like “This is Ryan Seacrests friend.” Scores of framed autographed photos and notes from patients line the walls: Alex Morgan (“Thinking back to the World Cup, I was only able to get through it playing every game because of you”), Leonardo DiCaprio (“Cant thank you enough for my new knee”). Charlize Theron told me, “I run into people all the time on my movie sets: Oh, Neal did this for me!’ ”
In his younger years, ElAttrache could have passed for a star on “General Hospital.” He has intense green eyes, a prominent chin, and an imposing chest. As a freshman at Notre Dame, he won the schools light-heavyweight boxing championship. Now sixty-four, he effuses a certain Dos Equis-man masculinity. Ringo Starr told me that he consulted ElAttrache in 2002. “He was there with the intake form, doing it himself,” Starr said. “Name? Age? I just burst out laughing, because it looked like Elvis was doing the name check.” Starrs shoulders were in bad shape. “I was going to some homeopathic people in England,” he said. “One guy even injected O3 into me. *Woo-ooh*. Anyway, none of it worked.” A family member suggested ElAttrache, who found bone spurs that no one else had seen, and operated successfully. Starr had been distressed that he couldnt lift his arms to flash peace signs onstage. “And now!” he said, demonstrating for me triumphantly. After the surgery, ElAttrache stayed with Starr and his wife, Barbara, at their house in Surrey. Starr and ElAttrache have attended each others birthday parties. Last year, Barbara got hurt in a riding accident, and ElAttrache treated her as well. “Shes doing good!” Starr said.
One day recently, the whiteboard said “Patiño, Room 11.” This was Luis Patiño, a friendly twenty-four-year-old Colombian pitcher for the San Diego Padres, whod complained of arm pain. “I felt a tingly feeling in my elbow every time I threw,” he told me. Patiño wore ripped jeans and shiny Jordans. He sat on an examination bench, eyes wide, swinging his legs off the edge.
ElAttrache walked in wearing a white coat over a blue blazer. He has a regal nose, which can make him appear imperious when he looks down, though he rarely does. “If Im delivering bad news, Im at their level or lower,” he told me of his patients. He sat next to Patiño on the bench and patted his knee. (“It immediately makes someone feel like theyre being protected.”) He pulled up MRI scans on a computer and talked Patiño through the images. ElAttrache saw damage at the top of the ulnar collateral ligament, or U.C.L., a two-inch band that holds the upper and lower arm together. ElAttrache prefers to avoid surgery. They discussed Patiños pitching repertoire. Then Patiño removed his shirt so that ElAttrache could test his range of motion. Below his right shoulder, Patiño had a tattoo that said “*TRUST NO ONE*.” ElAttrache later told me, “His tattoo may say that, but I promise you, by the time I operate on him, I could tell him Im going to do whatever crazy thing Id want to do and hell let me do it.”
Thirty minutes had gone by. A team trainer, who occasionally helped translate, said, “Hes asking if hes gonna get surgery.”
ElAttrache was facing Patiño from a stool, which hed positioned down low. “I think he needs it,” he said. “Do you think you need it?”
Patiño laughed. “If you have a knife now, Im ready,” he said.
Very few things exist that havent, at some point, injured a baseball player. Players have got hurt putting on shirts, putting on pants, taking off shirts, taking off pants, washing dishes, and eating a doughnut. At least nine players since 1985 have missed games after a painful sneeze. For decades, sports medicine was little help. Not that long ago, pitchers had teeth pulled to treat their arms. Players played until their bodies broke. Years of pitching mangled Sandy Koufaxs arm so severely that his tailor had to shorten his left sleeve. He retired at thirty. Mickey Mantle, as a parlor trick, would twist his bum kneecap around, “as if opening a pickle jar,” his [biographer](https://www.amazon.com/Last-Boy-Mickey-Americas-Childhood/dp/0060883537) Jane Leavy wrote. The strongest and fastest athletes tended to destroy their own bodies; the survivors remained small and slow. There was a time when many N.F.L. linemen were, on average, built like Jimmy Kimmel.
