ANAHEIM, Calif._For weeks, the question bounced around in Shohei Ohtani's head.
The Angels' two-way star had known since Sept. 5 that the damage to the ulnar collateral ligament in his right elbow was too severe to be healed by stem cell injections or plasma treatment.
His shredded elbow needed to be mended by a surgeon.
If he took the recommendation of the team's medical staff, Ohtani would have to give up pitching for the entirety of his second major league season. He'd be limited only to hitting in 2019.
The situation was not ideal for a 24-year-old who had committed years ago to take a path few had traveled at baseball's highest level.
It took some time, but Ohtani eventually acquiesced.
Twenty days after first learning his fate, and just hours before they beat the Rangers 4-1 for their second win in a row to start a season-ending homestand, the Angels on Tuesday announced Ohtani will undergo UCL reconstruction surgery, or Tommy John surgery, in Los Angeles next week.
Renowned orthopedist Dr. Neal ElAttrache will perform the procedure.
"I think we knew he was leaning towards it but as far as exactly when, it was just really in the last couple days when he made the decision to go to Dr. ElAttrache and set a date for it," manager Mike Scioscia said.
"We never discussed it. We let the medical staff discuss that and I knew Shohei was leaning towards that."
Ohtani already had spent time on the disabled list in June nursing a sprained UCL.
He had been the Angels' most effective starter to that point in the season. He'd held batters to a paltry .202 average, striking out 30.5 percent of them.
In a world where pitcher wins barely matter, Ohtani had emerged victorious in four of nine starts. The Angels were 7-2 when he took the mound, which allowed them to remain within six games of the Houston Astros, the American League West leaders, through the first week of June.
Then the list of Angels pitchers sidelined for various ailments continued to grow. The Angels' efforts to keep pace in the divisional race were thwarted by the upstart Seattle Mariners and Oakland Athletics and their own inability to stay healthy.
Ohtani's misfortune came at an inopportune time. The Angels will never know what might have been had his elbow not barked at him during his last home start June 6, which he departed after holding the free-falling Royals to one run on four hits in four innings.
At least the Angels have already gotten a taste of what can happen when Ohtani is left solely to his bat.
Ohtani returned to hitting in early July after treating the injury with a platelet-rich plasma injection and an injection of stem cells.
Free of the limitations he happily followed as a two-way player early in the season, Ohtani first struggled in July, then batted .328 with three doubles, six home runs and 18 runs batted in 24 games in August.
One month after going 13 for 64 with five RBIs in 22 July games, Ohtani had launched himself back into the conversation for the American League rookie of the year award.
When he attempted to enhance the already legendary status of his debut season, Ohtani only lasted 21/3 innings in his return to a major league mound Sept. 2 in Houston. The velocity of his fastball had dipped from 98 mph to 89 mph in a span of three pitches. He allowed a two-run homer before departing in the third inning. Days later, an MRI revealed new damage to the ligament. Ohtani has not pitched since.
Ohtani, who was not immediately made available to media, had a game-tying single in Tuesday night's win. Hitless in his first two at-bats, Ohtani turned an ugly swing at a down-and-away slider from Rangers reliever Martin Perez into an RBI single to center field that knotted the score 1-1. As the Angels sent nine batters to the plate, Ohtani also scored for the Angels in the four-run frame.
Ohtani entered the night batting .280 with a .925 on-base-plus-slugging percentage and a wins above replacement (WAR) of 2.6, according to Baseball-Reference's version of the statistic, in 99 games. His 21 homers ranked fourth among American League rookie. Meanwhile, his 3.31 ERA and 63 strikeouts in 512/3 innings had helped him accumulate 1.2 WAR as a pitcher.
Although he won't be able to pitch competitively again until 2020, it's only a matter of when in 2019 Ohtani will return as the team's designated hitter, a role he'll likely split with Albert Pujols.
It's impossible to say now how quickly he'll bounce back in his recovery from Tommy John surgery, though the Angels are optimistic about Ohtani being ready in April.
Regardless of when he's cleared to return to the batting order, Ohtani's journey at the plate next season will continue to be a captivating storyline.
"I think that he put all his focus into hitting once he knew he wasn't going to be pitching this year," Scioscia said. " ... I think he's at peace with it and he's focused on hitting."