In 1974, Tommy John, of the Dodgers, threw a pitch and, as he has recounted, “felt as if I had left my arm someplace else.” Hed shredded his U.C.L. Frank Jobe, the Dodgers team physician, performed an experimental operation. He drilled holes in two bones at the elbow and transplanted a tendon from Johns wrist, looping it in a figure eight through the eyelets as if hitching a boat to a mooring—a MacGyvered ligament. An earlier generation of doctors, operating on knees, had achieved moderate results, but Jobes procedure was a breakthrough. John, whose career had seemed over, returned better than before. The operation, now common, is known as Tommy John surgery.
About a decade later, ElAttrache entered medical residency at the University of Pittsburgh. Many of the big-shot surgeons were in the cardiothoracic department. ElAttrache was talented and ambitious, and was drawn to the department. He assisted on one of the first pediatric heart-and-lung transplants. There was a monthlong span when he slept at home just once. An older surgeon pulled him aside, hoping to give him some perspective. “We went through the I.C.U. that night,” ElAttrache said. “His message to me was You know, six or seven of these kids are not getting out of here. Starting tomorrow, youre going to come with me and talk to the families.’ ” ElAttrache went on, “My ego was so strong on one hand but fragile on the other. All I could see was fucking misery. And then I see that my orthopedic surgical colleagues are dealing with people that break, and you fix them, and they get back to being healthy and happy.”
[](https://www.newyorker.com/cartoon/a24739)
“Once upon a midnight dreary, while I waited weak and weary, Over many a package of goods galore—While I nodded nearly napping, suddenly there came a tapping, As if Amazon gently rapping, rapping at my chamber door—But its a stupid bird and nothing more.”
Cartoon by Brooke Bourgeois
ElAttrache took a fellowship with Jobe and his clinic partner, Robert Kerlan, in Los Angeles. Jobe was a surgical artist. “It was a waltz, everything moved in a certain way,” James Bradley, the Steelers team physician, who worked with ElAttrache at Pittsburgh and at Kerlan-Jobe, told me. “Neal had that early on.” Kerlan, meanwhile, suffered from a debilitating form of arthritis, which eventually prevented him from performing surgery, but patients trusted nobody more. He was a creature of Los Angeles. He liked to bet the horses at Hollywood Park with his friends Fred Astaire and Burt Bacharach. “I remember one day Kerlan called up to the fellows room yelling and screaming,” ElAttrache said. “And so, of course, I come running down to his office. And Clint Eastwood and Bob Newhart are there, and Kerlan said, I told you he was fast!’ ”
As sports doctors were becoming more effective, athletes were becoming more dependent. There were few high-level players in the nineties and two-thousands who didnt visit James Andrews, an orthopedist then based in Birmingham, Alabama, who was one of ElAttraches mentors. Andrews treated Michael Jordan, Albert Pujols, Jack Nicklaus, and most of the Yankees cornerstones: Roger Clemens, Andy Pettitte, Bernie Williams, Jorge Posada, Mariano Rivera. Andrews flew in a Falcon 10 jet and had a yacht that competed for a spot in the Americas Cup. He told me that he would perform about a thousand surgeries per year.
No players have come to rely on surgery as much as pitchers. In the past twenty years, the average major-league fastball has become five miles an hour faster. For the U.C.L., speed destroys. ElAttrache has operated on elbows whose tissue resembled spaghetti. Today, more than a third of pitchers on major-league rosters have undergone Tommy John surgery. At the beginning of this season, more star pitchers were on the injured list than not. “Heres the problem,” Andrews told me. “Weve made it too good an operation. Theyre not scared about blowing their ligament out, because they think its easily fixed.”
Each year, more and more athletes show up in ElAttraches office, a parade of cartoonishly strapping young men and women. When I visited, Id sit next to them at the clinic, feeling like a Schwinn in an F1 lineup. The delts. The quads. Its typical now for the football patients to arrive with knees looking like explosion sites, with multiple structures blown out. The limbs owners tended to understand what it meant—a hundred million dollars at stake in a couple of inches of stretchy tissue. As Andrew Friedman, who runs the Dodgers baseball operations, put it, “Theyre fearing their mortality.” He meant the end of their careers, not their lives. But an injury could also prompt wonder at the miracle and the precarity of sinew and bone.
The most connected players and agents are in touch with ElAttrache regularly. “In a way, he helps them map out their career,” one person who knows him said. Four of the last five major-league-baseball M.V.P.s are ElAttrache patients. Brady won more Super Bowls after his knee surgery than before it. “If it didnt go well, I mean, its pretty self-explanatory,” Brady told me. (Several Patriots fans called ElAttraches office and threatened revenge if the surgery went poorly.)
Last September, ElAttrache performed a second elbow surgery on [Shohei Ohtani](https://www.newyorker.com/news/letter-from-los-angeles/its-shohei-ohtani-season-in-la), the Japanese superstar. (After his first surgery, his fastball got faster; he threw one pitch 103.5 miles an hour.) Until recently, surgical “revisions” meant the end of a pitchers career. A few months after Ohtanis second surgery, the Dodgers signed him for seven hundred million dollars. Later, they signed another Japanese pitcher, Yoshinobu Yamamoto, to a contract worth more than three hundred million. ElAttrache reviewed both mens physicals. Sam Reeves, a friend of his, told me, “The Dodgers are betting a billion dollars that hes right.”
For some in Hollywood, having an in with ElAttrache is a status symbol akin to a membership at Riviera country club (where ElAttrache himself is a member, with a ten handicap). ElAttraches earliest patients included more actors than athletes. In the nineties, he treated Helen Hunt and Paul Reiser while they were starring in “Mad About You.” He was invited to sit at their table at the Golden Globes. A few years ago, Reiser pulled his biceps while moving a couch and saw ElAttrache again. Afterward, he wrote a standup bit about a friend referring him to an orthopedist: “He said, I got you my guy. My guy is the best, dont even look around, I got the guy.’ ” He continues, “That cant be! They cant all be the best.” When I asked Reiser about this recently, he said, of ElAttrache, “The thing is, he *is* the best!”
ElAttraches office has a separate entrance for celebrities that bypasses the waiting room. They wait, instead, in his personal office. “He does not rush,” Teri Gonzalez, his executive assistant of thirty-one years, told me. “Patients are waiting and theyre upset. We offer them coffee, water, snacks. But once he walks into that room and starts talking, everybody calms down.”
ElAttrache has been known to answer patient calls at all hours of the night. He did Kobe Bryants Achilles surgery early on a Saturday morning, with a few hours notice. (Directly beforehand, he had inserted a metal plate to fix the broken collarbone of the Dodgers pitcher Zack Greinke.) The baseball agent Scott Boras keeps tabs on ElAttraches vacation plans. Lon Rosen, an executive for the Dodgers, told me that a few years ago his wife, Laurie, got hurt playing pickleball on Memorial Day weekend: “I call Neal. Hes in the South of France. He goes, Ill get her an MRI. So on Memorial Day Saturday she gets an MRI. Ten minutes later, my phone rings. Its Neal. Shes got a torn Achilles tendon. I go, Neal, youre in the South of France. Laurie is still in the tube! And then he got back and did the surgery.”
A few years ago, ElAttrache stopped accepting workers-compensation claims, and began charging higher rates; he has a contract with teams outlining his unique prices. (He said that workers compensation was not meant for professional athletes, whose cases are time-intensive, and that the new model allows him to be more involved.) “We thought maybe it would cut his schedule, but nope, no, it did not,” Gonzalez said. Professional and college athletes make up roughly three-quarters of his practice, but he also sees high schoolers and non-V.I.P. non-athletes. Players, agents, and the well connected can get an appointment by texting his staffer Sidney Jones or ElAttrache directly. (He used a BlackBerry until a few years ago, when it stopped working, and was forced to switch to an iPhone.) Others have to try their luck calling cold, or be willing to wait for months.
For decades, [Pat Kingsley](https://www.newyorker.com/magazine/1994/03/21/kingsleys-ransom) was the most powerful publicist in Hollywood. Friends referred her to ElAttrache after an injury twenty years ago. “I had hurt my knee in Taipei when I was with Richard Gere, because some thugs from the mainland were trying to get after him, and I fell on some stairs,” she told me. (“Hes banned in China, because of Tibet,” she said of Gere.) Several directors and producers called ElAttrache on her behalf. “Finally, they gave up and they gave me an appointment,” she said. “God, was he good-looking. He had these great green eyes.”
Friends call ElAttrache “Doc Hollywood.” “He has a reputation as a bit of a self-promoter,” one told me. “But hes also, like, an artist.” Some of his famous patients were inherited from Kerlan and Jobe. Rodney Dangerfield was one. “Id visit him in Centinela Hospital,” ElAttrache said. “He never went a day in his adult life without smoking dope. Hed take wet towels and put them under the door.” Others—Keanu Reeves, Travis Scott, Finneas—came later. In his office is a statue of a Black fist. “Thats the Black Excellence Award,” he told me. “Sean Combs gave it to me.” ElAttrache once flew to Spain, where “Moulin Rouge!” was being filmed, to treat Nicole Kidmans knee. “He milks it,” Kingsley, who represented Kidman, said.
Of course, other doctors are capable of treating sprained ankles and balky shoulders. “I dont know that I *need* the best,” Reiser told me. “I was never looking to be Tom Brady good. My standard was if I could eat soup without spilling.” ElAttrache said, “If youre taking care of somebody that can go anywhere and they go to you, its some sort of weird affirmation.” He hastened to add that what he finds most rewarding is successfully treating an athlete on the fringe of viability. “If his life takes one of two very, very different trajectories and its because of something I did, its fucking unbelievable,” he said. “Its almost so good its selfish.”
One day, when I was at the clinic, the whiteboard read “Apatow, Room 11” (Judd, shoulder), “Beckham, Room 7” (Odell, knee checkup), and “Ruscha, Room 5.” ElAttrache treats the artist Ed Ruschas entire family. In between examinations, he told me that he has purchased some Ruscha works. “One of them is hanging in *LACMA* right now,” he said.
[Ruscha](https://www.newyorker.com/magazine/2013/07/01/ed-ruschas-l-a) told me, “I was on a yacht in Sardinia and I was windsurfing, and I slipped off the board into water about ten inches deep, and I heard this crunch.” Another friend who was on the yacht, which was owned by the billionaire real-estate developer Donald Bren, sent him to ElAttrache. He diagnosed a torn A.C.L., and performed the surgery. Years later, he did both rotator cuffs so that Ruscha could keep painting. “Hes just been a real friend ever since,” Ruscha said. Ruscha has brought him to his studio. ElAttrache has acquired two of the artists pieces, titled “Muscles in Motion” and “Bones in Motion.”
Patiño, the Padres pitcher, arrived at ElAttraches office for surgery, followed by his girlfriend and his mini goldendoodle, Rayo. ElAttrache greeted him in blue scrubs, with bootees and a hair cap. An anesthesiologist put Patiño under. ElAttrache sits in a swivel chair while he operates. Above him is a canopy of bright lights. Everyone else stands around him. There are usually five other people in the room: an anesthesiologist, an assistant surgeon, a nurse, and two scrub techs. ElAttrache likes to play music; he lets the patients choose. He conducts the room: he opens a hand, a technician places an instrument. The space is called the operating theatre, but it can also be thought of as a stadium. The pressure, the ego, the man calling out instructions as his colleagues scurry about him—I am not the first to be reminded of a quarterback.
ElAttrache made an incision in Patiños elbow. He removed a calcified piece of bone that had embedded in the ligament. The tissue wasnt shredded beyond salvaging—a beleaguered rigatoni, maybe, but not spaghetti. ElAttrache repaired the ligament by crisscrossing sutures into the tear, as if lacing a shoe. Then he did his typical Tommy John procedure—the snipping of the wrist tendon, the weaving through the elbow. He laid the new graft into the shoelaces, and then tied it all tight. Patiños new ligament was now double reinforced—“belt and suspenders,” as ElAttrache put it. A hand surgeon, Steven Shin, did the delicate work of relocating the ulnar nerve, the cause of Patiños tingling, by tucking it into a fatty pouch. ElAttrache sewed the elbow shut. The whole thing took about ninety minutes.
Patiño woke up in a recovery room, groggy and babbling about his favorite Colombian soccer team. ElAttrache debriefed Patiños agency representatives and a Padres trainer. He sat in a chair, with an arm slung over the back. He appeared deeply relaxed, almost blissful. It would not have looked off if he had been smoking a cigarette. “Ive been playing around with a couple different ways that I like to do it, and this turned out the best of all,” ElAttrache said. “He had a beautiful tendon on his wrist and forearm. Very satisfying.”
The success of the surgery depends on the shoelace suture. It has to be tight enough to hold but flexible enough to give the pitcher his accustomed range of motion. Improvisation is sometimes required. Lon Rosen, the Dodgers executive, once needed elbow surgery and insisted on staying awake, against ElAttraches advice. “All of a sudden, he goes, Get another pillow,’ ” Rosen recalled. “I said, That doesnt sound like a surgery thing. He says, Thats why I wanted to put you to sleep.’ ” ElAttrache practices on cadavers to refine his touch with suturing. “Its very unforgiving,” he said. “Its a fine-tuning of millimetres.”
As surgeons have scrambled to keep up with increasingly catastrophic injuries, ElAttrache has invented many of their tools himself. In 1999, he devised a socket-and-screw system that could fasten a tendon or a ligament to bone. He took his idea to Reinhold Schmieding, who owns the medical-device company Arthrex. “He nicknamed that first patent orthopedic duct tape,’ ” ElAttrache said. Its used in feet, ankles, knees, elbows, thumbs, shoulders, and spines. Arthrex pays him about seven million dollars a year to license his creations.
Last year, Aaron Rodgers [tore his Achilles](https://www.newyorker.com/sports/sporting-scene/no-not-aaron-rodgers) on his third play of the season. Rodgers remembered going into an emotional spiral. “The tailspin is: Im thirty-nine years old, my career is over,” he said. Half of all quarterbacks with the injury are forced to retire. He was carted off to the locker room. As he lay on the trainers table, he took out his phone. “I typed in Kobe Bryant Achilles,’ ” he said. “I had forgotten that Neal did his surgery. I literally got off of Google and texted Neal.” A couple of years earlier, ElAttrache, building on the work of a Scottish surgeon named Gordon Mackay, came up with a new remedy for a torn Achilles, by stringing a cable of sutures down through the tendon, affixed to Arthrex anchors below, like a suspension bridge. It allowed the native tendon to heal naturally while bearing enough weight for rehab to begin almost immediately.
The first player to have the procedure was Cam Akers, a running back for the Rams, who got hurt in July, 2021. The injury usually required at least nine months of recovery time. “I thought he was for sure out for the year,” McVay, the Rams coach, told me. ElAttrache had him ready within four months. They waited another month just to be safe. Akers returned for the Rams Super Bowl run and was the teams primary rusher.
Rodgers wondered if an even faster recovery was possible. “I basically said, Neal, Whats the craziest timeline that you could come up with?’ ” he told me. They decided to find out. Rodgers read up on anatomy. ElAttrache monitored his rehab daily. By mid-December, the Jets were playing Miami, trying to keep their playoff hopes alive. Rodgers was hoping to return the following week. It wouldve been three months since he underwent surgery. “I had cleared him to play,” ElAttrache said.
Last month, ElAttrache had a spot at a table for “The Roast of Tom Brady,” the live comedy show on Netflix, but he preferred to watch from home. He lives in a big Spanish-style house in the hills, at the end of a long gated drive, that he bought in 2017, for more than fifteen million dollars. Justin Bieber and Dwayne Johnson have houses nearby. ElAttraches brother-in-law Sylvester Stallone used to live in the area, too, but he recently moved to Florida. (The Stallones sold the house to Adele, for fifty-eight million dollars.) The ElAttraches daughters—they have three—and two of the Stallones had just returned from the Stagecoach music festival, where theyd stayed in Tom Bradys house in the desert. ElAttrache smoked a cigar and watched the show in front of the biggest home television I have ever seen. He winced at the first of many divorce jokes. “Some of this stuff was supposed to be off limits, because of the kids,” he said.
He propped open a door to a balcony. A pleasant breeze blew in, and light glinted off the hills. Personal chefs downstairs were making tacos. ElAttrache had his feet up. Bradys giant face, on the giant TV, seemed to be devoid of any fat. His skin looked almost like a teen-agers. One of his roasters was Drew Bledsoe, the quarterback whom Brady replaced after a brutal hit put him in the hospital.
ElAttrache moved to the kitchen for dinner with his wife, Tricia, a former O.R. nurse. The two met on ElAttraches first day at Kerlan-Jobe; both were engaged to other people. Four years later, they married. ElAttraches practice is a kind of family business. Charlize Theron told me, “My mom broke a bone in her foot playing tennis. It happened at five, I called him at seven or eight, and he just said, Come by the house. Trish and the girls were there, and I was, like, Sorry! He was looking at her foot in the living room. I think they were about to go to dinner.”
[](https://www.newyorker.com/cartoon/a28224)
“The city never fails to excite after two hours of traffic.”
Cartoon by Amy Hwang
He sometimes puts up patients at his house after surgery—the Dodgers pitcher Clayton Kershaw, the Rams receiver Cooper Kupp, the Cowboys defensive lineman Mazi Smith. “I dont like somebody to come in and just go to a hotel,” ElAttrache told me. “Im not going to stick them in an Uber and wait for the concierge at a hotel to tuck them in.”
Tricia usually looks after the guests. “Laura Ingraham from Fox stayed over,” she said as we ate. (While I was at the clinic, ElAttrache brought in the book “Government Gangsters: The Deep State, the Truth, and the Battle for Our Democracy,” by the former Donald Trump adviser Kash Patel, as a gag gift for a liberal-leaning staffer.) Ingraham blew out her knee last year while skiing in Aspen. Shed met ElAttrache through a mutual friend; in June of 2020, he hosted a dinner for her birthday, and invited a group of friends who included Mel Gibson. “Recovery was actually fun, if thats possible,” Ingraham said. “I did my podcast from there with ice bags around my legs.”
Andrews, ElAttraches early mentor, told me, “A lot of professors would tell you that you shouldnt become friends with your patients, because it may make you make the wrong decision. Personally, I think thats wrong.” ElAttrache mused to me, “Where does the familiarity with a patient begin and end? I dont know anymore. It seems it goes to the depth it needs to go to.”
The intimacy is useful during rehab, which can have as much to do with psychology as with physiology. “It has to be complete trust,” ElAttrache said. He likes his patients to recuperate locally. Recently, I visited his preferred physical therapist, Heather Milligan, who has an office outside Santa Monica. Roughly half the space is used by professional athletes and V.I.P.s, who run on antigravity treadmills and do weight training on blood-flow-restriction machines, and the other half is for the rest of the population, whod lately been showing up with a lot of Achilles injuries. “Pickleball,” Milligan said. ElAttrache visits the rehab clinic on Fridays and Saturdays, and likes to be heavily involved. “He is at your house checking in, he is at your first physical-therapy appointments,” Arnold Schwarzenegger, who had his shoulder done by ElAttrache, told me. [Schwarzenegger](https://www.newyorker.com/tag/arnold-schwarzenegger) chose ElAttrache on the recommendation of Stallone, who happened to have a shoulder surgery of his own scheduled the same day; they were both preparing to film the action movie “Escape Plan.” “They wanted to hang out together in the recovery room,” ElAttrache said. “Literally, one gurney ran into the other.” At the first rehab appointment, ElAttrache introduced Schwarzenegger to Milligan. “He told me he wouldnt hand me over to just any physical therapist,” Schwarzenegger said. He and Milligan started dating shortly after his therapy ended.
In 2021, ElAttrache worked intensively with the golfer Brooks Koepka, who had shattered his knee so badly that it hung sideways. ElAttrache did a procedure similar to the one hed later do for Rodgers. At that point, he hadnt tried it on a knee. The closest he had come was a surgery he did for the rapper Travis Scott, whod injured himself during a concert. Koepka had one request: he wanted to play at the Masters, less than four weeks later. Rehab began immediately. Milligan took Koepka to the driving range at Riviera, nearby, so she and ElAttrache could make sure that his knee was sound, and that he trusted it. He made it back for Augusta.
Almost all of ElAttraches friends believe that his philosophy on the doctor-patient dynamic comes from his family. ElAttrache grew up in Mount Pleasant, Pennsylvania, a small town outside Pittsburgh nicknamed Helltown, in part because of the glow from its coke furnaces. ElAttraches mother, Vera, was a nurse. “She looked just like Grace Kelly,” Bradley, the Steelers doctor, told me. ElAttraches father, Selim, was born in Syria. The extent of ElAttraches knowledge of the al-Atrash clan, as they were known, is that they were a prominent Druze family. In fact, one patriarch, Sultan, led the Great Syrian Revolt against the French, in the nineteen-twenties. Sultan was striking, with penetrating eyes. As a Druze, he considered hospitality sacrosanct. Hostilities with the French began in earnest when a man en route to Sultans villa was arrested as a suspected insurrectionist. Sultan considered the man his guest and begged for his release. Rebuffed, Sultan ambushed a French convoy. He eventually routed an entire French column so decisively that the commander of the colonial forces killed himself on the spot.
Selim was sent to study at a Jesuit boarding school outside Beirut. (ElAttrache was raised Lutheran.) Years later, he began an orthopedic practice in Mount Pleasant. He was known for drawing strikingly detailed skeletal diagrams on his patients casts. He harbored hopes that ElAttrache, his eldest child, would one day practice with him. When Kerlan was recruiting ElAttrache to Los Angeles, he visited Selim to ask for his blessing, “like he was asking to marry him,” Tricia said. Selim and Vera also put up patients at their home. Many were members of the United Mine Workers. Some couldnt afford to pay. Selim worked on the barter system. One family owned a hardware-and-clothing store and paid in boots. Others gave food. After ElAttrache got married, one patient paid Selim with a llama that hed named Tricia. ElAttrache told me, “Youd watch how my dad and my mother were involved with people that were peripheral acquaintances, but the depth of intimacy that they instantly had—it struck me that theres no profession where you had the privilege of having that kind of experience with another human being.”
Walker Buehler and his wife, McKenzie, are over at ElAttraches house enough that Buehlers friends joke that he is part of the doctors family. “Everyone at the field calls him my uncle Neal,” Buehler told me. He was twenty-one when ElAttrache performed Tommy John surgery on him, in 2015. He recovered and became one of the best pitchers in the league, but over time the repeated trauma of pitching had partially calcified the flexor tendon and the U.C.L. at the elbow. Two years ago, he felt some strange sensations in his arm. “I made three throws,” Buehler said. “I felt a popping, I felt like something went into my ligament, and I felt like something was cutting my ligament.” (ElAttrache explained that the sensations were the result of a tear widening.) He needed Tommy John surgery again.
ElAttrache opened his clinic on a Saturday to examine him. “Me, my wife, and him were sitting in his office,” Buehler said. “No one else was there.” He went on, “Getting an answer quickly is really the only thing that can keep you from spiralling mentally—the panic of it.” Buehler will be a free agent after this year. His health could mean a difference of a hundred million dollars or so. “Youre thinking of the worst case over and over and over,” he continued. “If Im hurt, maybe Im not the same again.”
Two years later, in May, Buehler was scheduled to make his return to the major leagues. ElAttrache went to Dodger Stadium to see it. Beforehand, at his office, he passed by an autographed photo on the wall, from Buehler after his first surgery: “Thank you for wrapping this elbow really tight.” ElAttrache considered it. “Maybe not tight enough!”
A patients return to the field is like a graduation day. ElAttrache recalled José Fernández, a dazzling young pitcher from Cuba, who played for the Miami Marlins before he [died](https://www.newyorker.com/sports/sporting-scene/mourning-jose-fernandez) in a boating accident, in 2016. “Oh, I loved him,” ElAttrache said. He had come to ElAttrache for Tommy John surgery. Before the procedure, the ballplayers mother, with whom hed made a near-fatal [escape](https://grantland.com/features/marlins-rookie-pitcher-jose-fernandez-journey-cuban-defector-mlb-all-star/) from Cuba, had accompanied him to the clinic for an appointment. “She had these big green eyes, looking at me,” ElAttrache said. “She said something in Spanish: Take care of my love, my *ojitos*—her eyes, her most loved thing.” When Fernández returned to playing, ElAttrache got a text in the middle of a game. “He said, Boss, we did it,’ ” ElAttrache recalled. “I didnt know what he was talking about.” Then Fernández sent him a screenshot, showing a pitch and a radar reading. “It was the first time hed hit one hundred after Tommy John.”
At the stadium, ElAttrache went to his seats behind home plate and greeted some friends. Buehler had said that he didnt want to see him in the clubhouse before the game. As Buehler took the field, ElAttrache peered out at the mound. “I have chills,” he said. He zipped up to a private suite, where McKenzie was hosting a watch party.
A slightly nervous celebration was under way. Tricia was already there, as was a large contingent of Buehlers family and friends from Kentucky, his home state, including the horse trainer Bob Baffert. McKenzie was holding their three-month-old daughter. “Thanks for being here,” she told ElAttrache. In a more private moment, she turned to him and asked, “Hes still a big deal, right?”
“Hes still a big deal,” ElAttrache said.
The umpire called “Play ball,” and everyone in the suite got quiet. ElAttrache looked out at the field, with his hand covering his mouth. Buehler took a deep breath, reared back, and threw. ♦
 
 
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